¿Quién juzga la actuación médica? / Who judges medical practice?

Resumen Las demandas judiciales por la percepción del paciente de una actuación médica inadecuada son una realidad creciente en la práctica médica, la cual entraña una preocupación extendida en el gremio médico. Las demandas judiciales frecuentemente conllevan circunstancias adicionales a la primaria preocupación de prevenir o sancionar actos de negligencia médica. CETREMI emite algunas recomendaciones a los profesionales jurídicos y médicos para mejorar esta situación y evitar daños en la relación médico-paciente.

Abstract Lawsuits due to patient perception of inappropriate medical actions are a growing reality in medical practice, which entails widespread concern in the medical community. Lawsuits often entail additional circumstances beyond the primary concern of preventing or sanctioning acts of medical negligence. CETREMI proposes various recommendations aimed at legal and medical professionals to improve this circumstance and avoid harming the doctor-patient relationship.

Sufficient informed consent to medical treatment of adults legal and ethical perspectives from Malawi

This special communication discusses the current legal and ethical requirements for informed consent to medical treatment of adults in Malawi. It analyzes the scope of the laws and code of ethics on professional discipline, including criminal privilege for surgeries and clarifies when insufficient disclosures entitle patients to compensation under civil law. Inconsistencies and uncertainties in the law are made apparent. It evaluates to which degree disclosure standards of other Commonwealth jurisdictions (e.g. the case of Montgomery) would be suitable for the health care setting of a country like Malawi that is characterized by shortages of resources, high illiteracy rates and a communitarian cultural context. Doctor-patient communication is not alien to African culture and part of sufficient informed consent. In order to balance the need for efficiency in health care delivery, accountability for quality care, fairness and effective patient-doctor communication the authors suggest to adopt the reasonable patient test only, if a defence of heavy workload on case-to-case basis is introduced at the same time. This does not dispense the need for organisational diligence on part of the institutional health care provider within its capacity

Willingness to Forgive among Colombian Adults / Los determinantes del perdón entre colombianos adultos

Abstract We examined Colombian people's determinants of willingness to forgive. A sample of 104 adults was presented with 24 scenarios depicting a situation in which a medical error resulted in severe consequences for a patient. Four factors were manipulated in the scenarios: (a) the severity of consequences of the error (e.g., extremely severe, including the risk of death), (b) the degree of negligence associated with the physician's act, (c) apologies or contrition for the act from the physician (e.g., direct apologies at the bed of the patient), and (d) the patient's current health status (e.g., consequences fully canceled). Through cluster analysis, four qualitatively different positions were found: (a) never forgive, irrespective of circumstances (15% of the sample), (b) depends on the circumstances of the offense (55%), (c) almost always forgive (24%), and (d) undetermined (5%). As regards forgiveness, therefore, Colombians' views and practices were similar to people from other cultures' ones. If most participants in previous studies on Colombians' willingness to forgive expressed extreme positions -- either never forgive or always forgive, irrespective of circumstances, it was because they deliberately wished to express strong opinions regarding the proper treatment that, in their view, the violent people depicted in the scenarios - paramilitary, guerillas, and members of drug cartels - deserved.

Resumen Hemos examinado los determinantes del perdón en una muestra de 104 adultos colombianos, utilizando una técnica de escenarios. Cada escenario describía una situación de error médico que tuvo consecuencias graves para el paciente. Los factores manipulados en los escenarios eran: (a) la gravedad de las consecuencias (e.g., muy grave incluyendo el riesgo de muerte), (b) el nivel de negligencia por parte del médico, (c) la presencia de excusas o contrición por parte del médico (e.g., excusas personales frente al paciente en su cama del hospital), y (d) el estado de salud presente (e.g., el paciente ha vuelto a casa y las consecuencias han desaparecidas). A través de un análisis en clústeres, cuatro posiciones, cualitativamente distintas, fueron encontradas: (a) jamás perdonar, independientemente de las circunstancias (15% de la muestra), (b) depende de las circunstancias del daño ocurrido (55%), (c) casi siempre perdonar (24%), y (d) no sé (5%). En relación con el perdón entonces, los colombianos no difieren de las otras personas que pertenecen a otras culturas. Si en los estudios previos, la voluntad de los colombianos a personar ha sido tan escasa, esto se debe al contexto de posconflicto de estos estudios.

Measure of liability in Medical Negligence A hospital based study

Background: Negligence is the breach of a legal duty of care. Liability is the responsibility of a person for his acts of commission and omissions. Aim: This study aimed to determine the role of liability in medical negligence in teaching hospital. Materials and methods: A total 36 medical negligence cases reported during the period of 3 years i.e. from July 2011 to June 2014 were gathered from Hospital Case Records, Inquest Reports, Post Mortem Examination Reports, and Forensic Science Laboratory Reports. Results: Among these 36 cases of medical negligence doctors were liable for their negligence in 15 cases i.e. 41.7% and vicariously liable in 3 cases i.e. 8.3%. There was no liability for doctors in 18 cases i.e. 50%. Conclusion: It this study, male and female was equally suffered for medical negligence. Among the females pregnant cases were more common. Most of the medical negligence cases had come to the hospital with major health problem. Health care professionals are increasingly facing complaints Naveen Kumar E, Ramesh K, Alugonda Y, Kothapalli J, Goud AK. Measure of liability in Medical Negligence – A hospital based study. IAIM, 2016; 3(3): 123-127. Page 124 regarding the facilities, standards of professional competence and the appropriateness of their therapeutic and diagnostic methods.

Medical practice and professional liabilities in Bijapur region of Karnataka.

The present study that is Medical Practice and Professional Liabilities in Bijapur Region of Karnataka was carried out in the northern part of Karnataka, details of the cases are collected from the district consumer forum Bijapur between January 1, 1995 and December 31, 2009 (15 years). In each case, complaint of the complainant and response to a complaint by the opponent is studied and analyzed. Date of filing and date of judgment is noted in each case. If needed complainant and opponent were consulted personally for details about the case. The most common cause for litigation was found to be misguided allegation; this can be prevented by proper communication to the patient at first consultation. Hence, it is important to spend more time at first consultation. It is the utmost importance that professional liability claims should be avoided. The lawsuits not only have heavy emotional toll on doctors and patients but on the society as a whole.

Comparison of medical malpractice, negligence and error / 中华医学教育探索杂志

Identifying the similarity and differences of malpractice,medical negligence and medical error has realistic meaning to deal with medical disputes efficiently.They are all subjective negligence and belong to the category of medical behavior.This paper mainly discussed the criteria and civil liability of their differences.

On the inevitability and controllability of medical negligence / 中华医学教育探索杂志

This thesis analyzed the inevitability of medical negligence according to the nature of medical behavior,particularity of medical profession and psychological factors of medical staff.How to control the occurrence of medical errors is an important social problem which is the whole community has been looking forward to solve.This thesis proposed methods to reduce medical negligence from the aspects of service concept,medical education and healthy psychology.

Res ipsa loquitor in post mortem examination.

The doctrine of Res ipsa loquitor means that “facts or thing speaks for itself”. It signifies that further details are unnecessary; the facts of the case are self-evident. This doctrine is applied when there is gross medical negligence on the part of treating doctor. It is often being presented when the damage resulted from teamwork where the doctor and some other persons were involved. In such circumstances, the doctor himself being ignorant about the cause of damage and the person actually responsible may find it difficult to prove his innocence, though he may actually be innocent. I am presenting here a case report of year 2008, which is a new type of example of Res Ipsa Loquitor in which an expert opinion was given by a board of medical doctors about medical negligence as per orders of Hon’ High Court on the basis of documents forwarded by Police.

A review of second medical opinion cases and its attribute to medical negligence: A retrospective study.

Today the number of cases of medical litigation is increasing and already it has become a great problem for surgeons, anaesthetists and obstetricians. The general practitioners and physicians are also facing the problem and in coming years the profession may turn into a nightmare. SMS Medical College is the biggest and oldest medical teaching institution in Rajasthan. The department of Forensic Medicine handles all types of medico legal works and there is a separate established Medical Board under the chairmanship of the Head of the department. Here we receive second opinion cases from different law enforcing agencies including the hospital and public administration. In this paper we have reviewed the second opinion cases with a primary focus on medical negligence cases in the time period of 2005 t 2009. Total 55 cases were identified out of which 42 were dead and 13 were alive. Maximum numbers of cases were observed in the age group of 21-30years. The number of female cases outnumbered the number of males. Maximum numbers of cases were related to surgical practice (OG-21, Surgery-8, Ortho-6, Neurosurgery-3, ENT-2, Opthal-1 and Urology-1).

Unexpected Death by Amniotic Fluid Aspiration Misconceived as Feeding Problem / 대한법의학회지

Aspiration of amniotic fluid, whether being meconium-stained or not, can cause a respiratory distress in neonates. This disorder may result in fatal consequence including unexpected death. Fetal hypoxia stimulates fetal gasping respiration, which can provoke massive amniotic fluid aspiration. A new born male-baby was found dead on the next day after vaginal delivery, and according to the statement of care-giver there was no serious event to the baby except for poor feeding. The diagnosis of amniotic fluid aspiration was confirmed at autopsy. The authors present the autopsy findings, clinical features and courses, failing medicolegal system and medical negligence, with literature review.

Issue of failed sterilization, medical negligence and compensation: A global review

It is a general perception among the medical fraternity that failure of sterilization operation leading to unwanted pregnancy is not a medical negligence on their part. But situations do arise when it may amounts to medical negligence and compensation may be awarded by the court as damages. In case of Government employees it may be a case of vicarious liability and for which state has to pay for the fault of its employees. This paper deals with global and Indian scenario of the problem, views of various courts in India and across the globe on the question of medical negligence, compensation and vicarious liability, etc. It also discusses these issues in detail in light of decision of the Supreme Court of India in Santra case of 2000.

‘Bolam test’.

The issue of medical negligence is always debated in any medical or legal forum. There are multiple criteria to term a medical professional as negligent and one amongst them is Bolam test. In present paper the applicability of this test is discussed.

Negligence in the Medical Tort Liability——The Doctor's Duty of Care / 中华医学教育探索杂志

As an element of tort liability,negligence is the main form of fault in medical tort.The essence of negligence is disobeying "the duty of care".So,understanding "the duty of care" correctly is very important in the judgement of medical tort.