Doctors in court: palliative care in Sweden

Xavier Symons
3 Aug 2013
Reproduced with Permission

Two Swedish bioethicists have called for law reform to protect palliative care doctors in the Journal of Medical Ethics. Their article comes in the wake of acquittal of an intensivist who was tried for manslaughter. He was "accused of having used high doses of thiopental after having withdrawn life-sustaining treatment when a child was imminently dying." Judges found that there was insufficient evidence to support a charge, and they rejected as inconclusive the report of the medico-legal specialist involved.

The authors, from the Centre for Health Care Ethics and Stockholm University, argue that greater scrutiny of medico-legal reports is needed. They recommend that "a peer review system within forensic medicine be introduced for cases of suspected homicide. Such a system could prevent a prosecutor placing too much weight on a single medico-legal expert's opinion."

The authors also claim that current penal law is a blunt instrument for prosecuting criminal activity in medicine. They make the following suggestion:

"One way to improve the legislative system would, in our opinion, be to add a provision to the 'exceptions' already stated in the Penal Code, from penal liability in cases of self-defence, emergency, consent, etc. This provision should state that an act or an omission within the healthcare system is not a crime if it accords with good clinical practice."

In Sweden in recent years there has been a number of similar cases to the one addressed in the article. The movement for law reform is rapidly gaining support.