When something goes wrong in healthcare, it is important that patients are informed in an open and honest manner. This dissertation focuses on the question: what is the role of law when something goes wrong in health care? To answer this question, research was conducted in three domains: action research with Dutch hospitals that want to become more open and practice being open in a better way; quantitative questionnaire research into the impact of medical disciplinary procedures on doctors who received a disciplinary measure, and traditional legal research into openness and the settlement of complaints and claims under the Quality, Complaints and Disputes in Health Care Act (Wkkgz). This study shows that openness requires policy, such as assistance for patients and support for care providers. At the institutional level, it is important to strive for a just culture, in which open discussion and learning from mistakes is the norm. The law appears to have adverse side effects in all three domains. The organisation of openness in hospitals is compartmentalised in procedures that make it difficult to pay attention to the full range of needs of the people involved; medical disciplinary law has a negative impact on the professional practice of defendants and rarely leads to learning; in principle, the Wkkgz has the potential to improve the settlement of both complaints and claims. Restorative justice, as a legal perspective on the principles of a just culture, has been explored as a way of realising that potential. Reflecting on these findings in a broader sense, it appears that the problems described here are not an isolated phenomenon. What can be learned from this dissertation is that when solving problems, it is important to strive for participation of those who are affected; in this dissertation patients and caregivers. In line with the principles of a just culture, restorative justice has been studied as a legal perspective for the settlement of incidents. The challenge this dissertation poses is how a restorative response after a medical incident can be organized concretely. Three methods were used in this thesis: action research, quantitative questionnaire research, traditional legal literature and case law research. As such, this dissertation is in line with the development towards a more empirical approach to law. Action research in particular offers potential for (legal) scholars who want to contribute to the improvement of an undesirable situation. The legal method does not lose its added value in this approach; on the contrary, it is one of the methods that action researchers will need in order to understand and change a problem in its entirety.
|Translated title of the contribution
|De rol van het recht als er iets misgaat in de gezondheidszorg: Over openheid in de praktijk, de manco’s van het medisch tuchtrecht en een betere afwikkeling van schade
|16 Nov 2022
|Place of Publication
|Published - 16 Nov 2022
- Liability, open, disclosure, healthcare, patient, complaints, disciplinary, law, restorative justice, just culture