Administrative compensation of medical injuries: a hardy perennial blooms again

Periods in which the costs of personal injury litigation and liability insurance have risen dramatically have often provoked calls for reform of the tort system, and medical malpractice is no exception. One proposal for fundamental reform made during several of these volatile periods has been to relocate personal injury disputes from the tort system to an alternative, administrative forum. In the medical injury realm, a leading incarnation of such proposals in recent years has been the idea of establishing specialized administrative "health courts." Despite considerable stakeholder and policy-maker interest, administrative compensation proposals have tended to struggle for broad political acceptance. In this article, we consider the historical experience of administrative medical injury compensation proposals, particularly in light of comparative examples in the context of workplace injuries, automobile injuries, and vaccine injuries. We conclude by examining conditions that may facilitate or impede progress toward establishing demonstration projects of health courts.     

Just compensation: a no-fault proposal for research-related injuries

Biomedical research, no matter how well designed and ethically conducted, carries uncertainties and exposes participants to risk of injury. Research injuries can range from the relatively minor to those that result in hospitalization, permanent disability, or even death. Participants might also suffer a range of economic harms related to their injuries. Unlike the vast majority of developed countries, which have implemented no-fault compensation systems, the United States continues to rely on the tort system to compensate injured research participants—an approach that is no longer morally defensible. Despite decades of US advisory panels advocating for no-fault compensation, little progress has been made. Accordingly, this article proposes a novel and necessary no-fault compensation system, grounded in the ethical notion of compensatory justice. This first-of-its-kind concrete proposal aims to treat like cases alike, offer fair compensation, and disburse compensation with maximum efficiency and minimum administrative cost. It also harmonizes national and international approaches—an increasingly important goal as research becomes more globalized, multi-site trials grow in number, and institutions and sponsors in the United States move to single-IRB review.     

ILO standards and compensation for employment injuries in Nigeria

In 2010, Nigeria enacted the Employees’ Compensation Act (ECA) to provide compensation for employment injuries. This work assesses the Act with a view to evaluate the extent of Nigeria’s compliance with the social security minimum standards of compensation for employment injuries set by the International Labour Organisation (ILO). It finds that whilst the ECA 2010 is in substantial conformity with ILO standards, there are core challenges of applicability, adaptability and administration. The work recommends that progressive realisation of the standards and process consideration is imperative for realistic attainment of the philosophy of a compensation scheme for employment injuries in Nigeria.     

医疗事故损害赔偿问题研究(1)(山西大学2004届法律硕士研究生毕业论文)

本文以《医疗事故条例》与民事法律、法规及司法解释的冲突为切入点,首先从医疗事故的构成要件着手分析,将医疗事故界定为“医疗机构及其工作人员在医疗活动中,违反医疗卫生法律、行政法规、部门规章和诊疗护理规范、常规,过错造成患者人身损害的事故”,拓宽了医疗事故的范围,并在此基础上着重强调医疗机构的谨慎注意义务,缩小了医疗事故的免责事由。其次,经过分析认为医疗事故损害赔偿责任的性质是侵权责任与违约责任的竞合,在实践中应根据当事人意思自治原则区别对待,适用不同的归责原则,同时指出了赔偿范围与标准以及医疗事故鉴定的不足,批驳了“不属于医疗事故的,不承担赔偿责任”的错误观点,论证了惩罚性赔偿原则在医疗事故损害赔偿纠纷中适用的可行性,提出了医疗事故网上鉴定的设想。最后为了强化对患者的司法救济,分散医疗机构的风险,消化医疗机构的损失,平衡医患双方的利益冲突,构筑完整的医疗事故损害赔偿体系,对医疗责任保险的保险范围、除外责任提出了自己的看法,同时提出医事法律应借鉴其他法律的相关规定,对医疗责任保险做出强制投保规定的设想。     

医疗事故损害赔偿问题研究(1)(山西大学2004届法律硕士研究生毕业论文)

本文以《医疗事故条例》与民事法律、法规及司法解释的冲突为切入点．首先从医疗事故的构成要件着手分析，将医疗事故界定为“医疗机构及其工作人员在医疗活动中，违反医疗卫生法律、行政法规、部门规章和诊疗护理规范、常规，过错造成患者人身损害的事故”，拓宽了医疗事故的范围，并在此基础上着重强调医疗机构的谨慎注意义务．缩小了医疗事故的免责事由。其次，经过分析认为医疗事故损害赔偿责任的性质是侵权责任与违约责任的竞合。在实践中应根据当事人意思自治原则区别对待，适用不同的归责原则，同时指出了赔偿范围与标准以及医疗事故鉴定的不足．批驳了“不属于医疗事故的，不承担赔偿责任”的错误观点，论证了惩罚性赔偿原则在医疗事故损害赔偿纠纷中适用的可行性．提出了医疗事故网上鉴定的设想。最后为了强化对患者的司法救济，分散医疗机构的风险，消化医疗机构的损失。平衡医患双方的利益冲突，构筑完整的医疗事故损害赔偿体系，对医疗责任保险的保险范围、除外责任提出了自己的看法．同时提出医事法律应借鉴其他法律的相关规定，对医疗责任保险做出强制投保规定的设想。     

Competition policy: consequences of restrictive trade practices and price-fixing provisions for medical practitioners in Australia and New Zealand

Competition laws have only applied to many participants in the health care industry in Australia and New Zealand since the mid 1990s. Since then, the Australian Competition and Consumer Commission has considered a number of applications by medical practitioner associations and private hospitals to authorise potentially anti-competitive conduct, while the New Zealand Commerce Commission has successfully prosecuted a group of ophthalmologists. Amongst medical practitioners, however, there is still confusion and misunderstanding concerning the type of conduct caught by the Australian Trade Practices Act 1974 (Cth) and the New Zealand Commerce Act 1986 (NZ). This is of serious concern given the substantial penalties associated with price-fixing and restrictive trade practices. This article examines the provisions of these Acts most relevant to medical practitioners as well as a number of determinations and judicial decisions. To provide practical assistance to medical practitioners, the key lessons are extracted.     

Beyond Compliance Monitoring: New Strategies for Safety Regulators

Although the advent of general duty legislation makes the task of the regulator far less clear-cut, inspectorates are still involved in monitoring and to some extent enforcing compliance with rules of various sorts. Monitoring compliance in this way is crucially important, but this article seeks to identify strategies that go beyond compliance monitoring, by drawing on research on the causes of accidents and the nature of organizations. The strategies identified include: auditing the auditors; proactive investigation; supporting company safety staff; advising on organizational design; exposing performance; and promoting regulatory crisis. These are all ways in which regulators can encourage companies to improve their management of risk, ways that are not focused on identifying noncompliance with rules of any sort.     

医疗损害赔偿案件中若干问题的思考

《侵权责任法》关于医疗损害责任的归责原则、免责事由、医疗机构实施过度医疗的责任以及患者知情权和隐私权的保护做出了更为明确和系统的规定,这在医疗损害赔偿立法史上是一个巨大的进步,对于维护医患双方的合法权益必将发挥重要的作用。     

浅议医疗损害赔偿案件中的几个问题简

近年来,随着患者维权和法律意识不断增强,法院受理的医疗损害赔偿案件不断增多。由于医疗行为的专业性和特殊性,在审理过程中,有些问题较为典型,引起了一定的争议,本文选取了优势证据制度的运用、公平责任原则的适用以及医患沟通的证据认定三个要点进行分析,以期能够为医疗损害案件的办理提供有益的帮助。     

New Zealand: Public Registers Report

In September 2007, the Commonwealth Law Bulletin (Vol. 33, No. 3), published an article on the New Zealand Law Commission’s Issues Paper on Public Registers (IP 3, 2007), including the four options for reform that the Commission was putting forward for consideration by interested persons.

The Law Commission’s Public Registers Report ¹ 1 New Zealand Law Commission’s Public Registers Report, NZLC R 101 2008. (the Report) has now been published, completing stage 2 of the Law Commission’s four stage Privacy Review.

It is available on the Law Commission’s website at http://www.lawcom.govt.nz.