Sun, Jan 28, 2007 - Page 8 News List

Government money could cut doctors some slack

By Kuo Cheng-deng 郭正典

The legislature will soon debate a draft law proposed by Democratic Progressive Party Legislator William Lai (賴清德) governing how disputes over medical malpractice injuries are handled. It would, depending on the type of injury, entitle victims to a certain amount of government compensation so that they wouldn't seek damages from the doctor. Lai said it would be a "win-win" law because it would also help reduce the number of malpractice lawsuits.

On Jan. 17, Hsieh Yen-yao (謝炎堯), a former professor from the College of Medicine at National Taiwan University, published a response in the Chinese-language newspaper Liberty Times (the sister paper of the Taipei Times) calling the law a piece of "lose-lose" legislation.

Although Lai's proposed law may not be perfect, it is a step in the right direction. It could help improve the way medical accidents are handled in Taiwan.

The nation needs to find a better way to manage such accidents than its complicated array of legislation, including the Civil Code (民法), Criminal Code (刑法), Physicians' Code (醫師法), Medical Treatment Act (醫療法), Consumer Protection Act (消保法) and the Drug Injury Relief Act (藥害救濟法). There are also major controversies over whether some of these laws can be applied. This disordered system only serves to highlight how far behind the times Taiwan's medical laws are. Lai's effort to deal with medical accidents under a single law should be seen as progress.

Hsieh questioned the plausibility of Lai's proposal by saying that the Drug Injury Relief Act -- which offers victims compensation for injuries caused from taking medicine -- has done nothing to check the increase of malpractice lawsuits in the six years since it was implemented. In fact, medication is just one of many causes of medical injury.

One can't use the increase in all medical lawsuits to prove that the Drug Injury Relief Law has been a failure.

Handling medical mistakes under the Criminal Code implies that any treatment that leads to a person's death is a matter for public prosecution. Under this logic, prosecutors should investigate every death in a hospital. They should file a public lawsuit as soon as they suspect an error was made.

The Criminal Code is the wrong law to use; fatal medical injuries have always been prosecuted only when a complaint is recived, never automatically. Hsieh's assertion that Lai's law "would be powerless in cases of fatal medical injury" is incorrect.

Hsieh claims that under the law, worries over the responsibility to make compensation for medical errors -- which are extremely difficult to completely eliminate -- would intrude into decisions on treatment. This is a misunderstanding. The responsibility to provide legal compensation for damages is laid out in Article 22 of the new version of the Medical Treatment Act, but Lai's law talks about compensation as a form of supplemental social aid. These are two different things. Legal compensation requires that the courts decide which party is right and which is wrong beforehand. There is no necessity for social compensation. Legal wrangling only delays the provision of social relief.

Without settlements, there would be even more malpractice lawsuits.

What a shame that in recent years an increasing number of people have been choosing to sue rather than settle, creating ever more tense relations between doctors and patients. As a result, important fields like internal medicine, surgery, obstetrics and pediatrics are now having trouble attracting doctors.

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