The Effects of Medical Accidents and Litigation on Doctors and Patients*

Medical accidents and litigation can have a profound and long lasting effect on both doctors and patients. Research has shown that for doctors, working in a profession which is intrinsically stressful, the added stress of litigation and accidents is leading to considerable strain and sometimes to maladaptive and inappropriate behaviors on the part of some doctors. For many it is leading to the practice of defensive medicine. For patients the picture is not better. Some are left with no clear idea of what has happened or why they have been injured by their medical treatment. Many are left needing further remedial treatment and for some the psychological effects are akin to those suffered by victims of major disasters. In this paper we have looked at these issues and have put forward proposals to suggest how things can be improved for both doctors and patients.     

Institutionalising participatory and deliberative procedures: The origins of the first permanent citizens’ assembly

In the context of public disaffection towards representative democracies, political leaders are increasingly establishing citizens’ assemblies to foster participatory governance. These deliberative fora composed of randomly selected citizens have attracted much scholarly attention regarding their theoretical foundations and internal functioning. Nevertheless, we lack research that scrutinizes the reasons why political leaders create such new institutions. This article fills this gap by analysing a specific case: the first permanent randomly selected citizens’ assembly that will work in collaboration with a parliament in the long-term (Ostbelgien, Belgium). This case is analysed through a framework that pays close attention to the context in which it developed, the profiles of political elites that supported its creation, as well as the multiple objectives it was vested with. The findings reveal that initiators of citizens’ assemblies fundamentally conceive them as a way to strengthen a polity's identity, to save the electoral model of democracy, and to restore the legitimacy of traditional political leaders. Our analysis of this particular conception lead us to argue for the need of developing context-sentive approaches to participatory and deliberative procedures, as well as to discuss whether we should consider the latter as mere elites’ legitimation tools.