Archiwum medycyny sa̧dowej i kryminologii
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The paper presents medico-legal problems associated with providing assistance to victims of traffic accidents. Legal acts have been analyzed in the aspect of help provision. ⋯ Particular attention has been paid to circumstances of providing emergency assistance, its scope, and situations when the obligation of providing first aid is no longer binding. The problem of provision or refusal to provide help seems--according to the authors--to be valid, since not all relevant legal regulations are generally known.
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Arch Med Sadowej Kryminol · Jan 2007
Review[Iatrogenic biliary ducts lesions after laparoscopic cholecystectomy: a medical technical error or a therapeutic failure in a routinely performed procedure. A medico-legal evaluation of selected cases].
Laparoscopic cholecystectomy due to cholelithiasis is associated with a higher risk of intraoperative lesions of biliary duct in comparison to classic surgery. Technical difficulties, a limited access to operating area, the presence of cholecystic adhesions and inflammatory lesions, as well as possible anomalies or anatomical variations of the extrahepatic biliary ducts pose the risk of damaging the biliary tract. At times, laparoscopic procedures are performed by surgeons with insufficient operator skills and qualifications. ⋯ Three instances were associated with investigations carried out by public prosecutors in medical error cases, and in three others, civil cases were brought in the court, with the plaintiffs advancing a claim. While defining the scope of the management--both diagnostic, therapeutic and decision-making--in the pre-, intra- and postoperative period, attention was drawn to the prescriptive character of patient management in such cases, including indications for laparoscopic surgery, an increased potential therapeutic risk that also included a possibility of the patient developing "normal, typical" complications, referring the above factors to the scope and limits of the physician's professional and criminal liability and analyzing them to assess whether a medical error had been committed, or else the events had represented a therapeutic failure within the limits of the accepted therapeutic risk. A separate problem emphasized by the authors focused on difficulties in objective evaluation of health-associated consequences that might be defined in a tabular manner as long-term or permanent detriment to health.
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Arch Med Sadowej Kryminol · Jan 2007
[Problems in medical certification of posttraumatic neuropsychiatric disorders for the purpose of criminal and civil law proceedings].
In the past several years, in the material of Forensic Medicine Department, Medical University of Silesia in Katowice, a significant increase has been noted in the number of cases associated with CNS dysfunctions, either as isolated conditions or in association with posttraumatic disorders. In the majority of cases, such dysfunctions were causally related to a head trauma. ⋯ In the present publication, the authors have emphasized difficulties in assessing the complaints reported by the claimants and the possibilities of objectivization of such complaints by neuro-psychiatric examinations. They also stress problems in application of obligatory ICD 10 terms denoting dysfunctions of the central nervous system in medico-legal opinions.
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Arch Med Sadowej Kryminol · Jan 2007
[The risk of medical error occurrence on holidays in the material of the Forensic Medicine Department, Medical University of Silesia, Katowice, in the years 2000-2005].
The issue of medical error is relatively often discussed at forensic congresses or conferences. The authors carried out a medico-legal analysis of records of proceedings related to the appraisal of medical procedures investigated in the Forensic Medicine Department, Medical University of Silesia, Katowice, in the years 2000-2005. ⋯ The majority of errors were associated with the decision-making process or diagnostic management and committed in hospital admission rooms or the so-called operative departments (orthopedic surgery, general surgery, gynecology, obstetrics). Evaluating the above presented cases, the authors drew attention to factors affecting the risk of medical error and the most common causes of inappropriate patient management.
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Arch Med Sadowej Kryminol · Jan 2007
[Consent of Jehovah's Witnesses to treatment with blood preparations: legal and ethical aspects].
A specific situation in medical practice involves a contact with the philosophy of life represented by Jehovah's Witnesses and their refusal to receive blood transfusions. The objective of the present study is to present legal problems related to the rights of Jehovah's Witnesses to refuse treatment with blood and its derivatives. ⋯ The legally unacceptable situation is also stressed, wherein the treatment is instituted without the patient's consent or despite his refusal, even if such treatment is administered by the physician positive as to his most noble motivation. Selected ethical issues associated with this problem are also presented, along with the stance of international conventions on human rights and biomedical aspects.