Elaine Gibson, ‘Is it Time to Adopt a No-Fault Scheme to Compensate Injured Patients?’

The tort system is roundly indicted for its inadequacies in providing compensation in response to injury. More egregious is its response to injuries incurred due to negligence in the provision of healthcare services in specific. Despite numerous calls for reform, tort-based compensation has persisted as the norm to date. However, recent developments regarding physician malpractice lead to consideration of the possibility of a move to ‘no-fault’ compensation for healthcare-related injuries. In this presentation I will explore these developments, examine programs in various foreign jurisdictions which have adopted ‘no-fault’ compensation for medical injury, and discuss the wisdom and feasibility of adopting an administratively-based compensation system for healthcare-related injury in Canada.

A number of jurisdictions around the world have created administrative bodies whose role is to assess and allocate appropriate compensation in response to healthcare-related injuries. The primary motivation has been either to accomplish greater justice or to deal with burgeoning costs of the medical malpractice system (often accompanied by threatened collapse of the major insurer). The administrative scheme adopted may replace tort completely vis-a-vis claims within its purview, or it may permit the claimant to select either to pursue the administrative route or to launch a civil lawsuit. The scheme may be comprehensive, i.e., attempting to cover all healthcare-related injury, or may be limited to a particular type or extent of injury. For example, three jurisdictions have adopted programs exclusively focused on serious neurological injury surrounding birth trauma.

Under these administrative schemes, an injured claimant must establish that she/he fits within the program criteria and therefore is entitled to compensation. The claimant is aided in the process by program administrative staff, and often by her/his health care provider. Thus, the adversarial relationship between plaintiff and defendant is replaced by a system wherein the care provider may provide assistance to the injured person in seeking compensation. Numerous prominent individuals have argued in favour of reform of the Canadian tort-based medical malpractice, but governments have not been highly motivated to take action. However, the Canadian Medical Protective Association has recently sharply hiked the premiums paid for the defence of physicians and residents, in some cases an increase of close to 100 per cent from 2014-15 to 2015-16. The lion’s share of these premiums is funded by provincial governments, whose budgets are straining as a result. The question to be addressed in this presentation is: Are events now such that governments will indeed by motivated to take on reform, perhaps radical reform? These recent price increases, combined with an enhanced focus on patient safety, may provide the stimulus for revision of our system’s response to healthcare related injury.

Gibson, Elaine, Is it Time to Adopt a No-Fault Scheme to Compensate Injured Patients? (March 7, 2016). Ottawa Law Review, forthcoming.

First posted 2016-03-10 13:12:43

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