Kwaliteit van zorg en het recht

Dutch medical disciplinary law aims to promote quality of care. Safety II is a scientific approach to quality promotion that is increasingly being adopted in the Dutch healthcare system. We compared both approaches. Safety II recognises that doctors act based on efficiency-thoroughness trade-offs and identifies factors that lead to success. Disciplinary law answers culpable actions with disciplinary measures. We conclude that for Safety II, the distinction between culpable and inculpable is meaningless, while the disciplinary approach mainly provides a negative warning function. Safety II is better suited for medical practice, because healthcare is complex and benefits from a high degree of discretion. Disciplinary law should therefore be given a role that facilitates more reflection on success factors. The fact that it can take action against doctors who perform poorly does not detract from that: Safety II fulfils this function better because it does not wait for something to go wrong but acts proactively.

Conflict of interest and financial support: none declared.