The Criminal and Delictual Liability of the Medical Practitioner
for Negligence
by Pieter Albert Carstens, submitted in partial fulfilment for
the requirements for the Degree DOCTOR LEGUM in the DEPARTMENT OF
CRIMINAL LAW, FACULTY OF LAW, UNIVERSITY OF PRETORIA, under
the supervision of PROF FFW VAN OOSTEN.
The aim of this thesis was an examination of the criminal and
delictual liability of the medical practitioner for negligence.
The examination was conducted within the framework of the South
African, English, American and German legal systems.
In particular the aim of this thesis was to analize and evaluate
the definition, content, application and test for medical
megligence in criminal law and the law of delict. This analysis
and discussion necessitated an extensive discussion of the proof
of medical negligence. Illustrations of the application of the
negligence criterium in medical practice further necessitated a
discussion and an evaluation of well-established examples/cases
of medical negligence. The question whether the advent of human
rights movements, the increasing legal acknowledgement of the
autonomy of patients, advancements in medical technology,
greater medical specialization and a more consumer-oriented
society have resulted in a shift away from the older
paternalistic medicine to patient autonomy, was also examined.
The most important findings of the examination are, interalia,
that the application in legal practice of the content,
definition and test for medical negligence is effective and
satisfactory. The shift that has taken place with regard to the
traditional role of the medical doctor is in accordance with the
present premise in terms of which the human being has become
"liberated" with legitimate claims to fundamental rights which
are enforceable in terms of bills of rights and constitutions.
Principles of fairness, equality and procedural justice demand that the patient's onus of proving medical negligence be
facilitated by the application of the maxim res ipsa loquitur when the
circumstances and facts justify the application thereof. The
application and evaluation of medical negligence is dependent
upon the mutual trust that should be maintained between the
courts and the medical profession while taking cognizance of the
interests of the patient.
Die Strafregtelike en Deliktuele Aanspreeklikheid van die
Geneesheer op grond van Nalatigheid
deur Pieter Albert Carstens, voorgele ter vervulling van 'n deel
van die vereistes vir die Graad DOCTOR LEGUM in die DEPARTEMENT
STRAFREG, FAKULTEIT REGSGELEERDHEID, UNIVERSITEIT VAN PRETORIA,
onder promotorskap van PROF FFW VAN OOSTEN
Die doel van hierdie proefskrif was 'n ondersoek na die
strafregtelike en deliktuele aanspreeklikheid van die geneesheer
op grond van nalatigheid. Sodanige ondersoek is binne die
raamwerk van die Suid-Afrikaanse, Engelse en Duitse regstelsels
onderneem.
In die besonder was die doel van hierdie proefskrif die
bespreking en evaluasie van die omskrywing, inhoud en toepassing
van, asook die toets vir mediese nalatigheid in die strafreg en
die deliktereg. Dit was ook nodig om die bewys van mediese
nalatigheid indringend te ondersoek. Ter illustrasie van die
toepassing van die nalatigheidskriterium in die mediese praktyk
was dit nodig om geykte gevalle van mediese nalatigheid te
bespreek en te evalueer. Die vraag is ook ondersoek of die
opkoms van menseregtebewegings, toenemende erkenning van
pasiente se outonomie, vooruitgang van mediese tegnologie,
groter mediese spesialisasie en 'n meer verbruikers-georienteerde
samelewing 'n klemverskuiwing weg van die ouer paternalistiese
geneeskunde na pasiente-outonomie tot gevolg gehad het.
Die belangrikste bevindings van die ondersoek is, onder meer, dat
die toepassing in die regspraktyk van die inhoud, omskrywing en
toets vir mediese nalatigheid effektief en bevredigend is. Die
klemverskuiwing wat met betrekking tot die tradisionele rol van
die geneesheer plaasgevind het, is in ooreenstemming met die
heersende uitgangspunt waaarvolgens die mens "vry" geword het en
aanspraak kan maak op fundamentele regte wat ingevolge
menseregte-aktes en grondwette afdwingbaar is. Beginsels van billikheid, gelykheid en prosedurele regverdigheid vereis dat
pasiente se bewyslas by die bewys van mediese nalatigheid
"vergemaklik" word deur die aanwending van die stelreel res ipsa
loquitur waar die omstandighede en die feite van die saak sodanige
toepassing regverdig. Die toepassing en beoordeling van mediese
nalatigheid in die regspraktyk is afhanklik van wedersydse
vertroue tussen die howe en die mediese professie met inagneming
van die belange van die pasient.
