Pratica Medica & Aspetti Legali
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L\u27obiezione di coscienza: quel poco che sappiamo di lei
No full text[Conscientious objection: the little we know on it] Abstract non presente. Si riporta l\u27inizio dell\u27editorialeLa presentazione di un libro è sempre un’operazione molto delicata e davvero rischiosa per il pericolo concreto che si corre di essere travisati nelle reali intenzioni: il rischio, già grande quando ci si cimenta nel compito di dare un’interpretazione personale alle opere di altri Commentatori, aumenta, naturalmente, quando la presentazione riguarda un libro di cui si è Autori..
Informatizzazione della checklist per la sicurezza in sala operatoria e i risultati raggiunti presso l\u27Istituto Ortopedico Rizzoli di Bologna
No full text[Computerization of the checklist in the operating room safety and the results achieved at the Rizzoli Orthopaedic Institute in Bologna] Since 2010, the Rizzoli Orthopaedic Institute in Bologna has joined the project of the Emilia-Romagna «Project SOS.net: Network operating theaters safe», adopting the surgical safety checklist regional in hard copy from three surgical units.Over the years, the adoption of the checklist has been extended to all surgical units, thanks to the computerization of the same: at the Institute had in fact been initiated a process of computerization of operating rooms, which also included the introduction/editing tools for the management of clinical risk in the operating room. This change has allowed not only to integrate computationally the moment of verification, by means of the surgical safety checklist regional, with the detection of deviations from the expected standard but also to be able to have specific reporting in real time.These implementations have been accompanied by appropriate training and organizational interventions, bringing the level of adherence to the instrument until it reaches almost 100%.
Valenza umana della cura (care) dei pazienti in SVP e ruolo dei caregivers
No full text[Human value of care and caregivers\u27 role in the management of permanent vegetative state (SVP) patients]As stated by the Royal College of Physicians, «patients who remain in a vegetative or minimally conscious state following profound brain injury present a complex array of clinical and ethical challenges to those who care for them». Patients in clinical condition of Permanent Vegetative State (SVP) are unaware of self and environment, enable of language comprehension or expression; they are able to survive along provided that we are able to ensure primary care, such as eating and hydration.With regard to this existential landmark, caregiver’s role is not only legally related, as guardian of will of his/her relative but also as “mediator” between the SVP patient and heath care professionals; in fact, the caregiver emphasizes the intentionality of patient behaviors, transforming them into care needing. Moreover, since the disease does not only indicate an impairment of one or more functions of an organ, and then the body, but also covers the mind, then the psyche, the sick body reflects in this way the soul’s suffering and this suffering has an impact on family caregivers
Ustioni da elettrobisturi: contributo casistico e considerazioni medico-legali
No full text[Electrosurgery burns: case series and medico-legal issues] In general and specialist surgical practice the use of the electrosurgical unit is consolidated for minimally invasive interventions, due to the ability to control the bleeding of the operative field and the interaction between the cutting and coagulative mechanisms.The authors take inspiration from four cases of personal observation, related to thermal injury produced by electrosurgery, to conduct a brief review of the literature on this issue and present some medical and legal aspects derived from their expert’s observation, in terms of healthcare liability.The authors underline the importance of an accurate knowledge of the procedures for the safe operation of the equipment and the monitoring of adverse reactions related to the use of the instrument itself, even in the global risk management approach
Una nuova relazione europea analizza il rischio correlato ai tumori professionali
No full text[A new European report analyzes the risks related to occupational cancer]Abstract non presente. Si riporta l\u27inizio dell\u27editorialeIl 4 febbraio 2015 è stata celebrata la giornata mondiale contro il cancro, e in questa occasione l’Agenzia europea per la sicurezza e la salute sul lavoro (EU-OSH) ha diffuso la sua relazione sui tumori lavoro-correlati, che rappresentano ancora un importante problema di salute in tutta Europa, e non solo, soprattutto in relazione all’esposizione dei lavoratori a sostanze cancerogene
Ricetta elettronica e certificati on line: analisi giuridica in ottica sicurezza e privacy
No full text[Medical electronic prescriptions and certificates online: legal analysis on security and privacy]The objective of the digitization of the medical prescriptions and certificate takes shape in our legislative system through complex rules, disseminated in a variety of interventions. The author of this article discusses in detail the legislation on electronic prescribing, since Decree Law. 269 of 30 September 2003 up to the data protection code. In addition to the electronic prescription by the family doctor, the author also presents the legal regulations concerning the issuance of medical certificates to be sent via Internet to the administrative control agency and to employer.The data protection code is a fundamental point, especially for the obligations imposed on the general practitioner regarding the information to be signed by the patient and the ownership of the data requested. Given the sensitivity of the data processed, security must be particularly ensured.The author finally illustrates the creation of databases in the health sector, emphasizing that it is an operation of extreme importance in terms of privacy, therefore should be paid great attention to the use of security measures
L’«affaire Vincent Lambert» e la Corte Europea dei Diritti dell’Uomo. Breve promemoria per il futuro legislatore italiano
No full text[L\u27«affaire Vincent Lambert» and the European Court of Human Rights. A brief memorandum for the future Italian legislator] Abstract non presente. Si riporta l\u27inizio dell\u27editorialeIl 5 giugno 2015 la Corte Europea dei Diritti dell’Uomo si è pronunciata a camere riunite (Grande chambre) sul cosiddetto “affaire Lambert” che ha visto contrapposti alcuni familiari di Vincent Lambert (in specie i genitori, una sorella e un fratellastro dellostesso) contro lo Stato Francese [1]. In particolare, i ricorrenti si opponevano all’interruzione dell’alimentazione e dell’idratazione artificiale di Vincent Lambert [...]
I servizi di inserimento lavorativo per le persone con disabilità in provincia di Torino: riflessioni su quindici anni di attività e incertezze e prospettive per il futuro
No full text[The job placement services for people with disabilities in the province of Turin: reflectionson fifteen years of activity and uncertainties and future prospects]The Regional fund for employment of people with disabilities, established by theRegional Law n. 51/00, has been the main method used in the past to make possibleand sustainable, as part of the services for the work, the targeted employmentof disabled people. The new institutional structure of provinces and “MetropolitanCity”, as defined by the reform introduced by the Law of 7 April 2014, n. 56, andthe uncertainty that still pervades the final structure of the functions assigned bythe state to the provinces, requires a rethinking of the organizational form of theservices, so as not to miss the precious heritage of relationships and cooperativepractices developed in recent years on the individual territories.This article intends to build a synthetic report of what has been done in recent years,in order to propose directions and work tracks for a new restart of activities and thedefinition of services more responsive to the needs expressed by the territory of thenew Metropolitan City area. The author emphasizes the need to start thinking seriouslyon practicality in our area to experiment devices and processes of inclusion inthe long term, based on forms of alternation between socialization - training - work,that the European practice called “sheltered workshop” and that in Italy can rely onthe widespread experience of “type B” social cooperative, which means “protected”job placement or “transition” to employment for people with greater difficulties (forreasons of age, experience , spendable skills, length of absence of work, etc.)
Omicidio e lesioni personali da incidenti della strada in stato di ebbrezza e di alterazione psico-fisica. Criticità e problematiche. Considerazioni medico-legali
No full textRoad traffic crashes are a main cause of physical harm and mortality. That means a heavy burden in terms of short, medium and long-term disability and public costs for society. Among the most relevant cases of severe accidents is driving under the influence of alcohol and psychoactive drugs. That’s the reason of the international strong effort to combating the phenomenon. In Italy the draft law concerning the criminal offence of vehicular homicide and road traffic personal injuries is currently being discussed. Previously the law n. 120/2010 has already changed the regulation in matter of drink-driving and driving under the influence of controlled substances with stiffer penalties for transgressors and (at least some) guidance as to assess the infringement. The draft law suggests that clinical and toxicological evidences of actual driving impairment has to be proved to reach significance in court, nevertheless no standard and effective procedure has being established for detection, at least for what concerns controlled substances. The purpose of this article is to put in evidence, in accordance with a medico-legal perspective, some of the issues that emerge from this complex matter (i.e. the need of a list of the impairing substance under detection, of well-defined legal cut-off values, of a better definition of the problems following the therapeutic use of drugs of abuse and other concerns), issues, those, that are now more troubling whereas the introduction of new crimes and punishments is becoming more concrete
Il progetto Agenas sulla medicina difensiva
No full text[The Agenas project on defensive medicine] Abstract non presente. Si riporta l\u27inizio dell\u27editoriale Da sempre e per loro stessa intrinseca natura le attività umane hanno a che fare con la possibilità che si commetta un errore; evento questo con una connotazione sempre negativa ed a volte drammatica. In ambito sanitario l’errore assume, in primis per le conseguenze sulla salute e l’alto impatto emotivo ed etico, una valenza ulteriormente accentuata e sovente tale da distorcere la comprensione delle reali dinamiche e di alcuni aspetti del suo stesso significato e, conseguentemente, delle misure oggettivamente più appropriate per prevenirlo..