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Errors and violations harm many patients: this book explores how to improve both accountability and patient safety in healthcare.
Merry and McCall-Smith question the understandable, but often inappropriate, tendency to blame individuals for medical errors. They point out that the goal of safety is far better served by a sophisticated understanding of the difference between negligence and inevitable error, and by a frank recognition of just why human error occurs and how things go wrong in any complex system. Although medicine is used as the book's primary example, the points made apply equally to aviation, industrial activities, and many other fields of human endeavour.
This book examines questions of medical accountability and ethics. It analyses how the criminal justice system regulates health care practice, and to what extent it can and should be used as a tool to resolve ethical conflict in health care. For most of the twentieth century, criminal courts were engaged in matters relating to medicine principally as a forum to resolve ethical controversies over the sanctity of life. However, the judiciary approached this function with reluctance and a marked tendency to defer to the medical profession to define what constituted ethical, and thus lawful conduct. However, over the past 25 years, criminal courts have increasingly been drawn into these types of question, and the criminal law has become a major actor in the resolution of ethical conflict. The trend to prosecute for aberrant professional conduct or medical malpractice and the role of the criminal process in medicine has been analytically neglected in the UK. There is scant literature addressing the appropriate boundaries of the criminal process in resolving ethical conflict, the theoretical legal analysis of the law's relationship with health care, or the practical impact of the criminal justice system on professionals and the delivery of health care in the UK. This volume addresses these issues via a combination of theoretical analyses and key case studies, drawing on the experiences of other carefully selected jurisdictions. It places a particular emphasis on the appropriateness of the involvement of the criminal justice system in health care, the limitations of this developing trend, and solutions to the problems that arise from it.
"Who should define what constitutes ethical and lawful medical practice? Judges? Doctors? Scientists? Or someone else entirely? This volume analyses how effectively criminal law operates as a forum for resolving ethical conflict in the delivery of health care. It addresses key questions such as: how does criminal law regulate controversial bioethical areas? What effect, positive or negative, does the use of criminal law have when regulating bioethical conflict? And can the law accommodate moral controversy? By exploring criminal law in theory and in practice and examining the broad field of bioethics as opposed to the narrower terrain of medical ethics, it offers balanced arguments that will help readers form reasoned views on the ethical legitimacy of the invocation and use of criminal law to regulate medical and scientific practice and bioethical issues"--
To date, little analysis exists of the criminal process's roles as a regulator of medical practice and as an arbiter of bioethics, nor whether criminal law is an appropriate forum for judging ethical medical dilemmas. The conscription of criminal law into moral controversy and the (perceived) rise in criminal investigations of medical errors sets the backdrop for this innovative historical and theoretical analysis of the relationship between medicine, bioethics and the criminal process. Case studies on abortion, end of life and the separation of conjoined twins reveal how judges grapple with bioethics in criminal cases and the impact of 'theatre' on the criminal law's response to ethically controversial medical cases. A central argument is that bioethics and criminal law are not necessarily incompatible; rather, it is the theatre surrounding interactions between bioethics and criminal law that often distorts and creates tension.
The criminalisation of healthcare malpractice has become a highly topical and somewhat controversial question in recent years. Studies have demonstrated that in England and Wales, the trend towards holding healthcare professionals to account for malpractice is rapidly growing, abolishing the deference doctors enjoyed decades ago. The changing attitude of judges to claims for clinical negligence has been well documented. The role of the criminal process in England and Wales has been less fully analysed with the criminal law playing a very limited role until recently in the regulation of poor healthcare practice. In contrast, in France, the criminal process has for a long time been invoked more readily to respond to cases of healthcare malpractice, which involved even mere errors. This book compares English and French criminal law responses to healthcare malpractice and considers what lessons the French model can provide for potential reform in England and elsewhere. The book takes the HIV-contaminated blood episode as a primary example of the different approaches France and England have in dealing with healthcare malpractice. Kazarian emphasises the impact of rules of substantive criminal law and criminal procedure on the way in which healthcare malpractice is criminalised in a given country. This book explores the key lessons to be drawn on whether the criminal process is an appropriate means to respond to instances of healthcare malpractice. It proposes that features of French criminal law and criminal procedure might be useful to counteract healthcare malpractice.
A historical examination of the liability of healthcare professionals in tort and other systems of compensation in various European countries.
In recent years, debates have arisen concerning the encroachment of the criminal process in regulating fatal medical error, the implementation of the Corporate Manslaughter and Corporate Homicide Act 2007 and the recent release of the Director of Public Prosecution's assisted suicide policy. Consequently, questions have been raised regarding the extent to which such intervention helps, or if it in fact hinders, the sustained development of medical practice. In this collection, Danielle Griffiths and Andrew Sanders explore the operation of the criminal process in healthcare in the UK as well as in other jurisdictions, including the USA, Australia, New Zealand, France and the Netherlands. Using evidence from previous cases alongside empirical data, each essay engages the reader with the debate surrounding what the appropriate role of the criminal process in healthcare should be and aims to clarify and shape policy and legislation in this under-researched area.
Self-regulation constitutes an important aspect of the regulatory and oversight process governing professionals. This book focuses directly on medical self-regulation in the context of both the wider regulatory framework and that of other regulatory models. Through a critical consideration of recent events, including high-profile and controversial cases, it is demonstrated that the self-regulatory process has failed and that only fundamental restructuring and a radical change in attitudes on the part of members of the profession can repair the damage. Attention is also given to the recent changes, current proposals for change and to alternative regulatory models. Medical Self-Regulation will be of international interest, appealing to policy makers, as well as students and practitioners in the fields of medicine, medical law and sociology and professional regulation.