At a recent seminar on crime and medical science, a speaker said that between 2001 and 2005, courts had ruled against doctors in 15 medical lawsuits. In other words, a doctor is found guilty of malpractice every three months in Taiwan. In five years, there have been more than 200 cases of malpractice in Taiwan, a world record.
Doctors and lawyers seem to have been opposing each other throughout the ages, both in Taiwan and other countries. As doctors know that the medical practice is full of uncertainties, and that they are not gods, they can't understand why lawyers keep bothering them and judging the rights and wrongs of medical practice according to picky legal standards. Lawyers, on the other hand, wonder why doctors break the law.
Take, for example, the following cases.
A doctor begins work at a clinic. As the owner of the clinic is not a qualified doctor, he uses the name and credentials of the doctor for registration and lists that doctor as the clinic's responsible party, while in fact most matters were still controlled by the owner. The boss charged health insurance cards for services that had not been provided. As a result, the doctor, who was only nominally responsible, was fined. The doctor objected, saying that he was a good doctor. The owner had broken the law out of greed but insisted that the doctor was responsible.
Incredibly, the real culprit was allowed to hide behind the law and evade punishment.
In a second case, a patient who had trouble breathing went to a clinic for help. The doctor found that the patient was suffering from acute respiratory problems and had to go to a hospital for emergency treatment. The doctor hailed a taxi in front of the clinic and brought the patient to a nearby teaching hospital. But because the patient had stopped breathing, he suffered brain damage and fell into a coma.
The patient's family was of the opinion that the clinic's doctor was at fault and should pay compensation, since the doctor had taken the patient to the hospital in a taxi instead of calling an ambulance. The doctor's defense was that calling an ambulance would have been useless, because ambulances don't service clinics.
In a third case, police brought a victim of a shooting to a hospital emergency room. The doctor on duty told police that the patient had to be operated on right away to remove a bullet that was lodged in the patient's body. Police said the doctor could operate on the patient, but not remove the bullet, because this would mean destroying evidence of the shooting. The doctor did not know what to do.
These three cases highlight two serious problems. First, the doctor's reactions show that they had very little legal knowledge. Although they were cautious and did their best, they could not escape legal repercussions. In the practice of medicine, there are not only risks to patients, but also legal risks for doctors.
It also shows that lacking a good understanding of law does not only harm doctors themselves, but also their patients.
In the first case, a competent doctor registered as the responsible person for a clinic had to bear all legal responsibility for the clinic. In the second, a doctor who didn't understand when to call for an ambulance had to pay damages. Even more tragically, the patient who was taken to the hospital by taxi was brain dead.
In the third case, the policeman's request that the bullet be left in the body for evidence purposes was completely against the principle that the law is to protect people's lives and dignity. A patient who has been shot has to be saved.
Many people think that if doctors learn more about law, they will use it as an instrument to protect themselves, and that this will be harmful for patients. However, if doctors don't have sufficient legal knowledge, they could easily become overly cautious in considering diagnoses and treatment -- which also does not benefit patients.
Only if doctors have some legal knowledge and understand legal limits can they make informed choices considering treatment. When deciding what is best for the patient, there is no need to object to doctors acquiring legal knowledge.
But medical education does not include training on the legal aspects of the profession. There is a vast amount of medical knowledge to be learned and medical science continues to evolve.
Even after studying diligently for seven years, medical professors still think students haven't learned enough about medicine. However, to keep doctors from becoming legal dangers, and for the sake of the patients, medical students should receive some legal training.
The law regulating the registration and continuing education for doctors (
But in my experience, doctors in the classroom reacted favorably to the classes.
Ethics are the basis of law, and people will not care for laws that are not based on ethics. Legal rules provide the most basic moral standards and only ethical rules can elevate humanity to a higher level.
I cannot think of any reason to object to continuing education for doctors, including classes on ethics and law.
Chen Tsung-fu is a professor at the College of Law and the Department of Social Medicine at National Taiwan University's College of Medicine.
Translated by Anna Stiggelbout
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