Rizzi D A
Bispebjerg Hospital, København, neuromedicinsk afdeling N.
Ugeskr Laeger. 1991 Jul 8;153(28):2000-3.
The case records of 41 patients with cerebral cancer and their death certificates were reviewed with the object of investigating clinicians' causal reasoning. No really clear impression could be obtained. The case records did not contain any reflections about clinical or paraclinical conditions which might be related to conceptions of causality. The death certificates contained errors and deficits which were so serious in 44% of the cases that the death certificate presented an erroneous picture of the cause or causes of death. Minor errors were encountered in further 19% of the death certificates. These involved logically untenable statements of causes in 11 certificates (27%), statements about conditions which were not in agreement with the reports in 13 cases (32%) and errors in the statements about duration in ten cases (24%). These results scarcely express doctors' causal reasoning but rather that there is no uniform conception of how death certificates should be completed.
为了研究临床医生的因果推理,我们查阅了41例脑癌患者的病历及其死亡证明。但未获得非常清晰的印象。病历中没有任何关于可能与因果观念相关的临床或辅助临床状况的思考。死亡证明存在错误和缺陷,在44%的病例中,这些错误和缺陷非常严重,以至于死亡证明呈现出关于死亡原因的错误描述。在另外19%的死亡证明中存在小错误。其中11份证明(27%)存在逻辑上站不住脚的死因陈述,13例(32%)关于状况的陈述与报告不一致,10例(24%)关于病程的陈述存在错误。这些结果几乎无法体现医生的因果推理,而是表明对于如何填写死亡证明没有统一的观念。