As organizações de saúde, instituições de ensino, pesquisadores e profissionais têm investido em mecanismos que visam aperfeiçoar a assistência integral à saúde ofertada aos pacientes. Todavia, a assistência pode estar sujeita a falhas que podem acarretar danos indesejados aos pacientes, familiares e profissionais, além de prejuízos ao sistema de saúde. Acionar o Poder Judiciário é um dos mecanismos adotados para reparar o dano causado. Nos últimos anos, no Brasil, especialmente a partir de 2003, observa-se um crescimento das demandas judiciais relacionadas aos serviços prestados pelos profissionais da saúde, reflexo das mudanças ocorridas na sociedade e da ampliação dos direitos sociais e fundamentais. Justifica-se, assim, um estudo retrospectivo de casos julgados, com análise da jurisprudência do Superior Tribunal de Justiça (STJ), no período de 2003 a 2013, acerca das ações judiciais movidas em face dos profissionais de saúde e instituições de saúde no âmbito público e privado. Realizada analise quantitativa e qualitativa do conteúdo dos discursos dos Ministros do STJ sobre o tema erro médico, aplicando o método do Discurso do Sujeito Coletivo (DSC). O estudo das decisões proferidas contribuiu para a compreensão dos assuntos que têm predomínio na jurisprudência do STJ sobre o erro médico. O trabalho identificou o sexo feminino como o mais vulnerável aos supostos erros médicos e as especialidades médicas diretamente relacionadas com a saúde feminina como a mais acionadas judicialmente. Ginecologia/Obstetrícia (27,08%), Ortopedia (12,5%) e Cirurgia Plástica (10,42%) foram, respectivamente, as especialidades mais demandadas. Em conclusão, o estudo traz subsídio para as organizações de saúde identificarem possíveis áreas estratégicas de atuação, no sentido de implementarem ações para reduzir a probabilidade de erros médicos, identificando mecanismos eficientes para o acompanhamento e a racionalização de possíveis falhas e para atuarem, preventivamente, nas práticas de gestão visando reduzir danos aos pacientes, diminuir custos decorrentes das indenizações, possibilitando, uma prestação de serviço de saúde de maior excelência, qualificado e seguro no sistema único e no sistema suplementar de saúde. / Healthcare organizations, educational institutions, researchers and healthcare professionals have invested in mechanisms to improve the integral medical assistance offered to patients, but these assistance could have failures that may result in injury to patients, family members, and damage to system. One of the mechanisms to repair the damage is to claim to the Judiciary. In Brazil, especially since 2003, there has been an increase the lawsuit number related to medical malpractice, reflecting the changes in society and the expansion of social and fundamental rights. This is a retrospective study of judged cases by the Superior Court of Justice, in the period from 2003 to 2013, regarding the lawsuits against healthcare professionals and institutions in the public and private practice. Performed quantitative and qualitative analysis of the Superior Court of Justice Ministers speeches content, using the collective subject discourse method. Analyze of decisions contributed to understanding of the predominated issues in the malpractice lawsuit. The study identified the women as the most vulnerable to medical errors and medical specialties directly related to women\'s health as the most driven in court. Gynecology/Obstetrics (27.08%), Orthopedics (12.5%) and Plastic Surgery (10.42%) were, respectively, the most demanded specialties. In conclusion, the study provides subsidy for healthcare organizations identify potential areas of action to implement strategies to reduce the likelihood of injury to patients, decreasing costs and medical malpractice.

O presente trabalho aborda o tema da responsabilidade civil pelo nascimento indesejado no Direito Brasileiro. Trata-se de um conflito que emerge nos casos em que a falha de um método contraceptivo redunda no nascimento de uma criança, contra a vontade de seus genitores. A primeira parte do trabalho é dedicada ao fato gerador da responsabilidade nessa espécie de litígio, a saber, a culpa médica e o defeito do produto ou serviço de contracepção. Os métodos anticoncepcionais são agrupados em duas categorias: de um lado, os métodos cirúrgicos de esterilização, que envolvem a prestação de um serviço médico; e, de outro, os métodos que empregam dispositivos anticoncepcionais fabricados industrialmente, isto é, os produtos contraceptivos. A segunda parte do trabalho discorre sobre as implicações éticas da reparação do nascimento indesejado. De fato, a indenização fundada no nascimento de um filho traz à tona uma série de considerações relativas à dignidade da criança e ao valor das relações parentais. O trabalho procura apontar em que medida o nascimento de uma criança pode ser interpretado como um prejuízo legítimo experimentado por seus pais. Conclui-se que a reparação integral do nascimento indesejado é necessária para a afirmação da autonomia reprodutiva das vítimas de contraceptivos defeituosos. A análise das soluções controversas adotadas no Reino Unido e na França onde os tribunais afirmaram que apenas o nascimento de uma criança deficiente pode ser considerado um prejuízo reparável revela que o direito dos pais à reparação não pode ser subordinado às condições de saúde da criança nascida / This thesis is an inquiry into wrongful conception claims under Brazilian Tort Law. This type of lawsuit arises out of cases involving failure of contraceptive methods, causing the birth of a child against the parents desire. The first part of the thesis addresses the basis of liability in wrongful conception claims, namely, medical malpractice and defect of products or services. Contraceptive methods are grouped into two categories: on one side, surgical methods of sterilization, that rely upon the supply of medical services; on the other, contraception methods that employ manufactured devices, that is, contraceptive products. The second part of the thesis discusses the ethical implications of awarding damages in wrongful conception claims. Compensation based on the birth of a child raises a series of issues concerning the child\'s dignity and the value of parental relationships. It is argued that full compensation is necessary in order to reaffirm the reproductive autonomy of the victims of defective contraceptive methods. The analysis of controversial solutions adopted in United Kingdom and France where courts have stated that only the birth of a disabled child is a recoverable damage leads to the conclusion that the chillds health condition cannot be a requirement for his parents right to compensation.

No description available.

This thesis attempts to identify what the barriers to building a trusted police service in China and India are through answering the questions: How has economic modernisation impacted upon policing? To what extent are the two police forces trusted by its citizens? Do the police carry out their duties in a fair and unbiased fashion? What do police corruption/malpractices look like and why does it persist? And what are the influencing factors in decision-making at the moments-of-truth? There is very limited research into the Chinese Police generally and even less on factors affecting organisational culture, practices, and decision making. There is no comparative study between the Chinese and Indian Police. This thesis found that the Chinese Police are held in higher esteem than the Indian Police by their respective citizenry. Both the Chinese and Indian police use stereotypes and are biased against certain section of society in the way they carry out their duties and that corruption and malpractices are tolerated and engrained in its culture but is subtler in China than in India. However, one surprised finding is that India is more at risk of the rule by man than China, even though India is said to be the world's largest democracy grounded on the principles of the rule of law.

國立政治大學風險管理與保險研究所八十七學年度第二學期碩士論文「醫療行為之法律責任與保險之研究」，旨在探討醫事人員執行醫療業務所生之責任與保險之相關問題。全文共分十章，約十六萬字，由研究生陳麗芬所撰，各章內容簡述如下： 第一章 緒論：隨著高等教育普及並醫學資訊發達，醫療糾紛可預期的有增無減，本章即說明本論文之研究動機、目的、所採行的方法及研究範圍。 第二章 醫療行為與醫療業務：醫療行為之意義為貫穿論文的重要概念，須就主管機關衛生署之見解與學理上加以定義。瞭解醫療行為定義後，須加以分類以適應不同醫療人員之業務範圍，並用以區別類似醫療行為之不同。最後論定不當醫療行為之內涵。 第三章 醫療行為實施者及其業務範圍：醫學科技分工精細，一件重大醫療行為往往需由整個醫療團隊合作始竟全功，故須區分醫療人員之身分與其法定業務，以明權責所在。本章另一重點為藥師、藥物、與藥害救濟的介紹，及醫師使用藥物治療時應盡之注意。 第四章 醫療契約：醫療契約之法律性質並非單純委任、承攬、或僱傭，而係非典型之混合契約。醫療契約當事人之身分，就病患的精神狀態與醫師之地位不同可組合成數種情形，並非絕對以病患或醫師為契約當事人。確定醫療契約之性質後，方能確認醫病雙方依契約所應盡之義務與所享之權利，並因此衍生出債務不履行之責任。 第五章 醫療契約之債務不履行：醫療債務不履行以不完全給付為最多，通常更因加害給付而致病患傷亡。欲要求醫師負債務不履行責任，除因醫師本身之故意過失外，醫療院所就醫療人員之故意過失要負同一責任。除故意過失之一般歸責原則外，消費者保護法創立無過失責任主義，至於是否適用於醫療服務爭議仍大。 第六章 醫療侵權行為：侵權行為之七要件，在醫師侵權責任領域同樣適用，但內容則不同。因病患同意而阻卻違法、疫學因果關係、醫師之監督過失、特異體質、醫療慣行及醫療團隊之共同侵權等為重點。 第七章 醫師業務責任保險市場概況：就我國目前狀況及英國、美國、日本的市場狀況說明。 第八章 醫師業務責任保險單之研究：首先認識醫師業務責任風險為何，是否為可保風險，然後再就保單條款重點部分加以研討，互相參照國內保單範本與業者實際出售之保單及美國保單，評析其間優缺點。主要有承保範圍、因果關係、除外不保、被保險人、責任限額、自負額、Claim Made Basis 及Occurrence Basis、索賠通知、擔保與先決條件、保險人之棄權與禁止抗辯、防禦義務、仲裁與強制調解、及第三人直接請求權等。 第九章 除保險外之其他避險方式：計有自己保險與專屬保險、相互保險（保險合作社）、行政上補償制度。 第十章 結論與建議：分別就醫學部分、法律部分、保險部分就所知提出結論並建議，希冀建構一個更和諧的醫療環境。 略 / 略

隨著社會變遷，近一二十年來，我國醫療糾紛有大幅增加之現象，而經由媒體的報導，醫療糾紛在我國亦經常成為眾所矚目、備受爭議的社會焦點。由於醫療行為所導致的損害，直接侵害病人之身體權、健康權、甚至生命權，對於病人及其家屬生活所造成之影響，難謂非為鉅大，故醫療糾紛之妥善處理，實係吾人從事醫療法律之研究者，應予正視並深入探討之議題。 我國醫療糾紛之處理，向以刑事訴訟為主要之救濟途徑，惟晚近醫界、法界均已達成共識，認為醫療糾紛應回歸至以民事程序為主之處理模式。惟吾人若欲藉由民事法律關係妥善處理醫療糾紛，則須注意醫療民事訴訟之特殊性，亦即，因醫病雙方專業知識上之落差，導致雙方在民事程序上處於武器不平等之地位。為衡平此一武器不平等，我國實務上部分法官在審理醫療民事訴訟時，曾打破傳統民事過失歸責原則，將消費者保護法無過失責任與民法第191條之3一般危險責任之規定適用於醫療行為，惟自民國93年醫療法第82條第2項修正之後，該法既規定「醫療機構及其醫事人員因執行業務致生損害於病人，以故意或過失為限，負損害賠償責任。」邇近之實務判決遂多採醫療行為過失責任之見解，也多排除民法第191條之3之適用。我國醫療訴訟醫病爭執之重點，乃於近年由實體法之無過失責任之採擇與否，轉換至程序法之舉證責任分配。 於醫療訴訟等現代型訴訟事件中，被害人時常發生舉證上之困難，倘若依照僵化固定的舉證責任分配規則，則不免有失公平正義。因此，舉證責任分配於醫療訴訟上應如何操作方屬適當，實為醫療民事訴訟中值得觀察的重點所在。基於上述之問題意識，本論文的研究架構共分為七章，其內容綱要如下： 第一章 緒論：闡釋說明研究動機，並指明目前民事醫療糾紛事件之問題重心在於「程序法」，特別係在「舉證責任之分配」。進而說明本論文之研究動機、研究目的、研究範圍與研究方法。 第二章 醫療糾紛之發生及其處理：本章由醫療糾紛之發生談起，進而說明醫療糾紛之法律關係，探討不同法領域下醫療提供者違反義務時之法律責任，包括民事責任、刑事責任及行政責任等，並論證醫療糾紛實應回歸至以民事程序為主之處理模式。最後，介紹醫療糾紛發生後，國內外現今法制上之醫療糾紛處理機制，並分析其優缺點。 第三章 醫療糾紛之民事法律關係與醫療民事訴訟之特殊性：本章聚焦於醫療糾紛之民事法律關係，探討醫療提供者之契約責任、醫療無因管理與醫療提供者之侵權責任等。同時，討論醫療民事訴訟之特殊性，分析醫療民事訴訟被害人舉證困難之原因，並分析加重醫療提供者民事責任之法理基礎、以及過度加重醫療提供者民事責任所可能導致之反效果。 第四章 民事訴訟舉證責任分配之學說：按我國關於民事舉證責任之立法明文，係規定於民事訴訟法第277條：「當事人主張有利於己之事實者，就其事實有舉證之責任。但法律別有規定，或依其情形顯失公平者，不在此限。」學者乃認為，在我國法制下，所謂舉證責任分配法則係一總體概念，而可區分為「舉證責任分配一般原則」與「舉證責任分配減輕」二者，而以前者為原則，後者為例外。本章即由舉證責任之基礎觀念出發，藉由介紹國內外之學說，而分別處理「舉證責任分配之一般原則」與「舉證責任分配之減輕」等概念。 第五章 醫療民事訴訟舉證責任分配規則之具體適用：本章集中討論醫療民事訴訟之舉證責任。本章前半段介紹醫療民事訴訟舉證責任分配之一般規則、以及比較法上(包括德國、美國與日本)醫療糾紛舉證責任減輕之具體規則，後半段則分析我國實務操作醫療糾紛舉證責任分配之問題。本文一共歸納出實務判決於適用舉證責任分配時共六個問題，並分別找出判決加以闡釋。於本章末，則提出將醫療糾紛類型化，應有助於解決我國實務之問題。 第六章 醫療糾紛之類型化與舉證責任分配體系之建構：本章先試從「法學思維」、「醫學思維」、以及「綜合醫學思維與法學思維」出發，分別建立三套操作模組，以將醫療糾紛類型化，並建構其各別之舉證責任分配體系。關於純粹由「法學思維」或「醫學思維」所建立之操作模組，本文將分析其操作上之侷限，而針對本文所建議「綜合醫學思維與法學思維」之操作模組，亦將於各醫療糾紛分類，舉實務案例諸例實際操作之，以驗證本文所建議操作流程之可行性。章末則另提出法院於適用舉證責任分配規則時，其他與客觀舉證責任分配無直接相關，但應予考量之事項，以助於更正確地適用舉證責任分配規則。 第七章 結論、建議與展望：綜合前開章節討論，針對醫療民事爭訟程序中之舉證責任分類體系與操作模式，做出總結。並提出其他相關建議，以終極落實醫療需求者憲法上基本權之保障。 / The number of malpractice claims filed in Taiwan against physicians has increased significantly in the recent decades. Medical malpractice litigations are characterized by a huge gap in medical knowledge between physicians and patients, leading to an unequal status between both parties in the trials. To ensure that the principle of equality of arms is upheld in civil procedures, the courts applied the strict liability embodied in Article 7 of the Consumer Protection Law and Article 191-3 of the Civil Code to malpractice cases. However, since the amendment and promulgation of Article 82 of the Medical Care Act, there has been a consensus that strict liability is no longer applicable in medical litigations, and negligence becomes an essential element for establishing the liability of medical practitioners. In addition to modifying liability rules, an alternative for achieving equality of arms is to relieve the plaintiffs from the burden of proof. However, the burden of proof should be adjusted with precaution, because an excessive shift might contribute to defensive medicine. Accordingly, this study aims to standardize the algorithm for allocating the burden of proof by classifying medical malpractice disputes. The thesis is composed of the following seven chapters: Chapter 1 Introduction: This chapter outlines the background of the present study, with a special emphasis on the pivotal role of the burden of proof in medical litigations. Also delineated in this chapter are the objectives and methodology of the present study. Chapter 2 The occurrence and resolution of medical malpractice disputes: In this chapter, the incidence of medical injury and medical malpractice is discussed first, followed by an analysis of the civil, criminal, and administrative liabilities of medical professionals. The plethora of resolutions for settling medical malpractice disputes are summarized at the end of the chapter. Chapter 3 Civil liabilities of medical malpractice and characteristics of medical litigations: This chapter focuses on the civil liabilities of medical malpractice, which arise from failure to undertake contractual duties or tort liabilities. The characteristics of medical litigations, such as the unequal status in arms between plaintiffs and defendants and the difficulties in concluding negligence or deciphering causation, are discussed in the second half of the chapter. Chapter 4 Theories and rules in allocating the burden of proof: The allocation of the burden of proof is determined according to Article 277 of the Taiwan Code of Civil Procedure: A party bears the burden of proof with regard to the facts which he/she alleges in his/her favor, except either where the law provides otherwise or where the circumstances render it manifestly unfair. Consequently, in principle, the burden of proof is allocated according to the “Normentheorie,” with specific rules applied to ease the plaintiff’s burden of proof under exceptional and unfair circumstances. Chapter 5 Rules for allocating the burden of proof in medical litigations: German, American, and Japanese rules for allocating or relieving plaintiffs from the burden of proof in medical litigations are introduced. The current problems in applying these rules to medical litigations in Taiwan are inspected. The solution to these problems relies on a precise classification of medical malpractice disputes. Chapter 6 Establishing the algorithm for allocating the burden of proof by classifying medical malpractice disputes: Three models for allocating the burden of proof are created on the basis of three classification systems: classification from a legal perspective, classification from a medical perspective, and classification from a combined medical-and-legal perspective. A comparison of these three models reveals that the last might be the best algorithm. Specific tips for an accurate application of this algorithm are also provided. Chapter 7 Conclusions: This chapter highlights the importance of an appropriate allocation of the burden of proof in medical litigations, as well as the algorithm for allocating the burden of proof established in the present study. Also included are suggestions on how to ameliorate Taiwan’s medical litigation system in the future.

University of Macau / Faculty of Law

Suretyships given in favour of banks are being challenged in the courts on the basis of equitable doctrines of unconscionable conduct, undue influence, or statutory provisions dealing with unfair conduct or unfair contract terms. This thesis is an enquiry into a bank's duties of disclosure or advice to an intending surety. Such an investigation also necessitates a study of the relationship between banker and customer, as the surety is quite often a customer of the bank as well, and, as a surety's obligation to the bank is an accessory obligation, the obligation is dependent on a valid principal obligation between the bank and the principal debtor - the customer. The face of modern banking has, however, changed dramatically and most major banks have become multi-functional. As a result, the banker-customer relationship may often be seen as a fiduciary relationship. A major problem brought about my multi-functioning banks is that of conflicts of interest between the bank and its customer. Furthermore, the banker-customer relationship is providing much more scope for lender liability than in the past. Various factors are currently having an impact on the law of contract, and this is expected to affect the legal policy makers in their assessments of whether a duty of disclosure of material facts exits or not. A surety has long been a favoured debtor in the eyes of the law, and the courts have developed a plethora of technical principles on which a surety can be relieved of his obligation. The escape routes of the surety, especially if he is a consumer as well, on the new grounds of public policy, unconscionability, good faith or unreasonableness, are growing. The results of these trends is the expected demise of suretyship as an acceptable, cheap form of debt security in the banking sector. / Jurisprudence / LL.D.

A sociological approach is used to analyze incidences of extreme opportunism in financial markets. Through an analysis of arguably the most widely publicized "rogue" trader events in recent history, a determination is made of the validity of explaining these events as aberrations, attributable to the actions of "rogues". The primary focus is the role of structural factors underlying these incidences of extreme opportunism in financial markets. A diverse range of documentary and other sources is used to avoid any form of bias as far as possible. It was found that structural factors act as countervailing forces to inhibit such behavior or as motivators and facilitators acting as catalysts for extreme opportunism. The balance between these factors largely determines the level of opportunistic behavior in a particular environment. Extreme opportunism is therefore not an aberration or "rogue" occurrence but a manageable phenomenon intrinsic to the social structural context within which it occurs. By conceptualizing these factors as countervailing forces one is forced to view structural factors, like compensation structures and formal and informal restraints, relative to one another and no longer in isolation. This realization translates into the conclusion that restraints and oversight systems for example, should be designed relative to the relevant motivators and facilitators in its area of application. In an environment where traders of highly geared financial products are motivated with multimillion USD incentive packages, a low budget oversight system and inexperienced regulatory staff, is clearly not the appropriate tools to control and manage extreme opportunism. / Criminology and Security Science / D.Phil. (Sociology)

Computers have become indispensable in all walks of life, causing people to rely increasingly on their accurate performance. Defective computer programs, the incorrect use of computer programs and the non-use of computer programs can cause serious damage. Expert systems are an application of artificial intelligence techniques whereby the human reasoning process is simulated in a computer system, enabling the system to act as a human expert when executing a task. Expert systems are used by professional users as an aid in reaching a decision and by nonprofessional users to solve a problem or to decide upon a specific course of action. As such they can be compared to a consumer product through which professional services are sold. The various parties that may possibly be held liable in the event of damage suffered by the use of expert systems are identified as consisting of two main groups, namely the producers and the users. Because of the frequent exemption of liability for any consequential loss in standard form computer contracts, the injured user may often have only a delictual action at her disposal. The faultbased delictual actions in SA law give inadequate protection to unsuspecting software users who incur ·personal and property damage through the use of defective expert systems since it is almost impossible for an unsophisticated injured party to prove the negligence of the software developer during the technical production process. For this reason it is recommended that software liability be grounded on strict liability in analogy to the European Directive on Liability for Defective Products. It is also pointed out that software standards and quality assurance procedures have a major role to play in the determination of the elements of wrongfulness and negligence in software liability and that the software industry should be accorded professional status to ensure a safe standard of computer programming. / Private Law / LL.D.