[Medical disciplinary law: drastic review necessary]. / Medisch tuchtrecht: vergaande herziening noodzakelijk.

The purpose of medical disciplinary law is to monitor and promote the quality of professional practice. This objective is insufficiently achieved, and the structure of the disciplinary procedure therefore requires drastic improvement. In disciplinary law, the (individual) complainant has been given too much responsibility for the general interest of quality assurance and promotion in healthcare. Continuing to refine the complainant's position will not substantially improve the functioning of disciplinary law. The complainant should be denied direct access to the disciplinary procedure and the right to complain should be vested exclusively in the Inspectorate. The submission of complaints by the Inspectorate must be limited to those matters that contribute to the purpose of disciplinary law. The system outlined will significantly reduce the number of unnecessary disciplinary proceedings, and the associated pressure on the accused professionals as well as the burden on the disciplinary committees.

[Prevention and control of infectious diseases from a disciplinary-law perspective]. / Preventie en bestrijding van infectieziekten in tuchtrechtelijk perspectief.

OBJECTIVE: To gain insight into the importance for medical disciplinary courts of the collective health interest in the prevention and control of infectious diseases. DESIGN: Descriptive retrospective study. METHOD: The electronic databases of the Dutch government gazette (Staatscourant) and the Netherlands' medical disciplinary courts were searched for disciplinary court rulings on actions and negligence in the prevention and control of infectious diseases. RESULTS: We found 67 verdicts relevant to our subject in the period 1995-2013. Of these 67 disciplinary hearings, 12 were filed by the Netherlands' health inspectorate, 29 by the patient and 26 by a representative or next of kin. The defendants included 31 medical specialists, 12 dentists and 11 general practitioners. The disciplinary tribunal imposed measures in 23 cases, including 5 suspensions. CONCLUSION: In the case of serious infectious diseases the disciplinary courts decide that the caregiver also has to take into account the interests of other parties than caregiver and the patient. Medical microbiologists in hospitals should even go so far as to surrender their responsibility for general patient safety, if they are unable to comply with the applicable medical guideline. It is also striking that in questions of vaccination the disciplinary court judge is inclined to put a child's health interests before parental authority. One final striking point is that the health inspectorate plays an important role as complainant in disciplinary cases concerning prevention of infection.

Self-induced water intoxication: a comparison of 34 cases with matched controls.

Of 2201 psychiatric patients in public facilities in a single metropolitan area evaluated for polydipsia, 34 (1.5%) were found to have a history of self-induced water intoxication. Among them, they had 101 episodes of water intoxication. Their mean age was 48.2 years, and they were predominantly white. Most had the primary diagnosis of schizophrenia. Compared with a matched control group, they had received more multiple courses of ECT but there were no significant differences in their use of psychotropic medications. Among nonpsychiatric medications, only phenytoin sodium and hydrochlorothiazide showed a trend toward significance.