Hizmet kusurundan kaynaklanan hatalı tıbbi uygulama davalarının Danıştay kararları ışığında analizi
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Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İzmir Bakırçay Üniversitesi Lisansüstü Eğitim Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hatalı tıbbi uygulamaya (malpraktise) bağlı açılan davalarda dünya genelinde olduğu gibi ülkemizde de ciddi şekilde artış görülmektedir. Devlet, sunmuş olduğu sağlık hizmetindeki meydana gelen hizmet kusurları nedeniyle yüksek miktarlarda tazminat ödemektedir. Tabii ki ödemiş olduğu bu tazminatı ilgili kamu görevlisine kusuru oranında rücu etmektedir. Sonuç olarak ilgili kamu görevlileri (sağlık çalışanları) cezai yaptırımlarla birlikte, rücu sonucu yüksek miktarlarda tazminat ödemeye mahkum edilmektedir. Çalışmanın konusunu hatalı tıbbi uygulama (malpraktis) iddiasına dayalı tam yargı davalarında, yargılamada nihai karar merci olan Danıştay kararları ışığında malpraktis iddialarının hangi tıbbi branşlarda daha yoğunlukta olduğu, hizmet kusuru olarak nitelendirilen durumlar ve Danıştay'ın bozma nedenleri ve gerekçeleri oluşturmaktadır. Bu sayede, sağlık çalışanlarının hatalı tıbbi uygulama (malpraktis) konusunda farkındalığının arttırılması amaçlanmıştır. Belge inceleme yöntemiyle yürütülen çalışmada, Danıştay'ın hizmet kusurundan kaynaklanan hatalı tıbbi uygulamaya ilişkin 01.01.2010 ile 03.11.2021 tarihleri arasında vermiş olduğu kararlar incelenmiştir. Çalışmada, hasta ya da hasta yakını tarafından şikayet edilen sağlık çalışanlarının çoğunluğunun hekim olduğu, şikayet olunan hekimlerin branşlarının başında kadın hastalıkları ve doğum uzmanları olduğu tespit edilmiştir. Yapılan başvuruların sorumlu tutulan sağlık merkezine göre dağılımında ilk sırada devlet hastanelerinin yer aldığı, sağlık çalışanlarının en çok özensizlik/ilgisizlik nedeniyle şikayet edildiği, hatalı tıbbi uygulama kaynaklı başvuruların %62.1'inde organda fonksiyon azalması/fonksiyon kaybının geliştiği tespit edilmiştir. Ölümle sonuçlanan vakaların hekimlerin uzmanlık alanına göre dağılımında ise yine ilk sırada kadın hastalıkları ve doğum uzmanlarının olduğu, olgularda hatalı uygulanan tıbbi işlemler açısından da cerrahi müdahalenin en yüksek orana sahip olduğu görülmüştür. Kararların incelemesinden idare mahkemelerinin hatalı tıbbi uygulamaya ilişkin açılan davalarda, %71,36 gibi yüksek bir oranda esastan red kararı verdiği sonucuna ulaşılmıştır. Danıştay tarafından hatalı tıbbi uygulamaya ilişkin en fazla kararın 2019 yılında verildiği, konuyla ilgili açılan davaların %43,3 gibi yüksek oranının Danıştay tarafından bir yıl ile iki yıl arasında sonuçlandırıldığı, yine bu davaların %85,5'inin ilk üç yıl içinde karara bağlandığı tespit edilmiştir. Yerel mahkeme kararlarının yarıdan fazlasının Danıştay tarafından bozulduğu ve çoğunlukla bilirkişi raporunun eksik ve yetersiz olması nedeniyle bozma kararı verildiği tespit edilmiştir. Çalışmanın bulgularından vardığımız sonuç, hatalı tıbbi uygulama (malpraktis) iddialarını en aza indirmek için sağlık hizmetlerinin kalitesinin arttırılması, çalışanların iş yükünün azaltılması, hizmet içi eğitimlerle çalışanların eğitim seviyelerinin artırılması ve hatalı tıbbi uygulama, aydınlatılmış onam, vb. konularda farkındalıklarının oluşması/artırılması gerekliliğidir. Ayrıca komplikasyon ve kusur kavramlarının ayrıntılı olarak ele alındığı bir malpraktis yasasına ihtiyaç vardır.
There is a serious increase in cases filed due to faulty medical practice (malpractice) in our country as well as in the world. The state pays high amounts of compensation due to the resultant service defects in the health care it provides. In course, he recourses this compensation paid to the relevant public official in proportion to his fault. As a result, the relevant public officials (health workers) are sentenced to pay high amounts of compensation as a result of recourse, together with penal sanctions. The subject of the study is in which medical branches the faulty medical practice (malpractice) claims are more concentrated in the light of the decisions of the Council of State, which is the final decision authority in the full remedy lawsuits based on the faulty medical practice (malpractice) claims, the cases described as service faults, and the reasons and justifications of the Council of State for reversing. In this way, it is aimed to increase the awareness of healthcare professionals about malpractice. In the study carried out with the document review method, the decisions of the Council of State between 01.01.2010 and 03.11.2021 regarding medical malpractice arising from service failure were examined. According to the study, it has been determined that the majority of the health workers complained by the patient or the patient's relatives are doctors, and gynecologists and obstetricians are at the forefront of the branches of the complained physicians. In the distribution of the applications made according to the health center held responsible, it was determined that the state hospitals took the first place, that the health workers were mostly complained about due to carelessness/indifference, and that 62.1% of the applications due to the faulty medical practice developed a decrease in function/loss of function in the organ. In the distribution of fatal cases according to the field of specialization of physicians, it was seen that gynecology and obstetrics specialists were in the first place, and surgical intervention had the highest rate in terms of medical procedures applied incorrectly in cases. From the examination of the decisions, it has been concluded that the administrative courts have given a high rate of 71.36%, on the merits, in cases filed regarding the faulty medical practice. It has been determined that the highest number of decisions regarding the faulty medical practice were made by the Council of State in 2019, a high rate of 43.3% of the lawsuits filed on the subject were concluded by the Council of State between one year and two years, and it was determined that 85.5% of these cases were resolved within the first three years. It has been determined that more than half of the local court decisions were reversed by the Council of State and the decision to reverse was given mostly due to the incomplete and inadequate expert report. Our conclusion from the findings of the study is that in order to minimize the claims of the faulty medical practice, it is necessary to increase the quality of health services, reduce the workload of the employees, increase the education level of the employees with in-service trainings, and raise/raise awareness on the faulty medical practice, informed consent, and similar issues. In addition, there is a need for a faulty medical practice law in which the concepts of complications and defects are discussed in detail.
There is a serious increase in cases filed due to faulty medical practice (malpractice) in our country as well as in the world. The state pays high amounts of compensation due to the resultant service defects in the health care it provides. In course, he recourses this compensation paid to the relevant public official in proportion to his fault. As a result, the relevant public officials (health workers) are sentenced to pay high amounts of compensation as a result of recourse, together with penal sanctions. The subject of the study is in which medical branches the faulty medical practice (malpractice) claims are more concentrated in the light of the decisions of the Council of State, which is the final decision authority in the full remedy lawsuits based on the faulty medical practice (malpractice) claims, the cases described as service faults, and the reasons and justifications of the Council of State for reversing. In this way, it is aimed to increase the awareness of healthcare professionals about malpractice. In the study carried out with the document review method, the decisions of the Council of State between 01.01.2010 and 03.11.2021 regarding medical malpractice arising from service failure were examined. According to the study, it has been determined that the majority of the health workers complained by the patient or the patient's relatives are doctors, and gynecologists and obstetricians are at the forefront of the branches of the complained physicians. In the distribution of the applications made according to the health center held responsible, it was determined that the state hospitals took the first place, that the health workers were mostly complained about due to carelessness/indifference, and that 62.1% of the applications due to the faulty medical practice developed a decrease in function/loss of function in the organ. In the distribution of fatal cases according to the field of specialization of physicians, it was seen that gynecology and obstetrics specialists were in the first place, and surgical intervention had the highest rate in terms of medical procedures applied incorrectly in cases. From the examination of the decisions, it has been concluded that the administrative courts have given a high rate of 71.36%, on the merits, in cases filed regarding the faulty medical practice. It has been determined that the highest number of decisions regarding the faulty medical practice were made by the Council of State in 2019, a high rate of 43.3% of the lawsuits filed on the subject were concluded by the Council of State between one year and two years, and it was determined that 85.5% of these cases were resolved within the first three years. It has been determined that more than half of the local court decisions were reversed by the Council of State and the decision to reverse was given mostly due to the incomplete and inadequate expert report. Our conclusion from the findings of the study is that in order to minimize the claims of the faulty medical practice, it is necessary to increase the quality of health services, reduce the workload of the employees, increase the education level of the employees with in-service trainings, and raise/raise awareness on the faulty medical practice, informed consent, and similar issues. In addition, there is a need for a faulty medical practice law in which the concepts of complications and defects are discussed in detail.
Açıklama
Anahtar Kelimeler
Hukuk, Law
