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Full-Text Articles in Medicine and Health Sciences
The Law Of Medical Misadventure In Japan, Robert B. Leflar
The Law Of Medical Misadventure In Japan, Robert B. Leflar
Robert B Leflar
This paper offers a comprehensive overview of Japanese law and practice relating to iatrogenic (medically-caused) injury, with comparisons to other nations’ medical law systems. The paper addresses criminal sanctions for Japanese physicians’ negligent and illegal acts; civil law principles of substantive law and related issues of procedure, practice, and liability insurance; and administrative measures including health ministry programs aimed at expanding and improving the quality of peer review within Japanese medicine, and a recently implemented no-fault compensation system for birth-related injuries. Among the paper’s findings are these. Criminal and civil actions increased rapidly after highly publicized medical error events at …
Human Flotsam, Legal Fallout: Japan's Tsunami And Nuclear Meltdown, Robert B. Leflar, Ayako Hirata, Masayuki Murayama, Shozo Ota
Human Flotsam, Legal Fallout: Japan's Tsunami And Nuclear Meltdown, Robert B. Leflar, Ayako Hirata, Masayuki Murayama, Shozo Ota
Robert B Leflar
We report on our field research in Fukushima Prefecture in July 2011. We interviewed legal professionals and community leaders in Fukushima City and in towns inundated by the March 2011 tsunami and within a few kilometers of Fukushima No. 1 nuclear reactor. We catalogued many of the extensive variety of problems faced by Fukushima residents, both evacuees and those who remained in their homes. Many of these problems, both legal and non-legal, arose from government actions as the disaster unfolded and afterwards, including the administration of the initial program for provisional compensation for disaster victims. We learned that in the …
Public And Private Justice: Redressing Health Care Harm In Japan, Robert B. Leflar
Public And Private Justice: Redressing Health Care Harm In Japan, Robert B. Leflar
Robert B Leflar
Japanese legal structures addressing health care-related deaths and injuries rely more on public law institutions and rules than do the common-law North American jurisdictions, where private law adjudication is predominant. This article explores four developments in 21st-century Japanese health care law. The first two are in the public law sphere: criminal prosecutions of health care personnel accused of medical errors, and a health ministry-sponsored “Model Project” to analyze medical-practice-associated deaths. The article addresses a private law innovation: health care divisions of trial courts in several metropolitan areas. Finally, the article introduces Japan’s new no-fault program for compensating birth-related obstetrical injuries. …
Medical Error As Reportable Event, As Tort, As Crime: A Transpacific Comparison, Robert B. Leflar, Futoshi Iwata
Medical Error As Reportable Event, As Tort, As Crime: A Transpacific Comparison, Robert B. Leflar, Futoshi Iwata
Robert B Leflar
All nations seek to reduce the human toll from medical error, but variations in legal and institutional structures guide those efforts into different trajectories. This article compares legal and institutional responses to patient safety problems in the United States and Japan, addressing developments in civil malpractice law (including discoverability of internal hospital documents), administrative practice (including medical accident reporting systems), and - of particular significance in Japan - criminal law. In the U.S., battles over rules of malpractice litigation are fierce; tort law occupies center stage. The hospital accreditation process plays a critical role in medical quality control, and peer …
Informed Consent And Patients' Rights In Japan: 2001 Epilogue, Robert B. Leflar
Informed Consent And Patients' Rights In Japan: 2001 Epilogue, Robert B. Leflar
Robert B Leflar
Japan is on a steeper trajectory toward the incorporation of informed consent principles into medical practice than the “gradual transformation” observed in a 1996 article, Informed Consent and Patients’ Rights in Japan. Among the most significant recent developments from 1996 to 2001 have been these seven: (1) the 1997 enactment of the Organ Transplantation Law permitting the use of brain death criteria in limited circumstances in which informed consent is present; (2) the strengthening of patients’ rights in clinical drug trials; (3) the continued trend toward increasing disclosure to patients of cancer diagnoses; (4) initiatives by the health ministry toward …
Informed Consent And Patients' Rights In Japan, Robert B. Leflar
Informed Consent And Patients' Rights In Japan, Robert B. Leflar
Robert B Leflar
This article analyzes the development of the concept of informed consent in the context of the culture and economics of Japanese medicine, and locates that development within the framework of the nation's civil law system. Part II sketches the cultural foundations of medical paternalism in Japan; explores the economic incentives (many of them administratively directed) that have sustained physicians' traditional dominant roles; and describes the judiciary's hesitancy to challenge physicians' professional discretion. Part III delineates the forces testing the paternalist model: the undermining of the physicians' personal knowledge of their patients that accompanies the shift from neighborhood clinic to high-tech …