Pratica Medica & Aspetti Legali
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L’invalidità civile
Full text linkThis article provides an overview on civil invalidity in Italy, starting from the first law, in 1939, in which the invalid subject was considered and a definition of invalid person was given. During the following years this status has been ascribed to even better defined categories of patients, and now a big system of invalidity calculation, economic and not economic social security benefits has been built. A detailed description of each benefit, including requirements and bureaucratic procedures, follows and a survey on the institutions involved, closes this articl
Integrare l’approccio professionale e l’approccio manageriale: i piani di cura
Full text linkQuality in healthcare is one of the key points of the clinical governance and cannot be omitted to assure patient’s safety. One of the most important aspects of quality in healthcare is the elaboration and application of integrated clinical pathways that can improve efficacy and save costs. The article describes the main characteristics of an adequate pathway, able to involve both medical and managerial skills
Aspetti medico-legali dei trapianti d’organo in Italia
Full text linkIn the last decade new immunosuppression strategies have been developed, with the introduction of new pharmacological agents that act on different stages of the cell cycle (including for example sirolimus and brequinar). Nevertheless, in transplantation management there are still many controversies concerning medicolegal aspects. This article examines the Italian normative on transplantation, underlining the debate about the meaning of the term “brain death” as a description of the clinical condition of patients’ status as living or dead
Amministrazione di sostegno, volontà del beneficiario e rifiuto delle cure
Full text linkMany recent judgments, authorize the so called “amministratore di sostegno” (introduced in our legal system by Law n. 6 of January 9th, 2004) to express informed consent to medical treatments in the interest of the beneficiary/ patient – when he/ she is not able to make a reasonable assessment of his/ her interests, and then to express a valid consent to medical treatments – and even to refuse medical treatments, according to the wishes of the patients, on the ground of his/ her opinion, expressed in an advance care directive or resulting from his/ her behaviour, cultural background, ethical and religious convictions, etc. The article examines some judgments of the Italian Court that can better explain the importance and the meaning of this figure
Profili legali della sperimentazione clinica
Full text linkThe iter of a clinical trial includes some steps: except for the earliest one, the preclinical phase, each step involves human beings that could be exposed to adverse events or unknown reactions caused by the new treatment. Starting from Nuremberg Code in 1949, an in-depth legislation has been developed to define the relationship between the two protagonists of the clinical trial: the experimenter and the volunteer or patient who takes the new drug. Responsibilities and possible faults are established, taking into account patient’s rights to be preserved and informed of the risks and experimenter’s responsibility in case of not-predictable side effects
Reazioni allergiche a farmaci nel piccolo paziente
Full text linkAdverse drug reactions are an important public health issue. Maculopapular rashes are the most common cutaneous reactions to drug in children and most of them occur during beta-lactam therapies. The diagnosis is a relatively complex and subtle art. This article describes an approach to recognize and manage adverse drug reactions in children
Il rischio tecnologico in sanità
Full text linkAn overall risk management process in healthcare should involve the evaluating of potential risk related to medical devices and technology. The importance of this analysis is undelined by many legislative measures of both the Italian Country and the European Community. This article describes the importance of a medical devices vigilance system and the analysis that can be conducted to establish the baseline hazards associated with a device, evaluating its potential hazards. To improve patients safety, the risk analysis should include any risks associated with the manufacture and delivery of the device