Oliva Antonio, Caputo Matteo, Grassi Simone, Vetrugno Giuseppe, Marazza Marco, Ponzanelli Giulio, Cauda Roberto, Scambia Giovanni, Forti Gabrio, Bellantone Rocco, Pascali Vincenzo L
From the Section of Legal Medicine, Department of Health Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome.
Section of Criminal Law, Department of Juridical Science, Università Cattolica del Sacro Cuore, Milan.
J Patient Saf. 2020 Dec;16(4):e299-e302. doi: 10.1097/PTS.0000000000000793.
On May 12, 2020, a symposium titled "Liability of healthcare professionals and institutions during COVID-19 pandemic" was held in Italy with the participation of national experts in malpractice law, hospital management, legal medicine, and clinical risk management. The symposium's rationale was the highly likely inflation of criminal and civil proceedings concerning alleged errors committed by health care professionals and decision makers during the COVID-19 pandemic. Its aim was to identify and discuss the main issues of legal and medicolegal interest and thus to find solid solutions in the spirit of preparedness planning.
There were 5 main points of discussion: (A) how to judge errors committed during the pandemic because of the application of protocols and therapies based on no or weak evidence of efficacy, (B) whether hospital managers can be considered liable for infected health care professionals who were not given adequate personal protective equipment, (C) whether health care professionals and institutions can be considered liable for cases of infected inpatients who claim that the infection was transmitted in a hospital setting, (D) whether health care institutions and hospital managers can be considered liable for the hotspots in long-term care facilities/care homes, and (E) whether health care institutions and hospital managers can be considered liable for the worsening of chronic diseases.
Limitation of the liability to the cases of gross negligence (with an explicit definition of this term), a no-fault system with statal indemnities for infected cases, and a rigorous methodology for the expert witnesses were proposed as key interventions for successfully facing future proceedings.
2020年5月12日,意大利举办了一场题为“新冠疫情期间医护人员及医疗机构的责任”的研讨会,医疗事故法、医院管理、法医学和临床风险管理领域的国内专家参与其中。该研讨会的基本原理是,在新冠疫情期间,针对医护人员和决策者所犯所谓错误的刑事和民事诉讼极有可能激增。其目的是识别并讨论法律和法医学关注的主要问题,从而本着预案规划的精神找到切实可行的解决方案。
有5个主要讨论要点:(A)如何判断在疫情期间因应用基于无效或证据不足的方案和疗法而犯下的错误;(B)医院管理人员是否应对未得到足够个人防护装备的受感染医护人员负责;(C)医护人员和医疗机构是否应对声称在医院感染的住院患者感染病例负责;(D)医疗机构和医院管理人员是否应对长期护理机构/养老院中的热点问题负责;(E)医疗机构和医院管理人员是否应对慢性病病情恶化负责。
提出将责任限制在重大过失案件(对此术语有明确界定)、对感染病例实行国家赔偿的无过错制度以及为专家证人制定严格方法,作为成功应对未来诉讼的关键干预措施。