Supreme court acquits Danish doctor in landmark case

Denmark’s Højesteret supreme court on Wednesday acquitted a junior doctor in a negligence case that last year sparked a nationwide support campaign by medical colleagues.

Supreme court acquits Danish doctor in landmark case
Photo: Sonny Munk Carlsen/Ritzau Scanpix

The junior doctor, formerly of Svendborg Hospital, had been convicted of negligence by the Østre Landsret high court following the death of a diabetic patient in 2013 – having initially been found not guilty at a district court.

But the supreme court overturned the guilty verdict on Wednesday.

A campaign by doctors, nurses and several other medical professional groups last year called for the the case to be brought to Denmark’s highest legal authority.

In the campaign online and in Danish media, medics expressed their support for the doctor, citing the potential impact of the conviction on daily practice at hospital wards across the country. 

One of the key issues for doctors involved in the support campaign was the legal sentencing of a colleague for what is generally considered daily practice – namely, giving instructions verbally.

READ ALSO: Danish junior doctors start viral campaign to overturn key ruling against colleague

The campaign carried the hashtag #detkuhaværetmig (‘it could have been me’) and also involved a petition, which gathered thousands of signatures.

Activists also demonstrated at the Ministry of Health in Copenhagen in December.

Doctors involved in the campaign told The Local in October 2017 that normalising legal pursuit over verbal communication would mean that medics could be sued every day – hence the ‘it could have been me’ sentiment of the protest.

The Danish Patient Safety Authority has also been criticised by medical profession representatives for its strict line over the issue.

Danish Medical Association (Lægeforeningen, DMA) chairperson Andreas Rudkjøbing called Wednesday’s verdict “a victory for common sense”.

“The acquittal of the junior doctor in the so-called Svendborg case is a victory for common sense and the only correct outcome of this case, which has been deeply sad,” Rudkjøbing said via a press statement.

“First and foremost for the patient and loved ones of course, but also in its principal significance for the medical professional community,” he added.

The DMA chairperson said that the consequences for medics of a guilty verdict in the case would have been significant.

“We work in a reality in which we must take decisions – sometimes quickly and on an incomplete foundation. We have to act and depend upon each other and colleagues from other disciplines,” he said.

In the verdict, four of the seven judges at the Højesteret court voted to acquit the doctor, finding that her actions could not be defined as grossly negligent or careless, Ritzau reports.

A minority of three judges found that she had acted “against basic medical knowledge,” due in part to a failure to implement a plan for treatment of the patient's diabetes.

The supreme court’s verdict provided final “legal clarity” in the case, Rudkjøbing said.

READ ALSO: 'Blame for tragic case should not be individualised': nurses join Denmark doctors' campaign


Over 2,000 of Denmark’s doctors are foreign professionals

Almost one in five doctors in rural parts of Denmark was trained abroad. The Danish Medical Association has called for more stringent language requirements.

Over 2,000 of Denmark’s doctors are foreign professionals
File photo: Liselotte Sabroe/Ritzau Scanpix

Statistics Denmark (DST) figures show an increase in the number of doctors working in Denmark who qualified abroad, newspaper Jyllands-Posten reported on Friday.

A total of 2,100 foreign-trained doctors working at Danish hospitals and general practices in 2017 represents an increase of 300, or 19 percent, since 2010.

The Danish Medical Association’s chairperson Andreas Rudkjøbing said the figures show the Danish health sector’s increasing need to recruit specialist medics.

“This reflects that it has not been possible to meet our needs with (Danish)-trained doctors, which has thereby made it necessary to fill vacancies with foreign-trained doctors. The Danish health system is completely dependent upon our foreign colleagues,” Rudkjøbing told Jyllands-Posten.

According to the DST analysis, 18 percent of hospital doctors and GPs in rural municipalities were foreign nationals who took their qualifications outside of Denmark. The national average was somewhat lower at 9 percent.

Rudkjøbing said the key consideration is quality of service, rather than the proportion of foreign doctors.

“The gauge is delivery of high quality treatment and high patient safety,” he said.

The most common nationality for the foreign-trained doctors is German (247 doctors) followed by Polish (219), then Iraqi (163), Lithuanian (156) and Russian (109).

The top 10 includes three non-European countries: Afghanistan and Iran in addition to Iraq. Hungary, Romania and Norway complete the top ten.

Current rules require doctors trained outside of Nordic countries and the EU to pass a series of courses in order to be granted authorization to practice medicine in Denmark. These include Danish language tests as well as tests relating to medical knowledge and Danish medical law.

Doctors who studied in the EU or the Nordic region are exempted from these courses and are able to gain authorization largely automatically under EU law, the Danish Patient Safety Authority states on its website.

That means individual employers – the health authorities known as Regions, in the case of public hospitals – are responsible for assessing the linguistic skills of medics before hiring them.

Rudkjøbing told Jyllands-Posten he is in favour of Danish language tests also applying to EU-trained doctors.

“You can end up in a situation in which a doctor is employed without having the necessary linguistic competencies to carry out the role. We have asked the minister for health, and parliament, to tighten the rules so we don’t end in such a situation,” he said.

The Social Democrats, Danish People’s Party and Red Green Alliance – who each represent different parts of the political spectrum – all said prior to June’s general election that they would support such a measure.

READ ALSO: Foreign doctors must meet Danish language standards: minister