Patients should be confident that they, along with their doctor, have decided to conduct a surgery or to take medication with possible side effects; thus, in the event of an unfavorable outcome of the treatment the results are more likely to be perceived as associated risks, not as negligence of the physician. Errors in relationship between doctors and patients are not rare in medical practice; reducing their number can be achieved by relationships of trust, based on the achievements of modern medical science, compliance technologies and high level of staff.
As a rule, the causes of conflict on the basis of dissatisfaction of patients of treatment are:
- low quality of medical services as a result of non-compliance examination and diagnosis of diseases of organs and systems before the start of treatment and lack of control measures on its stages (non-compliance of the rules of medical manipulations);
- failure to comply with deontological principles caused by the lack of well-established relationship with the patient
- failure to achieve positive results or failure to comply with the principle of patient information;
- deficiencies in the maintenance of medical records, not allowing to judge the completeness and structure of diagnostic, treatment, control and rehabilitation measures.
In medical practice, ‘accident’ is widely utilised, which in its origin is substantially different from a medical error, because it does not depend on any actions or omissions of the physician. However, an ‘accident’ is treated as a medical error until the circumstances and details are figured out. The majority of professionals use the term ‘accident’ in situations where an unfavorable outcome is related to accidental circumstances, ‘force majeure’, ie the outcome doctor simply couldn’t foresee and prevent. The accidents include:
1. Unforeseen complications or death due to allergic or toxic reactions when using drugs or prophylactic vaccination, used in accordance with the instructions;
2. Sudden death before or during the operation because of the mental or emotional shock;
3. Postoperative complications (air embolism or bleeding);
4. Reflex cardiac arrest during the manipulation (angiography, pyelography, EGD, cardiac catheterisation, and etc.).
Medical errors are considered to be improper acts or omissions in the performance of professional duties by a health care worker, which are not the result of bad faith and do not have signs of a crime or misdemeanor.
The concept of ‘medical error’ itself is not new, and even the appropriate penalties have been issued throughout the history of mankind. In Roman law the term ‘error’ was widely used, including the cases related to medical practice (Aquilia law). The concept included inexperience, negligence, and failure to provide assistance. In the 19th century progressive doctors have seen throughout the analysis and study of medical errors came to a conclusion that their elimination bears a major potential for healthcare area improvement. Ralph Emerson wrote that every conscientious person, especially a teacher, must have an inner need to publish error and therefore warn less competent people. (more…)