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医师培训中的医疗责任。

Medical liability of the physician in training.

机构信息

Department of Orthopaedic Surgery, University of Missouri, 1100 Virginia Avenue, DC953.00, Columbia, MO 65211, USA.

出版信息

Clin Orthop Relat Res. 2012 May;470(5):1379-85. doi: 10.1007/s11999-012-2244-4.

Abstract

BACKGROUND

Lawsuits alleging medical negligence by postgraduate physicians in training (residents) arise from treatment received by aggrieved patients at teaching hospitals. A threshold question in determining liability is whether or not the standard of care has been violated. Courts have questioned whether the proper standard governing resident physician conduct should be that of a reasonably competent generalist physician, that of a specialty physician, or whether the standard should be some subjective determination that addresses the resident level of training.

QUESTIONS/PURPOSES: We examined legal cases in which the standard of care for a physician in training has been questioned. Additionally, we address how resident conduct can extend liability to supervising physicians and employer hospitals.

METHODS

Westlaw and LexisNexis, two major legal databases used by law professionals, were searched to identify existing case law and law review articles related to the standard of care that applies to physicians in training. Of 57 sources initially identified, 15 legal cases and 10 law review papers addressed the standard of care pertaining to physicians in training. These selected cases and papers form the basis of the present article.

RESULTS

The standard by which the professional conduct of a physician in training is measured has varied; most recent legal cases have applied a specialty physician standard. Relevant court rulings have tried to strike a balance between patient interests versus the societal need to train physicians.

CONCLUSIONS

Physician representation, nature of conduct, and extent of supervision of that conduct are relevant factors used by courts to determine liability. However, the recent standards are those of the physician who directly supervises the professional conduct of a resident in a given situation.

摘要

背景

在教学医院中,接受过培训的住院医师(住院医生)治疗的患者会对其提起医疗事故诉讼。在确定责任时,首要问题是是否违反了护理标准。法院质疑是否应将管理住院医师行为的适当标准定为具有合理能力的全科医生,专科医生,还是应根据住院医师的培训水平进行主观判断。

问题/目的:我们研究了对医师培训标准提出质疑的法律案件。此外,我们还探讨了住院医师的行为如何将责任扩展到监督医师和雇主医院。

方法

我们在两个专业律师常用的法律数据库 Westlaw 和 LexisNexis 上进行了搜索,以识别与适用于医师培训的护理标准相关的现有案例法和法律评论文章。在最初确定的 57 个来源中,有 15 个法律案件和 10 篇法律评论文章涉及与培训医师相关的护理标准。这些选定的案例和论文构成了本文的基础。

结果

衡量住院医师专业行为的标准有所不同;最近的法律案件适用了专科医生标准。相关的法院裁决试图在患者利益与培训医生的社会需求之间取得平衡。

结论

医师的代表性,行为的性质以及对该行为的监督程度是法院确定责任的相关因素。但是,最近的标准是直接监督住院医师在特定情况下专业行为的医师的标准。

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