COVID-19 Risk Management: a Survey among Italian physicians.

Abstract: The COVID-19 pandemic had a significant global impact on public health. The increasing demand for intensive care and the closure of several health facilities has led to a reduction in the assistance of non-COVID patients. In our study, we investigated what changes health professionals have experienced in their professional activities and how they coped with them. A questionnaire was sent to 146 doctors, focused on three subjects: type of activity carried out during the pandemic; use of personal protective equipment (PPE) and recourse to vaccination; current medical liability profiles related to COVID-19. The questionnaire was completed by 111 doctors. The study showed no significant differences in the questionnaire response as regards the demographic and work variables of the participants (gender, age, area of specialties). Most of doctors assisted potentially positive patients, which also imposed derogations on their safety. Most of the complaints were about the low adequacy of PPE provision and about the compromission of specialist medical care. The interest in safety among participants was revealed by the high compliance to vaccination, with almost complete coverage. The questionnaires showed that most doctors (72,7%) believe that specialist medical care has been impaired during the COVID-19 pandemic. Secondly, a high percentage of participants (79.8%) expressed the need for both civil and criminal limitation of liability in connection with work in the management of SARS-Cov-2 patients. In conclusion, this survey tried to contribute to the identification of the main problems presented by healthcare professionals. Their versatility was a crucial element for the management of the pandemic, but also highlighted the need for health institutions to prepare pandemic plans in the future, with adequate and constant updating. Concerns were raised regarding financial deficits and legal protection. Political decisions must be entrusted to enhance medical assistance and to avoid the increasing phenomenon of defensive medicine.

Guidelines, good practices and best clinical health practices: valuable guidance for physicians and judges?

Enactment of law n. 24, 8th March 2017, (so-called "Gelli-Bianco" law), has given rise to substantial innovations in the realm of medical liability: on the one hand, an attempt has been made towards redefining the boundaries of professional liability, for the purpose of curbing the use of "defensive medicine"; on the other hand, there is the effort to delineate good medical conduct by means of "institutionalization" and a greater degree of consistency of guidelines and good clinical health care practices. There are, however, thought-provoking cues concerning the relationship between the two concepts, which can be sensibly developed, even in light of international scientific literature. This paper has been designed to critically analyze both principles and their relation within the framework of the newly enacted piece of legislation denominated "Gelli-Bianco", in light of the Italian jurisprudence while at the same time, searching for common ground in international law, particularly Anglo-Saxon countries, aiming to clarify the lawmakers' ultimate goal as well as the law's practical scope of application.

Medico-legal aspects of tort law patient safeguards within the Gelli-Bianco piece of legislation.

The authors aim to put into context the recently passed piece of Italian legislation known as "Gelli-Bianco", in an effort to highlight the root causes and the underlying motives that led to its enactment. The new law's innovative aspects are elaborated on, in terms of treatment safety and civil liability of health care professional and providers. The report's main purpose is to shed light on the alleged benefits, against the backdrop of the worrisome data from recent years, gathered from case-based analysis of adverse events and related costs, without overlooking the likely challenges associated with innovations that are meant to affect complex systems with conflicting interests at play.