Declaration on Realizing the Right to Safe and High Quality Medical Treatment
All people are eager to receive safe and high quality medical treatment, and all people have the right to receive safe and high quality medical treatment, which has been attained and made available by contemporary medical science and skills.
However, this right is being threatened as medical errors have continuously occurred, resulting in fatal or physical harm to patients. Therefore, when a medical error has occurred, it is essential to establish and analyze its cause and background to remedy the situation and prevent its recurrence.
Unfortunately, an attitude to investigate medical errors to “learn from errors” has not widely spread in the medical community in our country. The medical community has also lagged behind in understanding and implementing the human rights of patients, such as informed consent or disclosure of medical records. Under these circumstances, when a medical error occurred, it was dealt with within the hospital and was rarely revealed to the public or voluntarily explained to the patient or family. In 1999, a series of medical errors drew public attention when a doctor performed an operation on the wrong patient and another patient died as the result of receiving the wrong antiseptic. Since then, the importance of investigating medical errors has been pointed out, and efforts to investigate medical errors have gradually started recently, though medical errors are still continuously occurring.
Moreover, immediate, fair, and appropriate redress should be provided for the harm brought to patients’ lives and bodies through medical errors. However, it often takes a long time to obtain a court ruling on the legal liability of doctors and/or medical institutions and thus many victims are unable to get early relief. While there are cases where doctors and/or medical institutions have no legal liability because the accidents inevitably occurred due to the limit and risk of current medical science and skills, there is no redress system except for the Relief System for Sufferers from Adverse Drug Reactions, compensation for clinical research, and a compensation system for particular types of obstetric accidents without fault, which will be introduced in the near future.
In addition, the human and physical resources necessary to provide medical treatment are in short supply because of a shortage of doctors and nurses, demanding working conditions, suspended treatment at many departments, closure of medical institutions, and difficulties in accepting emergency patients. As a result, it can be difficult to receive medical treatment depending on the area, time, and/or department. People can only seek safe and high-quality medical treatment if sufficient access to medial treatment is provided. However, worsening conditions in providing medical treatment could threaten the safety and quality of medical care. This, together with inadequate systems for investigating medical errors and managing the risks inherent in medical treatment, is the background for medical errors. One of the major reasons why the health care system is deteriorating is that the state has not secured a sufficient budget to improve the health care system under the state’s policy to restrain the medical budget since 1980.
The present condition of medical treatment mentioned above is a critical and urgent human rights issue in Japan. The state, which is responsible for ensuring a system to provide safe and high-quality medical treatment, should make dealing with these issues a top priority.
Therefore, the Japan Federation of Bar Associations (JFBA) urges the state to take the following measures:
- The state should enact a law concerning the rights of patients, which establishes the right to receive safe and high-quality medical treatment, the right of patients to self-determination, including informed consent, and the responsibilities of the national and local governments for guaranteeing these rights.
- The state should establish systems inside and outside of medical institutions to investigate medical errors in order to find out how and why the errors occurred, explain the findings to victims, take necessary actions to prevent recurrence, and improve the safety of medical treatment as follows:
(1) The state should take measures to encourage medial institutions which have committed medical errors to establish an internal system to conduct an autonomous, fair, and objective investigation of the error.
(2) The state should establish a fair and neutral third-party investigative body composed of representatives of patients, lawyers, and others, in addition to medical professionals such as doctors.
- The state should establish a no-fault compensation system to relieve the victims of medical errors in an immediate, fair, and appropriate way.
- The state should allocate a sufficient budget to resolve the shortage of doctors and nurses, improve working conditions of doctors, and enhance the emergency medical system and local health care systems in order to ensure the human and physical resources necessary for providing safe and high quality medial treatment.
The JFBA will strive to realize the right to receive safe and high-quality medical treatment by collaborating with all people, bringing together their wisdom, and engaging in the establishment and operation of necessary systems.
Japan Federation of Bar Associations
October 3, 2008 at the JFBA Convention on Protection of Human Rights