No-fault patient compensation for medical malpractice in Thailand: option or not?
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Abstract
Thailand and its ASEAN partners, like many countries, employ strategies to provide quality care. They also face challenges from unsafe and negligent care, which may create transactions costs for their healthcare (e.g. defensive medicine) and legal systems (e.g. claims, litigation, and payouts). Like many countries, Thailand adopts traditional and/or nontraditional (e.g. nofault patient compensation system (NFPCS)) tort reforms to limit these costs. Attempts to enact NFPCS usually fail. Thailand failed to enact a NFPCS through its Law on Health Service Affected Person Protection in 2007. To learn why NFPCS adoption efforts fail, the authors conducted a modified scoping review of the literature employing electronic, English keyword-based Arksey and O’Malley and PICOTS search of public (Google, Google Scholar, EBSCO, and Medline) and private (Lexis) databases. Review yielded 105 reviewable NFPCS publications, which revealed 9 countries and 2 U.S states (Florida and Virginia) adopted general (N = 6) or limited (N = 5) NFPCS schemes. After 2000, 5 countries (Canada, England, Ireland, Scotland, and Thailand) and 6 US States (Georgia, Maine, Maryland, Montana, New Hampshire, and Tennessee) attempted and failed. Conditions (e.g. reasons or factors) favoring or disfavoring adoption) included concerns for: (1) fairness of compensation amounts versus judicial awards, (2) excessive NFPCS costs, (3) system-based tort reform preferences, and (4) professional (medical and legal) association resistances. In conclusion, a minority of countries and US states currently maintain successful NFPCSs. NFPCS adoption remains a challenge worldwide, especially if the medical and legal professions oppose adoption.
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