[On an unusual finger injury of a professional musician and its expert testimonial evaluation].
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A physician thinking in the usual diagnostic/therapeutic fashion is faced with numerous pitfalls when presenting expert opinions as a medical advisor in courts of law. The main source of errors in assessment is the lack of understanding of differences and peculiarities of terminology and how health disturbances are rated in the various legal fields. Additionally, there are major problems with different valuations of evidence in the "causative chain" and how to estimate the influence of previous health disturbances. Finally, it is important to avoid formal mistakes in the formulation of expert opinions and to avoid creating confusion in presentation, role conflicts, and conflicts of interest.
The principles of rehabilitation of patients with chronic liver disease are expert opinion, therapy and social care. The questions relevant for clinical practice concerning fitness for work, invalidity, disability certificate and nursing money are explained for patients with liver cirrhosis. In such cases a differentiated expert opinion is recommended taking into consideration activity and portal hypertension. The principles of therapy and social care are discussed. Finally with the help of an analysis of the number of patients in the dispensary of the II. medical clinic of the Charité is demonstrated that only about 50% of all cirrhotics are invalidity pensioners. Nearly 1/3 of all cirrhotics with porto-systemic anastomoses has become capable for work.
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