D'Attilio M, Centobeni R, D'Arcangelo C
Istituto di Discipline Odontostomatologiche, Università Studi G. D. Annunzio, Chieti.
Minerva Stomatol. 1996 Apr;45(4):179-88.
With reference to cases of American dentists sued for "malpractice" during the 80s, the authors summarise the causes why, initially, the American lawyers found it difficult to plead on behalf of their clients. Therefore, the authors suggest a number of measures in order to reduce the probability of being sued by patients. In particular, they focus attention on:--the duty to treat patients, with reference to experimentation on humans within the context of scientific research and citing the Declaration of Helsinki;--informed consent, with particular emphasis on the need to inform the patient regarding all aspects of treatment, including any risks or presumed complications that might arise during and after treatment;--professional liability, drawing a distinction between moral responsibility (regulated by the Code of Professional Practice) and legal liability (involving the legal field). Lastly, the authors underline the need to perfect and increase the awareness of the "management" risk of a dental practice, drawing special attention to the need to keep precise records on patients receiving treatment: radiographical and photographical examination, remote and recent medical history, the current state of teeth and gums, the presence of clicks and/or crepitus on ATM, cephalea, spontaneous and/or provoked pain involving masticatory and cervical muscles, obtaining the informed consent of the patient.
参照20世纪80年代美国牙医被起诉“医疗事故”的案例，作者总结了最初美国律师难以代表其客户进行辩护的原因。因此，作者提出了一些措施以降低被患者起诉的可能性。他们特别关注以下几点：——治疗患者的职责，涉及科学研究背景下的人体实验并援引《赫尔辛基宣言》；——知情同意，特别强调需要告知患者治疗的所有方面，包括治疗期间及之后可能出现的任何风险或假定并发症；——职业责任，区分道德责任（由《职业行为准则》规范）和法律责任（涉及法律领域）。最后，作者强调完善并提高对牙科诊所“管理”风险的认识的必要性，特别注意对接受治疗的患者保留精确记录的必要性：影像学和摄影检查、既往和近期病史、牙齿和牙龈的当前状况、颞下颌关节有无弹响和/或摩擦音、头痛、咀嚼肌和颈部肌肉的自发和/或激发性疼痛、获得患者的知情同意。
