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1.
J Perinat Neonatal Nurs ; 35(2): 116-119, 2021.
Article in English | MEDLINE | ID: covidwho-1684883
3.
J Emerg Med ; 60(5): e138-e139, 2021 05.
Article in English | MEDLINE | ID: covidwho-1492252
6.
Isr J Health Policy Res ; 10(1): 54, 2021 09 13.
Article in English | MEDLINE | ID: covidwho-1416817

ABSTRACT

BACKGROUND: Following other countries, Israel passed the Vaccine Injury Compensation Law in 1989, which provides for compensation to vaccine recipients who had suffered injuries without proving negligence. In 2021, after deliberations between the ministries of health and of finance Covid-19 vaccines (administered from the beginning of the campaign on December 20, 2020 and up to December 21, 2022) were included within the compensation law. The current study aims to examine the objectives of Israel's Vaccine Injury Compensation Law, at the time of its enactment, and to explore barriers to their fulfillment. These issues are especially relevant in light of the discussions held on the option for liability exemption which excludes the possibility of redress from the Covid-19 vaccine manufacturers in case of injury attributed to the vaccine, and considering the heavy burden of proof required in standard tort law. METHODS: The study employed a qualitative methodology which made use of both content analysis of relevant documents and in-depth interviews. RESULTS: In passing the Vaccine Injury Compensation Law, legislators sought to assist vaccine recipients who had suffered injuries by both lowering their burden of proof as well as establishing a short and efficient procedure for deliberating their claims. Furthermore, legislators believed that the assurance of compensation to vaccine recipients who had suffered injuries would help to encourage a high rate of vaccination compliance. An examination of the law's implementation over time revealed that the aforementioned goals were not attained. CONCLUSIONS: Implementation of the law since its enactment missed the opportunity to fulfill its original purposes to promote public health fundamental principles of fairness and solidarity. In addition, the adversarial proceedings as well as some of the law's provisions have the potential to undermine public trust in the State's willingness to grant compensation for injuries that are attributed to vaccines and thereby subvert the law's pivotal objective of promoting trust and vaccine compliance. We suggest that allowing circumstantial evidence as to an association between vaccine and an injury, transitioning to administrative deliberation, making available to the public details of cases where compensation was awarded, as well as other possible emendations would help it better reflect the values of fairness and solidarity that underlying the law's purpose. These would also promote the level of trust in healthcare authorities which is essential to preserving high vaccine coverage.


Subject(s)
COVID-19 Vaccines/adverse effects , Compensation and Redress/legislation & jurisprudence , COVID-19 Vaccines/economics , Health Policy , Humans , Israel , Liability, Legal , Patient Acceptance of Health Care
7.
S Afr Fam Pract (2004) ; 63(1): e1-e6, 2021 08 26.
Article in English | MEDLINE | ID: covidwho-1395089

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented international emergency, resulting in a need to adapt the existing healthcare systems, in order to enable ongoing patient care despite the current disruptions. Telemedicine may be a viable option to continue hospital workflow, however there are barriers to its implementation. We set out to establish what barriers might exist and to assess the viability of teleclinics within the province KwaZulu-Natal (KZN), as perceived by doctors. METHODS: This was a quantitative, observational, survey-based study targeted at medical doctors working in both the public as well as the private healthcare sector in University of KwaZulu-Natal (UKZN). RESULTS: One hundred and forty-seven (147) responses were included. The majority (86%) of respondents felt that telemedicine could provide a useful means to continuing hospital workflow, however, only 47% believed that it was a viable option for their unit. The major barrier identified was a feeling that doctors would-be at-increased medico-legal risk. Only 38.4% of doctors were familiar with the Health Professions Council of South Africa (HPCSA) guidelines on telemedicine usage. Other major barriers included: doctors feeling uncomfortable with not seeing a patient in person or not being able to perform a thorough physical examination. Other reasons identified as potential barriers were doctors foreseeing difficulty in accessing patient medical records and the absence of available systems to order investigations without the patient being physically present. CONCLUSION: Telemedicine is currently not widely utilised in KZN; although most doctors were of the opinion that it could be a useful tool in order to continue the workflow during the pandemic. The major barrier identified were issues surrounding medico-legal coverage.


Subject(s)
Attitude of Health Personnel , Medical Staff, Hospital/psychology , Remote Consultation/methods , Telephone , COVID-19/epidemiology , Female , Health Care Surveys , Humans , Liability, Legal , Male , Medical Records , Pandemics , Practice Guidelines as Topic , SARS-CoV-2 , South Africa/epidemiology
8.
Int J Environ Res Public Health ; 18(7)2021 03 25.
Article in English | MEDLINE | ID: covidwho-1378236

ABSTRACT

Over the past two decades, health litigation has followed an exponentially incremental trend. As insurance companies tend to limit their interest because of the high risk of loss, health facilities increasingly need to internalize dispute management. This study was conducted through a retrospective analysis of existing files concerning the civil litigation of the Sant'Andrea Hospital in Rome. All claims from 1 June 2010 to 30 June 2019 were included. Paid claims were further classified according to the areas of health care inappropriateness found. Authors indexed 567 different claims along the study period, with an average number of 59 per year (range 38-77). The total litigation involved 47 different units; more than 40% concerned 5 high-incidence wards or services. Concerning the course of disputes, 91 cases were liquidated before a judicial procedure was instituted, while 177 cases landed in a civil court. Globally, 131 different claims hesitated in compensation, for a total of 16 million 625 thousand euros, 41% of which was related to the internal medicine area. Dealing with the inappropriateness analysis, clinical performance alone involved 76 cases, for a total of 10 million 320 thousand euros, while organization defects involved 20 disputes equivalent to 1 million 788 thousand euros. The aim of this study was to enhance the clinical risk management at our facility through a litigation analysis.


Subject(s)
Liability, Legal , Malpractice , Compensation and Redress , Hospitals , Retrospective Studies
9.
Acad Med ; 96(7): 954-957, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1364834

ABSTRACT

Machine learning (ML) algorithms are powerful prediction tools with immense potential in the clinical setting. There are a number of existing clinical tools that use ML, and many more are in development. Physicians are important stakeholders in the health care system, but most are not equipped to make informed decisions regarding deployment and application of ML technologies in patient care. It is of paramount importance that ML concepts are integrated into medical curricula to position physicians to become informed consumers of the emerging tools employing ML. This paradigm shift is similar to the evidence-based medicine (EBM) movement of the 1990s. At that time, EBM was a novel concept; now, EBM is considered an essential component of medical curricula and critical to the provision of high-quality patient care. ML has the potential to have a similar, if not greater, impact on the practice of medicine. As this technology continues its inexorable march forward, educators must continue to evaluate medical curricula to ensure that physicians are trained to be informed stakeholders in the health care of tomorrow.


Subject(s)
Delivery of Health Care/organization & administration , Education, Medical/methods , Evidence-Based Medicine/history , Machine Learning/statistics & numerical data , Aged , Algorithms , COVID-19 Testing/instrumentation , Clinical Decision-Making/ethics , Clinical Trials as Topic , Curriculum/statistics & numerical data , Delivery of Health Care/statistics & numerical data , Diabetic Retinopathy/diagnosis , Diagnostic Imaging/instrumentation , Female , History, 20th Century , Humans , Liability, Legal , Male , Physician-Patient Relations/ethics , Physicians/organization & administration , Stakeholder Participation , United States , United States Food and Drug Administration/legislation & jurisprudence
10.
Am J Law Med ; 47(2-3): 264-290, 2021 07.
Article in English | MEDLINE | ID: covidwho-1361584

ABSTRACT

As the coronavirus pandemic intensified, many communities in the United States experienced shortages of ventilators, intensive care beds, and other medical supplies and treatments. Currently, there is no single national response to provide guidance on allocation of scarce health care resources. Accordingly, states have formulated various "triage protocols" to prioritize those who will receive care and those who may not have the same access to health care services when the population demand exceeds the supply. Triage protocols address general concepts of "fairness" under accepted medical ethics rules and the consensus is that limited medical resources "should be allocated to do the greatest good for the greatest number of people."1 The actual utility of this utilitarian ethics approach is questionable, however, leaving many questions about what is "fair" unanswered. Saving as many people as possible during a health care crisis is a laudable goal but not at the expense of ignoring patients's legal rights, which are not suspended during the crisis. This Article examines the triage protocols from six states to determine whose rights are being recognized and whose rights are being denied, answering the pivotal question: If there is potential for disparate impact of facially neutral state triage protocols against Black Americans and other ethnic groups, is this legally actionable discrimination? This may be a case of first impression for the courts to resolve."[B]lack Americans are 3.5 times more likely to die of COVID-19 than [W]hite Americans … . Latinx people are almost twice as likely to die of the disease, compared with [W]hite people." 2 "Our civil rights laws protect the equal dignity of every human life from ruthless utilitarianism … . HHS is committed to leaving no one behind during an emergency, and this guidance is designed to help health care providers meet that goal." - Roger Severino, Office of Civil Rights Director, U.S. Department of Health and Human Services. 3.


Subject(s)
COVID-19/ethnology , Civil Rights/legislation & jurisprudence , Ethics, Medical , Health Care Rationing/legislation & jurisprudence , Liability, Legal , Triage/legislation & jurisprudence , Ethical Theory , Humans , Organ Dysfunction Scores , Racism , SARS-CoV-2 , Social Discrimination , United States/epidemiology
11.
Ann Ist Super Sanita ; 57(2): 113-120, 2021.
Article in English | MEDLINE | ID: covidwho-1271020

ABSTRACT

The issue of political, institutional and professional liability in the context of the SARS-COV-2 pandemic is currently widely debated and involves several levels of investigation. One crucial aspect relates to the allocation of life-saving resources in situations where there is an imbalance between need and availability and the associated questions of ethical and legal liability. This work looks at the implications of the criteria applied to rationing under extraordinary conditions and the issue of their legitimacy. Considering the European scenario, we describe the approach taken by Italy in proposing criteria for pandemic triage of intensive treatment and highlight certain problems and critical issues. We emphasise that the decision, based on a comparative assessment, to deny treatment to a patient in critical condition, compromising that patient's right to care, exceeds the scope of decision-making autonomy of the professional concerned and requires a theoretical and procedural definition shared at multiple levels of society.


Subject(s)
COVID-19 , Health Resources/ethics , Health Resources/legislation & jurisprudence , Liability, Legal , Pandemics , Humans , Intensive Care Units , Italy
12.
Hastings Cent Rep ; 51(3): 5-7, 2021 May.
Article in English | MEDLINE | ID: covidwho-1239986

ABSTRACT

During the Covid-19 pandemic, as resources dwindled, clinicians, health care institutions, and policymakers have expressed concern about potential legal liability for following crisis standards of care (CSC) plans. Although there is no robust empirical research to demonstrate that liability protections actually influence physician behavior, we argue that limited liability protections for health care professionals who follow established CSC plans may instead be justified by reliance on the principle of reciprocity. Expecting physicians to do something they know will harm their patients causes moral distress and suffering that may leave lasting scars. Limited liability shields are both appropriate and proportionate to the risk physicians are being asked to take in such circumstances. Under certain narrow circumstances, it remains unclear that the standard of care is sufficiently flexible to protect physicians from liability. Given this uncertainty, the likelihood that physicians would be sued for such an act, and their desire for such immunity, this limited protection is morally legitimate.


Subject(s)
COVID-19/epidemiology , Liability, Legal , Physicians/legislation & jurisprudence , Standard of Care/legislation & jurisprudence , Health Care Rationing/legislation & jurisprudence , Humans , Pandemics , SARS-CoV-2 , Standard of Care/ethics
13.
J Law Med Ethics ; 49(1): 126-131, 2021.
Article in English | MEDLINE | ID: covidwho-1221086

ABSTRACT

Workplace exposure to SARS-CoV-2 has sickened workers and, subsequently, their family members. Family members might be able to recover from the employer in a negligence action using "take-home" liability theory.


Subject(s)
COVID-19/transmission , Compensation and Redress/legislation & jurisprudence , Family , Liability, Legal , Occupational Exposure/legislation & jurisprudence , Humans , Malpractice/legislation & jurisprudence , SARS-CoV-2 , United States , United States Occupational Safety and Health Administration/legislation & jurisprudence , Workers' Compensation/legislation & jurisprudence
15.
Am J Nurs ; 121(4): 61-64, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1209264
16.
J Forensic Leg Med ; 80: 102170, 2021 May.
Article in English | MEDLINE | ID: covidwho-1185064

ABSTRACT

Defensive medicine is a practice that has been utilized by clinicians in efforts of preventing patient dissatisfaction and malpractice claims and may be done through either omission or commission. As much as 57% of physicians have disclosed that they practice defensive medicine. However, this practice does not necessarily prevent malpractice claims and more importantly, neither does it equate to good medical practice, with some leading to poor outcomes. Unfortunately, there is a high percentage of malpractice claims lodged against clinicians in both primary care and hospital settings. Specialists such as surgeons, obstetricians, and gynecologists face the highest claims. In particular, during the SARS CoV-2 pandemic, with new challenges and limited treatment algorithms, there is an even greater concern for possible bourgeoning claims. Counteracting defensive medicine can be accomplished through decriminalizing malpractice claims, leaving physician oversight up to state medical boards and hospital claims management committees. Additional tort reform measures must also be taken such as caps on noneconomic damages to ensure emphasis on beneficence and nonmaleficence. Once these are in place, it may well serve to increase clinician-patient trust and improve patient independence in the shared decision-making process of their treatment, allowing clinicians to practice their full scope of practice without feeling wary of potential malpractice claims.


Subject(s)
Defensive Medicine , COVID-19 , Humans , Insurance Carriers , Liability, Legal , Malpractice , Pandemics , Unnecessary Procedures
17.
Leg Med (Tokyo) ; 51: 101880, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1171980

ABSTRACT

The SARS-CoV-2 pandemic has highlighted discrepancies between surgeons' professional duties and legal protections when acting outside their specialities during the pandemic. These discrepancies between legal and professional standards leave surgeons and the NHS vulnerable to litigation. In the following article, we explore the liabilities that have arisen for surgeons during this period in the United Kingdom and Canada. We recommend, upon review of the literature, that a two-pronged approach be taken to address these discrepancies; (a) a change in policy at the national level to accurately reflect the constraints and demands placed upon the profession in this acute health crisis and (b) the provision of clearer, more stringent legal protection. In the interim, we suggest that individual surgeons utilise a decision-making framework where they consider their personal and professional obligations in regard to resource stewardship, innovation in practice, patient-specific contexts, and patient advocacy while acting outside of their speciality.


Subject(s)
COVID-19 , Government Regulation , Liability, Legal , Societies, Medical/standards , Surgeons/legislation & jurisprudence , Canada , Humans , SARS-CoV-2 , Standard of Care/legislation & jurisprudence , United Kingdom
18.
Ginekol Pol ; 92(3): 216-219, 2021.
Article in English | MEDLINE | ID: covidwho-1145680

ABSTRACT

This paper is entirely devoted to a new legal instrument called the "Good Samaritan Clause". Its legal recognition constitutes the legislator's response to the concerns raised by the medical community, in view of the unique situation in the country, but also in the world, relating to the prevention, counteraction and suppression of COVID-19. The assumption is that this instrument is to constitute a countertype that excludes the criminal unlawfulness of the act, due to the increased risk of mistakes made by the physicians involved in providing health services during the epidemic. The paper focuses primarily on the dogmatic and legal issues, discussing the catalogue of conditions needed for the application of the instrument mentioned in the title, but it also attempts to critically evaluate the introduced solution. The idea itself of introducing a solution affecting the scope of criminal liability of physicians is good, however, it requires legislative clarification as well.


Subject(s)
COVID-19/epidemiology , Liability, Legal , Pandemics , Physicians/legislation & jurisprudence , Humans , Malpractice/legislation & jurisprudence , Poland/epidemiology , SARS-CoV-2
19.
J Forensic Leg Med ; 78: 102123, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1065321

ABSTRACT

The dental profession is considered at high potential risk of exposure and transmission of SARS-Cov-2. Thus, dentists should implement special safety measures in order to prevent any possible contamination during dental sessions and should be aware of the legal implications of their act in order to avoid malpractice leading them to be a causative agent of transmission of this virus. This paper aimed to provide a global review on COVID-19 preventive recommendations at dental clinics and discussed the legal values of such procedures, the dentist criminal and civil liability arising from transmitting this virus to a patient, the obligation of care under COVID-19 and the possible solution to this dilemma. The review concluded that dentists should follow all modern scientific procedures which are in their interest and in the interest of patients to maintain their safety and advised dentists to document all steps taken during the period of COVID-19 outbreak, because any undocumented action is considered not to have taken place, and they shall be bound by the burden of proof.


Subject(s)
COVID-19/prevention & control , Dentists/legislation & jurisprudence , Liability, Legal , Practice Patterns, Dentists'/legislation & jurisprudence , Safety Management/standards , Standard of Care/legislation & jurisprudence , Dental Clinics , Humans , Malpractice/legislation & jurisprudence
20.
Recenti Prog Med ; 112(1): 13-14, 2021 01.
Article in Italian | MEDLINE | ID: covidwho-1054908

ABSTRACT

Informed consent for CoViD-19 vaccines can be considered a step that can help us focus on an increasingly burdensome problem for contemporary medicine: the difficult relationship of trust between citizens and academic medicine. Filling out forms full of useless information cannot replace the rebuilding of trust based on shared essential ethical principles. Trust needs to be protected by a transparent accountability, which can also decrease the threatening looming of lawsuits. Medicine must be safe, first and foremost, for the practitioner. He cannot practice it if he feels constantly in check, if the outcome of the treatment does not correspond to the wishes of those who request it.


Subject(s)
COVID-19 Vaccines , Informed Consent/psychology , Physician-Patient Relations , Trust , Vaccination Refusal/psychology , Attitude to Health , France , Humans , Informed Consent/legislation & jurisprudence , Italy , Liability, Legal , Public Opinion , Vaccination Refusal/legislation & jurisprudence
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