Objectives For an Irish Medical Injuries Alliance

The Medical Injuries Alliance is a group of people with a particular interest in and experience in representing patients injured through medical negligence, misconduct and preventable error. Newly established in 2011, the Alliance hopes to be a voice for patients into the future. It intends to respond to matters of interest as and when they arise.  The Alliance advocates in particular:

International studies show that medical accidents represent a leading cause of premature death in our society. Estimates accepted in these studies suggest a rate between 4% and 11% of all hospital admissions. An influential report published by the Institute of Medicine in the U.S. National Academy of Sciences indicated that 4% of all patients admitted to US hospitals in 2000 suffered an adverse outcome to treatment, suggesting that between 44,000 and 98,000 Americans die each year from preventable error in hospitals. This finding was considered by our own Department of Health and Children in 2008, when it accepted that “although there are no available statistics for Ireland in this context it must be assumed that the rate of preventable error in Ireland matched those described above.” [ 1 ] Each year, more than 4 million patients are admitted to Irish hospitals. If a rate of 4% were to apply, potentially 160,000 patients are injured in this way each year in Ireland. In the absence of available statistics on the true rate, this figure may be contrasted with the 84,000 medical accidents reported by hospitals to the State Claims Agency in 2008 through their Star Web reporting system. It is also worthwhile noting the findings of the famous Harvard Medical Malpractice Study of 1993, since its relevance to the Irish situation was accepted by the Minister for Health in 2001. [ 2 ] The Study found that only a minority of potential malpractice claims are ultimately litigated – and the true figure may lie in the realm of one in eight.

The challenge ahead is to work towards a safer system of healthcare by safeguarding the accountability and deterrence objectives achieved by the tort liability. However, the duty of candour, and the right of patients to expect it from doctors and hospitals, transcends the concerns that arise in medical litigation. Candour must also be viewed in the broader context of transparency and accountability for medical fault. In principle, patients who suffer preventable or untoward injury in the medical or hospital system ought to be entitled to know precisely what went wrong and what caused their injury. Despite the predominantly public character of the medical services provided by hospitals and doctors in Ireland, no such duty has been imposed by the law to date, and in practice candour is achieved, if at all, through the civil liability process.

The benefits of candour have already been accepted by the Department of Health. The following is an extract from its report in 2008 called Building a Culture of Patient Safety:

“Over the last two decades there has been growing support in the international literature for the concept that doctors should make full disclosure of medical errors to their patients. As well as enhancing patient safety by acknowledgement that an error occurred, it is also in keeping with the ethical commitment of honesty to patients.

“Failure to communicate effectively with patients following errors therefore damages the integrity of the profession. Studies show that openness can decrease the trauma felt by patients following an adverse event and that patients often forgive the medical error when it is disclosed promptly, fully and compassionately and action is taken to make sure it does not happen to another patient.

“The overriding principle accepted by the Commission is that patients are entitled to expect honest and open communication in relation to adverse events that may have caused them harm”. [ 3 ]

The recommendations in that report were subsequently reflected in the most recent Irish Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners published in November 2009.  Paragraph 18.3 states:

“Patients and their families are entitled to honest, open and prompt communication with them about adverse events that may have caused them harm. Therefore you should:

The Alliance believes that numerous inequities in the current system require to be addressed:

Adopted by MIA Committee 28th June 2011

[1] "Building a Culture of Patient Safety Report of the Commission on Patient Safety and Quality Assurance", Department of Health and Children, July 2008.

[2] "Road to Enterprise Liability", Department of Health, February 16, 2001.

[3] para 4.3.6 at page 81 of the report

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