In recent years, doctor-patient disputes have become a hotspot of social concern in China. In fact, doctor-patient disputes are a worldwide problem: not only in developing countries such as China, but also in developed countries such as Japan and the United States. The good thing is that many countries in how to scientifically deal with doctor-patient disputes has been a step ahead of the experience gained or lessons learned can be used as a reference for us.
Increased supervision of hospitals and doctors.
Under the guidance of the Japanese government, medical evaluation organizations have been born at the central and local levels. Generally speaking, every year, the public, officials and independent experts give comprehensive ratings to all hospitals and doctors in service, and issue certificates of conformity to those who pass the evaluations, and issue warnings of different levels to those who do not, which are publicized online or to the media. As a result, patients and their families have a basic idea of which hospitals and which doctors are trustworthy before they see a doctor or are hospitalized, so they can make rational choices conveniently and accurately, and on the contrary, those hospitals and doctors who are often "in trouble" will be less likely to be asked. Those hospitals and doctors with poor ethics or medical skills are in danger of being knocked out of their jobs.
Lessons learned from the accident.
In order for hospitals and doctors to learn from their experiences through accidents, Japan's Ministry of Health, Labour and Welfare has set up a database of medical accidents, and a medical accident seminar with the participation of doctors, lawyers and representatives of civil society organizations, focusing on identifying the causes of the accidents and demonstrating how to prevent the recurrence of similar accidents in the future. And with the marked reduction in medical accidents, doctor-patient disputes have naturally been greatly reduced.
Requiring hospitals to buy "accident insurance" for doctors.
Under government supervision, most hospitals have purchased accident insurance for their doctors, so most small and medium-sized disputes can be expected to be resolved through the insurance company, preventing them from developing into larger doctor-patient conflicts.
Harmonizing the doctor-patient relationship through legal means.
According to the relevant regulations, in the event of a medical malpractice, the hospital, regardless of the size of the incident, must report the incident to the relevant government departments, and then the government will act as an intermediary to report to the patient's family. If it is confirmed that the hospital's mistakes, the hospital must make a sincere apology, and in the financial compensation as much as possible, to try to settle the dispute. If there is a dispute between the patient and the doctor about the responsibility and it is difficult to realize "*** knowledge" for a long period of time, then it is also possible to resort to the law. It is worth noting that the Japanese government has stepped up its efforts to establish a system to help patients and their families who are at a relative disadvantage in medical litigation.
The Ministry of Health, Labour and Welfare plans to establish a new compensation mechanism in the near future, the families of patients who are victims of medical malpractice in the implementation of the "no-fault compensation system", that is, regardless of whether there is medical negligence in the hospital, the families of the victims can receive a certain amount of compensation, the amount of money by a third party after careful evaluation to decide.
Working to shorten the duration of litigation cases.
Because medical malpractice lawsuits are often complex and time-consuming to handle and resolve, many of them have been jokingly called "marathon lawsuits". For example, in 1996, the average trial time for each case was 37 months. As a result of the delay in obtaining a reasonable solution, the conflicts between doctors and patients were often further intensified artificially. But in the government, hospitals and the courts *** with efforts, by 2006, the average trial time has been shortened to 25.1 months, and this year, it has been "accelerated" to just 16 months.
At the same time, the settlement rate of medical lawsuits nationwide has been increasing, reportedly by 40 percent in the last 15 years, contributing to the creation of a Japanese-style "harmonious society.
Russia:
Insisting on
"Prioritizing the law"
Unlike many countries that prioritize mediation in resolving doctor-patient disputes, Russia decisively prioritizes mediation. Unlike many countries, Russia decisively puts "mediation" aside in favor of "law". This means that legal solutions are preferred.
If a patient determines that his or her health or life has been jeopardized by medical malpractice, he or she can file a claim with the hospital, the hospital's higher authority, the local judiciary, and the health insurance agency.
Russia's many laws (more than any other Western country) are based on the ironclad principle that the health of its citizens comes first. The right of patients to protect their health, regardless of ethnicity, gender, economic status, or cultural background, is considered sacrosanct and is fully protected in many laws.
The legal arsenal available to patients or their families includes the Russian Code of Administrative Offenses, the Law on Consumer Protection, the Civil Code, the Criminal Code, the Civil and Criminal Procedure Code, the Law on Medical Forensics, and so on.
However, Russian law, while vigorously defending the rights and interests of patients, the medical malpractice caused by the medical side of the "specific problem specific analysis", rather than "a stick to death".
Russia's relevant laws and regulations will be divided into two categories of medical malpractice: the first category is the medical staff "unintentionally" caused by the technical level of medical personnel and medical institutions often caused by the low level of equipment and equipment conditions are limited, but also with the complexity of the disease itself and unpredictability; the second category is the medical personnel The second category is caused by the "intentionality" of medical personnel, which includes negligence, carelessness and even intentional violation of the law. The courts have imposed different penalties on those responsible for these two types of accidents, and the compensation received by patients has varied considerably.
Under the supervision of the judiciary, the hospital involved in the case is required to provide a written response within 30 days after receiving a written claim from the patient, which includes whether or not it agrees with the patient's allegations, whether or not it has taken disciplinary action against the medical staff concerned under the Code of Administrative Offenses and the Hospital Regulations, whether or not it will pay compensation, the amount, manner and period of the compensation payment, and which of the claims cannot be agreed to, and the reasons for that. etc. If the affected party does not agree with the hospital's decision to handle the case, then he or she can further file a civil lawsuit in court and submit relevant evidence.
United States:
Law and mediation "two-pronged"
The United States each year, the number of people who die from medical malpractice is more than the number of people who die in traffic accidents, and successive administrations have made efforts, but the situation has not been fundamentally improved. The good news is that the relevant laws are constantly being improved and the system for dealing with accidents is constantly being upgraded, which gives Americans the courage to say "NO" to medical malpractice. In fact, even though medical malpractice in the U.S. is not uncommon, "medical malpractice" is rare.
First of all, this is because American doctors in more than 200 years, there has been a face to face patients must be "transparent" good tradition, and now began to implement a strict "informed consent" system. Specifically, that is, the doctor must disclose to the patient the true condition of the patient, all the problems that may occur during the medical process, the success rate of the treatment, the possible sequelae, etc., every bit of which must be clearly stated in advance. In this way, the hospital can ensure that the patient has a complete understanding of their own situation, so as to avoid disputes after treatment.
Once the doctor has communicated the basics of the condition and the recommended treatment, he or she must then determine whether the patient fully understands and agrees with the doctor's treatment plan. According to the law, "informed consent" must contain four elements: knowledge, information, understanding and agreement, so it is not just a form for the patient to sign, but a process of building a relationship of knowledge, understanding and trust between doctor and patient in a democratic and equal manner in accordance with the law.
In order to ensure that all doctors are able to make what can be complex medical terminology "easy to understand" and "understandable" to patients, medical students and physician training departments are placing great emphasis on training future doctors in the relevant language. Medical students and doctors' training departments attach great importance to language training for future doctors, and make it a basic quality that is as important as medical skills. How to both principles and flexibility in dealing with the doctor-patient relationship is a compulsory subject in the U.S. medical school, the focus of learning on "doctor-patient communication to avoid disputes" and other preventive education.
Since the U.S. is a multiracial country, hospitals also emphasize the need for medical staff to be respectful of "multiculturalism" to ensure that "informed consent" is implemented as smoothly as it is with minority patients. All of these efforts are directed toward one goal: Since the medical side of the so clear, understandable, comprehensive, then the patient again "mess" is "knowingly"!
Americans in the use of legal means to resolve and deal with doctor-patient disputes at the same time, but also wisely recognize that legal means, although important, but is not the only way, and sometimes not even the best way. In fact, doctor-patient disputes are not purely legal issues, and there are often many complex factors hidden behind them.
In view of this, the U.S. has adopted a "two-pronged approach" of law and mediation. All hospitals are required to set up arbitration committees, in fact, is "disguised" mediation committee, members from all aspects of society, including hospital doctors, registered nurses, chaplains, community representatives, social workers, training workers, teachers, lawyers, and so on, and many of these people are still volunteers, do not receive any compensation. The Board of Arbitration is tasked with ---
1. Specializing in the investigation of medical malpractice, the focus of the investigation is to certify that the doctor in charge is doing his or her job and is not negligent, and to inform the patient of the facts. Once it is confirmed that the doctor in charge was negligent, it will be reported to the judiciary for a court decision and punishment.
Secondly, the role of the mediation committee is similar to that of the neighborhood committee in China. As doctors and patients consider different perspectives, doctor-patient conflicts are actually inevitable, the Committee will have to step in, responsible for "buffering" the tension between the two sides, to put it bluntly, that is, to minimize the major issues, minor issues until both sides reach an understanding or understanding. However, the arbitration committee is only a consulting service, providing advice to doctors, patients and families, and does not have the force of law.
If mediation is not possible, the victimized patient or his/her family can hire a lawyer to prove, based on the evidence available, that the doctor was indeed negligent. The U.S. law is very good and strict, and the chances of the injured party winning the case are not low. If a doctor is proven to be grossly negligent, the fines can run into millions of dollars, even causing the hospital to go bankrupt and shut down, and the negligent doctor can no longer practice medicine.
Finally, it is worth noting that the insurance companies involved also monitor the medical process. This adds another layer of "insurance" to ensure that the patient's interests are protected. This is because the insurance company has specialized personnel to make professional appraisals, and has the ability to make the patient get compensation through various means.
On the contrary, if the patient went to the hospital to make trouble, even if there is a reason, but also likely to jeopardize the medical or public **** order and detained, and if the use of violence and make other people hurt, serious and even go to jail. Since relying on the hand of the law is not difficult to resolve disputes, the affected party will not be easy to take the risk of "medical trouble".