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妇产科医疗实践中的医师责任。

Physicians' liability in obstetric and gynecology practice.

作者信息

Mavroforou Anna, Koumantakis Evgenios, Michalodimitrakis Emmanuel

机构信息

Department of Forensic Sciences, University of Crete Medical School, Crete, Greece.

出版信息

Med Law. 2005 Mar;24(1):1-9.

Abstract

PURPOSE

Litigation in obstetric and gynecologic practice has arisen as an important issue. This article aims to highlight issues related to malpractice in obstetrics and gynecology in order to point out several important aspects of medical practice, which may offer adequate professional protection.

METHODS AND MATERIAL

Search of the current relevant literature.

RESULTS

The four most common clinical causes of medical litigation in obstetrics and gynecology are cases involving fetal distress, uterine rupture after a vaginal birth in a woman with a previous Cesarean section, shoulder dystocia, and misdiagnosis of breast cancer. Litigation raised in most of the cases is driven by bad outcomes and not by malpractice. Additionally, both juries and the public often expect perfection as the natural result of pregnancy and any deviation from this expectation has to be the result of someone's negligence. For this reason it has become mandatory for doctors in hospitals and private practices to acquire a sufficient knowledge relating to modem management, to document carefully in writing their procedural and management plans and to become familiar with the legal aspects of medical practice. Adequate communication and a written patient's consent form are of paramount importance.

CONCLUSION

Maintenance of high standards in daily practice with continuous training, clear communication and a signed Patient's Informed Consent Form along with the appropriate documentation of any procedure carried out may provide professional safety to practicing obstetricians and gynecologists in case of medical litigation.

摘要

目的

妇产科医疗纠纷已成为一个重要问题。本文旨在强调妇产科医疗事故相关问题,以指出医疗实践中的几个重要方面,这些方面可能提供充分的专业保护。

方法与材料

检索当前相关文献。

结果

妇产科医疗纠纷最常见的四个临床原因是涉及胎儿窘迫、有剖宫产史的妇女经阴道分娩后子宫破裂、肩难产以及乳腺癌误诊的病例。大多数案件引发的诉讼是由不良后果而非医疗事故驱动的。此外,陪审团和公众通常期望妊娠的自然结果是完美的,任何偏离这一期望的情况都必定是某人疏忽所致。因此,医院和私人诊所的医生必须掌握与现代管理相关的充分知识,仔细书面记录其程序和管理计划,并熟悉医疗实践的法律方面。充分的沟通和书面的患者同意书至关重要。

结论

在日常实践中保持高标准,进行持续培训、清晰沟通并签署患者知情同意书,同时对所实施的任何程序进行适当记录,在医疗纠纷发生时可能为执业妇产科医生提供专业安全保障。

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