In Taiwan, physicians face with both civil and criminal liabilities for medical negligence. As medical disputes are increasing, physicians tend to practice defensive medicine and run away from high risk specialties. And Taiwanese society has tried to establish special laws for medical dispute resolution stressing the role of alternative dispute resolution. Taiwan’s Ministry of Health and Welfare (MOHW) started a pilot project encouraging the resolution of birth adverse events in health care institutions since 2012, and in 2014 expanded the scope to surgical and anesthetic adverse event disputes. MOHW offers incentives for both health care providers and patients and their families to reconcile by themselves. Due to the emphasis on not determining whether there is negligence by the pilot project, the general public has doubt about how we can compensate without truth.
The current pilot project in formality requires that the health care provider and the patient and his or her families have reached an agreement or settlement before the government can provide monetary awards. However, one of the exclusion criteria is that the adverse event is completely and obviously attributable to the health care provider’s or the patient’s fault. The task of determining eligibility is left with the adverse event review committee, but the project proclaims the review process does not assess whether there is negligence. It appears that there is no expert evidence in name but to some extent there is in reality.
In terms of the involvement of the administrative branch of government in medical dispute resolution, U.S. relevant authorities only have low degree participation in mediation and arbitration, Taiwanese government provides expert evidence in court proceedings and quasi expert evidence in miscellaneous administrative proceedings, and Mainland China provides expert evidence in all kinds of dispute resolution proceedings irrespective of public or private. Whether providing easily accessible and credible expert witnesses can promote the application of alternative dispute resolution to medical disputes is worth further exploration.