The Concept of the Patient’s Autonomy: From the Vaults of Civil Law

The concept of patient’s rights itself was fairly known before the last four or five decades, and medical malpractice of all kinds made the aggrieved party to seek redress at a court; but no special legislation, apart from rare exceptions, has ever existed to anchor the patient’s rights before the late 20th century. In the civil law tradition of the 20th century, especially its earlier decades, doctors could be held criminally or civilly liable for a wide variety of malpractice, including unauthorised medical intervention or divulgation of patient’s information, though such provisions did not develop actual rights, were quite general in their nature, and were individually assessed by the courts in each case. Within in the gradual change in the doctrines of medical law, the term “autonomy”, shaping the patient’s right to decide what medical interventions could or could not be performed upon his body, intervened into the existing legal scholarship, which was later augmented with various issues, such as access to medical records of the patient, refusal of blood transfusion, participation in medical experiments, deciding upon end-of-life situations or relating to various reproductive law considerations, not always permitted by national law. Many of these rights are much older than the concept of patient’s autonomy themselves, and have developed in the case law which itself has originated from lawsuits against doctors and hospitals for acts, being nearly obscure in the existing legal doctrine, such as unauthorised medical experiments. The given paper is aimed to discuss the academic development and overall gist of the patient’s right to autonomy, as well as some of its early interpretations in civil law doctrine. Keywords: patient’s rights, medical malpractice, theory of law, medical law, patient autonomy, civil law.

The application of graph theoretical analysis to complex networks in medical malpractice: Lessons learned from China (Preprint)

BACKGROUND Studies have shown that hospitals or physicians with multiple malpractice claims are more likely to be involved in new claims; this finding indicates that medical malpractice may be clustered by institutions. OBJECTIVE We aimed to identify common factors that contribute to developing interventions to reduce future claims and patient harm. METHODS This study implemented a null hypothesis whereby malpractice claims are random events—attributable to bad luck with random frequency. As medical malpractice is a complex issue, thus, this study applied the complex network theory, which provided the methodological support for understanding interactive behavior in medical malpractice. Specifically, this study extracted the semantic network in 6610 medical litigation records (unstructured data) obtained from a public judicial database in China; they represented the most serious cases of malpractice in the country. The medical malpractice network of China (MMNC) was presented as a knowledge graph; it employs the International Classification of Patient Safety from the World Health Organization as a reference. RESULTS We found that the MMNC was a scale-free network: the occurrence of medical malpractice in litigation cases was not random, but traceable. The results of the hub nodes revealed that orthopedics, obstetrics and gynecology, and emergency department were the three most frequent specialties that incurred malpractice; inadequate informed consent work constituted the most errors. Non-technical errors (e.g. inadequate informed consent) showed a higher centrality than technical errors. CONCLUSIONS Hospitals and medical boards could apply our approach to detect hub nodes that are likely to benefit from interventions; doing so could effectively control medical risks. CLINICALTRIAL Not applicable

Pertanggungjawaban Hukum Terhadap Tindakan Malpraktik Tenaga Medis di Rumah Sakit

This article aims to find out the legal arrangements and liability related to malpractice acts in hospitals. The liability for criminal acts of malpractice is currently an important spotlight because the legal rules governing it are still vague. This is because the qualifications of malpractice acts are not clearly stated in the legal rules. These malpractice acts cannot be seen solely from a scientific point of view, but from a legal perspective too. Malpractice acts contain criminal and civil elements, this should be considered so that each party does not give their interpretations according to their respective knowledges. The research method used in this study is normative juridical by applying library research and conceptual approaches which will then be analyzed using Wetsen Rechtshitorische Interpretatie, grammatical interpretation, and systematic interpretation. Since the independence time until now, Indonesia has experienced three times of the Health Law enactment. The regulations related to medical malpractice in the Health Law state that, in the event that health workers are suspected of negligence in carrying out their profession, the negligence must be resolved first through mediation.