Socio-legal Analysis on Effects of Legal Sanction on Prevention of Medical Accidents

本研究的观察调查、对医护人员的访谈研究和问卷调查的结果表明，刑事指控、民事损害赔偿甚至被起诉风险等法律制裁对医护人员的行为都有负面影响。不仅在事故发生的瞬间，而且在日常实践中，医护人员倾向于采取防御性的行为，试图避免高风险的做法，并对患者的索赔持谨慎态度。相反，医护人员对替代纠纷解决机制的可能性抱有积极的期望，并相信调解和促进技能的普及将改善患者和医护人员的态度，进而有助于促进医疗安全。基于这种理解，我建议在医疗事故领域引入ADR，并制定有效的调解技能培训计划，用于医护人员在事故发生时对患者和家人的第一阶段反应。这一基于我的研究的结果和命题几乎与宾夕法尼亚州哥伦比亚大学侵权改革法学院的卡罗尔·利布曼教授和克里斯·海曼教授的结论类似。

The results of observation survey, interview research to health care professionals and questionnaire survey done in this research, shows that Legal sanctions like criminal charge, civil damages compensation and even the risk to be sued have negative effects on the behavior of health care professionals. Not only at the moment of accident but also in everyday practice, health care professions tend to behave defensively trying to avoid risky practice and being cautious against patients' claims.On the contrary, health care professionals have positive expectation on the possibility of alternative dispute resolution mechanism and believe that introduction of mediation and prevalence of facilitation skills would improve both patients' and health care professionals' attitude and then contribute to promote the safety in medical care.Based on this understanding, I proposed introduction of ADR in medical malpractice field and develop an effective training program of mediation skills that could be applied to first stage response by health care professionals to a patient and the family at the time of accident. This result and proposition based on my research is almost sama as that made by professor Carol Liebman and Chris Hyman of Columbia Law School for Tort Reform in Pennsylvania.