Despite efforts spanning 200 years, judges are yet to find a form of words that can explain adequately the meaning of ‘gross’ to a jury trying gross negligence medical manslaughter. Accordingly, those assessing whether to prosecute the crime are equally bewildered unable to calculate the likelihood of conviction. Jurors tasked with determining a defendant’s guilt are faced with a lack of clarity that often fails to render just results. We are led to conclude that an entirely different formula is required for assessing whether a defendant is guilty of manslaughter in the medical context. We propose that, rather than requiring the prosecution to prove that the defendant’s actions were truly, exceptionally bad (as currently required for gross negligence manslaughter), a more appropriate test would be whether there has been a betrayal of trust by the doctor towards his patient, resulting in death. This is akin to breaching a fiduciary duty. Through applying the test to the facts of well-known cases, we argue that the ‘betrayal of trust’ test would be easier for juries, defendants and practitioners to understand. Furthermore, the proposed test avoids the long-standing difficulty of circularity that exists in the current law and is able to separate more effectively the distinction between a doctor’s personal failings and the failings of the system. We conclude that though the ‘betrayal of trust’ test may result in fewer prosecutions, the corresponding impact on the medical profession would ultimately be beneficial to society.

中文翻译：

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医疗过失杀人对信任的背叛

尽管进行了 200 年的努力，但法官们仍未找到一种可以向审理严重过失医疗过失杀人案的陪审团充分解释“严重”含义的词语。因此，那些评估是否起诉犯罪的人同样感到困惑，无法计算定罪的可能性。负责确定被告有罪的陪审员面临着缺乏明确性的问题，这往往无法给出公正的结果。我们得出结论，需要一个完全不同的公式来评估被告在医学背景下是否犯有过失杀人罪。我们建议，与其要求控方证明被告的行为确实非常恶劣（如目前严重过失杀人罪的要求），一个更合适的测试是医生是否背叛了他的病人的信任，导致了死亡。这类似于违反受托责任。通过将测试应用于众所周知的案件事实，我们认为“背叛信任”测试更容易让陪审团、被告和从业人员理解。此外，提议的测试避免了现行法律中长期存在的循环困难，并且能够更有效地区分医生的个人失误和系统的失误。我们得出的结论是，尽管“背叛信任”测试可能会导致更少的起诉，但对医疗行业的相应影响最终将有利于社会。通过将测试应用于众所周知的案件事实，我们认为“背叛信任”测试更容易让陪审团、被告和从业人员理解。此外，提议的测试避免了现行法律中长期存在的循环困难，并且能够更有效地区分医生的个人失误和系统的失误。我们得出的结论是，尽管“背叛信任”测试可能会导致更少的起诉，但对医疗行业的相应影响最终将有利于社会。通过将测试应用于众所周知的案件事实，我们认为“背叛信任”测试更容易让陪审团、被告和从业人员理解。此外，提议的测试避免了现行法律中长期存在的循环困难，并且能够更有效地区分医生的个人失误和系统的失误。我们得出的结论是，尽管“背叛信任”测试可能会导致更少的起诉，但对医疗行业的相应影响最终将有利于社会。提议的测试避免了现行法律中长期存在的循环困难，并且能够更有效地区分医生的个人失误和系统的失误。我们得出的结论是，尽管“背叛信任”测试可能会导致更少的起诉，但对医疗行业的相应影响最终将有利于社会。提议的测试避免了现行法律中长期存在的循环困难，并且能够更有效地区分医生的个人失误和系统的失误。我们得出的结论是，尽管“背叛信任”测试可能会导致更少的起诉，但对医疗行业的相应影响最终将有利于社会。