Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.227
Harefuah ; 161(11): 701-705, 2022 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-36578242


INTRODUCTION: The goal of the medical staff is to provide proper, effective and efficient treatment to the patient and to take care of his well-being. An error in medical care that causes a serious outcome or mortality, can be considered negligence when the caregiver did not meet the requirements of a reasonable physician for reasonable care and did not take the necessary precautions in providing the treatment, in light of the information available to him. The perception of punishment and compensation due to harm, caused to a patient as a result of a medical error, changed dramatically over the years. Starting with direct and severe punishment according to Hammurabi laws and ending with the "no fault" approach that is accepted widely in some countries. Following an adverse event that occurred in medical treatment, a process should be conducted in order to draw lessons to reduce the likelihood of recurrence of similar incidents in the future, by answering 4 questions: What happened? How did it happen? Why did it happen? and What should be done to prevent similar incidents in the future? The Patient Rights Act does not suggest conducting a safety investigation but recommends an examination board in cases of negligence or error in treatment. By law, the protocols of the examination board are confidential and can be removed by the court in case the protocol contains evidence of importance that is unlikely to be found in the medical record. Lack of confidentiality may cause medical staff to be reluctant of conducting a safety investigation due to fear of using its findings for a lawsuit or appointing an examination board whose conclusions will be reported to the victim and his family. The "no fault" method overcomes these barriers by enabling a thorough safety investigation and has important professional, economic and social aspects with a direct impact on the quality and safety of treatment. The method expands the accessibility of victims to compensation, reduces the number of claims and the burden on the courts. Among additional benefits are transparency and consistency in decisions, promoting patient safety due to physicians' willingness to report failures, reduction in "defensive medicine" and spending in the health care system.

Imperícia , Médicos , Masculino , Humanos , Direitos do Paciente , Erros Médicos/prevenção & controle , Confidencialidade
Soins Gerontol ; 27(158): 10-14, 2022.
Artigo em Francês | MEDLINE | ID: mdl-36503658


The coordinated care pathway consists of entrusting the attending physician with the coordination of care of the patient for the realization of medical follow-up with the ethical concern of a responsible consultation of the caregivers. This, so that medical practices and care devices are turned towards efficient care but also integrative, a qualitative search for life combining continuity of care and promotion of global health. This evolution towards greater respect for patients' rights requires that decisions taken be intelligently regulated in a context where caregiving interventions are still very prevalent and potentially intrusive in regard to the privacy of the persons being cared for.

Procedimentos Clínicos , Pessoal de Saúde , Humanos , Direitos do Paciente
Wiad Lek ; 75(9 pt 2): 2286-2292, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36378710


OBJECTIVE: The aim: Study of the system of pharmaceutical activity legal support in emergency conditions, namely, the period of epidemics outbreak and during the war. PATIENTS AND METHODS: Materials and methods: In the mentioned study, we analyze the state of the governmental pharmaceutical policy during the pandemic and the war in Ukraine. Legal norms and doctrinal positions of scientists regarding the above-mentioned issue are studied. The work analyzes the information presented by specialists in various scientific publications, and also uses scientific methods from a medical and legal point of view. This material is based on dialectical, comparative, analytical, synthetic, and complex research methods. This study analyzes the activities of pharmaceutical enterprises in the emergency state and the problem of ensuring patients' rights to medical care and epidemic safety. As part of the above-mentioned methods, we investigated the problems of pharmacies utilizing questionnaires. A survey of representatives of pharmacy chains, managers of purchasing pharmaceutical products and their pricing, in the cities of Kharkiv, Poltava, Kyiv, Mykolaiv and Lviv in the number of 460 specialists, shows negative trends in price gouging. This is a violation of patients' rights to affordable pharmaceutical products. CONCLUSION: Conclusions: The pharmaceutical industry of Ukraine was not prepared in advance for extraordinary events, such as a pandemic and martial law, as well as for other natural disasters and foreseeable emergencies. This negatively affected and continues to affect the health of patients.

Farmácias , Farmácia , Humanos , Pandemias , Direitos do Paciente , Preparações Farmacêuticas
BMC Palliat Care ; 21(1): 178, 2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36224654


BACKGROUND: Signing advance directives (ADs) ensures that terminally ill patients receive end-of-life care, according to their wishes, thereby promoting human dignity and sparing them from unnecessary suffering. Despite the enactment of the Hospice Palliative Care Act in Taiwan in 2000, the completion rates of ADs have been found to be low among patients with chronic illness conditions. To date, limited existing research is available regarding the factors associated with AD completion in terminally ill patients in Taiwan. To explore signed AD characteristics, compare differences in signing ADs between patients with and without cancer, and examine the factors associated with signing ADs in terminally ill patients. METHODS: A nationwide study was conducted using data collected via a retrospective review of medical death records from 18 randomly selected hospitals in the northern, central, and southern parts of Taiwan. We collected 200 records, including both cancer and non-cancer-related deaths, from each hospital. Univariate and multivariate logistics regressions were conducted to examine factors associated with signing advance directives among all patients- with and without cancer. RESULTS: Among the 3004 reviewed medical records, 79% had signed ADs, with most (95%) being signed by patients' caregivers. A higher education level (OR = 1.52, 95% CI = 1.10, 2.08, p = 0.010); cancer diagnosis (OR = 2.37, 95% CI = 1.79, 3.16, p < 0.001); having family members (OR = 5.62, 95% CI = 2.95, 10.69, p < 0.001), care homes (OR = 4.52, 95% CI = 1.97, 10.38, p < 0.001), friends, or maids (OR = 3.82, 95% CI = 1.76, 8.29, p = 0.001) as primary caregivers; and patients knowing about their poor prognosis (OR = 15.39, 95% CI = 5.66, 41.83, p < 0.001) were associated with a higher likelihood of signing ADs. CONCLUSIONS: Patients with non-malignant chronic illnesses were less likely to have ADs signed by either patients or family caregivers than those with cancer, with the lowest likelihood observed in patients with cardiovascular diseases. Whenever possible, primary caregivers should be involved in discussing ADs with patients, and the importance of truth telling should be reinforced. Following these principles, each patient's end-of-life care preferences can be respected, thereby promoting quality of care before the patient's death.

Neoplasias , Doente Terminal , Diretivas Antecipadas , Humanos , Neoplasias/complicações , Direitos do Paciente , Prevalência , Taiwan
J Nurs Manag ; 30(7): 2379-2382, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36193793


AIM: This commentary aims to spark debate on the ethical, legal, professional and institutional challenges faced by nurses' use and interactions when using traditional, mass and social media. BACKGROUND: Freedom of expression is a core value of democratic systems. However, it appears to be a complex right when exercised by nurses in traditional media and/or during online interactions. Active use of these types of media can help promote healthcare incentives and reach larger audiences, or even influence public policy. Nevertheless, with the increase in social media use, some nurses have been found to have engaged in unprofessional practices, which, in some serious cases, have led to their dismissal. EVALUATION: We identified specific instances of conflicts-most commonly related to breach of privacy, inappropriate interactions on social media or a simple lack of knowledge or guidance regarding its use-and formal complaints concerning nurses' freedom of expression. KEY ISSUES: While nursing codes do exist, professional guidelines concerning the use of mass and social media are still much needed. With the advent of social media, there may be ambiguity regarding how nurses engage with and make use of these platforms. In order to ensure that nurses interact professionally with any form of media, clear ethical, legal and professional frameworks of use are needed. Specific codes exist, such as the new ICN code of ethics or the NMC code, among other initiatives, but more comprehensive guidance is needed in order to support nurses in using better judgement regarding their media interactions. While the existence of such frameworks may not fix the problem of incorrect use, it can help those nurses looking for clear guidance when interacting with mass media or using social media. Also, it is important that more professionals are aware that such guidance exists, since understanding the limits and dangers of certain interactions would ultimately protect nurses' and patients' rights. CONCLUSION: The increasing use of media platforms by nurses calls for further professional guidance regarding its professional utilization. To date, limited guidance exists to support media interactions. In an interconnected world that favours media interaction in both professional and private spheres, the development and widespread dissemination of clear guidance for professionals must also detail two essential points: how professionals can better interact with media platforms and also how they can avoid having unethical media interactions in the first place. IMPLICATIONS FOR NURSING MANAGEMENT: The existence of a solid, comprehensive framework for generalized media use should ensure that nurses can exercise their right to freedom of expression. Clearer limitations should support nurses' professional presence and interactions in the media.

Mídias Sociais , Humanos , Princípios Morais , Direitos do Paciente , Liberdade
Rev. esp. med. legal ; 48(4): 144-150, Octubre - Diciembre 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-213682


Introducción: El principio de autonomía es la base del concepto de consentimiento informado. El consentimiento informado es un derecho del paciente que consiste en que este, previamente a que se efectúe la intervención médica en su cuerpo, debe expresar su conformidad que debe ir precedida de la debida información que le permite decidir según sus intereses. En este trabajo, nuestro objetivo fue conocer la situación de la información médica y del consentimiento informado del paciente en el Servicio de Traumatología y Cirugía Ortopédica del Hospital Universitario de Burgos.Material y métodosSe elaboró y distribuyó un cuestionario anónimo entre 647 pacientes de cirugía ortopédica y traumatología del Hospital Universitario de Burgos. Posteriormente, se realizó un estudio cuantitativo observacional descriptivo de corte transversal. Se estudió la asociación de las variables sociodemográficas con las respuestas a los ítems del cuestionario.ResultadosSolo el 28,9% de los pacientes conoce que la información es un derecho, pero la mayoría (97,3%) manifestaron la necesidad de recibir información sobre riesgos y complicaciones del tratamiento y consideran que la información no aumenta el miedo o ansiedad (63,4%). La mayoría afirmaron que fueron informados sobre la actuación asistencial (98,1%), comprendiendo las explicaciones recibidas (98,0%). El tiempo utilizado fue suficiente (73,7%). En general, la información recibida fue calificada como suficiente (89,8%).ConclusionesLos pacientes, en su mayoría, se sintieron informados y consideraron que el tiempo que el facultativo había tenido para ello era suficiente. (AU)

Introduction: The principle of autonomy is the basis of the informed consent concept. Informed consent is a patient´s right consisting in prior to the medical intervention being carried out on his body, he must express his agreement that it must be preceded by the proper information that allows him to decide according to his interests. In this work, our objective was to know the status of medical information and informed consent of the patient in the Traumatology and Orthopedic Surgery Service of the University Hospital of Burgos.Material and methodsAn anonymous questionnaire was prepared and distributed among 647 orthopedic surgery and trauma patients at the University Hospital of Burgos. Subsequently, a descriptive, cross-sectional, observational quantitative study was carried out. The association of sociodemographic variables with the responses to the questionnaire items was studied.ResultsOnly 28.9% of the patients know that information is a right, but the majority (97.3%) expressed the need to receive information on risks and complications of the treatment and consider that the information does not increase fear or anxiety (63.4%). The majority stated that they were informed about the care performance (98.1%), understanding the explanations received (98.0%). The time used was sufficient (73.7%). In general, the information received was rated as sufficient (89.8%).ConclusionsMost of the patients felt informed and considered that the time that the doctor had had for this was sufficient. (AU)

Humanos , Consentimento Livre e Esclarecido , Direitos do Paciente , Acesso à Informação/ética , 24960 , Epidemiologia Descritiva , Estudos Transversais , Espanha
Artigo em Inglês | MEDLINE | ID: mdl-36078783


During clinical rotations, medical students experience situations in which the patients' right to privacy may be violated. The aim of this study is to analyze medical students' perception of clinical situations that affect patients' right to privacy, and to look for the influential factors that may contribute to the infringement on their rights, such as the students' age, sex, academic year or parents' educational level. A cross-sectional study was conducted with a survey via "Google Drive". It consisted of 16 questions about personal information, 24 questions about their experience when rotating and 21 questions about their opinion concerning several situations related to the right to privacy. A total of 129 medical students from various Spanish medical schools participated. Only 31% of 3rd-6th year students declared having signed a confidentiality agreement when starting their clinical practice, and most students (52%) reported that doctors "sometimes", "rarely" or "never" introduce themselves and the students when entering the patients' rooms. Additionally, about 50% of all students reported that they would take a picture of a patient's hospitalization report without his/her (consent), which would be useful for an assignment. Important mistakes during medical students' rotations have been observed, as well as a general lack of knowledge regarding patient's right to privacy among Spanish medical students. Men and older students showed better knowledge of current legislation, as well as those whose parents were both university-educated and those in higher academic years.

Privacidade , Estudantes de Medicina , Confidencialidade , Estudos Transversais , Feminino , Humanos , Masculino , Direitos do Paciente , Percepção
Health Policy ; 126(11): 1187-1193, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36180281


Cross-border patient mobility has become a topic of increasing interest for policy-makers and academic scholars. However, the focus on international dynamics hinders the fact that healthcare mobility takes place within national boundaries as well, particularly in countries characterized by decentralized health systems. This paper shifts the focus from the drivers of international patient mobility to the ones of policy-making on patient mobility within national borders, analyzing more than fifty policy arrangements adopted between Spanish Regions in the period 2000-2020. As the findings indicate, geographical/historical, economic and political factors are key to understanding the development of cross-border healthcare agreements, as well as the conflicts that may arise therefrom. Accordingly, these arrangements may become a controversial issue and a key arena for partisan competition, affecting the articulation of effective responses to patient mobility in Spain and, ultimately, patients' rights.

Limitação da Mobilidade , Política , Atenção à Saúde , Humanos , Direitos do Paciente , Formulação de Políticas
Nursing ; 52(9): 15-20, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36006745


ABSTRACT: This article discusses the principles of informed consent and informed refusal (IR) in the context of patient-centered care and evidence-based practice, the right of patients to refuse care when properly informed, and the implications of IR for nursing practice.

Direitos do Paciente , Recusa do Paciente ao Tratamento , Humanos , Consentimento Livre e Esclarecido
Nurs Stand ; 37(9): 75-79, 2022 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-35968629


Patients who experience pain require adequate pain management provided by healthcare professionals who have access to pain relief medicines and are trained in the assessment and treatment of pain. Patients also need their pain to be acknowledged, understood and believed. These patient needs in relation to pain management can be considered from a legal and human rights perspective. This article describes human rights legislation in the UK, how it affects healthcare practice and what it means for healthcare professionals. It discusses barriers to pain management, the concept of pain management as a human right, the obligation of healthcare organisations to provide pain management and the limits to patients' rights to pain management. Finally, it proposes strategies that nurses can use to uphold a patient's human rights in relation to pain management.

Direitos Humanos , Manejo da Dor , Atenção à Saúde , Humanos , Dor , Direitos do Paciente
Ophthalmologie ; 119(6): 647-660, 2022 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-35925368


Particular importance and diligence must be attached to patient information prior to ocular surgery. A surgical intervention performed without error according to the state of the art in medicine remains exempt from punishment according to § 228 German Criminal Code (StGB) only if effective consent to the treatment is given and only then is there no liability if a risk inherent to the intervention materializes. The patient's consent is only effective if the patient has been properly informed beforehand. In medical malpractice proceedings, a breach of the duty to inform is regularly alleged. From the outset, the physician bears the burden of proof that he has obtained consent in accordance with Section 630d of the German Civil Code (BGB) and provided information in accordance with the requirements of Section 630e of the BGB. The provisions of the Patients' Rights Act also contain formulations that regularly lead to a very detailed individual review of possible errors of disclosure in medical liability proceedings. Apart from the indispensable requirement of an oral clarification discussion by a physician qualified to do so, who informs about "all essential circumstances" of the planned eye operation, the adherence to formal requirements for the clarification discussion and a written documentation with the individual discussion contents are of decisive importance in a lawsuit in order to reduce possible liability risks from the outset. On the one hand, case law sets high requirements for information and on the other hand, every ophthalmologist should also be aware that this effectively counteracts a depersonalization of the physician-patient relationship.

Imperícia , Oftalmologia , Humanos , Consentimento Livre e Esclarecido , Masculino , Educação de Pacientes como Assunto , Direitos do Paciente
Rev. ADM ; 79(4): 209-212, jul.-ago. 2022.
Artigo em Espanhol | LILACS | ID: biblio-1395552


Deontology and bioethics regulate the professional actions of doctors and dentists from a human and moral point of view. The dentist collects private information from each of his patients during the interrogation or clinical examination, and it is the dentist's obligation to keep silent about everything he sees or hears during the dental practice about the private life of his patients. The disclosure of secrets without the full authorization of the patient could undoubtedly affect their person, honor and reputation. In addition, the dentist has another type of private information about patients, known as personal data, which must be handled with great care and discretion. Professional secrecy is an ethical obligation of every dentist and its omission may bring legal repercussions. The aim of this article is to analyze the concept of professional secrecy, its ethical, deontological and legal aspects in dental practice (AU)

La deontología y bioética norman el actuar profesional de los médicos y odontólogos desde el punto de vista humano y moral. El odontólogo recaba información privada de cada uno de sus pacientes durante el interrogatorio o la exploración clínica, y es obligación del odontólogo guardar silencio de todo aquello que ve o escucha durante la consulta sobre la vida privada de sus pacientes. La revelación de secretos sin la plena autorización del paciente, podría generar sin duda afectaciones a su persona, honorabilidad y reputación. Además, el odontólogo posee otro tipo de información privada sobre los pacientes, conocida como datos personales, mismos que debe manejar con mucha cautela y discre- ción. El secreto profesional es una obligación ética de todo odontólogo y su omisión puede traer consigo repercusiones legales. El objetivo de este artículo consiste en analizar el concepto de secreto profesional, sus aspectos deontológicos, bioéticos y legales en la práctica odontológica (AU)

Humanos , Masculino , Feminino , Bioética , Confidencialidade , Ética Odontológica , Legislação Odontológica/normas , Registros Médicos/legislação & jurisprudência , Direitos do Paciente/legislação & jurisprudência , Teoria Ética
Artigo em Inglês | MEDLINE | ID: mdl-35805270


There are complex ethical dilemmas inherent to medicine teaching, particularly in clinical practice involving actual patients. Questions must be raised on fulfilling medical students' training needs while still respecting patients' fundamental rights to autonomy and privacy. We aimed to assess patients' perspectives regarding medical students' involvement in their medical care. An observational, cross-sectional study was developed, and a questionnaire was applied randomly to patients waiting for a consultation/admitted to three distinct departments: General Surgery, Obstetrics/Gynaecology, and Infectious Diseases. Of the 77% interviewed patients who reported previous experiences with medical students, only 59% stated that they were asked for consent for their participation, and 28% stated that students had adequately introduced themselves. Patients from Gynaecology/Obstetrics were the ones who reported lower rates of these practices and were also the ones who were most bothered by students' presence, stating that they would be more comfortable without the presence of medical students. Male patients received more explanations than female patients regarding the same matters. Thirty-five percent of patients stated that they would feel more comfortable without the medical students' presence. The study shows a need to pay closer attention to fulfilling patients' fundamental rights.

Educação Médica , Estudantes de Medicina , Estudos Transversais , Feminino , Humanos , Consentimento Livre e Esclarecido , Masculino , Direitos do Paciente
J Law Med ; 29(2): 421-427, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35819382


Intensive, inpatient physical rehabilitation in a dedicated unit can have a hugely positive influence on a person's life after a major injury or illness. This resource, however, is scarce and not every participant will benefit. Appropriate and fair participant selection for inpatient rehabilitation is therefore vital. This article considers challenges in these selection decisions, including the potential for inconsistency, bias and controversy, and the limits of evidence-based selection criteria. To provide best care in this setting, this article suggests that a clear process of decision-making is also important, alongside the use of objective selection criteria. One possible framework for this selection process is New Zealand's Health and Disability Commissioner Code of Patients' Rights, which is informative for clinicians and health authorities in rehabilitation selection in all jurisdictions, and which supports appropriate and fair participant selection.

Pessoas com Deficiência , Pacientes Internados , Humanos , Direitos do Paciente
Rev. bioét. derecho ; (55): 165-191, Jul. 2022.
Artigo em Espanhol | IBECS | ID: ibc-210233


Els metges estan facultats per a prescriure medicaments en una manera diferent a l'aprovada per l'agència reguladora, és a dir, per fora de l'indicat en el seu prospecte, per a un pacient determinat. Això pot derivar en l'ús del medicament en una indicació diferent a l'aprovada; o, en la mateixa indicació aprovada, però en un diferent subgrup de pacients; o bé, baix condicions diferents. Les prescripcions fora de prospecte o indicacions “off-label” són d'exclusiva responsabilitat del mèdic tractant. Llavors,ens preguntem quines precaucions ha d'adoptar el professional en l'acte prescriptiu, quins drets té el pacient sobre aquest tema, si aquest tractament ha de ser igualment cobert per l'assegurança mèdica i quines accions ha de prendre l'Estat, en cas de correspondre, com a garant últim de la salut de les personesresidents a l'Argentina. La necessitat i les especials circumstàncies que envolten els temes de salut determinen que és ètica i regulatòriament permissible la prescripció de medicaments fora de prospecte u off label. Això ha de donar-se baix condicions determinades, disposades pel mateix mèdic tractant, però també des de les autoritats, a fi de coordinar la participació de diversos actors del sistema i l'aplicació d'eines de monitoratge i d'afavorir la informació científica adequada, i tot això recolzarà l'ús fora de prospecte u off labelde medicaments per a brindar accés racional en un cas en concret i acceptat pel pacient.(AU)

Physicians have the authorityto prescribe medications in amannerdifferent from thatapproved by the regulatory agency, this means, outside of what is indicated in the package leaflet, for a specific patient. This may result inthe use of the medicinein an indication other than theapprovedindication; or, in the same approved indication, but in a different patientsubgroup; or,under different conditions. Off-label prescriptionsare the sole responsibility of the treating physician. The question then arises as to what precautions the professional should take in the prescribingact, what rights the patient has in this regard, whether suchtreatment should also be covered by healthinsurance,and what actions the Stateshouldtake, if any, as the ultimate guarantor of the health of people residing in Argentina. The need and the special circumstances surrounding health issues determine that it is ethically and regulatory permissible toprescribemedicinesoff-label. This should be doneunder certain conditions, setby the treating physician himself, but also bythe authorities, in order to coordinate the participation of various actors in the system and the application of monitoring tools and to promoteadequate scientific information, all of which will support the off-label use of medicinesto provide rational access in a specific case and accepted by the patient.(AU)

Los médicos están facultados para prescribir medicamentos en una manera diferente a la aprobada por la agencia reguladora, es decir, por fuera de lo indicado en su prospecto, para un paciente determinado. Ello puede derivar en el uso del medicamento en una indicación distinta a la aprobada; o, en la misma indicación aprobada, pero en un distinto subgrupo de pacientes; o bien, bajo condiciones diferentes. Las prescripciones fuera de prospecto o indicaciones “off-label” son de exclusiva responsabilidad del médico tratante. Entonces nos preguntamos qué precauciones debe adoptar el profesional en el acto prescriptivo, qué derechos tiene el paciente al respecto, si dicho tratamiento debe ser igualmente cubierto por el seguro médico y qué acciones debe tomar el Estado, en caso de corresponder, como garante último de la salud de las personas residentes en Argentina. La necesidad y las especiales circunstancias que rodean los temas de salud determinan que es ética y regulatoriamente permisible la prescripción de medicamentos fuera de prospecto u off label. Ello debe darse bajo condiciones determinadas, dispuestas por el mismo médico tratante, pero también desde las autoridades, a fin de coordinar la participación de diversos actores del sistema y la aplicación de herramientas de monitoreo y de favorecer la información científica adecuada, todo lo cual respaldará el uso fuera de prospecto u off labelde medicamentos para brindar acceso racional en un caso en concreto y aceptado por el paciente.(AU)

Humanos , Prescrições de Medicamentos , Preparações Farmacêuticas , Direitos do Paciente , Responsabilidade Legal , Direito Sanitário , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Argentina , Bioética , Ética , Princípios Morais