Pratica Medica & Aspetti Legali
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Pensare in numeri e usare i numeri per comunicare il rischio
Full text linkBad presentation of the risks associated with a medical intervention can lead to patients making poor decisions on treatment. Some ways in communicating clinical risk are particularly confusing, expecially when physicians use conditional probabilities (such as sensitivity and specificity), and relative risks. However, the inability to understand statistical information is not a mental deficiency of doctors or patients but is largely due to the poor presentation of the information. This articles gives some advices to improve an adequate communication of statistical information, so that patients can make well informed decisions
La responsabilità del primario nell’attività in équipe
Full text linkTeamwork is now a fact of life for physicians working in hospitals and other institutional settings. When a case of malpractice occurs, it is necessary to define the extent of liability of each member of the team. In this article, the Author analyzes specifically the role of the head physician. Juridical and medico-legal aspects are evaluated on the basis of civil law and specific regulations now in force
Il danno da emotrasfusione: dieci sentenze delle Sezioni Unite della Cassazione
Full text linkDuring recent years, health care authorities as well as patients are increasingly concerned about possible transmission virus (HBV, HIV HIV, etc), through a negligent transfusion of infected blood. Until now, despite the extreme importance of this subject, no univocal guidelines have been defined by the Italian Law. Recently the United Sections of the Court of Cassation issued ten judgements concerning cases of malpractice in blood transfusion. This article provides a summary of these legal decisions and describes their implications in clinical practice
Prescrizione dei medicinali: aspetti normativi
Full text linkMedications must be approved by AIFA or EMEA before they are allowed to be marketed in Italy. Once a drug is on the market, physicians may use it to achieve therapeutic goals other than those for which the drug was originally approved: this is referred to as off-label prescribing. Off-label prescribing has become an ubiquitous part of mainstream medical practice and it’s particularly common in oncology, paediatrics, and infectious disease. In Italy this practice is regulated by a specific normative who underlines the criteria for off-label prescription and gives a positive list of accepted in-hospital off-label uses. This article examines the Italian regulatory context concerning the prescription of off-label, from the so called “legge Di Bella” to the dispositions of “legge finanziaria 2007” and the most recent “legge finanziaria 2008”. Its aim is to help the physician to understand his responsibilities and limitations in drug off-label use
Danno alla persona di natura estetica in ambito civile
Full text linkIn current talk, a damage represent harm or injury to property or a person, resulting in loss of value or the impairment of usefulness. In the medical context a damage is an injury caused by a wound, a disease or a trauma, while in civil law, the technical sense of the term it is a delict committed in contempt, or outrage of any one, whereby his body, his dignity, or his reputation, is maliciously injured. Aesthetical damage is a classical example of how consequences of an injury may include physical hurt as well as damage to reputation or dignity
Implicazioni medico-legali del trattamento endoscopico dell’ipertrofia prostatica benigna
Full text linkWe report a case of chronic urinary and faecal incontinence after transurethral resection of the prostate (TURP) and inguinal erniotomy. The analisys of the surgical techniques used in the treatment of prostatic hypertrophy (IPB) and the characterization of the complications demonstrate that many adverse effects are due to faulty surgical technique. Diagnostic, prognostic and therapeutic aspects of prostatic hypertrophy are estimated and the “state of the art” of surgical treatment is traced, including positive and negative aspects. Particular attention was dedicated to the TURP, gold standard for IPB, singling out the risks and the possible iatrogenic injuries. Scientific references prove that the frequency of such injuries is wide distributed in endoscopic treatment and can be referred mainly to jatrogenic causes. The fundamental lines of professional liability are analyzed in order to the right of injury compensation, according to civil law
Accordo di linee guida per l’utilizzazione dei filler nell’aumento del tessuto cutaneo e sottocutaneo
Full text linkThe presence of a lot of dermal fillers for aesthetical use and many adverse events has made necessary an accord of guidelines, among the experiences of the experts about use of this devices, that concerned the ideal characteristics of a filler, the criteria of choice (anatomical area, type of aesthetical defect ), the consolidate procedural habits, the legal aspects (clinical chart and informative consent), the behaviours in the different anatomical zones
La valutazione medico-legale delle malattie dell’apparato digerente integrata da accertamenti specialistici non invasivi
Full text linkInflammatory Bowel Diseases (IBD) present a symptomatology characterised by periods of remission followed by clinical and endoscopic worsening; this makes the assignment of the functional damage for a correct medical-legal evaluation difficult, especially as far as the judgment of “permanency” in taken into consideration. Invasive investigations, such as endoscopic procedures, are not allowed for medical-legal evaluations. So it may prove particularly useful and resolving in such diseases using abdomen echography which, together with some other supplementary tests, allows the gathering of a fundamental quantity of data for the diagnosis, the research for the complications, the definition of the state of activity of the pathology and the follow up of the patients. A reasoned and competent use of the abdomen echography – well-endured, non-invasive and economical – can help in reducing the employment of endoscopic exams or other types of tests otherwise contraindicated, and it represents a precious impletion of the specialist gastroenterological medical examination guiding the forensic doctor to the meditated evaluation of the damage
Il danno estetico: valutazione in sede penale
Full text linkThe authors examine the meaning of permanent slash of the face from the Penal code point of view, with an excursus from ancient codes to current Rocco code, undelining the reasons that lead to an equalization of the damage terms in the context of serious personal injuries. In the evaluation of aggravating circumstances in personal injuries, a great caution must be taken before couching an ultimate medical legal judgement
