Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Tıbbi Malpraktis Kavramının Bazı Gelişmişlik Göstergeleri Üzerinden Değerlendirilmesi: Korelasyonel Çalışma
Evaluation of Medical Malpractice in Regard to Various Development Indicators: A Correlational Study
Samet GÜLMEZa , Fatma YÜCEL BEYAZTAŞb , Esra GÜLTÜRKc , Celal BÜTÜNb , Ali YILDIRIMb
aSivas Numune Hastanesi, Adli Tıp Kliniği, Sivas, Türkiye
bSivas Cumhuriyet Üniversitesi Tıp Fakültesi, Adli Tıp ABD, Sivas, Türkiye
cSivas Cumhuriyet Üniversitesi Tıp Fakültesi, Biyoistatistik ABD, Sivas, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2023;20(2):105-14
doi: 10.5336/forensic.2023-95727
Article Language: TR
Full Text
ÖZET
Amaç: Tıbbi malpraktis kavramı çok eski çağlardan beri biliniyor olmasına rağmen XIX ve XX. yüzyıllarda gerçekleşen mesleki, hukuki, sosyal ve ekonomik değişimler sonucu modern hâline kavuşmuş ve sonrasında, hekimliğin riskli doğası nedeniyle çeşitli ülkelerde tıp hukuku ayrıca değerlendirilmeye, buna yönelik yasalar çıkartılmaya başlanmıştır. Çalışmamızda çeşitli ülkelere ait hekimlere karşı oluşturulan şikâyet ve tıbbi malpraktis olgu sayıları ile bazı sağlık, hukuk ve ekonomik gelişmişlik göstergeleri arasındaki ilişkinin tespiti hedeflenmiştir. Gereç ve Yöntemler: Tıbbi malpraktis istatistiklerine internet üzerinden ulaşılabilen Almanya, Kaliforniya, Danimarka, Meksika ve Norveç'e ait veriler bu ülkelerin hekim başına düşen nüfusları, kişi başı sağlık harcamaları, Hukukun Üstünlüğü Endeksleri ve İnsani Gelişim Endeksleri bağlamında değerlendirilmiştir. Bulgular: Toplam şikâyet ve tıbbi malpraktis olgu sayılarında hekimlerin payı sırasıyla Almanya'da %86/%77, Danimarka'da %89/%81, Meksika'da %90/%97 olarak bulunmuştur. Hekimlere yönelik şikâyetlerin tıbbi malpraktis olarak neticelenme oranları ise Almanya'da %24, Kaliforniya'da %28, Danimarka'da %23, Meksika'da %12, Norveç'te %29 olarak bulunmuştur. Ülkelere ait tıbbi malpraktis iddia ve olgu sayılarının, İnsani Gelişme Endeksi ile pozitif yönde güçlü derecede, Hukukun Üstünlüğü Endeksi ile ise pozitif yönde çok güçlü derecede korele olduğu; iddiaların tıbbi malpraktis olarak neticelenmesi oranının ise insani gelişme ve Hukukun Üstünlüğü Endeksleri ile pozitif yönde güçlü derecede korele olduğu tespit edilmiştir. Sonuç: Gelişmekte olan ülkeler başta olmak üzere tüm dünyada tıbbi malpraktis konusunun öneminin yadsınamaz bir gerçek olmasından hareketle; tıbbi, hukuki, bürokratik ve toplumsal açılardan objektif bakış ile çözüm yolları aranması ve konuya yönelik önleyici tedbirlerin alınması gerekmektedir.

Anahtar Kelimeler: Mesleki sorumluluk; tıbbi malpraktis; gelişmişlik göstergeleri; adli tıp
ABSTRACT
Objective: Although medical malpractice has been known since ancient times, reached its modern status as result of professional, legal, social and economic changes that took place in the 19th and 20th centuries. Due to the risky nature of medicine, medical law has been started to evaluate separately and special laws have been enacted. In our study, it was aimed to determine the relationship between the number of medical malpractice allegations/cases and several healthcare, judicial and economic development indicators. Material and Methods: Data for Germany, California, Denmark, Mexico and Norway, whose medical malpractice statistics are available online, were evaluated according to population per physician, per capita health expenditure, Rule of Law and Human Development indices. Results: The share of physicians in the total number of complaints and medical malpractice cases was found 86%/77% in Germany, 89%/81% in Denmark, and 90%/97% in Mexico, respectively. The ratio of medical malpractice cases to complaints against physicians was found 24% in Germany, 28% in California, 23% in Denmark, 12% in Mexico, and 29% in Norway. The number of claims and cases of were found strongly positive correlated with the Human Development Index, and very strongly positive correlated with the Rule of Law Index. The ratio of medical malpractice/complaints against physicians was found strongly positive correlated with the rule of law and the human development indices. Conclusion: Based on the importance of the issue especially in developing countries; solutions should be sought with an objective view from medical, legal, bureaucratic and social perspectives and preventive measures should be taken.

Keywords: Professional responsibility; medical malpractice; development indicators; forensic medicine
REFERENCES:
  1. Berlin L. Medical errors, malpractice, and defensive medicine: an ill-fated triad. Diagnosis (Berl). 2017;4(3):133-9. [Crossref]  [PubMed] 
  2. Mehlman MJ. Professional power and the standard of care in medicine. Ariz St L J 2012;44:1166-235. [Link] 
  3. Hellín T. The physician-patient relationship: recent developments and changes. Haemophilia. 2002;8(3):450-4. [Crossref]  [PubMed] 
  4. Ferrara SD, Boscolo-Berto R, Viel G. Malpractice and Medical Liability European State of the Art and Guidelines. 1st ed. Berlin, Heidelberg: Springer; 2013. [Crossref] 
  5. McClellan FM, White AA 3rd, Jimenez RL, Fahmy S. Do poor people sue doctors more frequently? Confronting unconscious bias and the role of cultural competency. Clin Orthop Relat Res. 2012;470(5):1393-7. [Crossref]  [PubMed]  [PMC] 
  6. Der Medizinische Dienst Bund [Internet]. [Cited: January 21, 2023]. Behandlungsfehler. Available from: [Link] 
  7. U.S. Department of Health & Human Services, National Practitioner Data Bank [Internet]. [Cited: December 12, 2022]. Data analysis tool. Available from: [Link] 
  8. The Medical Board of California, Resources, Annual Reports [Internet]. © 2023 State of California [Cited: January 19, 2023]. Available from: [Link] 
  9. Styrelsen for Patientklager [Internet]. [Cited: January 21, 2023]. Statistik Tidligere statistiske oplysninger, Statistiske oplysninger om patientklager. Available from: [Link] 
  10. Comisión Nacional de Arbitraje Médico [Internet]. [Cited: November 14, 2022]. Información Estadística, Información anual institucional (tabulados seleccionados). Available from: [Link] 
  11. FLÅTE Sølvi, Medical Specialty and Decisions 2013-2019 in NPE, sfl@npe.no (20.04.2021), sametgulmez@cumhuriyet.edu.tr (20.04.2021).
  12. Norsk pasientskade-erstatning [Internet]. [Cited: March 10, 2022]. Statistikk. Available from: [Link] 
  13. The World Justice Project [Internet]. © World Justice Project 2008-2019 [Cited: January 21, 2023]. Publications: Rule of Law Index Reports. Available from: [Link] 
  14. Statistisches Bundesamt, Genesis-Online [Internet]. © 2022 [Cited: January 24, 2022]. 12411-0006: Population: Germany, reference date, age,nationality/sex/marital status. Available from: [Link] 
  15. The United States Census Bureau [Internet]. [Cited: January 24, 2022]. Explore Census Data, Populations and People, California. Available from: [Link] 
  16. Statistics Denmark [Internet]. [Cited: January 24, 2022]. FOLK2: Population 1. January by sex, age, ancestry, country of origin and citizenship. Available from: [Link] 
  17. OECD Statistics [Internet]. © OECD 2022 [Cited: January 24, 2022]. Demography and Population, Population Statistics, Historical population data. Available from: [Link] 
  18. Statistics Norway [Internet]. [Cited: January 24, 2022]. Population. Available from: [Link] 
  19. Bundesärztekammer [Internet]. [Cited: January 24, 2022]. Ärztestatistik der Vorjahre. Available from: [Link] 
  20. Association of American Medical Colleges, Data & Reports [Internet]. © 2022 AAMC [Cited: January 24, 2022]. Physician specialty data report. Available from: [Link] 
  21. Laegeprognose 2018-2040 Udbuddet af laeger og speciallaeger. København: Sundhedsstyrelsen; 2019. [Link] 
  22. Nordic Medico-Statistical Committee, Nordic Health & Welfare Statistics [Internet]. [Cited: January 21, 2023]. Health statistics for the nordic countries. Available from: [Link] 
  23. OECD Statistics [Internet]. © OECD 2022 [Cited: January 24, 2022]. Health, Health Care Resources. Available from: [Link] 
  24. Gobierno de México, Datos Abiertos, Recursos de Salud, Nivel Central. (25.05.2023 tarihinde erişilmiştir). [Link] 
  25. Heinze-Martin G, Olmedo-Canchola VH, Bazán-Miranda G, Bernard-Fuentes NA, Guízar-Sánchez DP. Los médicos especialistas en México. Gac Med Mex. 2018;154(3):342-51. [Crossref]  [PubMed] 
  26. Den norske legeforening [Internet]. © 2022 Legeforeningen [Cited: January 24, 2022]. Legestatistikk, Yrkesaktive leger i Norge. Available from: [Link] 
  27. World Health Organization [Internet]. © WHO 2014 [Cited: January 24, 2022]. Available from: Global Health Expenditure database. [Link] 
  28. United Nations Development Programme, Human Development Reports, Global Human Development Indicators. (24.01.2022 tarihinde erişilmiştir). [Link] 
  29. The Global Data Lab, Subnational Human Development Index. (24.01.2022 tarihinde erişilmiştir). [Link] 
  30. Mullis J. Medical malpractice, social structure, and social control. Sociological Forum. 1995;10(1):135-63. [Crossref] 
  31. Algan B. İstanbul'da Yapılan Adli Otopsilerin Malpraktis Açısından İrdelenmesi. Tıpta Uzmanlık Tezi, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Adli Tıp Anabilim Dalı, İstanbul, 2012. s.87.
  32. Huycke LI, Huycke MM. Characteristics of potential plaintiffs in malpractice litigation. Ann Intern Med 1994;120(9):792-8. [Crossref]  [PubMed] 
  33. Moore PJ, Adler NE, Robertson PA. Medical malpractice: the effect of doctor-patient relations on medical patient perceptions and malpractice intentions. West J Med. 2000;173(4):244-50. [Crossref]  [PubMed]  [PMC] 
  34. Mello MM, Hemenway D. Medical malpractice as an epidemiological problem. Soc Sci Med. 2004;59(1):39-46 [Crossref]  [PubMed] 
  35. de Macêdo Filho LJM, Aragão ACA, Moura IA, Olivier LB, Albuquerque LAF. Malpractice and socioeconomic aspects in neurosurgery: a developing-country reality. Neurosurg Focus. 2020;49(5):E13. [Crossref]  [PubMed] 

.: Up To Date

Login



Contact


Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com