Personligt ansvar i en patientsäkerhetskultur : Avvägningar i rätten, rättslig förutsebarhet och drabbades behov
(2026)- Abstract
- This thesis clarifies and highlights how selected parts of Swedish law in the field of health care relate to different ways of understanding events that have caused or could have caused patient injury: a systems perspective and an individual perspective, respectively. It thus examines how the law and its application relate to conflicts between supporting openness and learning based on a systems perspective, and professional accountability based on an individual perspective. The approach expressed by the law and its application is evaluated on the basis of legal predictability as a principle of the rule of law. In addition, the thesis highlights what the law’s approach to these perspectives, and the considerations made, imply for the... (More)
- This thesis clarifies and highlights how selected parts of Swedish law in the field of health care relate to different ways of understanding events that have caused or could have caused patient injury: a systems perspective and an individual perspective, respectively. It thus examines how the law and its application relate to conflicts between supporting openness and learning based on a systems perspective, and professional accountability based on an individual perspective. The approach expressed by the law and its application is evaluated on the basis of legal predictability as a principle of the rule of law. In addition, the thesis highlights what the law’s approach to these perspectives, and the considerations made, imply for the ability to meet the needs of persons affected by adverse events in healthcare.The study was conducted using a deconstructive and revealing legal dogmatic method, as well as through an empirical study of healthcare providers' reports of incidents that caused or could have caused serious patient injury, and the Swedish Health and Social Care Inspectorate's handling of these cases.
The thesis concludes that Swedish law gives the impression of wanting to achieve a “just culture” a culture in which boundaries are drawn between errors that are acceptable and those that are not. However, the answers provided by the law on how these boundaries should be drawn are characterised by considerable uncertainty. This lack of clarity stems from the fact that the provisions leave considerable room for subjective interpretation, but also from the fact that the legal answers in some cases send directly contradictory signals. The empirical study shows that healthcare providers have generally embraced the prospective preventive main purpose of investigating more serious incidents. At the same time, healthcare providers may apply different considerations depending on whether they adopt a systems or an individual perspective in their investigations, and it is not clear when or why one perspective is favoured over the other.
The ambition to promote high patient safety based on a systems perspective has led to a gradual and significant limitation of access to justice for patients and their relatives. Patients and relatives affected by adverse events are today largely dependent on the goodwill and capacity of healthcare providers to meet their needs. In particular, the possibility for patients and relatives to hold individuals personally accountable – and thereby obtain a sense of redress – has been limited. (Less) - Abstract (Swedish)
- This thesis clarifies and highlights how selected parts of Swedish law in the field of health care relate to different ways of understanding events that have caused or could have caused patient injury: a systems perspective and an individual perspective, respectively. It thus examines how the law and its application relate to conflicts between supporting openness and learning based on a systems perspective, and professional accountability based on an individual perspective. The approach expressed by the law and its application is evaluated on the basis of legal predictability as a principle of the rule of law. In addition, the thesis highlights what the law’s approach to these perspectives, and the considerations made, imply for the... (More)
- This thesis clarifies and highlights how selected parts of Swedish law in the field of health care relate to different ways of understanding events that have caused or could have caused patient injury: a systems perspective and an individual perspective, respectively. It thus examines how the law and its application relate to conflicts between supporting openness and learning based on a systems perspective, and professional accountability based on an individual perspective. The approach expressed by the law and its application is evaluated on the basis of legal predictability as a principle of the rule of law. In addition, the thesis highlights what the law’s approach to these perspectives, and the considerations made, imply for the ability to meet the needs of persons affected by adverse events in healthcare.The study was conducted using a deconstructive and revealing legal dogmatic method, as well as through an empirical study of healthcare providers' reports of incidents that caused or could have caused serious patient injury, and the Swedish Health and Social Care Inspectorate's handling of these cases.
The thesis concludes that Swedish law gives the impression of wanting to achieve a “just culture” a culture in which boundaries are drawn between errors that are acceptable and those that are not. However, the answers provided by the law on how these boundaries should be drawn are characterised by considerable uncertainty. This lack of clarity stems from the fact that the provisions leave considerable room for subjective interpretation, but also from the fact that the legal answers in some cases send directly contradictory signals. The empirical study shows that healthcare providers have generally embraced the prospective preventive main purpose of investigating more serious incidents. At the same time, healthcare providers may apply different considerations depending on whether they adopt a systems or an individual perspective in their investigations, and it is not clear when or why one perspective is favoured over the other.
The ambition to promote high patient safety based on a systems perspective has led to a gradual and significant limitation of access to justice for patients and their relatives. Patients and relatives affected by adverse events are today largely dependent on the goodwill and capacity of healthcare providers to meet their needs. In particular, the possibility for patients and relatives to hold individuals personally accountable – and thereby obtain a sense of redress – has been limited. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/fc18f5dc-aae0-4fe9-b54b-2fba9aea8f6a
- author
- Åkerman, Sofia LU
- supervisor
- opponent
-
- Associate Professor Zillén, Kavot, Stockholm University
- organization
- publishing date
- 2026
- type
- Thesis
- publication status
- published
- subject
- keywords
- Health law, Hälsorätt
- pages
- 417 pages
- defense location
- Pufendorfsalen, Lilla Gråbrödersgatan 3 C
- defense date
- 2026-02-27 10:15:00
- ISBN
- 978-91-8104-768-4
- 978-91-8104-767-7
- language
- Swedish
- LU publication?
- yes
- id
- fc18f5dc-aae0-4fe9-b54b-2fba9aea8f6a
- date added to LUP
- 2026-01-19 09:36:38
- date last changed
- 2026-01-19 09:36:38
@phdthesis{fc18f5dc-aae0-4fe9-b54b-2fba9aea8f6a,
abstract = {{This thesis clarifies and highlights how selected parts of Swedish law in the field of health care relate to different ways of understanding events that have caused or could have caused patient injury: a systems perspective and an individual perspective, respectively. It thus examines how the law and its application relate to conflicts between supporting openness and learning based on a systems perspective, and professional accountability based on an individual perspective. The approach expressed by the law and its application is evaluated on the basis of legal predictability as a principle of the rule of law. In addition, the thesis highlights what the law’s approach to these perspectives, and the considerations made, imply for the ability to meet the needs of persons affected by adverse events in healthcare.The study was conducted using a deconstructive and revealing legal dogmatic method, as well as through an empirical study of healthcare providers' reports of incidents that caused or could have caused serious patient injury, and the Swedish Health and Social Care Inspectorate's handling of these cases.<br/><br/>The thesis concludes that Swedish law gives the impression of wanting to achieve a “just culture” a culture in which boundaries are drawn between errors that are acceptable and those that are not. However, the answers provided by the law on how these boundaries should be drawn are characterised by considerable uncertainty. This lack of clarity stems from the fact that the provisions leave considerable room for subjective interpretation, but also from the fact that the legal answers in some cases send directly contradictory signals. The empirical study shows that healthcare providers have generally embraced the prospective preventive main purpose of investigating more serious incidents. At the same time, healthcare providers may apply different considerations depending on whether they adopt a systems or an individual perspective in their investigations, and it is not clear when or why one perspective is favoured over the other.<br/><br/>The ambition to promote high patient safety based on a systems perspective has led to a gradual and significant limitation of access to justice for patients and their relatives. Patients and relatives affected by adverse events are today largely dependent on the goodwill and capacity of healthcare providers to meet their needs. In particular, the possibility for patients and relatives to hold individuals personally accountable – and thereby obtain a sense of redress – has been limited.}},
author = {{Åkerman, Sofia}},
isbn = {{978-91-8104-768-4}},
keywords = {{Health law; Hälsorätt}},
language = {{swe}},
school = {{Lund University}},
title = {{Personligt ansvar i en patientsäkerhetskultur : Avvägningar i rätten, rättslig förutsebarhet och drabbades behov}},
url = {{https://lup.lub.lu.se/search/files/239895642/Sofia_kerman.pdf}},
year = {{2026}},
}