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Medical errors, medical negligence and defensive medicine: A narrative review
Miziara, Ivan Dieb; Miziara, Carmen Silvia Molleis Galego.
  • Miziara, Ivan Dieb; Universidade de São Paulo. Faculdade de Medicina. Department of Legal Medicine, Ethics and Occupational Health. São Paulo. BR
  • Miziara, Carmen Silvia Molleis Galego; Faculdade de Medicina do ABC. Santo André. BR
Clinics ; 77: 100053, 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1384620
ABSTRACT
Abstract Error in medicine and medical liability has a long history dating back to Antiquity. During the 19th Century, most lawsuits related to errors in treating surgical problems were settled. However, in the first half of the 20th Century, lawsuits claimed that mistakes were related to the doctor's action the doctor made something wrong (errors of commission). In Brazil, medical error is defined as inappropriate conduct, including negligence and recklessness, that causes harm to the patient. The physician's fear of being suited is the reason for some practice named defensive Medicine (D.M.), defined as ordering unnecessary tests and procedures or avoiding treatments for patients considered at high-risk. Thus, this narrative review aims to analyze and describe the relationship between medical errors, medical negligence, and the practice of D.M. So, the authors propose procedures and attitudes to avoid medical errors and the approach of D.M. a national focus to create leadership and research tools to enhance the knowledge base about patient safety; a reporting system that would help to identify and learn from errors; the use of a computer-based protocol reminder; some technological devices to help the medical practice (electronic prescribing and information technology systems); creating risk management programs in hospitals. Therefore, the authors conclude that the most critical attitude to avoid medical liability is a good and ethical medical practice with the proper use of technology, based on knowledge of scientific evidence and ethical principles of medicine - for the benefit of patients. HIGHLIGHTS This article defines medical errors and medical responsibility from a Brazilian perspective. This article calls attention to the risks of medical liability and the unethical use of defensive medicine. The authors propose some procedures and attitudes to avoid medical errors like the use of technology at the bedside and computer-based protocols. The authors state that a good and ethical medical practice can avoid medical liability.


Full text: Available Index: LILACS (Americas) Type of study: Practice guideline / Prognostic study Language: English Journal: Clinics Journal subject: Medicine Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: Faculdade de Medicina do ABC/BR / Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Type of study: Practice guideline / Prognostic study Language: English Journal: Clinics Journal subject: Medicine Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: Faculdade de Medicina do ABC/BR / Universidade de São Paulo/BR