[On the classification of the failure to render medical assistance to the patient].

The authors propose the classification of the failure to render medical assistance to the patient. At present, much attention is given to the analysis of drawbacks in the provision of medical care to the victims of various human activities. A variety of classifications of these disadvantageous practices have been proposed. However, they either only casually deal the problem of failure to render medical assistance to the patient or totally disregard it. The necessity to develop the new classification of the failure to render medical assistance to the patient arises from the formulation of article 124 of the Criminal Code of the Russian Federation that requires to evaluate the severity of harm to the health of the patient resulting from the inaction of the person(s) obliged to provide the necessary medical aid.

[The definition of a failure to render assistance to the patient in the forensic medical practice].

The authors consider the necessity of determining the severity of harm inflicted to human health by the inaction of the officials and other persons responsible for rendering assistance to a patient in accordance with article 124 of the Criminal Code of the Russian Federation. The absence of the normative formulation of the forensic medical criteria for the assessment of the degree of the harm to human health as a result of inaction of the subjects responsible for rendering medical aid creates difficulties for the enforcement of article 124 of the Criminal Code of the Russian Federation in its present wording. This problem awaits further studies for the possible adoption of the uniform normative and regulatory documents for the consistent application of the definition of inaction with reference to the assessment of not rendering medical assistance.

Putting theory into practice - a case study in one UK medical school of the nature and extent of unprofessional behaviour over a 6-year period.

BACKGROUND: Producing a medical profession which is fit for the demands and expectations of society involves ensuring that practitioners learn what it means to behave in a 'professional' way. Codes of professional conduct have been developed for medical students in the UK, but the literature on how medical schools actually apply these is small. More detail is needed to evaluate approaches to assessing professionalism, or to analyse the extent to which students 'fail' this aspect. AIM: To describe one UK medical school's approach to monitoring and assessing aspects of professional behaviour; quantify the prevalence and severity of behaviours recognised as cause of concern in the first 6 years of the programme; evaluate whether there is evidence of any association between professional and academic underperformance and draw conclusions for further development of fitness to practice procedures. METHODS: Mixed methods utilising exam board and administrative data for statistical and descriptive analysis. RESULTS: Even under detailed scrutiny, only 3% of students received formal warnings for behavioural problems over the course of a 5-year programme, and notifications decreased as students entered the senior years. There was a trend towards association between academic and professional underperformance. CONCLUSION: Creating clear expectations, providing positive role models and monitoring student behaviour makes explicit what is expected of students as 'professionals in the making', and contributes to overall low rates of misdemeanour. The predictive value of recurrent and serious behavioural problems is not yet known as it is too soon for these graduates to have established careers. Students who are struggling academically may also present with unprofessional behaviours but the cause of this is unclear. Further research is needed to benchmark systems across the UK, and to know whether formalising expectations of undergraduates result in less problems in subsequent practice.

Perception of teacher sexual misconduct by age of student.

This study explored whether student age influenced perceptions of teacher sexual misconduct. Participants (300 undergraduates) read scenarios depicting teacher sexual misconduct in which the student's age was varied (9, 12, 15), and then answered questions about their perceptions. Data were analyzed with 2 (respondent gender) 2 (cross-gender dyads) 3 (student age) MANOVAs. Experiences involving the youngest student were viewed as the most abusive, followed by the 12-year-old, and the 15-year-old. Gender differences were evident, with women viewing the experiences more negatively. Scenarios involving a male teacher/female student were viewed more negatively than a female teacher/male student dyad. These findings illustrate the importance of educating students and school personnel about teacher sexual misconduct.

Medical student professionalism: are we measuring the right behaviors? A comparison of professional lapses by students and physicians.

BACKGROUND: Examining the relationship between unprofessional behaviors observed in medical students and those manifested by physicians is important in determining whether medical school faculty are observing and reporting behaviors relevant to medical practice. METHOD: This study compares the relationship between unprofessional behaviors identified in students at our medical school through Early Concern Notes, and behaviors for which physicians were sanctioned by our state medical board. RESULTS: The majority of reports in both groups were related to lapses in professional responsibility and integrity, and the specific behaviors identified in the groups were similar. A smaller number of reports in both groups were related to pursuit of excellence or personal interactions. CONCLUSION: There are common features to the professional shortcomings seen in students at our medical school and practicing physicians in our state. These similarities add credibility to our faculty's observations, and reinforce the relevance of monitoring such behaviors in future physicians.

Boundaries in the doctor-patient relationship.

Boundaries in the doctor-patient relationship is an important concept to help health professionals navigate the complex and sometimes difficult experience between patient and doctor where intimacy and power must be balanced in the direction of benefiting patients. This paper reviews the concept of boundary violations and boundary crossings in the doctor-patient relationship, cautions about certain kinds of boundary dilemmas involving dual relationships, gift giving practices, physical contact with patients, and self-disclosure. The paper closes with some recommendations for preventing boundary violations.