Assessment of Knowledge of Legal Provisions on Organ Donation and Transplantation amongst Healthcare Workers in Nigeria: A Cross-sectional Study.

BACKGROUND: Advancements in the medical field have made organ transplantation an attractive treatment option for patients when indicated. Shortage of organs and commodification of organs are major challenges encountered in organ donation and transplantation. These could potentially breed unethical practices, if the process is not well regulated. AIM: The aim of this study was to assess the knowledge of healthcare workers (HCWs) on the legal provisions regulating organ donation and transplantation in Nigeria. METHODOLOGY: This cross-sectional study was conducted amongst physicians and nurses across Nigeria. Knowledge of legal provisions on organ donation and transplantation was assessed using a validated questionnaire that had 21 questions derived from the National Health Act. Each correctly answered question was given 1 point with a total obtainable score of 21 points. A score of ≥14 points was classified as good knowledge. P <0.05 was considered significant. RESULTS: A total of 836 physicians and nurses with a mean age of 37.61 ± 9.78 years participated in the study. Females and physicians constituted 53.3% and 62.9% of the respondents, respectively. The mean knowledge score of the respondents was 9.70 ± 2.91 points. Eighty-three (9.9%) respondents had a good knowledge score. There was a significantly higher proportion of male HCWs (P < 0.037) and older HCWs (P = 0.017) with good knowledge of legal provisions. On logistic regression, age was the only factor found to be associated with good knowledge of legal provision (adjusted odds ratio: 3.92; confidence interval: 1.33-11.59; P = 0.01). CONCLUSION: The overall knowledge of legal provisions on organ donation and transplant was very poor amongst HCWs in Nigeria. There is a need to educate them on these provisions to curb unethical practices.

Doctors, FIRs, and Arrest in Alleged Medical Negligence Cases in India: Demystifying the Legal Tenability.

The relationship between a doctor and a patient is a contract, retaining the essential elements of the tort. Modern medical practice has evolved alongside the court of law to regulate the conduct of doctors and hospitals to reduce litigations of medical negligence. Lately, Indian patients have become more aware of their rights and the Consumer Protection Act. This awareness encourages patients to litigate and seek the help of redressal forums to mitigate their loss/injury in cases of medical negligence. Though there is a rise in complaints of medical negligence filed against doctors and hospitals, these allegations are often frivolous. The specter of litigation constantly looms over medical practitioners, who frequently struggle to defend themselves in a court of law, causing undue anxiety and anguish. Thus, a doctor can be considered the second victim in a medical negligence case. Lack of awareness regarding their legal rights and pertinent laws coupled with contradictory actions of the law enforcement agencies while handling alleged medical negligence cases worsens a doctor's trepidation. Hence, this article attempts to raise awareness among medical professionals, which will thereby allay undue fear while facing an allegation.

[Critical results reporting: the importance of local partnership agreements]. / Overdracht van sterk afwijkende laboratoriumuitslagen.

Critical results should be reported to the physician as soon as possible so that the physician can take the necessary follow-up actions. Failure or non-timely reporting of such results may lead to serious health damage or death to the patient. This article focusses on the reporting of results from the laboratory to the physician and discusses the bottlenecks and the separate (legal) responsibilities of the physician and the laboratory. Improving the process of the reporting and follow-up of critical results is a joint responsibility of the laboratory and the physician requesting the laboratory tests. This could be achieved by local partnership agreements.

Consideraciones bioéticas para la investigación sobre los programas de residencias médicas / Consideracions bioètiques per a la investigació sobre els programes de residències mediques / Bioethical considerations for research on medical residents

El presente artículo argumenta que es necesaria la investigación sobre los programas de residencias médicas para mejorar el entorno laboral y académico que viven los médicos y médicas en su formación como especialistas. Por lo que se proponen algunas consideraciones para garantizar una investigación ética. Para ello, el artículo sigue la estructura de dos premisas y una conclusión, donde cada premisa se fundamenta analíticamente. La primera premisa es que los factores estructurales de los programas de residencias médicas conducen a una condición de vulnerabilidad, se sustenta la primera premisa al explorar los factores estructurales que contribuyen a su vulnerabilidad desde el análisis del contexto mexicano y el marco teórico de la interseccionalidad. Así, se presentan algunas de las características que se entrecruzan y determinan la forma en la que los y las residentes experimentan en sus espacios sociales y ambientes de desarrollo. La segunda premisa es que la investigación de un grupo vulnerable conduce al desarrollo de estrategias para el cambio. El artículo reconoce la necesidad de investigar y desarrollar intervenciones para los grupos sociales vulnerables con el fin de mejorar su situación y proporcionar un entorno más seguro.(AU)

L'article actual argumenta que és necessària la investigació sobre els programes de residències mèdiques per millorar l'entorn laboral i acadèmic que viuen els metges en la seva formació com a especialistes. Per això, es proposen algunes consideracions per garantir una investigació ètica. L'article segueix l'estructura de dues premisses i una conclusió, on cada premissa es fonamenta analíticament. La primera premissa és que els factors estructurals dels programes de residències mèdiques porten a una condició de vulnerabilitat. Aquesta primera premissa es fonamenta explorant els factors estructurals que contribueixen a la seva vulnerabilitat des de l'anàlisi del context mexicà i el marc teòric de la interseccionalitat. Així, es presenten algunes de les característiques que es creuen i determinen la forma en què els residents experimenten en els seus espais socials i entorns de desenvolupament. La segona premissa és que la investigació d'un grup vulnerable condueix al desenvolupament d'estratègies per al canvi. L'article reconeix la necessitat d'investigar i desenvolupar intervencions per als grups socials vulnerables amb l'objectiu de millorar la seva situació i proporcionar un entorn més segur.(AU)

This paper argues that research on medical residency programs is necessary to improve the work and academic environment that physicians experience in their training as specialists. Therefore, some considerations are proposed to ensure ethical research. on medical residents. For this purpose, the paper follows the structure of two premises and a conclusion, where each premise is analytically supported. The first premise is that the structural factors of medical residency programs lead to a condition of vulnerability. The first premise is supported by exploring the structural factors that contribute to their vulnerability from the analysis ofthe Mexican context and the theoretical framework of intersectionality. Thus, some of the characteristics that intersect and determine the way in which residents experience their social spaces and development environments are presented. The second premiseis that researching a vulnerable group leads to the development of strategies for change. The article recognizes the need to research and develop interventions for vulnerable social groups to improve their situation and provide a safer environment.(AU)

Critics Say New State "Conscience Laws" Give Physicians Carte Blanche to Refuse Patients.

This Medical News feature discusses state laws that protect physicians who refuse to provide certain services because of religious or moral beliefs.

The Supreme Court Decision on Affirmative Action-Fewer Black Physicians and More Health Disparities for Minoritized Groups.

This Viewpoint discusses the US Supreme Court's June 2023 ruling on affirmative action and its repercussions for Black physicians and health equity for racial and ethnic minority groups.

Generative AI in Health Care and Liability Risks for Physicians and Safety Concerns for Patients.

This Viewpoint discusses the potential use of generative artificial intelligence (AI) in medical care and the liability risks for physicians using the technology, as well as offers suggestions for safeguards to protect patients.

Acerca del artículo La responsabilidad jurídica del médico, conceptos que se debaten entre dos ciencias / About the Article The legal Responsibility of the Physician, Concepts that are Debated between Two Sciences

Después de leer el artículo La responsabilidad jurídica del médico, conceptos que se debaten entre dos ciencias, del licenciado y profesor Camilo L. Momblanc,1) desearíamos realizar algunas consideraciones y, sobre todo, resaltar algunos aspectos que consideramos clave en la publicación. En primer lugar, quisiéramos destacar la gran importancia del artículo por lo sensible del tema que trata pues, a pesar de su trascendencia, no ha sido abordado con la amplitud necesaria en nuestras revistas médicas. El error en medicina sirvió tradicionalmente para aprender lo que no se podía hacer, hasta que apareció la reacción de castigar al responsable del error, suponiendo que fuera producto de la incapacidad o irresponsabilidad individual, y que generara un sujeto culpable. El error pasó así a constituir una problemática no solo ética sino también con implicación legal. Ciertamente, la posibilidad de equivocarse está presente en toda actividad humana, quien nunca comete errores es porque nunca hace nada, y de hecho comete la mayor de las equivocaciones, que es precisamente no hacer nada. El peor error no es equivocarse, sino no aprender a no cometer el mismo error uno mismo y no enseñar para que no lo cometa ningún otro profesional de salud. La práctica de la medicina está sujeta a una variabilidad que no siempre puede ser controlable. Esta situación expone al personal de salud a la comisión de errores, que pueden conducir o no a la producción de daño para el paciente. Todas las intervenciones médicas diagnósticas y terapéuticas tienen riesgos de complicaciones, a veces mínimos, pero no totalmente ausentes y pueden afectar a cualquiera, aunque sean muy bien indicadas y ejecutadas.2 El problema...(AU)

Legal Penalties for Physicians Providing Gender-Affirming Care.

This Viewpoint explains the "legal limbo" physicians may find themselves in, straddling state laws banning gender-affirming care and federal nondiscrimination law, both of which remain unclear due to ongoing legal challenges in the courts.

As Laws Restricting Health Care Surge, Some US Physicians Choose Between Fight or Flight.

In this Medical News article, 13 physicians and health care experts spoke with JAMA about the increasing efforts to criminalize evidence-based medical care in the US.

Physicians Say an Idaho House Bill That Would Criminalize Administering mRNA Vaccines Is an Attack on the Medical Profession-Even If It Doesn't Become Law.

This Medical News article discusses a bill introduced in Idaho that would ban administering mRNA vaccines.

The Problem with Using Medical Boards to Regulate Misinformation.

Some stakeholders called on medical boards to sanction physicians for spreading misinformation during COVID-19 and discussing off-label medications. In 2022, California passed AB 2098, which classifies physician dissemination of misinformation as unprofessional conduct subject to discipline by the state medical board. This article describes the purpose and function of state medical boards, the law relating to off-label prescribing, and why using medical boards to discipline physicians for discussing controversial opinions exceeds the traditional role of state medical boards. Though physicians do have a duty to provide accurate information to the public, defining misinformation is difficult and poses five distinct problems. Although California's law was repealed, this article asserts that disciplining physicians for disseminating misinformation could pose Constitutional concerns, hinder physicians' ability to practice medicine, or suppress information that is important to the public interest.

Legal Risks and Ethical Dilemmas for Clinicians in the Aftermath of Dobbs.

This Viewpoint discusses the ways in which the Supreme Court's ruling in Dobbs v Jackson Women's Health Organization, which triggered abortion bans or restrictions in half of states, presents serious legal risks to clinicians and major ethical dilemmas.

College complaints against resident physicians in Canada: a retrospective analysis of Canadian Medical Protective Association data from 2013 to 2017.

BACKGROUND: An understanding of regulatory complaints against resident physicians is important for practice improvement. We describe regulatory college complaints against resident physicians using data from the Canadian Medical Protective Association (CMPA). METHODS: We conducted a retrospective analysis of college complaint cases involving resident doctors closed by the CMPA, a mutual medicolegal defence organization for more than 100 000 physicians, representing an estimated 95% of Canadian physicians. Eligible cases were those closed between 2008 and 2017 (for time trends) or between 2013 and 2017 (for descriptive analyses). To explore the characteristics of college cases, we extracted the reason for complaint, the case outcome, whether the complaint involved a procedure, and whether the complaint stemmed from a single episode or multiple episodes of care. We also conducted a 10-year trend analysis of cases closed from 2008 to 2017, comparing cases involving resident doctors with cases involving only nonresident physicians. RESULTS: Our analysis included 142 cases that involved 145 patients. Over the 10-year period, college complaints involving residents increased significantly (p = 0.003) from 5.4 per 1000 residents in 2008 to 7.9 per 1000 in 2017. While college complaints increased for both resident and nonresident physicians over the study period, the increase in complaints involving residents was significantly lower than the increase across all nonresident CMPA members (p < 0.001). For cases from the descriptive analysis (2013-2017), the top complaint was deficient patient assessment (69/142, 48.6%). Some patients (22/145, 15.2%) experienced severe outcomes. Most cases (135/142, 97.9%) did not result in severe physician sanctions. Our classification of complaints found 106 of 163 (65.0%) involved clinical problems, 95 of 163 (58.3%) relationship problems (e.g., communication) and 67 of 163 (41.1%) professionalism problems. In college decisions, 36 of 163 (22.1%) had a classification of clinical problem, 66 of 163 (40.5%) a patient-physician relationship problem and 63 of 163 (38.7%) a professionalism problem. In 63 of 163 (38.7%) college decisions, the college had no criticism. INTERPRETATION: Problems with communication and professionalism feature prominently in resident college complaints, and we note the potential for mismatch between patient and health care provider perceptions of care. These results may direct medical education to areas of potential practice improvement.