RESUMO
There have been repeated calls from all quarters of healthcare for more clinicians to be leaders. The risks of not accepting this responsibility have been demonstrated by harrowing reports into failed care in England. Ambiguity persists over what clinical leadership encompasses, how it can be developed and how to inspire clinicians to practise it. A supportive organisational culture, dedicated resources and national support are needed to foster leadership skills among trainee clinicians. Here we discuss a possible blueprint based on the recent reviews of English NHS Trusts with high mortality rates for future initiatives in empowering medical and nursing trainees to learn from leaders and practise leadership skills.
Assuntos
Relações Interprofissionais , Liderança , Corpo Clínico Hospitalar/organização & administração , Enfermeiras e Enfermeiros/organização & administração , Competência Clínica , Comportamento Cooperativo , Inglaterra , Humanos , Cultura Organizacional , Desenvolvimento de Programas , Medicina EstatalRESUMO
Insanity acquittees are often (erroneously) believed to get away with murder. This article examines one possible cause of this view--that insanity acquittees may have, to various degrees, caused or exacerbated their own mental disorder in the first instance. Such a component of prior fault is illustrated with recourse to the putative insanity defense of Dr. Jekyll, who, while almost certainly not criminally responsible at the time he committed murder (in the guise of Mr. Hyde), was culpable for bringing about that nullification of responsibility (thereby causing the conditions of his own defense). Such culpability (also found in intoxication cases) is examined in relation to medication noncompliance in mentally disordered offenders, and possible solutions for dealing with "culpable madness" are presented.
