Concept of a physician's standard of care and its role in applying the physician's civil liability in Lithuania and other countries

Straipsnyje lyginamuoju aspektu analizuojama gydytojo veiksmų standarto reikšmė sprendžiant gydytojo veiksmų neteisėtumą. Gydytojo veiksmų standartas yra kompleksinis teisės institutas, apimantis teisės, gydytojo etikos, pripažintos medicinos praktikos reikalavimus. Pagrindinis šio instituto nustatyti rūpestingo, sąžiningo, patyrusio ir kvalifikuoto gydytojo elgesio modelį tam tikroje konkrečioje situacijoje. Straipsnyje nagrinėjama šio teisės instituto raida bendrosios teisės sistemos ir civilinės sistemos valstybėse, teismų praktika. Straipsnio autorius taip pat pateikia gydytojo veiksmų standarto taikymo teisės praktikoje pasiūlymų.A patient claiming against doctor usually has little difficulty in establishing that the doctor owes him a duty of care, but the same cannot be said about establishing that the medical practitioner has breached that duty of care by acting in such a manner as to have fallen below the standard of medical care prescribed by law. There is widespread agreement among the most jurisdictions on the standard of care owed by physicians, where the obligation owed is not to produce a result, but to apply conscientious effort, that which a reasonably competent physician would provide under circumstances. The expected skill is higher for specialists, but it is that of a reasonably competent physician professing that speciality. Those who undertake work calling for special skill must not only exercise reasonable care, but measure up to the standard of proficiency that is expected from persons of such profession and speciality. Moreover, the duty to exercise due care and skill is implied in every contract for medical services, so that the standard will be the same whether the basic theory of recovery is tort or contract. The standard is one set in the first instance by the medical profession, thus in most cases where a claim is made that a physician failed to exercise due care, the expert opinion of a professional will be required to prove the standard and its breach. But it is clear that the ultimate responsibility for determining the applicable standard in civil liability (and in criminal too) lies with the court as the standard of care is question of law. It should be mentioned, that the standard of care is an objective standard which does not take account of the subjective attributes of the particular defendant. It would not be inaccurate to say that as a result of a review of law and legal practice, it will become apparent that along with the difficulties of establishing causation, breach of duty or wrongfulness (falling below the required standard of care) is the main stumbling block for the plaintiff and the main protector of the defendant doctor