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医学-法律评估老年人的人身伤害:多学科共识会议报告。

Medico-legal assessment of personal damage in older people: report from a multidisciplinary consensus conference.

机构信息

Ageing Research Centre, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Irnerio 49, 40126, Bologna, Italy.

Department of Legal Medicine, ASUR Marche AV4, Fermo, Italy.

出版信息

Int J Legal Med. 2020 Nov;134(6):2319-2334. doi: 10.1007/s00414-020-02368-z. Epub 2020 Jul 17.

Abstract

Ageing of the global population represents a challenge for national healthcare systems and healthcare professionals, including medico-legal experts, who assess personal damage in an increasing number of older people. Personal damage evaluation in older people is complex, and the scarcity of evidence is hindering the development of formal guidelines on the subject. The main objectives of the first multidisciplinary Consensus Conference on Medico-Legal Assessment of Personal Damage in Older People were to increase knowledge on the subject and establish standard procedures in this field. The conference, organized according to the guidelines issued by the Italian National Institute of Health (ISS), was held in Bologna (Italy) on June 8, 2019 with the support of national scientific societies, professional organizations, and stakeholders. The Scientific Technical Committee prepared 16 questions on 4 thematic areas: (1) differences in injury outcomes in older people compared to younger people and their relevance in personal damage assessment; (2) pre-existing status reconstruction and evaluation; (3) medico-legal examination procedures; (4) multidimensional assessment and scales. The Scientific Secretariat reviewed relevant literature and documents, rated their quality, and summarized evidence. During conference plenary public sessions, 4 pairs of experts reported on each thematic area. After the last session, a multidisciplinary Jury Panel (15 members) drafted the consensus statements. The present report describes Conference methods and results, including a summary of evidence supporting each statement, and areas requiring further investigation. The methodological recommendations issued during the Conference may be useful in several contexts of damage assessment, or to other medico-legal evaluation fields.

摘要

人口老龄化给各国的医疗保健系统和医疗保健专业人员带来了挑战,包括法医学专家,他们要对越来越多的老年人进行人身伤害评估。老年人的人身伤害评估较为复杂,且由于缺乏证据,妨碍了这一主题的正式指南的制定。第一届老龄化人口人身伤害法医学评估多学科共识会议的主要目标是增加对这一主题的认识,并在该领域建立标准程序。该会议是根据意大利国家卫生研究院(ISS)发布的指南组织的,于 2019 年 6 月 8 日在意大利博洛尼亚举行,得到了国家科学协会、专业组织和利益攸关方的支持。科学技术委员会就 4 个主题领域准备了 16 个问题:(1)老年人与年轻人受伤后果的差异及其在人身伤害评估中的相关性;(2)预先存在状况的重建和评估;(3)法医学检查程序;(4)多维评估和量表。科学秘书处审查了相关文献和文件,对其质量进行了评估,并对证据进行了总结。在会议全体会议期间,4 对专家就每个主题领域进行了报告。最后一次会议结束后,一个多学科评审团(15 名成员)起草了共识声明。本报告介绍了会议的方法和结果,包括支持每项声明的证据摘要以及需要进一步调查的领域。会议期间发布的方法学建议可能在多种损害评估情况下或在其他法医评估领域有用。

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