Hudson Michael Jason, Moore Gregory P
Emergency Department, Madigan Army Medical Center, Tacoma, Washington, USA.
J Emerg Med. 2011 Dec;41(6):598-606. doi: 10.1016/j.jemermed.2010.07.001. Epub 2010 Nov 20.
Emergency medicine is a high-risk specialty that carries a constant risk of malpractice litigation. Fear of malpractice litigation can lead to less-than-optimal patient care as well as impairments in physician quality of life. Although malpractice fear can be ubiquitous among emergency physicians, most receive little to no education on malpractice.
Medical malpractice requires that 1) The physician had a duty, 2) The physician breached the duty, 3) There was harm to the patient, and 4) The harm was caused by the physician's breach of duty. Even if all four medical malpractice conditions are met, there are still special legal defenses that have been and can be used in court to exonerate the physician. These defenses include assumption of the risk, Good Samaritan, contributory negligence, comparative fault, sudden emergency, respectable minority, two schools of thought, and clinical innovation.
These legal defenses are illustrated and explained using defining precedent cases as well as hypothetical examples that are directly applicable to emergency medical practice. Knowledge of these special legal defenses can help emergency physicians minimize their risk of litigation when caring for patients.
急诊医学是一个高风险专业,一直存在医疗事故诉讼的风险。对医疗事故诉讼的恐惧可能导致患者护理不够理想,以及医生生活质量受损。尽管医疗事故恐惧在急诊医生中可能普遍存在,但大多数人很少或根本没有接受过关于医疗事故的教育。
医疗事故要求:1)医生负有责任;2)医生违反了责任;3)患者受到了伤害;4)伤害是由医生违反责任造成的。即使满足了所有四个医疗事故条件,仍有一些特殊的法律抗辩理由,过去和现在都可以在法庭上用来免除医生的责任。这些抗辩理由包括风险承担、《好撒玛利亚人法》、共同过失、比较过错、突发紧急情况、少数合理观点、两种思想流派以及临床创新。
使用具有决定性意义的先例案例以及直接适用于急诊医疗实践的假设示例,对这些法律抗辩理由进行了说明和解释。了解这些特殊的法律抗辩理由有助于急诊医生在照顾患者时将诉讼风险降至最低。