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In today's increasingly competitive medical practice environment, legal challenges to credentialing decisions abound. To minimize the risk of liability, hospitals and their medical staffs must be especially careful when adopting and applying the criteria for medical staff membership.
The impact of shift-work on sleep, performance and general health appears to be substantial. The most immediate consequence of night shiftwork is sleep loss. The aim of the present paper is to describe legal cases involving accidents attributed to sleepiness or fatigue, mainly as a consequence of shift-work or prolonged work hours, in the UK, USA and Australia. The paper will describe how legal systems are dealing with such incidents and how this may change in the future. Accidents related to sleepiness may result in criminal prosecution, for example charges of culpable driving. For acts performed while a person is sleeping (e.g., motor vehicle accidents), the legal question of voluntariness may be raised. The issue of employers' liability in such cases is contentious. Special liability regimes are in place to cover employers' liability. Employers may be deemed liable for injuries of third parties caused by wrongful acts of employees committed in the course of their employment. In the future, it is likely that employers will need to take greater precautions to reduce sleepiness and fatigue in the workplace, especially where the risk to public and environmental safety, health and productivity are significant.
Enacted in the pre-managed care days, ERISA has shielded health plans from liability in a way the nation's lawmakers may never have intended. The business community watches warily as this blanket protection erodes.
This essay presents a preventive ethics to hidden aspects of the professional liability crisis, which is now affecting physicians throughout the world. It draws on the concept of fiduciary responsibility and its four professional virtues of integrity, compassion, self-effacement, and self-sacrifice to identify preventive ethics approaches to the professional liability crisis for practicing physicians and physician leaders. Physicians should adhere to integrity in clinical practice and testimony, to compassion and self-sacrifice by focusing on patients rather than their own needs, and to self-effacement by not allowing risk of litigation to influence patient care. Physician leaders should create organizational cultures to support physicians in this important work. Fiduciary responsibility and professional virtues should guide practicing physicians and physician leaders in creating best-practice models to improve organizational culture and influence health policy.
As the health care system undergoes change, the traditional areas of liability continue to exist while new areas of risk exposure evolve. Trends are identified.
While individual accountability is a serious problem for health care providers, corporate liability is a major problem for the institution. In addition to the cases expanding this theory of law for hospitals, managed care organizations are beginning to experience significant financial losses.
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What should you do? Take this attorney's advice to protect yourself and your facility from legal repercussions.
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