See inaugural speech of top lawyer Dutch medical association, May 2006.
Johan Legemaate, lawyer of the Royal Dutch Medical Association
receives the Declaration of the IEU-Alliance. July 2006.
The most important message of this inaugural speech by the top lawyer of the Royal Dutch Medical Association KNMG, who represents the interests of the physicians is the following:
Generally physicians do NOT inform the victims of medical errors nor their family about the fact that a medical error has occurred. The insurances of physicians and hospitals do not allow them, for fear of litigation. The medical error is �silenced to death� to the unknowing victims, unless e.g. the wrong leg has been amputated.
Legemaate pleads to delete these clauses from the insurance-policies* and pleads for open disclosure to the patient, to which the physicians in fact are already obliged on the basis of the Law on the Agreement of Medical Treatment ( WGBO).
Legemaate is however silent about the fact that as a consequence of the silence, victims of medical errors do not receive genuine follow-up diagnostics nor remedial medical care. If the physicians , who committed the error, would give adequate remedial medical care it would be the equivalent of informing the victim of the error, who would be able to start legal procedures.
The denial and silence on the medical error implies that the victim is sent away without adequate medical care. Unfortunately it is useless for the innocent victims of a medical error to consult another physician. Than it becomes clear that all physicians cover up, close ranks and send the victim away.
This is the important principle of the medical professional allegiance, which is a national and international phenomenon. It causes that not only the original physician who caused the error is silent, but it involves all other physicians who choose to be silent as well.
The overwhelming silence and cover-up leads to the horror position of a victim of a medical error: no access to adequate medical care! One can wonder whether victims of medical errors are blacklisted as potential litigants and whether those who have dared to challenge physicians and hospitals in court, have been blacklisted….
As Prof. Legemaate justly pleads for open disclosure to the victims, and has acknowledged in public that this has not been the standard approach, the following question arises:
What is the position of the present group of victims of medical errors, the iatrogenic patients?
Will he be willing to change his former advice of non-disclosure to a culture of change and convince his employer the Dutch Medical Physicians Association (KNMG), based on their ethical, legal and professional obligations to provide extra good medical care to those who have been harmed by a medical error?
Recently a prestigious group of Harvard hospitals has adopted this approach**, which was already outlined in a Directive to Veteran Affairs Hospitals by the Veteran Health Administration, october 2005, see above.
Is the Dutch practice part of an international code of silence, as experienced by thousands of patients and their families? Let us hope that the call for open disclosure by Prof. Legemaate will be followed by the development and implementations of international guidelines for full open disclosure and genuine follow up diagnostics and remedial medical care for damaged patients, worldwide.
*research has shown that MEDIRISK the largest Dutch insurer is owned by 74 Dutch hospitals.
This means that the silence about medical errors is imposed by the hospitals themselves!!
**Harvard Consensus When Things Go Wrong: Responding To Adverse Events, Massachusetts Coalition for the Prevention of Medical Errors, March 2006