Pratica Medica & Aspetti Legali
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203 research outputs found
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Danno da emotrasfusione: responsabilità e prescrizione
No full text[Damage caused by blood transfusion and medical liability]A wide scientific and jurisprudential literature is available on the issue of medical liability for damage by blood transfusion. National laws and jurisprudential guidelines had transposed the scientific development in term of preventive diagnostic techniques designed to minimize the risk of post-transfusion infections. For this reasons the Ministry of Health has issued several decrees to preserve patients from viral post-transfusion infections, avoiding compensation due to unpredictable transfusion damages. Particularly, by implementing all the methods provided by law, it is now possible to minimize the risk of infection, but it is impossible to cancel it. On the other hand, in the “so-called windows period” for viral infections, potential infective donors can’t be identified, although the recent molecular technique (PRC: polymerase chain reaction) has been applied for HBV, HCV, and HIV. This technique has been introduced in the nineties but applied only since 2000. Consequently an unappropriated transfusion therapy for wrong indication or a careless collection, analysis, and storage of blood, according to laws since 2000, remain compensable. Post-transfusion infections, which are impossible to identify for the sensitivity limits of analytical methods, are not compensable. Another important issue is the time-barred for the request of the damage: in this case, the prescription term doesn’t start since the time of infection, but since the time when the disease was perceived or it could be perceived as a post-transfusion damage. The purpose of this review is to provide an overview on the responsibility and the time-barred of damage caused by blood transfusion
L’introduzione della legge 41/2016 in tema di omicidio e di lesioni personali stradali: aspetti medico-legali e analisi della giurisprudenza
No full text[The introduction of the law 41/2016 on vehicular homicide and road traffic injuries: medical-legal issues and analysis of case law]The law n. 41/2016 has recently introduced, into the Italian penal code, articles n. 589-bis and 590-bis that concern vehicular homicide and road traffic personal injuries. Although this leads to a tightening of the penalties, today a lot of criticities still remains; in particular, the assessment of the psychophysical condition of the driver and relative applying procedures. These problematic issues have alreadybeen highlighted under a medico-legal perspective and today emerge also from an acquittal or conviction sentences that, arising from equivalent evidences, are interpreted in divergent or even antithetical ways
La sicurezza del paziente in ambiente ospedaliero e la responsabilità professionale dei vertici strategici
No full text[Patient safety in the hospital setting and the professional responsibilities of top managers] The authors underline the evolution of legislation concerning the creation of Hospital Companies and the reasons for the implementation of clinical risk management activities, then analyse the responsibilities involving the top figures of the top hospital management. In particular, the authors highlight the obligation and responsibilities of the strategic apex of a Hospital Company and show that, sometimes, the technical consultants – who express a medical-legal advice – underestimate the responsibility of these figures.It is a management responsibility that determines the obvious and inevitable consequences on those who work in contact with the patient and who bear the obligations and responsibilities.In some cases, the responsibility of the top figures is indisputable and obvious, but there is no awareness about the possibility of the top management involvement within the assessment evaluation
L’infortunio psichico da causa lavorativa
No full text[Psychological work-related injury]In Italy the recognition of the occupational injury, caused by acute damage to the mental health of the worker, is still difficult and exceptional. The study points out the clinical case of a worker, recently published, that in the scientific literature is probably, to date, the only event of psychic damage related to work in which an occupational cause has been found and the recognition of an accident at work has been done.A worker, after a verbal, animated dispute with some colleagues and superiors, had an acute psychiatric agitation attack and went to the nearest emergency room where, on the strength of the anamnesis, the physicians diagnosed an anxiety crisis reactive to the work environment. The worker has been off work for 110 days because of an anxious and depressive syndrome, due to the verbal conflict. In a later assessment, INAIL recognized only the first 30 days of the employee’s time off as injury at work, while judging the following period off work as related to affectivity disturbance due to common disease, not related to work environment.This case opens new perspective for the occupational physician in the assessment of ASD as work injury and of PTSD as professional disease, suggesting to put more attention to psychiatric health of workers
Nutrizione oggi: nuove tendenze, vecchi principi?
No full text[Nutrition Today: new trends, old principles?]Abstract non presente. Si riporta l\u27inizio dell\u27editorialeLa vasta diffusione di teorie e pratiche nutrizionali, sbandierate come il futuro ormai prossimo, capaci di modificare radicalmente alcuni paradigmi consolidati, ovvero certezze che sembravano inossidabili, oltre che gli approcci terapeutici tradizionali, ha gettato nella massima confusione professionisti, pazienti e popolazione generale, creando aspettative irrealistiche che spesso rasentano l’illusione di poter curare patologie complesse con interventi singoli e semplificati
Il concetto medico legale di lavoro usurante in ambito previdenziale: corretta applicabilità nella pratica valutativa presso i Centri Medico Legali (CML) INPS.
No full text[The medico-legal concept of «arduous work» in the social security medicine and its proper application in evaluation practices among the medico-legal departments (CML) of the Italian national welfare institute (INPS)] Some work categories are considered difficult for the effort they need, thus requiring a specific categorization. These work categories are defined as “arduous”.The article describes the recognition for certain job categories of the arduous status in the evaluation practice among the medico legal departments (Centri Medico Legali – CML) of the Italian national welfare institute (Istituto Nazionale della Previdenza Sociale – INPS).Frequently, the adjective “arduous” is attributed to work categories that are not defined in that way by the physicians of the INPS Institute, by the family doctors who draw up the medico legal certificates (the so called “SS3” certificates) and by the doctors who work at the so called “Patronato”, an Italian social organization which offers medical and legal services to all citizens.The article aims to define the working activities for which it is suitable to use the categorization “arduous” and highlight at the same time those work categories for which such a categorization is not always applicable.This research describes some cases observed by our medico legal department of the incorrect use of the categorization “arduous” for work activities that should not be considered as such. The purpose of the article is to provide a short guide to family doctors and physicians who work at “Patronato” on how to properly categorize a work as “arduous” in the context of the social security medicine
Sindrome delle apnee ostruttive del sonno e rischio di incidenti stradali: doveri del medico e possibili responsabilità del paziente
No full text[Obstructive Sleep Apnea Syndrome and road accident risk: physician’s duties and patient’s potential liability] Obstructive Sleep Apnea Syndrome (OSAS) is the most common sleep disorder associated with excessive daytime sleepiness (EDS), and it is estimated to affect 1,600,000 people in Italy. Untreated OSAS is significantly associated with an increased risk of driving accidents. This article reviews the main professional duties of physicians dealing with patients with OSAS, and the patient’s potential liability in case of sleep-related road accidents. Physician’s duties were divided into the following: 1. duties related to certification according to the law 120/2010 and the Decree 22 December 2015; and 2. duties related to patient education about the risks related to EDS and about his/her potential liability in case of driving accidents. The latter issue was reviewed in light of several Italian Supreme Court decisions about the criminal and civil liability in case of motor vehicle crashes due to sudden “sleep attack”. Finally, since in Italy there is not a specific law requiring physicians to report the drivers affected by OSAS associated with EDS, circumstances in which physicians may (or have to) inform driving licence authorities are discussed. Indiscriminate reporting of patients is not recommended, but it should be limited to selected and actually dangerous patients
La dignità come dotazione della persona demente
No full text[The dignity as an endowment of the person with dementia]The author analyzes the practical dimensions of human dignity, starting from its various representations and constituent elements. In particular, the author relates the human dignity with dementigene diseases that affect the biographical identity of the person and are a real testing ground in the daily clinical practice.The article presents the rights of the person with dementia that, taken together, give to dignity a clear expressive face, and consistent with the various multilevel order and with professional medical ethics
L’utilizzo dei casi in ambito etico-deontologico nella formazione infermieristica
No full text[The use of cases in nursing education on ethics and deontology]The present article describes the case analysis methodology for ethics and deontology in nursing education and continuing education for nursing staff. For this purpose, it illustrates a specific pedagogical approach for the analysis of the cases, borrowed from reference models in the existing literature, for example the model by Fry and Johnston and the grid for the analysis of clinical cases developed by Spinsanti.In the second part of the article we are given the experience of application of this training approach, carried out during the first-level university master in nursing management of the University Vita-Salute San Raffaele in Milan; it is in fact discussed a case on admission to the emergency department of a subject highly disadvantaged: immigrant, illegal, homeless and drunk
Comunicazione sanitaria e social media: rischi e opportunità
No full text[Healthcare communication and social media: risks and opportunities]Social networks represent one of the most common ways of communication in the world. Learning its wise use, and knowing the alphabet, it is one of the essential steps to be pursued with greater tenacity in health, because of the risks and benefits that these powerful tools offer. Social media have become a powerful vehicle that you have to learn to drive carefully, otherwise it could get out of hand with all the attendant risks. The risks are civil, penal, ethical, and are widely considered in the public administration codes of conduct. Still in Italy there is no trace of social networks in the codes of ethics of the health professions, however there are a number of references to the benefits that are derived from the well-set communication