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Swedish malpractice reports and convictions.

The Swedish system, with the Board of Health and Welfare as supervisor, and Medical Board of Responsibility gives both authorities and patients the opportunity to file reports demanding disciplinary action where an error is perceived to have been committed. A total of 184 primary care complaints, involving 230 staff of which 170 were physicians and 42 nurses, were reviewed. Complaints were made by patients or parents in 73% and by the Board of Health in 14%. Handling took up to 4 years. Erroneous or delayed diagnosis was the cause in 58%, erroneous medication in 11%, rudeness in 14%. Of the 230 staff reported, 23 received warnings and 19 reprimands.

Adolescent↗

Complaint and disciplinary systems in dentistry in Sweden: a presentation and discussion of their efficacy in preventing malpractice.

The Swedish systems for complaints and supervision with many possibilities of claiming on different levels may lead to prevention of future problems in medical and dental care. The systems are corrective, preventive and compensatory, and are important in the process of quality assurance. However, some elements need improvement. The present paper gives as a background an overview of the Swedish systems and discusses a few cases. Comparisons with systems in other countries, especially the USA, are made, and new measures are discussed. There is a need for smooth, preventive measures as well as strong, punitive and corrective measures. Recidivist doctors/dentists must be stopped.

Cross-Cultural Comparison↗

Clinical ethics in assisting euthanasia: avoiding malpractice in drug application.

The debate on the ethical permissibility of euthanasia in medicine has a corollary in the ethical application of drugs. The overall moral limits of medical treatment apply evenly to the moral acceptability of the pharmacological aspect of the act of euthanasia. The pharmacological aspect of the act is of ethical importance not only for the person requesting an active ending of his or her life, but also for the grieving family.

Defensive Medicine↗

Error, malpractice, and the problem of universals.

This article begins with a criticism of McIntyre and Gorovitz's account of medical error. Their theory implies that error, at least sometimes, is a necessary consequence of the inductive character of medical inquiry. The counter intuitive consequences of this account suggest that the issues surrounding induction may not be the most fertile area for developing a coherent interpretation of medical error. Given these shortcomings, I develop a new theory which assumes that the best philosophical soil for constructing a theory of medical error is the problem of universals. I then explain the problem and how the medical universal functions within arguments concerning diagnosis and treatment. A Wittgensteinian solution to the problem is presented which emphasizes the "borderline" character of some, if not many, medical judgments. Next, an argument is offered to establish that questions of medical error are not purely professional questions. This is because the theories used to make such professional judgments permit borderline cases even under the best circumstances. Finally, while there are a number of legitimate responses to this situation, I recommend one which involves legislative action.

Clinical Competence↗