Die strafregtelike en deliktuele aanspreeklikheid van die geneesheer op grond van nalatigheid

Abstract

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.