Medical Law – Challenges in Bosnia and Herzegovina

There are four types of responsibilities that arise on the basis of medical errors: a) Disciplinary (Punishment of the competent Association for restriction or revocation of the license); b) Civil liability (compensation); c) Criminal responsibility (protection of individual interests to protect the interests of the society); d) Violation (fine for minor damage) To increase the number of criminal proceedings mostly influenced the lack of compensation system for harm because the injured party considered that after the positive completion of criminal proceedings can easily make a claim. Therefore they do not address the local Association or Ministry of Health to investigate a case, but to the criminal proceedings to try to get compensation. It turned out that this is a dispute that is usually long lasting, with an uncertain outcome, which does not bring satisfaction to the plaintiff, and had a series of negative consequences in the general approach to the treatment of patients known as “defensive medicine”. As a result of the increased number of lawsuits due to medical errors are caused the following negative consequences: a) Great vigilance of physicians in communicating with patients, who must sign a 2-3 statements when entering the hospital, and that sometimes are not really familiar with the nature of illness and required treatment; b) Significant increase in the number of unnecessary tests which are required by doctors to insure themselves from the potential liability, which at a given moment are not really necessary; c) Lack of medical error reporting system allows individuals to avoid their reporting, which affects the course of treatment and prognosis; d) Often avoidance by the doctors to perform some necessary procedures that are risky, with increasingly open refusal to cure a poor prognosis case which they left to the next level of treatment. Disappears so called “heroic approach” to the treatment in the B&H health system known from the war period and gives way to extreme caution, because the doctors expect that their every procedure will be under scrutiny; e) All of these factors create a mode known worldwide as “defensive medicine”, which increases the cost of treatment and lower level of health care; f) Reduced volume of education, because older physicians are reluctant to let residents decide on specific work procedures and operations; g) There is already a critical shortage of some medical specialties, and inevitably follows increase in price from these service areas and increase of the waiting list.