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Social Control of Medical Malpractice:A Sociological AnalysisLin, Dong-long 05 September 2004 (has links)
This study explores resolution mechanisms for all types of medical malpractice cases with a special focus on the patients and their families¡¦ subjective experiences in such disputes, as well as the relevant factors that influence the process of decision-making and the relevant results. The previous studies on patients¡¦ actions to medical disputes in the literature assumed that patients and their families took certain actions due to monetary reasons or discriminated status under a restricted medical system. Most studies simply state the variables that led the patients and their families to certain resolution mechanism. Nevertheless, not many researchers have explored the micro experiences of meaning construction during the process to resolve malpractice cases. Neither did they study how the patients interpret the cultural and structural variables, which might result in different dispute resolution mechanism being used. Therefore, this study attempts to develop a tentative approach to integrate macro and micro analyses and take the advantage of the procedure of grounded theory to explore the dynamic process in the resolution of disputes over medical malpractice. In-depth interviews were applied in the study involving 16 patients and their family members, 13 third party groups and two physicians for a total of 31 people. Among the 16 patients and their family members, there were 14 cases of medical treatment dispute.
It was found that the core concept of ¡§admitting a mistake was made¡¨ is the main goal of patients and their family members when dealing with the dispute. If the injury is not critical, normally the physician will admit his/her mistake in the beginning of the dispute. If the injury is critical, since the patients and their family members not having professional knowledge regarding medical injury and their social economical status as well as lower mobilization capabilities than physicians, they do not get an apology or the truth regarding the medical injury. They only receive compensation at most. There are two key causes of providing compensation: (a) crisscrossed interpersonal connection between patient, physician and the third party, such as a civil representative, who plays the role of coordinator; (b) after litigation, usually the court prosecutor or the judge will mediate between the patient and physician, so that compensation can be made. No direct judgment is made. Yet the patients and their family members are not satisfied because they do not receive a response from the involved physician regarding their request about ¡§admitting mistake was made¡¨ which is terminated since their is no money for further litigation, pressure from the civil representative or other objections of the family members. Furthermore, the interview of the third party and the involved physician show that public hospitals are more afraid of irrational acts from patients and their family members or the intervention of the civil representative when dealing with medical disputes. Even if there is no medical negligence, they still submit to the requests of the patients and their family members.
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