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PubMed2002

Medical malpractice: a review of issues for providers.

The worlds of law and medicine meet in some very interesting and very important ways. Together, lawyers and physicians tackle such subjects as cloning, right to die, surrogate parenthood, and embryo preservation and implantation, to name a few. The most personal and painful nexus for physicians comes when a physician is sued and must then deal with the legal system as a defendant. The world of plaintiffs, experts, legal doctrines, state and federal law, and judicial application of law to the facts of the case can be intimidating. It is hoped that this overview has allowed the hematology-oncology practitioner to become more familiar with the theories and procedures involved in medical negligence actions. The physician, when comfortable with the basics, may better tolerate the apparent idiosyncrasies of the system and even may be able to protect him or herself from becoming involved in a lawsuit ab initio.

Confidentiality↗
PubMed1998

Act first and look up the law afterward?: medical malpractice and the ethics of defensive medicine.

This essay examines the so-called phenomenon of "defensive medicine" and the problematic aspects of attempting to maintain the safest legal position possible. While physicians face genuine litigation threats they frequently overestimate legal peril. Many defensive practices are benign, but others alter patient care and increase costs in ways that are ethically suspect. Physicians should learn to evaluate realistically the legal risks of their profession and weigh the emotional, physical, and financial costs to the patient before employing a defensive measure.

American Medical Association↗
PubMed2003

Malpractice liability implications of pacemaker and defibrillator guidelines in Canada.

Different guidelines for implantable pacemaker and cardioverter defibrillator therapy pose problems for legal liability in Canada. Medical practices in the United States provide measures for comparative assessment, but the Canadian health care system is operated and publicly funded on West European principles. Provincial governments accept the responsibility to provide their residents with reasonable access to medically necessary services, including devices, on conditions of partial reimbursement by federal government funds. However, some provinces may fund services for which they will not be reimbursed. Practitioners may practise according to governmental funding arrangements. The law recognizes that practitioners in a respected minority in their specialty can depart from generally approved professional guidelines, by retaining earlier practices that are not discredited, or by adopting newer, but non-mainstream practices. They can similarly follow professional guidelines different from those of their colleagues. Practitioners who depart from guidelines they profess to follow risk legal liability, but compliance does not invariably ensure judicial approval. Judges preserve the right to set standards of professional proficiency, since they are a matter of law, but usually endorse professional guidelines. Patients' choices must be adequately informed, according to well-established criteria of disclosure that must be applied to evolving professional views of best and acceptable practice, which are usually influenced by practice guidelines. Inadequate governmental provision of devices or services to ensure patients' care according to practice guidelines can be challenged in legal proceedings. Success may require governments to improve supplies, but judges may decline to give directions with serious budgetary implications. However, unsuccessful litigants against, for instance, governments or physicians, are liable to be required to pay the successful defendants' legal costs, and usually their own.

Canada↗