1. THE PRESENT MEDICAL MALPRACTICE LITIGATION IN CHINA Zhen L. Kunming Medical College, Kunming P. R. China

3. TERMINOLOGY

4. Forensic Pathology 法医病理 Public Security Organs 公安机关 Judicial Procedure 司法程序 Crime Scene 事故现场 Evidence 证据 Autopsy 尸体解剖 Tissue Analysis 组织学分析 Toxicological Analysis 毒物分析

5. Cause of Death 死亡原因 Cause of Death 死亡原因 Manner of Death 死亡性质 Manner of Death 死亡性质 Suicide 自杀死 Suicide 自杀死 Homicide 他杀死 Homicide 他杀死 Unexpected Death 意外死 Unexpected Death 意外死 Violent Death 暴力性死亡 Violent Death 暴力性死亡 Natural Death 自然性死亡 Natural Death 自然性死亡 Alleged Malpractice 医疗纠纷 Alleged Malpractice 医疗纠纷

6. FORENSIC PATHOLOGY ROLES

7. (1) To determine the cause of death; (2) To determine the manner of death; (3) To identify the deceased if unknown; (4) Trying to show the relation between the deaths and the alleged “malpractice” involved the hospital; (1) To determine the cause of death; (2) To determine the manner of death; (3) To identify the deceased if unknown; (4) Trying to show the relation between the deaths and the alleged “malpractice” involved the hospital;

8. (5) To provide clues and direction for (5) To provide clues and direction for criminal or civil investigation; criminal or civil investigation; (6) To provide the expert evidence if (6) To provide the expert evidence if a case goes to trial. a case goes to trial.

10. Ⅰ INTRODUCTION A recent forensic autopsy case, which involved a very serious medical dispute case, will be i llustrated here. Two deceased, the pregnant woman and her new-born baby, dead in this case.

11. The autopsy was performed by Judicial Expertise Center of Yunnan Province for the purpose of (1) determining the causes of death; (2) trying to show the relation between the deaths and the alleged malpractice involved the hospital.

13. 2 CASE REPORT The 22-year-old young woman was taken to one of the hospitals in to give birth to her first baby. For months during her pregnancy period this patient had been examined many times for her pregnancy situation, and the result always showed an abnormal fetus position (breechbutt). 2 CASE REPORT The 22-year-old young woman was taken to one of the hospitals in to give birth to her first baby. For months during her pregnancy period this patient had been examined many times for her pregnancy situation, and the result always showed an abnormal fetus position (breechbutt).

14. For months during her pregnancy For months during her pregnancy period the examinations for her fetus position showed abnormal (breech).

16. Before her admission to the hospital she had tried to deliver her baby for hours at home at her granny ’ s insistence. Before her admission to the hospital she had tried to deliver her baby for hours at home at her granny ’ s insistence.

17. The results taking place in the hospital as the following: First, the urgent medical serious situation was informed but the operation was rejected firmly by the family members especially the patient ’ s granny; Second, the family members signed a letter saying "Family members reject the operation ” ; Third, the patient and her baby died of uterine rupture; The results taking place in the hospital as the following: First, the urgent medical serious situation was informed but the operation was rejected firmly by the family members especially the patient ’ s granny; Second, the family members signed a letter saying "Family members reject the operation ” ; Third, the patient and her baby died of uterine rupture;

18. Fourth, the bodies were kept in the hospital for medical compensation; Finally, the hospital had to pay the family a big sum of money before the autopsy report was issued and the whole dispute was solved. Fourth, the bodies were kept in the hospital for medical compensation; Finally, the hospital had to pay the family a big sum of money before the autopsy report was issued and the whole dispute was solved.

19. About the doctors involved in this case: (1) They had been tortured a lot; (2) They did not know why the hospital must listen to the family members and paid for the family without any principle; (3) They also did not understand why the hospital could not save the deceased's life. About the doctors involved in this case: (1) They had been tortured a lot; (2) They did not know why the hospital must listen to the family members and paid for the family without any principle; (3) They also did not understand why the hospital could not save the deceased's life.

21. Ⅱ DISCUSSION The main characteristics which the authors called “ Chinese-style malpractice ” are as the following. Ⅱ DISCUSSION The main characteristics which the authors called “ Chinese-style malpractice ” are as the following.

22. Firstly, in China the medical staff gets only a relatively limited “ medical privilege ” compared with the patients and their families. Firstly, in China the medical staff gets only a relatively limited “ medical privilege ” compared with the patients and their families.

23. Secondly, the filial piety is still regarded as the basic moral standard in China which affects the alleged malpractice situation a lot. Secondly, the filial piety is still regarded as the basic moral standard in China which affects the alleged malpractice situation a lot.

24. Thirdly, the superstition sometimes also plays an important role in the alleged malpractice cases. Thirdly, the superstition sometimes also plays an important role in the alleged malpractice cases.

25. Fourthly, the media propaganda for the medical dispute is a big issue at present. It has greatly affected a lot on the public and the Chinese society. Fourthly, the media propaganda for the medical dispute is a big issue at present. It has greatly affected a lot on the public and the Chinese society.

26. Fifthly, life insurance in China is not perfect enough for the medical compensation and some of the people do hope to get some money back from the relevant hospital.

27. Sixthly, some population gets less income and some of the patients still live in the “ poor class ” in the present society.

28. Finally, some other factors in Chinese society, such as lawyers ’ unscrupulous practice and ambiguous laws criteria about medical malpractice, make the sequence of medical work even worse. Finally, some other factors in Chinese society, such as lawyers ’ unscrupulous practice and ambiguous laws criteria about medical malpractice, make the sequence of medical work even worse.

29. Ⅲ THE AUTHORS ’ ATTITUTE ABOUT THIS CHINESE-STYLE MEDICAL SITUATION Ⅲ THE AUTHORS ’ ATTITUTE ABOUT THIS CHINESE-STYLE MEDICAL SITUATION

30. The doctors in China should claim that they are engaging in a “ high risk career ” due to the increasing medical disputes; The medical situation in China is not good for the medical science development in the near future! The doctors in China should claim that they are engaging in a “ high risk career ” due to the increasing medical disputes; The medical situation in China is not good for the medical science development in the near future!

31. In China the “ medical right ” has been totally left to the patients and their relatives!!! The so called Chinese-style “ informed consent ” should be reconsidered!!! In China the “ medical right ” has been totally left to the patients and their relatives!!! The so called Chinese-style “ informed consent ” should be reconsidered!!!

32. Thank you!!! Thank you!!!