Error, blame, and the law in health care ? an antipodean perspective

Article Abstract:

Patients are frequently harmed by problems arising from the health care process itself. Addressing these problems requires understanding the role of errors, violations, and system failures in their genesis. Problem-solving is inhibited by a tendency to blame those involved, often inappropriately. This has been aggravated by the need to attribute blame before compensation can be obtained through tort and the human failing of attributing blame simply because there has been a serious outcome. Blaming and punishing for errors that are made by well-intentioned people working in the health care system drives the problem of iatrogenic harm underground and alienates people who are best placed to prevent such problems from recurring. On the other hand, failure to assign blame when it is due is also undesirable and erodes trust in the medical profession. Understanding the distinction between blameworthy behavior and inevitable human errors and appreciating the systemic factors that underlie most failures in complex systems are essential for the response to a harmed patient to be informed, fair, and effective in improving safety. It is important to meet society's needs to blame and exact retribution when appropriate. However, this should not be a prerequisite for compensation, which should be appropriately structured, fair, timely, and, ideally, properly funded as an intrinsic part of health care and social security systems.

Prevention, Tort reform, Medical errors, Compensation (Law), Author Abstract

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Diagnosing Suffering: A Perspective

Article Abstract:

The alleviation of suffering is crucial in all of medicine, especially in the care of the dying, but the patient's perception, which is the basis of suffering, is subjective information, and this may present a problem for physicians who are oriented toward objective findings and may even see a conflict between the two kinds of information. Knowing a patient as an individual person well enough to understand the source of the suffering and its best treatment requires methods of empathic attentiveness and nondiscursive thinking that can be learned and taught. Often, questioning and attentive listening, which take little time, are in themselves ameliorative.

Care and treatment, Suffering

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Antipodean advances

Article Abstract:

The status of midwives in New Zealand has improved greatly over recent years, particularly as women have started demanding more options in maternity care. The New Zealand College of Midwives has gained considerable support from ordinary women, and now plays a strong political role. Consumer groups have also been brought into to back the development of midwifery as an independent profession.

Midwives, New Zealand

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