Medical Liability in Europe (eBook)

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Bernhard A. Koch, Professorof Civil Law, University of Innsbruck, Austria;Ken Oliphant, Professor, Institute for European Tort Law of the Austrian Academy of Sciences, Vienna, Austria.

Die Idee 6
Preface 8
Table of Contents 10
List of Contributors 30
Questionnaire 32
Medical Liability in Austria 46
General Questions 46
A. The Health Care System Framework 46
I. General Introduction 46
1. The health care system in overview 46
II. Social Welfare Provision 49
2. The role of public healthcare 49
3. Differences in treating patient’s claims 51
4. Right of recourse 51
III. Private Insurance 51
5. The role of private health insurance 51
6. Liability insurance 52
IV. Professional Standards 53
7. Applicable professional standards 53
8. Quality and/or risk management systems 54
B. Tort Liability 55
9. Fundamentals of tort liability 55
10. Burden of proof 56
11. Uncertain causation. 58
12. Loss of a chance 60
13. Multiple persons involved 61
14. Strict liability 65
C. Contractual Liability 66
15. Basics of contracts in the healthcare sector 66
16. Differences to tort law 69
17. Contractual claims in the absence of direct contracts? 70
18. Informed consent 70
D. Public Liability 75
19. Key differences from cases involving private hospitals or doctors 75
E. Alternative Compensation Regimes 75
20. Funds and/or other alternative compensation regimes 75
F. Extent of Liability/Remedies 77
I. Pecuniary Loss 77
21. Introduction to indemnifying pecuniary loss 77
22. Loss of earnings vs loss of earning capacity 79
23. Periodic payments or lump sum? 80
24. Caps and thresholds 80
II. Non-Pecuniary Loss 80
25. Introduction to indemnifying non-pecuniary loss 80
26. Who can claim compensation for non-pecuniary loss? 82
G. Procedural Matters 82
27. Specific rules of jurisdiction or procedure 82
28. Special institutions handling malpractice claims 82
H. Outlook 84
29. Reform plans 84
Cases 84
Case 1 84
Case 2 88
Case 3 90
Case 4 95
Case 5 98
Case 6 102
Medical Liability in Belgium 106
General Questions 106
A. The Health Care System Framework 106
I. General Introduction 106
1. The health care system in overview 106
II. Social Welfare Provision 109
2. The role of public health care 109
3. Differences in treating patient’s claims 110
4. Right of recourse 111
III. Private Insurance 112
5. The role of private health insurance 112
6. Liability insurance 113
IV. Professional Standards 113
7. Applicable professional standards 113
8. Quality and/or risk management systems 115
B. Tort Liability 117
9. Fundamentals of tort liability 117
10. Burden of proof 118
11. Uncertain causation 118
12. Loss of a chance 119
13. Multiple persons involved 120
14. Strict liability 121
C. Contractual Liability 122
15. Basics of contracts in the health care sector 122
16. Differences to tort law 123
17. Contractual claims in the absence of direct contracts? 124
18. Informed consent 124
D. Public Liability 126
19. Key differences from cases involving private hospitals or doctors 126
E. Alternative Compensation Regimes 126
20. Funds and/or other alternative compensation regimes 126
F. Extent of Liability/Remedies 126
I. Pecuniary Loss 126
21. Introduction to indemnifying pecuniary loss 126
22. Loss of earnings vs loss of earning capacity 127
23. Periodic payments or lump sum? 127
24. Caps and thresholds 128
II. Non-Pecuniary Loss 128
25. Introduction to indemnifying non-pecuniary loss 128
26. Who can claim compensation for non-pecuniary loss? 128
G. Procedural Matters 129
27. Specific rules of jurisdiction or procedure 129
28. Special institutions handling malpractice claims 129
H. Outlook 129
29. Reform plans 129
Cases 130
Case 1 130
Case 2 131
Case 3 133
Case 4 134
Case 5 136
Case 6 139
Medical Liability in the Czech Republic 142
General Questions 142
A. The Health Care System Framework 142
I. General Introduction 142
1. The health care system in overview 142
II. Social Welfare Provision 146
2. The role of public health care. 146
3. Differences in treating patient’s claims 151
4. Right of recourse 151
III. Private Insurance 152
5. The role of private health insurance 152
6. Liability insurance 153
IV. Professional Standards 154
7. Applicable professional standards 154
8. Quality and/or risk management systems 157
B. Tort Liability 158
9. Fundamentals of tort liability 158
10. Burden of proof 160
11. Uncertain causation 161
12. Loss of a chance 162
13. Multiple persons involved 163
14. Strict liability 165
C. Contractual Liability 166
15. Basics of contracts in the health care sector 166
16. Differences to tort law 167
17. Contractual claims in the absence of direct contracts? 168
18. Informed consent 169
D. Public Liability 172
19. Key differences from cases involving private hospitals or doctors 172
E. Alternative Compensation Regimes 173
20. Funds and/or other alternative compensation regimes 173
F. Extent of Liability/Remedies 174
I. Pecuniary Loss 174
21. Introduction to indemnifying pecuniary loss 174
22. Loss of earnings vs loss of earning capacity 175
23. Periodic payments or lump sum? 177
24. Caps and thresholds 177
II. Non-pecuniary Loss 178
25. Introduction to indemnifying non-pecuniary loss 178
26. Who can claim compensation for non-pecuniary loss? 180
G. Procedural Matters 181
27. Specific rules of jurisdiction or procedure 181
28. Special institutions handling malpractice claims 183
H. Outlook 183
29. Reform plans 183
Cases 184
Case 1 185
Case 2 191
Case 3 193
Case 4 196
Case 5 201
Case 6 204
Medical Liability in England 210
General Questions 210
A. The Health Care System Framework 210
I. General Introduction 210
1. The health care system in overview 210
II. Social Welfare Provision 212
2. The role of public health care. 212
3. Differences in treating patient’s claims 212
4. Right of recourse 213
III. Private Insurance 214
5. The role of private health insurance 214
6. Liability insurance 215
IV. Professional Standards 216
7. Applicable professional standards 216
8. Quality and/or risk management systems 217
B. Tort Liability 217
9. Fundamentals of tort liability 217
10. Burden of proof 219
11. Uncertain causation. 222
12. Loss of a chance 225
13. Multiple persons involved 229
14. Strict liability 231
C. Contractual Liability 231
15. Basics of contracts in the health care sector 231
16. Differences to tort law 232
17. Contractual claims in the absence of direct contracts? 232
18. Informed consent 232
D. Public Liability 234
19. Key differences from cases involving private hospitals or doctors 234
E. Alternative Compensation Regimes 234
20. Funds and/or other alternative compensation regimes 234
F. Extent of Liability/Remedies 235
I. Pecuniary Loss 235
21. Introduction to indemnifying pecuniary loss 235
22. Loss of earnings vs loss of earning capacity 235
23. Periodic payments or lump sum? 236
24. Caps and thresholds 237
II. Non-Pecuniary Loss 237
25. Introduction to indemnifying non-pecuniary loss 237
26. Who can claim compensation for non-pecuniary loss? 238
G. Procedural Matters 239
27. Specific rules of jurisdiction or procedure 239
28. Special institutions handling malpractice claims 239
H. Outlook 239
29. Reform plans 239
Cases 240
Case 1 240
Case 2 243
Case 3 244
Case 4 246
Case 5 247
Case 6 249
Medical Liability in France 252
General Questions 252
A. The Health Care System Framework 252
I. General Introduction 252
1. The health care system in overview 252
II. Social Welfare Provision 253
2. The role of public health care 253
3. Differences in treating patient’s claims 253
4. Right of recourse 253
III. Private Insurance 253
5. The role of private health insurance 253
6. Liability insurance 254
IV. Professional Standards 254
7. Applicable professional standards 254
8. Quality and/or risk management systems 255
B. Tort Liability 255
9. Principles of tort liability 255
10. Burden of proof 256
11. Uncertain causation 256
12. Loss of a chance. 256
13. Multiple persons involved 257
14. Strict liability 257
C. Contractual Liability 257
15. Basics of contracts in the health care sector 257
16. Differences from tort law 257
17. Contractual claims in the absence of direct contracts? 257
18. Informed consent 258
D. Public Liability 258
19. Key differences from cases involving private hospitals or doctors 258
E. Alternative Compensation Regimes 259
20. Funds and/or other alternative compensation regimes 259
F. Extent of Liability/Remedies 261
I. Pecuniary Loss 261
21. Introduction to indemnifying pecuniary loss 261
22. Loss of earnings vs loss of earning capacity 261
23. Periodic payments or lump sum? 261
24. Caps and thresholds 261
II. Non-Pecuniary Loss 261
25. Introduction to indemnifying non-pecuniary loss 261
26. Who can claim compensation for non-pecuniary loss? 262
G. Procedural Matters 262
27. Specific rules of jurisdiction or procedure 262
28. Special institutions handling negligence claims 262
H. Outlook 264
29. Reform plans 264
Cases 264
Case 1 264
Case 2 266
Case 3 267
Case 4 269
Case 5 272
Case 6 275
Medical Liability in Germany 278
General Questions 278
A. The Health Care System Framework 278
I. General Introduction 278
1. The health care system in overview 278
II. Social Welfare Provision 282
2. The role of public health care. 282
3. Differences in treating patient’s claims 284
4. Right of recourse 285
III. Private Insurance 286
5. The role of private health insurance 286
6. Liability insurance 286
IV. Professional Standards 288
7. Applicable professional standards 288
8. Quality and/or risk management systems 290
B. Tort Liability 292
9. Fundamentals of tort liability 292
10. Burden of proof 294
11. Uncertain causation 295
12. Loss of a chance 297
13. Multiple persons involved 297
14. Strict liability 306
C. Contractual Liability 307
15. Basics of contracts in the healthcare sector 307
16. Differences to tort law 307
17. Contractual claims in the absence of direct contracts? 308
18. Informed consent 308
D. Public Liability 311
19. Key differences from cases involving private hospitals or doctors 311
E. Alternative Compensation Regimes 311
20. Funds and/or other alternative compensation regimes 311
F. Extent of Liability/Remedies 311
I. Pecuniary Loss 311
21. Introduction to indemnifying pecuniary loss 311
22. Loss of earnings vs loss of earning capacity 314
23. Periodic payments or lump sum? 315
24. Caps and thresholds 315
II. Non-Pecuniary Loss 315
25. Introduction to indemnifying non-pecuniary loss 315
26. Who can claim compensation for non-pecuniary loss? 317
G. Procedural Matters 318
27. Specific rules of jurisdiction or procedure 318
28. Special institutions handling malpractice claims 318
H. Outlook 319
29. Reform plans 319
Cases 319
Case 1 320
Case 2 323
Case 3 326
Case 4 328
Case 5 329
Case 6 331
Medical Liability in Hungary 336
General Questions 336
A. The Health Care System Framework 336
I. General Introduction 336
1. The health care system in overview 336
II. Social Welfare Provision 338
2. The role of public health care. 338
3. Differences in treating patient’s claims 339
4. Right of recourse 340
III. Private Insurance 341
5. The role of private health insurance 341
6. Liability insurance 341
IV. Professional Standards 342
7. Applicable professional standards 342
8. Quality and/or risk management systems 343
B. Tort Liability 344
9. Fundamentals of tort liability 344
10. Burden of proof 344
11. Uncertain causation. 345
12. Loss of a chance 347
13. Multiple persons involved 348
14. Strict liability 350
C. Contractual Liability 353
15. Basics of contracts in the health care sector 353
16. Differences to tort law 354
17. Contractual claims in the absence of direct contracts? 355
18. Informed consent 356
D. Public Liability 357
19. Key differences from cases involving private hospitals or doctors 357
E. Alternative Compensation Regimes 358
20. Funds and/or other alternative compensation regimes 358
F. Extent of Liability/Remedies 358
I. Pecuniary Loss 358
21. Introduction to indemnifying pecuniary loss 358
22. Loss of earnings vs loss of earning capacity 360
23. Periodic payments or lump sum? 361
24. Caps and thresholds 363
II. Non-pecuniary Loss 363
25. Introduction to indemnifying non-pecuniary loss 363
26. Who can claim compensation for non-pecuniary loss? 365
G. Procedural Matters 366
27. Specific rules of jurisdiction or procedure 366
28. Special institutions handling malpractice claims 366
H. Outlook 366
29. Reform plans 366
Cases 366
Case 1 366
Case 2 368
Case 3 368
Case 4 370
Case 5 371
Case 6 372
Medical Liability in Italy 374
General Questions 374
A. The Health Care System Framework 374
I. General Introduction 374
1. The health care system in overview 374
II. Social Welfare Provision 375
2. The role of public health care 375
3. Differences in treating patient’s claims 377
4. Right of recourse 377
III. Private Insurance 377
5. The role of private health insurance 377
6. Liability insurance 378
IV. Professional Standards 378
7. Applicable professional standards 378
8. Quality and/or risk management systems 380
B. Tort Liability 380
9. Fundamentals of tort liability 380
10. Burden of proof 382
11. Uncertain causation 382
12. Loss of a chance 384
13. Multiple persons involved 385
14. Strict liability 385
C. Contractual Liability 386
15. Basics of contracts in the health care sector 386
16. Differences to tort law 388
17. Contractual claims in the absence of direct contracts? 389
18. Informed consent 390
D. Public Liability 392
19. Key differences from cases involving private hospitals or doctors 392
E. Alternative Compensation Regimes 392
20. Funds and/or other alternative compensation regimes 392
F. Extent of Liability/Remedies 393
I. Pecuniary Loss 393
21. Introduction to indemnifying pecuniary loss 393
22. Loss of earnings vs loss of earning capacity 394
23. Periodic payments or lump sum? 395
24. Caps and thresholds 395
II. Non-Pecuniary Loss 395
25. Introduction to indemnifying non-pecuniary loss 395
26. Who can claim compensation for non-pecuniary loss? 398
G. Procedural Matters 399
27. Specific rules of jurisdiction or procedure 399
28. Special institutions handling malpractice claims 399
H. Outlook 399
29. Reform plans 399
Cases 399
Case 1 399
Case 2 401
Case 3 402
Case 4 402
Case 5 403
Case 6 403
Medical Liability in the Netherlands 406
General Questions 406
A. The Healthcare System Framework 406
I. General Introduction 406
1. The health care system in overview 406
II. Social Welfare Provision 408
2. The role of public healthcare 408
3. Differences in treating patient’s claims 409
4. Right of recourse 409
III. Private Insurance 410
5. The role of private health insurance 410
6. Liability insurance 411
IV. Professional Standards 412
7. Applicable professional standards 412
8. Quality and/or risk management systems 413
B. Tort Liability 414
9. Fundamentals of tort liability 414
10. Burden of proof 416
11. Uncertain causation. 420
12. Loss of a chance 425
13. Multiple persons involved 429
14. Strict liability 430
C. Contractual Liability 431
15. Basics of contracts in the healthcare sector 431
16. Differences to tort law 432
17. Contractual claims in the absence of direct contracts? 433
18. Informed consent 434
D. Public Liability 435
19. Key differences from cases involving private hospitals or doctors 435
E. Alternative Compensation Regimes 435
20. Funds and/or other alternative compensation regimes 435
F. Extent of Liability/Remedies 436
I. Pecuniary Loss 436
21. Introduction to indemnifying pecuniary loss 436
22. Loss of earnings vs loss of earning capacity 438
23. Periodic payments or lump sum? 438
24. Caps and thresholds 438
II. Non-pecuniary Loss 439
25. Introduction to indemnifying non-pecuniary loss 439
26. Who can claim compensation for non-pecuniary loss? 441
G. Procedural Matters 442
27. Specific rules of jurisdiction or procedure 442
28. Special institutions handling malpractice claims 442
H. Outlook 443
29. Reform plans 443
Cases 443
Case 1 443
Case 2 446
Case 3 449
Case 4 452
Case 5 453
Case 6 454
Medical Liability in Poland 456
General Questions 456
A. The Health Care System Framework 456
I. General Introduction 456
1. The health care system in overview 456
II. Social Welfare Provision 457
2. The role of public health care 457
3. Differences in treating patient’s claims 458
4. Right of recourse 458
III. Private Insurance 459
5. The role of private health insurance 459
6. Liability insurance 459
IV. Professional Standards 461
7. Applicable professional standards 461
8. Quality and/or risk management systems 462
B. Tort Liability 465
9. Fundamentals of tort liability 465
10. Burden of proof 466
11. Uncertain causation. 468
12. Loss of a chance 469
13. Multiple persons involved 470
14. Strict liability 472
C. Contractual Liability 472
15. Basics of contracts in the health care sector 472
16. Differences to tort law 473
17. Contractual claims in the absence of direct contracts? 474
18. Informed consent 474
D. Public Liability 476
19. Key differences from cases involving private hospitals or doctors 476
E. Alternative Compensation Regimes 477
20. Funds and/or other alternative compensation regimes 477
F. Extent of Liability/Remedies 477
I. Pecuniary Loss 477
21. Introduction to indemnifying pecuniary loss 477
22. Loss of earnings vs loss of earning capacity 479
23. Periodic payments or lump sum? 480
24. Caps and thresholds 480
II. Non-pecuniary Loss 480
25. Introduction to indemnifying non-pecuniary loss 480
26. Who can claim compensation for non-pecuniary loss? 482
G. Procedural Matters 483
27. Specific rules of jurisdiction or procedure 483
28. Special institutions handling malpractice claims 484
H. Outlook 484
29. Reform plans 484
Cases 486
Case 1 486
Case 2 487
Case 3 487
Case 4 488
Case 5 490
Case 6 492
Medical Liability in Spain 496
General Questions 496
A. The Health Care System Framework 496
I. General Introduction 496
1. The health care system in overview 496
II. Welfare Provision 500
2. The role of public health care 500
3. Differences in treating patient’s claims 501
4. Right of recourse 502
III. Private Insurance 503
5. The role of private health insurance 503
6. Liability insurance 505
IV. Professional Standards 507
7. Applicable professional standards 507
8. Quality and/or risk management systems 510
B. Tort Liability 511
9. Fundamentals of tort liability 511
10. Burden of proof 515
11. Uncertain causation 519
12. Loss of a chance 523
13. Multiple persons involved 526
14. Strict liability 528
C. Contractual Liability 530
15. Basics of contracts in the health care sector 530
16. Differences to tort law 533
17. Contractual claims in the absence of direct contracts? 535
18. Informed consent 535
D. Public Liability 539
19. Key differences from cases involving private hospitals or doctors 539
E. Alternative Compensation Regimes 542
20. Funds and/or other alternative compensation regimes 542
F. Extent of Liability/Remedies 545
I. Pecuniary Loss 545
21. Introduction to indemnifying pecuniary loss 545
22. Loss of earnings vs loss of earning capacity 546
23. Periodic payments or lump sums? 547
24. Caps and thresholds 548
II. Non-Pecuniary Loss 549
25. Introduction to indemnifying non-pecuniary loss 549
26. Who can claim compensation for non-pecuniary loss? 551
G. Procedural Matters 552
27. Specific rules of jurisdiction or procedure 552
28. Special institutions handling malpractice claims 553
H. Outlook 554
29. Reform plans 554
Cases 554
Case 1 554
Case 2 557
Case 3 559
Case 4 561
Case 5 563
Case 6 566
Medical Liability in Sweden 570
General Questions 570
A. The Health Care System Framework 570
I. General Introduction 570
1. The health care system in overview 570
II. Social Security 572
2. The role of public health care. 572
3. Differences in treating patient’s claims 572
4. Right of recourse 573
III. Private Insurance 573
5. The role of private health insurance 573
6. Liability insurance 574
IV. Professional Standards 574
7. Applicable professional standards 574
8. Quality and/or risk management systems 574
B. Tort Liability 575
9. Fundamentals of tort liability 575
10. Burden of proof 576
11. Uncertain causation. 576
12. Loss of a chance 577
13. Multiple persons involved 577
14. Strict liability 577
C. Contractual Liability 579
15. Basics of contracts in the health care sector 579
16. Differences to tort law 579
17. Contractual claims in the absence of direct contracts? 579
18. Informed consent 579
D. Public Liability 581
19. Key differences from cases involving private hospitals or doctors 581
E. Fund and other alternative compensation regimes 581
20. Funds and/or other alternative compensation regimes 581
F. Extent of Liability/Remedy 581
I. Pecuniary loss 581
21. Introduction to indemnifying pecuniary loss 581
22. Loss of earnings vs loss of earning capacity 582
23. Periodic payments or lump sum? 582
24. Caps and thresholds 582
II. Non-pecuniary loss 583
25. Introduction to indemnifying non-pecuniary loss 583
26. Who can claim compensation for non-pecuniary loss? 585
G. Procedural Matters 585
27. Specific rules of jurisdiction or procedure 585
28. Special institutions handling malpractice claims 586
H. Outlook 586
29. Reform plans 586
Cases 586
Case 1 586
Case 2 588
Case 3 588
Case 4 589
Case 5 590
Case 6 591
Medical Liability in Switzerland 592
General Questions 592
A. The Health Care System Framework 592
I. General Introduction 592
1. The health care system in overview 592
II. Social Welfare Provision 595
2. The role of public health care 595
3. Differences in treating patient’s claims 600
4. Right of recourse 601
III. Private Insurance 602
5. The role of private health insurance 602
6. Liability insurance 603
IV. Professional Standards 605
7. Applicable professional standards 605
8. Quality and/or risk management systems 606
B. Tort Liability 607
9. Fundamentals of tort liability 607
10. Burden of proof 610
11. Uncertain causation 612
12. Loss of a chance 614
13. Multiple persons involved 614
14. Strict liability 617
C. Contractual Liability 618
15. Basics of contracts in the health care sector 618
16. Differences to tort law 620
17. Contractual claims in the absence of direct contracts? 623
18. Informed consent 623
D. Public Liability 626
19. Key differences from cases involving private hospitals or doctors 626
E. Alternative compensation regimes 628
20. Funds and/or other alternative compensation regimes 628
F. Extent of Liability/Remedies 629
I. Pecuniary loss 629
21. Introduction to indemnifying pecuniary loss 629
22. Loss of earnings vs loss of earning capacity 631
23. Periodic payments or lump sum? 632
24. Caps and thresholds 632
II. Non-pecuniary loss 633
25. Introduction to indemnifying non-pecuniary loss 633
26. Who can claim compensation for non-pecuniary loss? 635
G. Procedural Matters 636
27. Specific rules of jurisdiction or procedure 636
28. Special institutions handling malpractice claims 637
H. Outlook 638
29. Reform plans 638
Cases 640
Case 1 640
Case 2 643
Case 3 644
Case 4 647
Case 5 649
Case 6 652
Medical Liability in Europe: Comparative Analysis 656
Introduction. 656
General Questions 659
A. The Health Care System Framework 659
I. General Introduction 659
1. The health care system in overview 659
II. Social Welfare Provision 662
2. The role of public health care. 662
3. Differences in treating patient’s claims 664
4. Right of recourse 665
III. Private Insurance 666
5. The role of private health insurance 666
6. Liability insurance 668
IV. Professional Standards 669
7. Applicable professional standards 669
8. Quality and/or risk management systems 670
B. Tort Liability 671
9. Fundamentals of tort liability 671
10. Burden of proof 675
11. Uncertain causation 679
12. Loss of a chance 681
13. Multiple persons involved 682
14. Strict liability 685
C. Contractual Liability 685
15. Basics of contracts in the health care sector 685
16. Differences to tort law 687
17. Contractual claims in the absence of direct contracts? 688
18. Informed consent 689
D. Public Liability 693
19. Key differences from cases involving private hospitals or doctors 693
E. Alternative compensation regimes 695
20. Funds and/or other alternative compensation regimes 695
F. Extent of Liability/Remedies 699
I. Pecuniary loss 699
21. Introduction to indemnifying pecuniary loss 699
22. Loss of earnings vs loss of earning capacity 700
23. Periodic payments or lump sum? 700
24. Caps and thresholds 701
II. Non-pecuniary loss 702
25. Introduction to indemnifying non-pecuniary loss 702
26. Who can claim compensation for non-pecuniary loss? 704
G. Procedural Matters 705
27. Specific rules of jurisdiction or procedure 705
28. Special institutions handling malpractice claims 706
H. Outlook 708
29. Reform plans 708
Cases 709
Preliminary remarks 709
Case 1 710
Case 2 716
Case 3 719
Case 4 724
Case 5 727
Case 6 731
Conclusions 734
Index 738