Doctors call for medical courts

THE SA Medical Association has called for the establishment of specialised medical courts to deal with medico-legal cases.

In addition to the courts, the association called for an urgent review of culpable homicide law and its application in health-care settings.

Chairperson Dr Angelique Coetzee said: “Recent cases have again demonstrated the deficiencies the current legal framework has with medical cases. Magistrates are often placed in the unenviable position of adjudicating exceedingly complex clinical interventions, without possessing the necessary training or medical expertise. This has severe and long-ranging impacts on doctors and, ultimately, on patients. Something must be done, and quickly, to remedy this situation.”

The association supported the view of eight other leading healthcare organisations which recently wrote to Minister of Justice and Correctional Services Ronald Lamola, urging a review of the current legal framework. In the letter, they write: “Our organisations are committed to the highest level of safety for all patients in South Africa. This will, however, require replacing the current culture of blame and fear with one of learning, where health-care professionals feel able to apologise and learn from mistakes, which will help to reduce the number of errors and thus enable progress in improving patient safety.

“When health-care professionals are allowed and supported to learn from mistakes, lessons are learnt, and patients are better protected in the future.

“We appreciate the intricacy of these issues, and while they are difficult to resolve, their complexity only highlights how important it is that our health-care workers have clarity from their leaders, and ultimately in law. Patients and clinicians want the same thing: for those in need to receive the best care.”

Coetzee said that without proper legal judgment on medical cases, doctors will increasingly become afraid to perform certain procedures, a serious situation which will have negative consequences for patients.

“We already have doctors who have been incarcerated following poor procedures, saying they will no longer continue practising medicine. When other doctors see these events unfold, and doctors being vilified without proper medical scrutiny of their work, they become anxious and opt to either leave the country altogether, or stop performing procedures. We cannot allow this to continue. Specialised courts that call on expert witnesses must be created to deal with these cases.”

Coetzee said all surgeries carried a level of risk, and doctors often have to make split-second decisions under enormous pressure. Medical practitioners must always be called on to evaluate these decisions, because they are trained to assess these decisions.

“There is no such thing as doctors protecting each other in situations such as these; in fact, doctors will be harsher on their colleagues if there’s been a mistake. As an initial intervention, processes and guidelines should be introduced to ensure that investigators, coroners and prosecutors are guided by independent medical experts to determine whether further investigation or prosecution is warranted. Something urgent is required, the minister must seriously consider the call for change,” she said.