I work in a large hospital, and sometimes there are “unfavorable outcomes”, which in hospital-speak translates as a death or life changing mistake. When we have an unfavorable outcome families typically gather in front of the administration offices and battle with the hospital’s security guards (we have a whole police office). These skirmishes have become increasingly common in China, and I’ve written about such an instance before (A fight at the hospital – Abortion in China), but it is a topic that deserves further discussion.
Let’s start with a recent example; a patient committed suicide by jumping out of his hospital room window as a result of being dissatisfied with his treatment, either because his disease was incurable, the pain was intolerable, or the bill was unaffordable (each person seemed to have heard something slightly different). The next day his family attempted to storm the offices of the hospital administrators in an effort to get compensation. This means literally forming an angry mob, and attempting to rush past the front desk and occupy someone’s office. Usually the police arrive first, and a brief brawl transpires. It can be pretty scary.
Something like this happens here about every 4-6 weeks, and each time I feel incredibly torn. These people are clearly in great emotional pain, but it is often unclear if there was actually any malpractice on the part of the hospital.
From talking with many of the administrators about these “events”, which isn’t easy, it seems that there is a single major underlying problem; the legal system would almost always favor the state-funded hospital, so lawsuits are rarely considered, and these violent mobs become the only viable way of seeking compensation. After the suicide, the patient’s family was seeking 100,000RMB in damage because the hospital did not stop him from killing himself (co-worker’s words, not mine, it is possible that the hospital was in someway at fault). This case would almost certainly be thrown out by the courts, but the angry mob approach may earn them some compensation. Occasionally these mobs are successful, which further encourages copycats.
Normally I would be tempted to side with the patients, they are disempowered by China’s flawed legal system. After one of my close friends was accused of malpractice, I realized just how difficult these cases can be. He is a well trained surgeon with years of experience, but one high risk operation did result in a patient losing vision in one eye. For the next week he could not come to work, out of fear that this family may try injure or even kill him. The doctor was completely devastated by the result of the surgery, as he had once prided himself on being the best in the department. It was a complication beyond his control, but he had no way of clearing his name.
With the current system there is no justice for the patients or the doctors. Without an impartial referee there is no real way to establish whether or not this was a case of malpractice, or something that happened as part of the normal risk of treatment. Doctors honestly dread giving bad news to patients, because it could be a matter of life and death for both parties (I’m embarrassed to say that at another large hospital, one oncologist writes patients’ diagnoses in English so they can’t lash out at him). At the same time patients worry that doctors are prescribing unnecessary medications (a topic that will be more completely addressed later) and treatments simply in an effort to increase their own profits (doctor pay is relatively low in China).
Without the law, there is no trust between the parties, and everyone suffers. Hopefully a more transparent system will be created so that China’s clinical gains in medicine are not overshadowed by patient experiences which leave family members contemplating violence as a first choice.