歯科診療にまつわる法律問題

〜紛争予防のためにできること〜

抄録

The number of medical malpractice cases in Japan increased through 2004, then turned to a declining trend, and has been slightly increasing in recent years. When including partial wins, around 20％ of these cases are won by patients.
In dental treatment, negligence is judged when the treatment does not reach the “medical standard of care”. The “medical standard of care” is not a nationwide uniform standard, but is determined in light of “various circumstances” such as the specialty of the doctor （dentist）, the character of the medical institution, and the characteristics of the local healthcare environment.
In civil lawsuits, clinical practice guidelines can be used as evidence without limitation. There is a report that negligence was judged in 2.2％ of the cases that adhered to clinical practice guidelines, and in 47％ of the cases that did not, indicating the significance of clinical practice guidelines in litigations.
Doctors （dentists） need to inform the patient of not only the recommended therapy, but also what alternatives there are, and the possible merits and demerits when followed without treatment. Dental records are important evidence in court and must be fully described.
Doctors and dentists have a duty called “Ousho Gimu.” Under this duty, doctors and dentists should not refuse a patient’s request for medical treatment without reasonable cause, though in recent years new notices have been promulgated by the Ministry of Health, Labour and Welfare.
Looking back at the history of delirium onset by anesthetics, there were many cases in which dentists were involved, further indicating the importance of providing full information and sufficient patient management.