Legal liability and risks during infusion therapy

N. Lisnevska
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Unfortunately, in Ukraine, people often do not care about their own health and do not take preventive measures, shifting all responsibility to HCW. Citizens have the right to receive health care and the right for the compensation of improper medical care and damage caused by the actions of the HCW. According to surveys, a lawsuit from a patient is the leading fear of HCW. This fear needs to be reduced, as the doctor and nurse should not be afraid of their patients. According to the objective model of liability, the HCW is guilty of the damage caused to the victim (patient), if the average citizen believes that the actions of HCW were the cause of the unfavorable course of events. This model is often used by domestic media, although in Ukraine it is not enshrined in law. For a long time, criminal liability for medical crimes has dominated Ukraine. Currently, there are criminal, administrative, disciplinary and civil kinds of liability. According to the criminal legislation of Ukraine, criminal liability arises for a crime that contains a crime according to the Criminal Code. Criminal activity contradicts the very essence of medical activity, so special attention is paid to such crimes. It should be noted that the intentional crimes committed by HCW are much less common than crimes of negligence. An important problem is that lawyers do not always understand the specifics of the nature of a medical crime. There are circumstances in which HCW are released from liability for a crime. These circumstances include actions of extreme necessity and actions in risk settings. Extreme necessity often takes place in urgent medical interventions. These circumstances often accompany emergency care in case of accidents, military problems and disasters. \nIT is often a kind of experiment, because the drugs administered may be perceived differently by the patient, even with a normal previous history. Because treatment is often associated with risk, for example, in case of IT side effects, a nurse who continues to administer the drug on a protocol or off-protocol (subject to consultation with the patient and/or the board of physicians) will not be criminally liable. Similarly, a nurse will not be criminally liable in case of deciding to discontinue IT due to the patient’s deterioration. In such circumstances, the nurse should inform the physician of the situation as soon as possible and eliminate the danger to the patient as soon as possible. Cases in which the damage was caused intentionally for a useful purpose is a separate category of cases. This is most common in chemotherapy and in experimental studies. The HCW should take sufficient, in his opinion, and appropriate to his qualification measures to improve the patient’s condition. Sometimes nurses have to make decisions in time deficit, for example, as for measures for a patient with a psychiatric illness that threatens other people. In such cases, there is also no criminal liability, as the act was committed to save the lives and health of others. \nMedical crimes are divided into professional and official. The first are directly related to the performance of professional duties (HIV/AIDS, illegal abortion, disclosure of personal information of the patient, violation of the patient’s rights, not providing medical care provision, etc.). It should be noted that the HCW cannot be blamed for not providing medical care if it does not meet his/her qualifications. \nConclusions. 1. HCW must know their rights and act for the benefit of patients. 2. Medical crimes are divided into professional and official. 3. There are situations in which HCW are released from criminal liability.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infusion & Chemotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.32902/2663-0338-2020-3.2-175-177","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract

Background. The issue of legal liability is extremely important for all healthcare workers (HCW). HCW are solely responsible for medical violations during the performance of their professional duties. There is a misconception that in case of non-provision or error in the provision of medical care outside the medical institution, the HCW will be liable. However, this is not always so, as in this case the HCW is considered an ordinary citizen and bears ordinary civil liability. Objective. To describe the legal aspects of MP liability, in particular, during infusion therapy (IT). Materials and methods. Analysis of the legal framework. Results and discussion. The public consciousness has formed the idea of the great responsibility of HCW for human life and health. Unfortunately, in Ukraine, people often do not care about their own health and do not take preventive measures, shifting all responsibility to HCW. Citizens have the right to receive health care and the right for the compensation of improper medical care and damage caused by the actions of the HCW. According to surveys, a lawsuit from a patient is the leading fear of HCW. This fear needs to be reduced, as the doctor and nurse should not be afraid of their patients. According to the objective model of liability, the HCW is guilty of the damage caused to the victim (patient), if the average citizen believes that the actions of HCW were the cause of the unfavorable course of events. This model is often used by domestic media, although in Ukraine it is not enshrined in law. For a long time, criminal liability for medical crimes has dominated Ukraine. Currently, there are criminal, administrative, disciplinary and civil kinds of liability. According to the criminal legislation of Ukraine, criminal liability arises for a crime that contains a crime according to the Criminal Code. Criminal activity contradicts the very essence of medical activity, so special attention is paid to such crimes. It should be noted that the intentional crimes committed by HCW are much less common than crimes of negligence. An important problem is that lawyers do not always understand the specifics of the nature of a medical crime. There are circumstances in which HCW are released from liability for a crime. These circumstances include actions of extreme necessity and actions in risk settings. Extreme necessity often takes place in urgent medical interventions. These circumstances often accompany emergency care in case of accidents, military problems and disasters. IT is often a kind of experiment, because the drugs administered may be perceived differently by the patient, even with a normal previous history. Because treatment is often associated with risk, for example, in case of IT side effects, a nurse who continues to administer the drug on a protocol or off-protocol (subject to consultation with the patient and/or the board of physicians) will not be criminally liable. Similarly, a nurse will not be criminally liable in case of deciding to discontinue IT due to the patient’s deterioration. In such circumstances, the nurse should inform the physician of the situation as soon as possible and eliminate the danger to the patient as soon as possible. Cases in which the damage was caused intentionally for a useful purpose is a separate category of cases. This is most common in chemotherapy and in experimental studies. The HCW should take sufficient, in his opinion, and appropriate to his qualification measures to improve the patient’s condition. Sometimes nurses have to make decisions in time deficit, for example, as for measures for a patient with a psychiatric illness that threatens other people. In such cases, there is also no criminal liability, as the act was committed to save the lives and health of others. Medical crimes are divided into professional and official. The first are directly related to the performance of professional duties (HIV/AIDS, illegal abortion, disclosure of personal information of the patient, violation of the patient’s rights, not providing medical care provision, etc.). It should be noted that the HCW cannot be blamed for not providing medical care if it does not meet his/her qualifications. Conclusions. 1. HCW must know their rights and act for the benefit of patients. 2. Medical crimes are divided into professional and official. 3. There are situations in which HCW are released from criminal liability.
输液治疗过程中的法律责任和风险
背景。法律责任问题对所有卫生保健工作者(HCW)极为重要。医护人员在履行其专业职责期间对医疗违规行为负全部责任。有一种误解认为,如果在医疗机构以外提供医疗服务时没有提供或出现错误,医疗保健中心将承担责任。然而,情况并非总是如此,因为在这种情况下,HCW被视为普通公民并承担普通民事责任。目标。描述MP责任的法律方面,特别是在输液治疗(IT)期间。材料和方法。法律框架分析。结果和讨论。公众意识形成了卫生保健对人类生命和健康负有重大责任的观念。不幸的是,在乌克兰,人们往往不关心自己的健康,也不采取预防措施,把所有责任都推给了氯氟烃。公民有权获得医疗保健,有权要求对卫生保健委员会的不当医疗和行为造成的损害进行赔偿。根据调查,患者的诉讼是对HCW的最大恐惧。这种恐惧需要减少,因为医生和护士不应该害怕他们的病人。根据客观责任模型,如果普通公民认为HCW的行为是造成不利事件的原因,则HCW对受害者(患者)造成的损害负有责任。这种模式经常被国内媒体使用,尽管在乌克兰并没有明文规定。长期以来,医疗犯罪的刑事责任在乌克兰占主导地位。目前,有刑事责任、行政责任、纪律责任和民事责任。根据乌克兰的刑事立法,对包含《刑法》规定的罪行的罪行产生刑事责任。犯罪活动与医疗活动的本质相矛盾,因此对此类犯罪给予了特别关注。应当指出的是,故意犯罪远不如过失犯罪常见。一个重要的问题是,律师并不总是了解医疗犯罪性质的具体细节。在某些情况下,HCW可以免除对犯罪的责任。这些情况包括极端必要的行动和风险环境中的行动。在紧急医疗干预中经常发生极端需要。这些情况往往伴随着事故、军事问题和灾难的紧急护理。这通常是一种实验,因为即使患者以前有正常的病史,也可能对所给药物有不同的看法。由于治疗通常与风险相关,例如,在出现IT副作用的情况下,按照协议或非协议(取决于与患者和/或医师委员会的协商)继续给药的护士将不承担刑事责任。同样,如果护士因患者病情恶化而决定停止治疗,也不承担刑事责任。在这种情况下,护士应尽快将情况告知医生,尽快消除对患者的危险。为了有用的目的而故意造成损害的案件是另一类案件。这在化疗和实验研究中最为常见。医护人员应采取他认为足够和适合他的资格的措施,以改善病人的情况。有时护士不得不在时间短缺的情况下做出决定,例如,为患有精神疾病的患者采取措施,该患者会威胁到其他人。在这种情况下,也不承担刑事责任,因为该行为是为了挽救他人的生命和健康。医疗犯罪分为职业犯罪和公务犯罪。第一类与履行专业职责直接相关(艾滋病毒/艾滋病、非法堕胎、泄露患者个人信息、侵犯患者权利、不提供医疗服务等)。应该指出的是,如果卫生保健专员不符合他/她的资格,就不能指责他/她不提供医疗服务。结论:1。HCW必须了解自己的权利,并为患者的利益而行动。2. 医疗犯罪分为职业犯罪和公务犯罪。3.在某些情况下,HCW可以免除刑事责任。
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