The number of doctors charged with manslaughter in the UK has risen substantially since the 1990s, a study has shown.
But the review, in the Journal of the Royal Society of Medicine, found the rate of conviction remains low.
Birmingham City Hospital researchers examined cases found 85 doctors had been charged with manslaughter since 1795, 38 of them since 1990.
They said the rise in charging was due to "vengeance and retribution".
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The earliest case discovered by the team involved a Dr Raeburn who was charged with manslaughter in 1831 following the death of a woman after childbirth.
There was a surge in the number of cases seen in the mid-19th century, the majority linked to obstetrics, which researchers say is probably due to the increased medicalisation of childbirth at that time.
Twentieth century cases tended to involve drugs, probably because of the introduction of more powerful - and therefore more dangerous - medications.
'Emotionally satisfying'
Over the 200 years studied by the researchers, 60 doctors have been acquitted compared to 22 recorded convictions and three guilty pleas.
In 37 of the cases, doctors were charged with manslaughter as a consequence of mistakes in planning a procedure - 10 were convicted.
Another 17 cases involved errors caused by being distracted, or having a lapse in concentration. Four of these doctors were convicted.
"It is difficult to see how bringing manslaughter charges against an individual doctor rather than investigating and resolving the underlying system failures that led to death is helpful"
Sixteen cases were deemed to involve a "deliberate deviation from safe practices". Ten of these doctors were convicted.
In the remaining cases, which involved 12 doctors, there was insufficient information to classify the case.
Dr Robin Ferner, who led the study, said: "The number of doctors charged with manslaughter has risen steeply since the beginning of the 1990s.
"However, the rate of conviction remains low.
"The evidence suggests that doctors are being charged for reasons of vengeance or retribution rather than to protect patients.
"Charging doctors with manslaughter following a medical error may be an emotionally satisfying way to exact retribution, but if individual doctors are singled out for punishment it will become much harder to foster an open culture."
Greater complexities
Dr Ferner added: "In the case of doctor error there are two choices; either we continue to perpetuate the myth of perfection or we examine the systems in which they work.
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"Threats or fears of prosecution do not result in better health systems.
"Rather, they lead to cover up where faults remain hidden and more patients die."
Ian Barker, a solicitor with the Medical Defence Union, which provides medico-legal assistance to doctors, says the study echoes the MDU's experience.
"We have seen an increase in investigations in the past few years, but many more doctors are investigated for manslaughter than are prosecuted and even fewer are convicted.
"One of the reasons for this is that there are greater complexities involved in cases where there has been a medical accident than in ordinary manslaughter cases, for example the actual cause of the death.
"Many cases involve system failures as well as individual error.
"In such cases, it is difficult to see how bringing manslaughter charges against an individual doctor rather than investigating and resolving the underlying system failures that led to death is helpful."
He said being involved in a manslaughter investigation could be extremely traumatic for the doctor involved, and called for a recognition that medics carry out dangerous procedures and use powerful drugs on people who are sometimes extremely ill.
A spokeswoman for the Patients Association said such cases, whether they involved individual doctors or wider NHS failures, were rare.
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