CAUSATION IN MEDICAL MALPRACTICE

Nina Mišić Radanović, I. Vukušič
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Abstract

Court proceedings in the field of medical law are currently a growing issue given the increasing migration of doctors and medical staff. Because of that fact, it is crucial to establish the standard of quality of health protection in the European Union (EU). Following the presentation of the existing levels of protection connected with the prevention of malpractice, the paper distinguishes between the legal documents of the EU and the Council of Europe because many documents related to health care and quality are adopted in the EU and in the Council of Europe. The general conclusion is that there is no uniform or cross-sectoral definition of quality in health care, however it has been found that important elements of health care quality include effectiveness, efficiency, access, safety, equity, appropriateness, timeliness, acceptability, satisfaction, patient responsiveness or patient-centeredness, and continuity of care. The health care aspect is analysed in the continental legal system and the common law legal system. The issue of causation is observed through different theories in the continental legal system and various case law examples in the common law legal system. The authors concluded that it would be preferable to adopt a theory of objective imputation as a legal standard for causation in criminal liability in medicine, because it analyses several possible causes in close or remote connection with the resulting consequence, i.e. said theory considers as relevant only the legal causes that result in a harmful event through the violation of due diligence. The paper primarily deals with criminal liability for malpractice, but it also presents the civil aspects in the states (for example the USA) which recognise only civil liability for malpractice.
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医疗事故的因果关系
鉴于医生和医务人员的移徙日益增加,医疗法领域的法庭诉讼目前是一个日益严重的问题。由于这一事实,在欧洲联盟(欧盟)建立健康保护质量标准至关重要。在介绍了与预防医疗事故有关的现有保护水平之后,该文件对欧盟和欧洲委员会的法律文件进行了区分,因为欧盟和欧洲委员会采用了许多与保健和质量有关的文件。总的结论是,卫生保健质量没有统一的或跨部门的定义,但已经发现卫生保健质量的重要要素包括有效性、效率、可及性、安全性、公平性、适当性、及时性、可接受性、满意度、患者反应性或以患者为中心以及护理的连续性。对大陆法系和英美法系的医疗保健问题进行了分析。大陆法系的因果关系问题是通过不同的理论和英美法系的判例来观察的。作者的结论是,最好采用客观归责理论作为医学刑事责任因果关系的法律标准,因为它分析了与所造成的后果有密切或遥远联系的几种可能原因,即该理论只考虑由于违反尽职调查而导致有害事件的法律原因。本文主要讨论医疗事故的刑事责任,但也介绍了在只承认医疗事故的民事责任的国家(例如美国)的民事方面。
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