[Guidelines in surgery: from the viewpoint of the legal process].
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Biomedical subjects
Publications and source records attributed to K Ulsenheimer.
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Considerable increase of premium for risk-insurance demands now risk management (RM) in German hospitals. RM is more than quality management and has other goals. The method we are using to analyse the risk in hospitals is given in detail. By this way we cover the main groups of potential personal damage of patients and reasons and fundamentals to sue the hospital. There is no total quality management (TQM) in hospitals without RM in the medical field. RM can be successful only with the awareness of medical and nursing staff for risks and liability claims. In our experience there is a lot of potential damages and sources of liability demands even in hospitals which seem to be well managed.
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In the area of medical professional blunder, the medical expert witness is the one participant in a trial whose statement is practically decisive for the court or the prosecutor. Legally, the responsibility remains naturally in the legal hand as the expert witness is only the assistant of the judge. The most important demands on the expert witness are strict objectiveness including towards the colleague, no independent inquiries or interrogations, comprehensive processing of the expert assessment, readiness to revise a written expert assessment according to better knowledge or new facts, independence from the client, no legal comments, clarity of language and intellectual honesty.
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Introductory, basic comments about the medical criminal law in the practice are given. The most important reasons for mistakes are demonstrated, i.e. the term "professional blunder", the individual proof of guilt, mistakes in informing the patient, harming the patient by careless actions. The problem of causality in court is mentioned and the role of the expert witness in professional blunder trials is explained.
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