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意大利医疗保健环境中的医疗差错披露:伦理义务与不自证其罪原则之间的微妙平衡。

Medical error disclosure in the Italian healthcare context: A delicate balance between ethical obligations and the principle of non-self-incrimination.

机构信息

Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy.

Section of Legal Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.

出版信息

Patient Educ Couns. 2022 Jul;105(7):1976-1979. doi: 10.1016/j.pec.2022.03.003. Epub 2022 Mar 9.

Abstract

Surprisingly, Italian legal doctrine and jurisprudence never systematically address the medical error disclosure issue. The topic of medical error communication represents a non-negligible profile of interest, relating to the possible detrimental effects on doctors who accuse themselves of conduct that does not comply with the lex artis. The effects of error disclosure on the effectiveness of insurance guarantees in civil and administrative liability are particularly relevant, as are the implications for ethical liability. Although the burden of reporting an error falls within the wide range of informative duties doctors hold, it still seems far from having found a factual statement in clinical practice, especially in Italy. This applies whether the error has a marginal or significant impact on the patient's health. The reasons lay in a very contradictory legal framework. Doctors tend with increasing ease not to comply with their information obligation - especially in cases where fulfilling this duty means admitting a personal, professional error - to preserve the integrity of their professional images. This article aims to offer a brief overview of that topic in the context of Italian healthcare.

摘要

令人惊讶的是,意大利的法律理论和判例从未系统地解决医疗错误披露问题。医疗错误沟通的话题代表了一个不可忽视的利益相关点,涉及到指责自己的行为不符合行业规范的医生可能受到的不利影响。错误披露对民事和行政责任中保险保证的有效性的影响,以及对道德责任的影响,尤其值得关注。尽管报告错误的责任属于医生承担的广泛告知义务范围内,但在临床实践中,尤其是在意大利,这似乎还远远没有得到事实陈述。无论错误对患者健康的影响是轻微还是重大,情况都是如此。原因在于一个非常矛盾的法律框架。医生往往越来越不愿意履行他们的信息义务——尤其是在履行这一义务意味着承认个人、专业错误的情况下——以维护他们职业形象的完整性。本文旨在简要概述意大利医疗保健领域的这一主题。

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