Zeitschrift für ärztliche Fortbildung und Qualitätssicherung
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Z Arztl Fortbild Qualitatssich · May 2004
[Fragmentation of the doctor-patient relationship as a result of standardisation and economisation].
Standards, guidelines and evidence-based medicine are suitable means to strengthen the doctor-patient relationship, but will have the opposite effect if they are unrelated to the subject and fail to address the patient's needs. This may be the case with collective agreements in terms of socialised medicine which serve to restrict the patient's individuality in favour of rigid austerity measures and rationing. For this reason, rationing can only be a political instrument; it should never be applied to the doctor-patient relationship. ⋯ Currently, the introduction of all these programmes means adding to the immense burden on medical doctors, which in turn will produce negative effects on time and personnel. If the application of the working time legislation is to be observed, then the hospital doctor is threatened with becoming either a temporary agency worker or a professional holiday-maker. If the doctor-patient relationship is to be strengthened then this can only be achieved through the quality of the medical services provided and humane patient care.
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Z Arztl Fortbild Qualitatssich · May 2004
[The influence of medical standards, medical guidelines and economic restrictions on the standard of legal liability].
First we will have to identify the components determining the standard for medical liability in civil law cases. The civil courts have so far uniformly regarded the medical standard defined by physicians themselves as the standard of legal liability. Medical standards are based on scientific knowledge, practical experience and professional acceptance. ⋯ With reference to the civil law, though, others demand that the medical standard must be given top priority. In accordance with the latter opinion rationing is only permitted in cases of a natural shortage of resources. Shortage of economic resources must not influence the standard of legal liability.