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1.
Bone Joint J ; 102-B(5): 550-555, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32349593

RESUMO

The cost of clinical negligence in the UK has continued to rise despite no increase in claims numbers from 2016 to 2019. In the US, medical malpractice claim rates have fallen each year since 2001 and the payout rate has stabilized. In Germany, malpractice claim rates for spinal surgery fell yearly from 2012 to 2017, despite the number of spinal operations increasing. In Australia, public healthcare claim rates were largely static from 2008 to 2013, but private claims rose marginally. The cost of claims rose during the period. UK and Australian trends are therefore out of alignment with other international comparisons. Many of the claims in orthopaedics occur as a result of "failure to warn", i.e. lack of adequately documented and appropriate consent. The UK and USA have similar rates (26% and 24% respectively), but in Germany the rate is 14% and in Australia only 2%. This paper considers the drivers for the increased cost of clinical negligence claims in the UK compared to the USA, Germany and Australia, from a spinal and orthopaedic point of view, with a focus on "failure to warn" and lack of compliance with the principles established in February 2015 in the Supreme Court in the case of Montgomery v Lanarkshire Health Board. The article provides a description of the prevailing medicolegal situation in the UK and also calculates, from publicly available data, the cost to the public purse of the failure to comply with the principles established. It shows that compliance with the Montgomery principles would have an immediate and lasting positive impact on the sums paid by NHS Resolution to settle negligence cases in a way that has already been established in the USA. Cite this article: Bone Joint J 2020;102-B(5):550-555.


Assuntos
Consentimento Livre e Esclarecido/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Procedimentos Ortopédicos/legislação & jurisprudência , Medicina Estatal/legislação & jurisprudência , Austrália , Alemanha , Humanos , Consentimento Livre e Esclarecido/ética , Medicina Estatal/ética , Decisões da Suprema Corte , Reino Unido , Estados Unidos
3.
Yale J Biol Med ; 92(4): 793-803, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31866796

RESUMO

The Eighth Amendment to the US Constitution prohibits the infliction of cruel and unusual punishments. However, no method of executing prisoners has ever been deemed by the Supreme Court to constitute Cruel and Unusual Punishment. Constitutional challenges to the dominant mode of executing prisoners today - lethal injection - are hobbled by a lack of clinical data that would reveal the likelihood this method might inflict gratuitous pain. Here, we assess the contemporary Eighth Amendment jurisprudence, including its legal and scientific limitations, and suggest modifications.


Assuntos
Pena de Morte/legislação & jurisprudência , Jurisprudência , Decisões da Suprema Corte , Humanos , Estados Unidos
7.
Rev. esp. med. legal ; 45(3): 108-113, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188611

RESUMO

Objetivo: Analizar los datos epidemiológicos y jurídicos de los casos por responsabilidad médica fallados por la Corte Suprema de Justicia chilena los años 2014 y 2015. Material y método: Se realizó un estudio retrospectivo, revisando los fallos de la Corte Suprema de Justicia en la base de datos electrónica del Poder Judicial chileno. Se seleccionaron y analizaron los fallos por responsabilidad médica. Resultados: Se detectó un total de 110 casos por responsabilidad médica. Todos correspondieron a causas civiles. La duración promedio de los procedimientos fue de 39 meses. La especialidad más demandada fue ginecología. La mayoría de las demandas afectó al Sistema Público de Salud. Los casos que dan origen a las demandas son, en su mayoría, de atención programada frente a los de urgencias, y de tratamiento frente a procedimientos quirúrgicos. El 39% de los casos resultaron en muerte del paciente. La mayoría de las demandas resultó desfavorable para los demandantes. Conclusiones: Se requiere un urgente análisis de los factores de riesgo, no solo de la ocurrencia de mala praxis, sino de la judicialización de los conflictos médico-paciente, especialmente en el área ginecoobstétrica. Además, dado que los juicios conllevan un alto coste no solo económico, sino también psicológico y emocional para todos los involucrados, un análisis de los mecanismos judiciales propios de este tipo de casos podría contribuir a que estos se resolvieran, en la medida de lo posible, en instancias prejudiciales o en procesos judiciales más cortos, beneficiando a todos los involucrados


Objective: The objective of the present study is to characterise the epidemiological and legal data on medical malpractice ruled by the Chilean Supreme Court (CSC) in the years 2014 and 2015. Material and method: A search of the CSC electronic database was conducted to identify and analyse CSC rulings for criminal and civil medical malpractice cases. Results: A total of 110 malpractice cases were identified. The CSC received only civil cases of medical malpractices during the studied period. The average duration of the trial was 39 months. Gynaecologists faced suits more frequently than any other type of specialist. The majority of cases were associated with the public health system. More claims were associated with scheduled than with emergency care. Likewise, more claims. Were associated with non-surgical treatment than with surgical procedures. More than a third (39%) of the cases resulted in the patient's death. The majority of CSC rulings were in favour of the defendants. Conclusions: An urgent analysis of the risk factors is necessary, not only of the occurrence of malpractice, but also of doctor-patient conflicts by judicial means, especially in the gynaecological-obstetrics area. In addition, considering that the trials not only involve a high economic cost, but also psychological and emotional one, for all involved, an analysis of the judicial mechanisms of these types of cases could help resolve them, and when possible, in preliminary courts or in shorter judicial processes, benefiting all parties


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Responsabilidade Civil , Erros Médicos/legislação & jurisprudência , Decisões da Suprema Corte , Chile , Estudos Retrospectivos , 25783
8.
Behav Sci Law ; 37(5): 493-511, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31441109

RESUMO

Murders committed by juveniles have been a major concern in the USA for more than 40 years. Due to decisions in the 21st century by the United States Supreme Court, the likelihood of juvenile homicide offenders being sentenced to life without parole (LWOP) is less than in past decades. In addition, hundreds of individuals in prison who were sentenced to LWOP under mandatory sentencing statutes or their equivalent as juveniles for murder are now eligible for resentencing and may be released. Given these changes in sentencing policies and practices, follow-up research on juveniles involved in murder is needed. This study is a 35-year follow-up study of 59 boys who were convicted of murder and sentenced to adult prisons in a southeastern state, and initially interviewed in the early 1980s. Twenty-two of these men agreed to participate in clinical interviews about their experiences in prison and upon return to the community if released. The experiences in prison are highlighted for all men. Thereafter, attention focuses on the 19 juvenile homicide offenders who have been released. Of these 19 men, 11 were classified as failures given that they were sent back to prison at least once. Length of time served and completion of GED were the best predictors of post-release success. Clinical observations, implications of the findings, limitations of the study, and directions for future research are discussed.


Assuntos
Criminosos , Homicídio/legislação & jurisprudência , Delinquência Juvenil/legislação & jurisprudência , Prisões , Reincidência , Adolescente , Escolaridade , Seguimentos , Humanos , Aplicação da Lei , Masculino , Decisões da Suprema Corte , Fatores de Tempo , Estados Unidos
9.
Psychiatr Serv ; 70(7): 622-624, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31258031

RESUMO

As death row prisoners age, a new set of issues arises regarding their competence to be executed. Can a prisoner with dementia who no longer remembers the crime be put to death? What if the dementia has progressed to the point that the prisoner no longer understands that he or she faces execution, or why? These issues were considered by the U.S. Supreme Court in its recent decision in Madison v. Alabama. Implicitly rejecting the cruelty of executing a highly impaired prisoner, the court clarified the conditions that could preclude execution and the degree of impairment that must be present.


Assuntos
Pena de Morte/legislação & jurisprudência , Demência , Psiquiatria Legal/legislação & jurisprudência , Competência Mental/legislação & jurisprudência , Prisioneiros/legislação & jurisprudência , Decisões da Suprema Corte , Idoso , Humanos , Masculino , Estados Unidos
14.
J Leg Med ; 39(1): 1-13, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31141456

RESUMO

The United States Supreme Court has upheld state vaccination mandates as a condition of entry to schools by relying on their police power in protecting public health and safety. Despite this broad authority, many state mandates include exemptions that permit parents to refuse vaccination on behalf of their children for nonmedical reasons, like religious, philosophical, or personal beliefs. A spectrum of these laws currently exists, ranging from California's ban of all nonmedical claims to Ohio's extremely permissive grant of exemptions. This article discusses each of these states' mandates and the relationship between relaxed exemption laws and measles outbreaks using statistical analyses. To curb the spread of this vaccine-preventable disease, states should consider the threat to public health paramount to individual liberty infringement by restricting access to nonmedical exemptions. This approach aligns with a century of case law that has rejected vaccination mandate challenges based on fundamental rights, religious freedom, equal protection, and due process. Now states must act within that authority to safeguard against the persistence of this potentially fatal disease.


Assuntos
Programas de Imunização/legislação & jurisprudência , Programas Obrigatórios/legislação & jurisprudência , Vacina contra Sarampo/administração & dosagem , Sarampo/prevenção & controle , Instituições Acadêmicas , Recusa de Vacinação/legislação & jurisprudência , Vacinação/legislação & jurisprudência , California , Criança , Pré-Escolar , Direitos Civis , Humanos , Programas de Imunização/tendências , Programas Obrigatórios/tendências , Sarampo/transmissão , Ohio , Pais , Saúde Pública/legislação & jurisprudência , Religião , Governo Estadual , Decisões da Suprema Corte , Estados Unidos , Vacinação/tendências , Cobertura Vacinal/tendências , Recusa de Vacinação/tendências
16.
Med Leg J ; 87(2): 80-83, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31066333

RESUMO

Patient autonomy requires full disclosure prior to a valid consent. The 2015 UK Supreme Court ruling in Montgomery has displaced Bolam on this issue and is inducing a disquieting sense of angst in some medico-legally conscious clinicians. For the time being, the Bolam test still applies for treatment and/or diagnosis claims. The very grossness of the defendant in Montgomery's withholding of information to the patient (remarkably not thought negligent by the lower courts) prompted the judges of the Supreme Court to dispense with the long-standing Bolam test. (The Editor considers the case should have been won using Bolam in any event.) The foreseeable shoulder dystocia that caused catastrophic injury to the claimant's baby would (and should) have been avoided by a planned caesarean section. The claimant's damage award of £5.25 million as a result of the defendant's obstetrician's failure to provide full disclosure seems to have induced clinicians to over-watch their step, at times to a ridiculous extent. On the one hand, many clinicians' anxiety may result in a defensive/protective approach: 'These are the facts, now you choose', thus leaving a sense of hurtful abandonment in patients. Much harm may be done within Medicine if the facts underlying the decision in Montgomery are not properly considered and evaluated.


Assuntos
Consentimento Livre e Esclarecido/legislação & jurisprudência , Autonomia Pessoal , Humanos , Consentimento Livre e Esclarecido/psicologia , Imperícia/legislação & jurisprudência , Relações Médico-Paciente , Decisões da Suprema Corte , Estados Unidos
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