The aim of the paper is, firstly, to try to understand the reasons for the different approaches to medical malpractice in two legal systems taken as models: the U.S., where professional negligence is almost exclusively subject of tort law; Italy, where criminal law instruments are instead widely used. The different extent of criminal responsibility for negligence and omission seems connectable to different political and cultural models: individualistic liberalism, on the one hand, solidarist statism and communitarianism, on the other hand; in juridical terms, to the ideal contrast between the reactive State and the active State; to the different approach to the relationship between subject and body, dominical-individual versus collectivist-social; with a tendential "privatization" of the health-good, in the US model, and a "socialization" of the good-health itself, in the Italian model. Secondly, the paper tries, in a comparative perspective, to evaluate these different approaches, in terms of access to justice, paths and outcomes of the two models. The article attempts to highlight the strengths and the weaknesses of the contingent-fee system in the U.S. tort arena, and of the criminal justice system as "free legal aid" in Italy: a balanced solution should also allow victims hindered by the costs and the length of civil actions the possibility of using these latter form of protection, avoiding that criminal justice is exploited for compensatory purposes. Indeed, tort law more easily can meet compensatory claims, due to the lower probative standard required, the preponderance of evidence, rather than the beyond any reasonable doubt standard, required in criminal law. Also in terms of outcomes, the main problems arising in the two systems need to be tackled: the problem of few persons compensated, allowing a greater number of injured parties to access to justice and obtain fair compensation; the problem of symbolic criminal convictions (observed in the Italian experience), avoiding the automatic use of suspended penalties and monetary penalties as substitute of penalties weighing on professional practice and freedom, since these automatic mechanisms limit the preventive effectiveness of the criminal sanction and run the risk of creating discrimination on a census basis.

中文翻译：

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在美国作为医疗侵权行为，在意大利作为犯罪行为：因素，原因，路径和结果

本文的目的是，首先，试图以两种模式的法律体系来理解不同医疗事故处理方法的原因：美国，专业过失几乎完全是侵权法的主体；意大利，刑法文书反而被广泛使用。疏忽和不作为的刑事责任的不同程度似乎与不同的政治和文化模式有关：一方面是个人主义的自由主义，另一方面是团结主义的国家主义和社区主义。从法律上讲，反应国与活跃国之间的理想对比；对主体与身体之间关系的不同处理方式，即个体-个人与集体-社会之间的关系；在美国模式下，对健康商品进行趋势化的“私有化”，然后对“ 刑法要求。同样在结果方面，两个制度中出现的主要问题也需要解决：少数人得到赔偿的问题，使更多的受害方有机会诉诸司法并获得公正的赔偿；象征性刑事定罪的问题（从意大利的经验中可以看出），避免了自动使用暂缓刑罚和金钱刑罚来代替权衡专业实践和自由的刑罚，因为这些自动机制限制了刑事制裁的预防效力并执行根据普查产生歧视的风险。允许更多的受害方诉诸司法并获得公正的赔偿；象征性刑事定罪的问题（从意大利的经验中可以看出），避免了自动使用暂缓刑罚和金钱刑罚来代替对专业执业和自由产生影响的刑罚，因为这些自动机制限制了刑事制裁的预防效力并执行根据普查产生歧视的风险。允许更多的受害方诉诸司法并获得公正的赔偿；象征性刑事定罪的问题（从意大利的经验中可以看出），避免了自动使用暂缓刑罚和金钱刑罚来代替对专业执业和自由产生影响的刑罚，因为这些自动机制限制了刑事制裁的预防效力并执行根据普查产生歧视的风险。