ABSTRACT
Objetivo: analisar o Programa Nacional de Segurança do Paciente brasileiro à luz do referencial teórico dos Direitos do Paciente. Metodologia: estudo descritivo, utilizando como fundamento os Direitos Humanos do Paciente, desenvolvido por Aline Albuquerque, além de bibliografia internacional sobre o tema. Resultados: o presente estudo apontou que o Programa Nacional de Segurança do Paciente não foi elaborado tendo as perspectivas dos Direitos do Paciente como elemento central, notadamente no direito de participar da tomada de decisão e na obtenção de informações. Conclusão: o Programa Nacional de Segurança do Paciente compreende avanços no âmbito da segurança do paciente, entretanto, os Direitos do Paciente não estão incorporados na Portaria de Consolidação do SUS nº 5/2017. É imprescindível, portanto, que haja uma legislação nacional específica sobre Direitos do Paciente e que seja a base para a reestruturação do Programa Nacional da Segurança do Paciente.
Objective: analyze the Brazilian National Program for Patient Safety considering the theoretical framework of patients' rights. Methods: descriptive study based on the patients' human rights, developed by Aline Albuquerque, in addition to an international bibliography on the subject. Results: this study showed that the Brazilian National Program for Patient Safety was not designed with patients' rights as a central element, especially regarding the right to participate in decision making and receive information. Conclusion: the Brazilian National Program for Patient Safety includes advances in the field of patient safety. However, patients' rights are not included in the Consolidation Regulation of the Unified Health System No. 5/2017. Therefore, it is imperative that there is specific national legislation on patients' rights and that this forms the basis for the restructuring of the Brazilian National Program for Patient Safety.
Objetivo: analizar el Programa Nacional de Seguridad del Paciente de Brasil, a la luz del marco teórico de los Derechos del Paciente. Metodología: estudio descriptivo, basado en los Derechos Humanos del Paciente, desarrollado por Aline Albuquerque, además de bibliografía internacional sobre el tema. Resultados: el presente estudio apuntó que el Programa Nacional de Seguridad del Paciente no fue diseñado con la perspectiva de los Derechos del Paciente como elemento central, en particular en el derecho a participar en la toma de decisiones y en la obtención de información. Conclusión: el Programa Nacional de Seguridad del Paciente comprende avances en el campo de la seguridad del paciente, sin embargo, los Derechos del Paciente no están incorporados en la Ordenanza de Consolidación del Sistema Único de Salud n° 5/2017. Es imperativo, por tanto, que exista una legislación nacional específica sobre Derechos del Paciente, y que ésta sea la base para la reestructuración del Programa Nacional de Seguridad del Paciente.
ABSTRACT
The behavior of patients' health information seeking might affect the doctor-patient relationship by increasing patients' rights and perceived incentives.The paper puts forward the hypothesis and builds a study model,prepares and collectes questionnaires,analyzes sample characteristics,and carries out the reliability analysis and factor analysis on the model rating scale as well as the empiri-cal analysis by using the structural equation model.On this basis,it makes discussion and gives suggestion for the study.
ABSTRACT
At present,China's law has more emphasis on the provisions of the rights and obligations of doctors,but is lack of provisions on the rights and obligations of patients.From ethical and legal point of view on the rights and obligations of patients,how to build the patients' rights and obligations system is explored to promote China's health stable development of the cause.
ABSTRACT
OBJECTIVES: The authors performed this survey to find out current status of petition and process for the extension of hospitalization of patients who were hospitalized more than 6 months. METHODS: Authors designed a questionnaire named 'Questionnaire for Survey of Current Status and Process of Petition for Extension of Hospitalization of Psychiatric Patients' and distributed it to 242 psychiatric facilities with closed wards for psychiatric patients. The psychiatric facilities includes 4 categories;psychiatric department of university hospital, psychiatric department of general hospital, psychiatric hospital and small sized private clinic. The period of survey was from Jan. 1 to Dec. 31 of 2002. RESULTS: Among 84 psychiatric facilities responded, 2,615 petitions for extension of hospitalization were submifted to the Local Mental Health Tribunal, and the dissent rate was 4.1%. The most of petitions were from psychiatric hospitals (2,265). The psychiatric departments of general hospitals favored the discharge-readmission method rather than applying extension by due process of the Mental Health Act when further admission was needed after 6 months hospitalization (280 vs. 106). The main reason for the petitions for extension of hospitalization was "no improvement" (72.7%) than "dangerousness to self or others" (14.7%). Against doctor's recommendation for discharge agter improvement, many patients couldn't be discharged becanse of guardians' refusal or cut off from caregiver or guardian. In cluded were these patients applied petitions for extension of hospitalization. CONCLUSION: This study suggests that hospitalization of some patients are extended improperly in view of the spirif of the Mental Health Act. The authors proposea new system of ambulatory treatment, reinforcement of psychiatric rehabilitation, legal control of the neglected patient by guardians.
Subject(s)
Humans , Caregivers , Civil Rights , Dissent and Disputes , Disulfiram , Hospitalization , Hospitals, General , Hospitals, Psychiatric , Mental Health , Patient Rights , Surveys and Questionnaires , RehabilitationABSTRACT
The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.
Subject(s)
Humans , Middle Aged , Bioethics , Coma , Crime , Criminal Law , Criminals , Dissent and Disputes , Euthanasia , Hematoma , Illegitimacy , Medical Futility , Patient Rights , Seoul , Spouses , Ventilators, MechanicalABSTRACT
An elderly Thai widow with progressive dementia was transferred to Siriraj Hospital for properly continued supportive treatment. Due to the course of the disease, she lacked the ability to make any valid decision related to giving consent to medical treatment and to manage her own affairs. Giving medical consent was a critical issue confronting the treating physician whereas the patient\'s relatives might face with the issue of administering her personal affairs and property. In order to establish the patient's lawful substitute decision maker and administration for the patient's best interest, a declaration of the patient\'s incompetency and the appointment of suitable guardian were needed. The legal proceedings would inevitably be undertaken by filing a petition to the court. This would also have profound implications for the patient's rights and the physician's roles under the justice system.
ABSTRACT
Medicine is a practicing and experiencing subject.The most important study method for medical students is to practice during clinic.With the development of society,patients' consciousness of sticking up for their rights is stronger and stronger.During their receiving medical treatment,they are not satisfied with the teaching behavior provided by physician,and even to make medical conflicts.To resolve these conflicts,it is necessary to rule the clinical practicing teaching,harmonize the relationship between clinical teachers,medical practicing students,and patients.Medical education should be based on humanity and should be behaved by law.