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why the doctors are wrong?

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by Jeannegda catherine Valverde farias, Sr




  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

 

 

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