Defensive medicine in the Netherlands: the effects of the legal system of liability on the professional behavior of internists and gynaecologists
PhD student: Mrs S.N.P. Wiznitzer
Promotors: Prof I. Giesen, Mrs Dr R. Rijnhout, Prof E.R. de Jong
Duration: 1/9/2016 - 31/8/2020
PhD defence: Utrecht, 9/7/2021
The research topic concerns the effects of the current legal system of liability on the professional behaviour of physicians. In the United States, a lot of research regarding this topic has already been conducted. The phenomenon of a physician altering his professional behaviour due to fear of legal liability, is referred to as defensive medicine. Defensive medicine is characterized by the fact that the physician bases his professional behaviour primarily on the fear of legal liability, instead of what is in the best interest of the patient. Therefore, defensive medicine causes a threat to the quality of health care. In the Netherlands, little research regarding this topic has been conducted. Given the call for reformations of medical liability law in the Netherlands, research concerning the effects of the current system is crucial. The research project will consist out of two parts. The first part concerns legal-analytical research into the current state of affairs regarding medical liability law in the Netherlands. In this project, a broad scope of liability law will be taken into account: liability according to civil law, criminal law as well as disciplinary law. The results of this part of the project, together with the results of previous research into defensive medicine, will be used to draw up a theoretical model. This model will include the different factors that possibly influence the behaviour of physicians. The second part of the research project entails qualitative empirical research. In our project, we have chosen to focus on two types of physicians: gynaecologists and internists. We made this choice based on, inter alia, several interviews with specialists and the kind of procedures that these types of physicians typically are involved in. Our goal is to conduct semi-structured interviews with 25-30 physicians out of each category. The results of the interviews will be used to further develop the theoretical model.