The New Zealand medical journal
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To characterise doctors' responses to complaints. ⋯ The complaints process in New Zealand has the potential to improve healthcare delivery at a systemic level and to reinforce appropriate standards of professional behaviour, but it may cause individual doctors to practice defensively. Unless an appropriate educational process is allied to the complaints process, defensive medicine may compromise patient care and constrain potential improvements in healthcare delivery overall.
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During overwhelming demand for resources, such as during an influenza pandemic, clinicians may be required to deny some patients access to a resource (for example ventilation, or hospital admission). However, no pragmatic guidance exists to help clinicians do this. This paper presents criteria for the prioritisation of access to resources during overwhelming demand. The criteria are in the form of eight questions related to the resource and the patients competing for it and are intended to be sufficiently comprehensive and sufficiently succinct to be useful to clinicians who might be required to make such decisions.