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Wednesday, May 4, 2016

Where can Chinese military hospitals be sued?

Protest at a civilian hospital
Since the 1980s, Chinese military hospitals have been seeking out civilian patients as a way to generate additional funds. At the military hospital highlighted in this (English language) media report, less than 1 in ten patients were military personnel.

Military hospitals have come under the international spotlight this week (see this report) because of the international uproar over the death of a college student who received inaccurate medical information from China's Baidu search engine, leading him to seek a type of immunotherapy from the Second Hospital of the Beijing Armed Police Corps. The student's cancer is generally treated with surgery and chemotherapy.

This is not the first time that patient care has gone wrong at a military hospital things, for some reasons identified in academic papers:
  • poor medical ethics; 
  • apathy and a sense of irresponsibility on the part of medical personnel; 
  • corruption; 
  • failure to comply with medical guidelines; 
  • failure to provide explanations to patients. 
This media report highlights the fact that some military hospitals have contracted out clinics or departments to private companies.

But what happens when those civilian patients believe they have been the victims of malpractice? Sometimes they protest and sometimes they go to court.

Malpractice mobs in the military hospitals

In China, frustration and anger with medical treatment and the medical system leads patients and their families to protest, or attack medical staff, as described in The New Yorker, in media reports, and in a landmark study by Columbia Law School Professor Benjamin Liebman. Although this study by a team of doctors in a Beijing civilian hospitals in English noted that no violent event has ever been reported in Chinese military hospitals, academic articles from those in the military medical system in various parts of China, east, west, north, south, suggesting otherwise, describing a high incidence of medical protests.

Suing military hospitals

According to data released by China's Supreme People's Court (SPC) in March, over 23,000 medical malpractice cases were brought in the Chinese courts in 2015. No separate statistics exist on how many of those cases were brought against military hospitals.

Under 2012 regulations of China's Supreme People's Court (SPC) (legal know-how services have an English translation), civilians can sue military hospitals in the civilian courts (an overview of the law on the subject seen here), despite the weakness of Chinese law on the subject, described here. and some have, with legal databases reporting on some of those cases:
  • 2012 (successful) case against a military hospital in Hangzhou;
  • 2009 (successful) case against a People's Armed Police hospital in Chongqing;
  • 2016 (unsuccessful) case against a military hospital in Shenyang;
  • 2015 (unsuccessful) case against a People's Armed Police hospital in Beijing;
  • 2014 (successful) case against a military hospital in Xinjiang.
What do PLA reforms mean for civilian patients at Chinese military hospitals (and malpractice litigation against them)? According to the media report cited above, a spokesman for China's Ministry of Defense said that military hospitals and other medical institutions would continue to provide medical services to civilians, but that “a new model” would be explored that could see military hospitals integrated more into the national health care system, under the auspices of China’s National Health and Family Planning Commission (NHFPC). So it is likely that we will see more malpractice litigation against Chinese military hospitals in the future, even if rarely reported outside of China.

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