産科医無罪

(Aug. 21, 2008) The Yomiuri Shimbun
Medical safety panels should be set up soon
産科医無罪　医療安全調査委の実現を急げ（8月21日付・読売社説）

How should causes of medical mishaps be determined and how should responsibility be determined? Wednesday's court ruling on an obstetrician who allegedly caused a woman's death following a cesarean section in a sense offered an answer to these questions.
医療事故の原因究明や責任追及は、どのような形で行われるべきか。それにひとつの答えを出した判決とも言えよう。
medical mishaps＝医療事故 cesarean section＝帝王切開の部署

The Fukushima District Court acquitted the obstetrician, who had been arrested and indicted over the death.
福島県立大野病院で帝王切開を受けた女性が死亡し、執刀した産婦人科医が逮捕・起訴された事件で、福島地裁は被告の医師を無罪とした。

The woman died of massive bleeding after undergoing a procedure at the prefecture-run Ono Hospital in Fukushima Prefecture, to remove the placenta attached to her uterine wall. Prosecutors and police charged the doctor with professional negligence resulting in death saying that removing the patient's uterus instead of just the placenta was the standard course of action.
女性は、子宮に癒着した胎盤をはがす処置で大量出血し、亡くなった。検察と警察は、胎盤をはがさずに子宮ごと摘出するのが「医学的準則」だった、として業務上過失致死罪などに問うた。
placenta＝胎盤 uterine＝子宮の

The court said the general medical standard must be a procedure determined by a majority of doctors who face similar incidents, but that there was no proof the Ono Hospital case fell into this category. The court ruling seems to imply criticism of investigators that sought criminal responsibility against the doctor, despite divided medical viewpoints.
しかし判決は、「医学的準則」とは同じ場面に直面した医師のほとんどが選択するものでなければならず、今回のケースはその証明がない、とした。医学的見解が分かれる中で刑事責任を追及した捜査当局への批判が読み取れる。

This incident has had an extremely grave impact on medical circles. After the doctor was arrested, a number of hospitals nationwide stopped obstetrics services and medical students avoided pursuing not only obstetrics but also other fields such as surgery that would entail operations that could risk patients' lives.
事件が医療界に与えた衝撃は極めて大きかった。医師が逮捕された後に、全国で多数の病院が出産の取り扱いを中止した。医学生は産科のみならず、外科など命にかかわる手術を行う分野を避けるようになった。
obstetrics＝産科学 entail＝～を伴なう、～をひきおこす

===

Too quick to judge
（あまりに早急な決断）

First of all, was it necessary to arrest the doctor? We cannot help but be skeptical of this.
そもそも、医師を逮捕までする必要があったのだろうか。疑問を禁じ得ない。

The present ruling was determined by a lower court and the doctor's acquittal has yet to be finalized. But it is a worrying situation that police can so quickly launch investigations into medical mishaps.
まだ１審であり、医師の無罪が確定したわけではない。だが、医療事故に関して、警察がいきなり捜査に入る現状は危うい。
acquittal＝無罪、釈放、放免

It would be better that a neutral and specialized entity first decide whether criminal responsibility should be pursued in each case. The creation of medical safety investigation committees, which the Health, Labor and Welfare Ministry is considering, should be realized as soon as possible.
刑事責任を問うべきほどの事案かどうかは、まず中立的な専門機関で判断した方がいい。厚生労働省が検討中の「医療安全調査委員会」の創設を急ぐべきだ。

The ministry envisages that such committees should be central and regional and that committee members should include not only doctors but also lawyers and experts in other areas, so that neutrality can be maintained.
厚労省の構想では、医療安全調査委は中央と地方ブロックごとに設ける。メンバーは医師だけでなく、法律家や他分野の有識者も加え、中立性を図る。
so that neutrality can be maintained＝中立性を保つために

Under the plan, medical institutions would be obliged to report certain cases--a patient dying in an unexpected way, for example--to the committees. The committees also would accept requests from patients' families to conduct investigations. The committees would make public its reports after giving due consideration to personal information and present recommendations on measures to prevent recurrence.
予期せぬ形で患者が死亡した場合などに、医療機関から調査委への届け出を義務づけ、遺族からの調査依頼も受け付ける。調査委は個人情報に配慮しつつ報告書を公表し、再発防止策を提言する。

===

Deciding what's malicious
（何が重大な過失であるのか？）

The committees would only notify the police regarding malicious cases such as intentional or serious negligence, or falsification of medical records. Police would investigate cases giving respect to judgments made by the committees and taking into account whether the committees have alerted them of the cases.
故意や重大な過失、カルテの改ざんといった悪質な事例のみ、警察に「通知」する。警察は調査委の判断を尊重し、通知の有無を踏まえて対応する。

This plan has already been worked out in detail so that it can quickly be made into a bill. But some in medical circles have said they would oppose the plan as long as it includes the police notification system. The plan has thus been stalled.
調査委構想は法案化目前まで煮詰まってきた。ところが医療界の中に、警察に通知する仕組みがある限り反対するとの声が強く、足踏みしている。

It is a matter of course that malicious cases be notified to police. If the committees do not notify incidents, even though they might possibly be constituted as crimes, there will be no change in the situation in which police directly initiate investigations even if committees are set up.
悪質な事例を通知するのは当然だろう。犯罪の可能性があるのに通知しないのならば、調査委ができたとしても、警察が直接捜査に乗り出す状況は変わるまい。

(From The Yomiuri Shimbun, Aug. 21, 2008)
（2008年8月21日01時51分 読売新聞）