Why doctors are wrong?
Jeannegda Catherine Valverde Farias
Egda Isbelia Farías Moya
Dedicated to the victims of error and malpractice
TABLE OF CONTENTS
Preface…………………………………………………………………….… 8 - 9
Historical background …………………………………………………. 10 - 11
Medical ethic in the Renaissance …………………………………… 12
Medical error ……………………………………………………………… 14, 19
Medical error. An ethical problem………………………………..14
Ethical conduct, medical error and malpractice ……………….. 16
Possibilities of errors and risks in the medical act …………………. 22
Factors that can negatively influence ……………………………... 24
Related error in decision making…………………………………24
Medical and professional responsibility act …………………… 22
Limitations of human knowledge due to insufficient training…..24
The accelerated development and advancement of medical knowledge with poor practice……………………………………….. 24
Uncertainty in medical decision and technological innovation misapplied each factors in the wrong indication……………… 25
Consequences of medical mistakes ………………………………….. 26
Classification of medical errors………………………………………….. 27
General errors………………………………………………………………. 27
Diagnostic errors ...………………………………………………………... 27
Treatment errors .…………………………………………………….... ….27
Prevention errors ……………………………………………………….27
Common medical errors in medical practice…………………………… 28
Factors involved in medical diagnostics……………………….. 31
Lex artis. Dispraxis and malpractice ………………………………32
Medical dispraxis………………………………………………………..….. 34
Evidence of absence………………………………………………………. 34
Evidence of damage……………………………………………………….. 34
Causal relationship between them …………………………………. 34
Why does malpractice? .......................................................................... 34
Poor doctor - patient relationship……………………..………………….34
Erroneous development of a history……………………………..…... 35
Poor communication between the health team…………….…. 35
Disgraceful working conditions…………………………………………... 36
Inadequate monitoring of the patient………………………………….. 36
Differences between error and medical malpractice……………37
Iatrogenesis……………………………….…………………………….………… 37
Classification of iatrogenic ………………………………………………. 38
Iatrogenic positive……………………………………………………………. 38
Iatrogenic negative …………………………………………………………… 38
Malpractice and law of the practice medicine ……..…………… 41
The importance of the doctor-patient relationship ………… 42 - 43
Hippocratic oath…………………………………………………………… 42 - 43
Respect for the human person………………………………………… ….43
Respecting the duty of loyalty………………………………………. 43
The doctor-patient relationship is trust and compliance rules for the accuracy, such as in the researcher / subject, security and confidence……………………………………………………………………….. 43
Obligations and duties of the doctor……………………………….. 47
Disturbing elements of medical practice……………………………… 47
The aggressive patient ………………………………………………… 48
Age and sex ………………………………………………………………….. 49
Relationship with the environment……………………………………….. 49
Institutional factors…………………………………………………………… 50
Violence…………………………………………………………………………. 51
The secrets revealed by the autopsy…………………………………. 52
Clinical pathological differences according to Goldman´s classification…………………………………………………………………… 53
Defensive medicine …………………………………………………………54
Susceptibility to medical errors at intensive care units……….…….. 55
Mistakes in critically ill adults …………………………………………….. 56
Neurological emergencies ………………………………………………… 58
Table illustrates various diseases pointing diagnostic errors some common neurological emergencies………………………………….…. 60
Safety, failures and latent errors in anesthesia…………... 61
Errors in the administration of the anesthetic medication.. 61
Surgery : How to avoid medical errors ………………………….… 62
Medical errors in transfusional medicine………………………….. 63
Haemovigilance system …………………………………………………… 64
Immune reactions in transfusions…………………….…………..…64 - 67
Failed component management……………………………...……… 64 - 67
Incident void or "near misses"……………………..………………… 64 - 67
Causes of errors in transfusional medicine………………… 64 - 67
Serious medical errors in transfusion medicine………………… 64 - 67
Post transfusion immunological reactions …………………….…..64 - 67
Statement of claims against medical staff ……………………………… 68
Trial and medical legal allegations…………………………………….. 68
Medical narcissism…………………………………………………………… 69
The Lucifer effect. Good and bad doctors ………………………...71
"Omerta" policy in the health centers ………………………………………74
Discussion of medical errors and adverse events …………….... 75
Comparison of the different attitudes of physicians and patients r
egarding a medical error ……………………………………………………..76
What you should not say or do before a medical error…………….… 78
The trial against the medical error………………………………………… 79
Negligence…………………………………………………………………… 80 - 81
Vicarious negligence……………………………………...………...……80 - 81
Malpractice………………………………………………………………….. 80 - 81
Failures…………………………………………………………………………80- 81
Intentional crimes…………………………………………………………81 - 82
Unforeseeable circumstances……………………………………..… 81- 82
Compensation due to errors ………………………………………….…84
How to deal with medical malpractice……………………….….…….. 84
Medical malpractice lawsuits………………………………………………. 85
Medical obstinacy……………………………………………………………….. 86
Medical history. Prophylactic tool ………………………… ………….. 87
Preventive strategies in diverse specialties …………………………… 88
Surgery …………………………………………………………………………… 88
Unnecessary surgeries…………………………………………………..… 89
Infectious diseases…………………………………………………………….. 89
Anesthesia………………………………………………………………………. 89
Transfusional medicine…………………………………………………….. 91
Suggestions to avoid bad praxis……………………………………… 92
Never lie ……………………………………………………………………….. 92
Be cautious …………………………………………………………………… 92
Acquire expertise and skill ……………………………………………… 92
Recognize the limits and capabilities…………………………….…. 92
The patient as active agent in the prevention of medical mistakes …………………………………………………………………….…… 95
When and how count …………………………………………………. 100
Conclusions……………………………………………………………………... 108
Recommendations………………………………………………………….… 114
Universally it considered that doctors do not have the reputation of being the best listeners…………………………. 120
Prophylaxis of medical error…………………………………………. 128
Prescription………………………………………………………………………128
Distribution …………………………………………………………………..… 128
Administration ………………………………………………………………. 128
Follow up ………..………………………………………………………..…. 128
Control and management systems……………………………….. 128
Prevention of errors during the medical guard …….…….… 129
Bibliographic references…………………………………………………… 131
why the doctors are wrong? Page 1
