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PubMed2004

[Legal responsibility in the exercising of the neurology clinical practice].

The importance of responsibility in the clinical practice is derived from the transcendency of what they affect (life and health) and the risk implicit to it. The clinical performance does not require curing. The obligations that are derived from them are means and not results. It is also not correct to associate error and responsibility. Responsibility of the professional may be claimed by civil, patrimony, corporative, disciplinary and penal routes based on the reasons and according to who is making the claim. These claims may be presented individually or jointly based on whether the modality of the professional practice is free or carried out by others, whether in public health or private health care. The professional has different alternatives to respond to the possible lawsuits that are presented, both penal and civil action or protection have the common problem of the difficulty of proof.

Humans↗
PubMed2006

Crisis!

Explore the source record for details and available documents.

American Medical Association↗
PubMed2006

Physician accountability, patient safety and patient compensation.

In Canada, the response to adverse medical events follows one or more of three main paths: patient safety, physician accountability and patient compensation. While their goals differ, each of these responses serves a valuable function. There are however competing imperatives inherent in each response, particularly in terms of information disclosure: Effective patient safety depends on the full and protected disclosure of all information relevant to an adverse event and requires a "no blame" environment. While natural justice demands that a physician be held accountable for his actions, the doctor should be accorded the right of due process and be judged against an established standard of care. This is necessarily a fault-finding activity. Patient compensation meets both accountability demands and the social justice imperatives of supporting a patient injured through physician negligence. The most effective approach is one that achieves balance between competing imperatives. With clear information disclosure rules, patient safety, physician accountability and patient compensation can operate synergistically.

Canada↗
PubMed1992

Medical staff privileges and the antitrust laws: does the Intracorporate Conspiracy Doctrine apply?

The occasional imposition of antitrust liability on medical staff members for actions involving peer review is not a sufficient reason to abandon medical staff participation in the peer review process. This article reviews some of the case law in which the applicability of the intracorporate conspiracy doctrine to medical staff peer review activity has been decided and explains why appropriate medical staff involvement in such activity does not raise the risk of antitrust liability.

Antitrust Laws↗
PubMed2003

Patient safety and medical malpractice: a case study.

The system of tort liability for medical malpractice is frequently criticized for poorly performing its theoretical functions of compensating injured patients, deterring negligence, and dispensing corrective justice. Working from an actual malpractice case involving serious injury but no apparent negligence, the authors explore these criticisms from the perspectives of both the plaintiff-patient and the defendant-physician. They then examine the tort system through the lens of patient safety and conclude that the tensions between the system and patient safety initiatives suggest a need to reexamine our attachment to adversarial dispute resolution in health care. They propose targeted reforms that could improve the functioning of the system and create incentives to improve safety and quality.

Female↗
PubMed2002

[In-flight medical emergencies. American and European viewpoints on the duties of health care personnel].

Today almost 2 billion passengers fly commercially each year--and the number is increasing. Different investigations indicate one medical event per 33,600-50,000 passengers, corresponding to 33-22 events daily. The events seem to increase, which can be explained by an increasing number of elderly passengers over longer distances. Most events are not serious. Among serious events, cardiac (46 per cent), neurological (18 per cent) and respiratory (6 per cent) dominate. 13 per cent of all acute events result in a diversion--an unscheduled landing. Airline companies have the right to refuse passengers to which flying means an increased health risk. A person, capable of walking 50 metres on level ground or up one flight of stairs without experiencing severe shortness of breath or chest pain, can be considered "fit for flight". Assisting medical personnel should ask for an airline company "Liability Form--Medical Assistance" or "Doctor's Waiver". Most (western?) airline companies have first aid kits and emergency drugs on board. An increasing number of airline companies have around-the-clock direct connection to ground based medical assistance. This competence within emergency and aviation medicine should be recognised by medical professionals on board. The decision to carry out a diversion is always made by the captain, and the cabin crew is responsible for the ill. Medical professionals can and should assist the cabin crew in their care for ill passengers on board. We also have unique possibilities to inform our patients in advance, whenever flying means an increased health risk.

Aerospace Medicine↗
PubMed2003

Liability in relation to the use of professional medical guidelines.

The author discusses the concept of professional guidelines in medicine and their relationship to potential malpractice accusations. He cites a case of omission to give a patient prophylactic medicine against post-operative thrombosis, as previously recommended in a clinical guideline. This paper develops the discussion of the problems of professional autonomy in the light of standards of medical care being increasingly governed by clinical guidelines. The question of legal liability of medical practitioners in these situations is explored.

Anticoagulants↗
PubMed2003

Postmarketing surveillance of abuse liability of sibutramine.

The abuse liability of medications is a growing concern as the number of newly approved psychoactive medications increases. Postmarketing surveillance can assist in determining abuse liability, but strategies are not well-defined for medications believed to be at low abuse risk. Using a newly approved medication (sibutramine--an anorectic drug), a novel approach to postmarketing abuse surveillance was introduced. A one-page anonymous questionnaire covering sibutramine, a scheduled anorectic drug (phentermine), and a fabricated name was added to the intake process of 58 treatment programs. From the 8780 completed questionnaires, 8.8% had heard of sibutramine and phentermine. For continued use to get high (a proxy for abuse), the rate for sibutramine was lower than for phentermine (0.6 vs. 2.2%, McNemar's chi(2) = 110.45, P < 0.001) but was higher than for the fabricated name (0.6 vs. 0.3%, McNemar's chi(2) = 11.86, P < 0.001). These results suggest the risk of abuse associated with sibutramine was lower than that associated with a known abused drug, one that itself is considered low risk despite decades of population exposure. The relatively high rate of hearing of sibutramine may be due to the direct-to-consumer advertisement. This approach is only one indicator in a surveillance framework but appears promising and validates findings from laboratory-based abuse liability studies that also indicate low abuse liability for sibutramine.

Adult↗
PubMed1975

Liability and compensation independent of medical negligence: the new Swedish system.

On the 1st of January 1975 a new system of Treatment Injury Insurance was introduced in Sweden. (Until then the rules of tort law governed all liability insurances.) Almost all medical attendance within, and much of the attendance outside, hospitals is managed by County Councils (Landstingen). The new insurance is contracted by the managing County Council to a pool of Swedish Insurance Companies. The total amount of the premiums for this first year is calculated to be 16 milj Skr (4 milj $ = 1/2$ per inhabitant per year). By treatment injury shall be understood "injury or illness of a physical nature...as a direct consequence...of...treatment (excepting natural or probably consequences of an act justified from a medical point of view), or of incorrect result(s) of technical examination or clinical diagnostics, or of accidents in hospitals, doctors' offices or in connection with ambulance services".

Diagnostic Errors↗