Jayalakshmi Sita, Vooturi Sudhindra
Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India.
Ann Indian Acad Neurol. 2016 Oct;19(Suppl 1):S3-S8. doi: 10.4103/0972-2327.192888.
Clinical neuroscience has made tremendous advances over the last century. Neurology as a discipline is still considered challenging and at times risky due to the natural history and progressive course of few of the neurological diseases. Encouragingly, the patient and their caregivers are now increasingly willing to be actively involved in making decisions. The patients' relationship with the doctor is a reflection of the society. A society that is orienting itself toward "rating" and "feedback" has made this doctor-patient relationship, a consumer-service provider relationship. This perhaps is due to commercialization of health that usually accompanies globalization. Moreover, a rapid influx of information from potential erroneous sources such as the Internet has also made patient and caregivers not being hesitant to taking legal course in the case of adverse events during treatment or simply because of dissatisfaction. The purpose of the legal process initiated by patients with neurological ailments is more often to compensate for the income lost, physical and psychological anguish that accompanies disease and its treatment, and to fund treatment or rehabilitation requirements. However, it is not clearly established if monetary benefits acquired lead to better opportunities for recovery of the patient. The consumer protection act and commercialization of medical services may well have an adverse effect on the doctor and patient relationship. Hence, there is a great need for all medical professionals to mutually complement and update each other. This review examines legal (litigation) processes with special interest on medicolegal system in patients with neurological ailments and the challenges faced by the neurologist during day-to-day clinical practice.
在过去的一个世纪里，临床神经科学取得了巨大的进展。由于一些神经疾病的自然病程和进展过程，神经病学作为一门学科仍然被认为具有挑战性，有时甚至有风险。令人鼓舞的是，患者及其护理人员现在越来越愿意积极参与决策。患者与医生的关系是社会的一种反映。一个以“评级”和“反馈”为导向的社会，使这种医患关系变成了一种消费者与服务提供者的关系。这可能是由于通常伴随全球化而来的医疗商业化。此外，来自互联网等潜在错误来源的信息迅速涌入，也使得患者和护理人员在治疗期间出现不良事件或仅仅因为不满时，毫不犹豫地采取法律手段。患有神经疾病的患者启动法律程序的目的，更多时候是为了弥补因疾病及其治疗而损失的收入、身体和心理上的痛苦，以及为治疗或康复需求提供资金。然而，目前尚不清楚获得的金钱利益是否会为患者带来更好的康复机会。消费者保护法和医疗服务商业化很可能会对医患关系产生不利影响。因此，所有医学专业人员非常需要相互补充和更新知识。本综述特别关注神经疾病患者的法医学系统以及神经科医生在日常临床实践中面临的挑战来审视法律（诉讼）程序。
