Doctors should not be prosecuted for deaths caused by errors, RCP says

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DOCTORS should not be prosecuted for deaths that result from involuntary mistakes or other errors, the Royal College of Physicians has said.

Healthcare leaders should also focus on learning from mistakes to improve patient safety, rather than apportioning blame.

These are among a number of key points made by the College in its written submission to the General Medical Council (GMC) working group that is looking into how gross negligence manslaughter and culpable homicide (in Scotland) are applied to medical practice.

Also in its response is a call for investigations to take into account the context in which a patient dies, “particularly the system and environment in which a healthcare professional was working”. It said a human factors assessment approach should be taken in investigations, and called for greater standardisation in terms of expert witness training and selection, investigation, and decision to prosecute.

A patient death should only become a criminal act of manslaughter or culpable homicide, the RCP said, when someone is “wilfully negligent or acts with deliberate intent to harm.”

It defines wilful negligence as:

  • acting with disregard of or indifference to someone’s safety
  • not following agreed protocols or accepted practice knowingly and for no valid reason
  • undertaking something for which one has not been trained.

The College argued that investigations designed to apportion blame provide a “perverse incentive to obfuscate, which makes it less likely that systemic faults will be uncovered and future lives saved.”

It added: “Criminalising error reduces patient safety, and militates against families, friends and carers receiving the support, clear explanations and apologies they need and deserve.

The College called for organisations to ensure the environment in which staff are working reduces the chance of error. This includes functional and effective IT systems, access to rest areas and refreshments, and having the time to take breaks.

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