规范医疗纠纷尸检工作的几个重要环节

近年来,医疗纠纷已成社会焦点问题,尸检是妥善解决医疗纠纷的重要依据。然而,医疗纠纷尸检的现状,已不适应纠纷解决的需要。作者结合检案实践及相关文献,简要分析了尸检存在的问题,提出规范医疗纠纷尸检的几个重要环节,为规范尸检,促进尸检质量控制,以更好的为此类事件的处理提供客观依据。     

硬膜外神经阻滞麻醉死亡原因分析(附1例尸检报告)

本文通过一例硬膜外神经阻滞麻醉下阑尾切除术后患者死亡的临床及尸检资料的分析,对死因认定及相关医疗纠纷的防范进行了讨论。指出规范的尸体检验对明确死因、解决医患纠纷具有重要作用,尸检前的解剖设计是做好尸检、找到死因不容忽视环节,规范、科学的死因分析是进行诊疗评价、责任划分、防范医疗纠纷的科学依据。     

硬膜外神经阻滞麻醉死亡原因分析(附1例尸检报告)

本文通过一例硬膜外神经阻滞麻醉下阑尾切除术后患者死亡的临床及尸检资料的分析，对死因认定及相关医疗纠纷的防范进行了讨论。指出规范的尸体检验对明确死因、解决医患纠纷具有重要作用，尸检前的解剖设计是做好尸检、找到死因不容忽视环节，规范、科学的死因分析是进行诊疗评价、责任划分、防范医疗纠纷的科学依据。     

医疗纠纷处理中的法医病理尸检

医疗纠纷中最后需医疗事故鉴定委员会鉴定或向各级人民法院起诉的,绝大多数是导致死亡的医疗纠纷,如果处理不好可能影响正常的医疗秩序和社会安定。以往医疗纠纷处理实践中存在的弊端,已引起不少意见,医疗纠纷处理的改革势在必行。新的医疗纷纷处理办法虽尚未出台,但法医的介入是必然的,只是如何介入和介入的程度问题。现就作者近２０年参加医疗纠纷尸检的体会总结报告如下。一、尸体检验在处理死亡医疗纠纷中的重要性卫生部１９８８年在《关于（医疗事故处理办法）若干问题的说明》中,对尸检问题有专门说明：“尸检对判明死因具有特…     

医疗纠纷的法医病理学鉴定──139例医疗纠纷尸检分析

近来医疗纠纷日益受到重现，并引起普遍关注。正确处理医疗纠纷，尤其是导致死亡的医疗纠纷，是保护医患双方合法权益，提高医疗质量，改善医疗管理，维护医院正常工作秩序和社会安定的一项重要工作，目前有关报道甚少。本文对139例医疗纠纷尸检材料进行回顾性研究，并按法医学观点进行分析讨论，以期为预防和正确处理医疗纠纷及其法医病理学鉴定提供参考资料。材料和方法从本教研室1972～1992年系列尸检资料中挑选出涉及医疗纠纷的尸检档案139份，每份档案包括法医病理学尸检鉴定书、尸体剖验记录、有关病历复印件或病历摘要。死者亲属和有…     

围产期母婴医疗纠纷尸检49例分析

围产期母婴死亡所致的医疗纠纷在医疗纠纷的法医学鉴定中占有相当大一部分比例。本文从死者性别年龄、涉及医院、尸检结果、医疗行为过错情况等方面统计分析了49例围产期母婴死亡的医疗纠纷尸检案例,揭示了围产期母婴的常见死亡原因、医疗因素在其中的作用以及医疗纠纷的发生原因等,希望能对该类医疗纠纷的法医学鉴定、医疗纠纷的正确处理和防范提供帮助。     

两地区医疗纠纷法医学尸检鉴定质量的比较研究

目的研究影响涉及医疗纠纷法医学尸检鉴定质量差异的原因。方法两个具有代表性的法医学尸检鉴定机构所涉及医疗纠纷的相关案例,进行字2检验、t检验等统计学研究。结果通过字2检验发现,在设定的10个指标中,有7个指标存在显著性差异,提示两鉴定单位在“涉及医疗纠纷的法医学尸检鉴定”中检验手段和标准、规范性等均存在极大的差异。结论通过研究,提示法医学鉴定人素质、尸检的标准化和规范化、尸检检材的提取标准化、死因或疾病的诊断标准、会诊制度及法医学鉴定书的书写规范化等是法医学尸检鉴定质量控制和管理的重要环节。     

46例医疗纠纷尸检的临床病理分析

<正> 本文简要报告近两年来大连地区46例医疗纠纷尸检的结果,进行临床病理分析,旨在引起人们的重视,能正确认识和对待医疗纠纷,也为法医参与医疗纠纷的检验、鉴定提供参考。     

涉及死亡医疗纠纷的发生:27年医疗纠纷法医尸检回顾性研究之一

为了探讨医疗纠纷法医尸检的特点,回顾性研究了1972～1998年27年间318例医疗纠纷尸检资料.在这第一篇报告中,介绍与死亡有关医疗纠纷发生上的一些特点:医疗纠纷尸检的案例数从1972～1983年的23例上升到1984～1998年的295例;死者中男女性别无显著差别;年龄分布有两个高峰,10岁以下有104例(32.71%),20～40岁组161例(50.63%);发生在市(县)级中等大小医院的纠纷最多见,有195例,占61.32%,近年私人诊所的医疗纠纷明显增多;医疗纠纷尸检最常涉及外科(71例,22.33%)和产科(58例,18.24%);也简略讨论了206例非医疗过失纠纷和99例医疗过失纠纷发生的原因.     

尸体解剖在医疗纠纷案件中的角色

第一部分 99例上诉案件的判决情况 尸体解剖在医学教育、咨询、疾病发病机理研究等方面具有非常重要的作用.不同时期的临床诊断和病理诊断的符合率一直没有改变.尽管如此,美国公共和教学医院的尸检率仍在下降.下降的原因之一,就是惧怕尸检结果中的不利信息会在医疗纠纷案件中被当作证据使用 .作者通过调取法院医疗纠纷案件的资料,对尸检结果作用进行研究.     

Fatal poisoning in drug addicts in the Nordic countries in 2007

The frequency of medico-legally examined fatal poisonings in 2007 among drug addicts was investigated in five Nordic countries; Denmark, Finland, Iceland, Norway, and Sweden. The number of deaths, age, sex, place of death, main intoxicant, and other drugs present in blood samples were recorded to obtain national and comparable Nordic data, as well as data to compare with earlier studies in 2002, 1997, and 1991. Norway had the highest incidence of drug addict deaths by poisoning followed by Denmark, with 8.24 and 6.92 per 100,000 inhabitants, respectively. The death rates in Finland (4.02), Iceland (4.56), and Sweden (3.53) were about half that of Norway and Denmark. Compared with earlier studies, the death rates were unchanged in Denmark and Norway, but increased in Finland, Iceland, and Sweden. In all countries, fewer deaths (29-35%) were recorded in the capital area compared with earlier studies. Females accounted for 11-19% of the fatal poisonings. Iceland deviates with a more equal distribution between men and women (40%). Deaths from methadone overdoses increased in all Nordic countries, and methadone was the main intoxicant in Denmark in 2007, accounting for 51% of the poisonings. In Norway and Sweden, heroin/morphine was still the main intoxicant with a frequency of 68% and 48%, respectively. In Iceland, 3 deaths each were due to heroin/morphine and methadone, respectively. Finland differs from other Nordic countries in having a high number of poisonings caused by buprenorphine and very few caused by heroin/morphine. The total number of buprenorphine deaths in Finland doubled from 16 in 2002 to 32 in 2007, where it constituted 25% of deaths. The general toxicological screening program showed widespread multi-drug use in all countries. The median number of drugs per case varied from 3 to 5. The most frequently detected substances were heroin/morphine, methadone, buprenorphine, tramadol, amphetamine, cocaine, tetrahydrocannabinol, benzodiazepines and ethanol.     

2008年中国法治亮点巡礼

2008年，是中国法治进程稳步推进和稳健发展的一年，也是法治亮点频频闪现的一年。2008年的立法景观依然多姿多彩，科学立法、民主立法继续推进，公民对立法工作的有序参与进一步扩大，已出台的十一届全国人大常委会立法规划值得人们期待。此外，实施不久的《政府信息公开条例》、全面开展的监狱体制改革，以及此起彼伏的问责风暴等都是值得我们关注的法治亮点。     

Trends in Non-Muslim Divorces in Singapore

This article examines the trends and patterns in the way thesecular divorce law has been utilized by couples in Singaporeseeking to end their marriage. Social and demographic featuresof the divorcing couples, as well as the ‘fact’relied on in support of their divorce petitions, are studiedand compared to earlier analyses. It is found that while somepatterns observed by earlier researchers have remained intact,others have changed. This article suggests explanations forthese observed patterns and contributes to the discussion onwhether and how the divorce law can be improved in Singaporeand elsewhere.     

Drugs in injured drivers in Denmark

As part of the project Impaired Motorists, Methods of Roadside Testing and Assessment for Licensing (IMMORTAL) under the European Commission's Transport RTD Programme of the 5th Framework Programme [I.M. Bernhoft, Drugs in accidents involved drivers in Denmark, D-R4.3 of the project Impaired Motorists, Methods Of Roadside Testing and Assessment for Licensing (IMMORTAL), www.immortal.or.at, 2005], a study regarding drugs in accident-involved drivers was carried out in Denmark. The main objectives of this study were: (1) to collect and analyse samples from injured drivers for the presence of drugs; (2) to give an indication whether drugs may have contributed to traffic accidents; and (3) to get information on the drug-positive drivers and their drug use. This paper focuses on objective 1. Injured drivers who were treated in hospital were asked to give a saliva sample, a blood sample or both. The samples were screened for the following substances: opiates, amphetamines, methamphetamines, incl. MDMA (ecstasy), cannabinoids and metabolites, cocaine and metabolites and benzodiazepines. Screenings were carried out by means of Cozart Microplate EIA kit. Positive screenings were confirmation analysed by gas chromatography–mass spectrometry (GC–MS) or liquid chromatography/tandem mass spectrometry (LC/MS/MS). In total, 26 out of 330 patients were confirmed positive for one or more of the six drug groups. However, three patients were excluded from the survey for various reasons. Of the remaining 23 drug-positive patients 15 were found positive for one drug group, and in five of these cases alcohol was present in a concentration over the legal limit in Denmark (0.05%). The other eight patients were found positive for two drug groups, and in four of these cases, alcohol was also present in a concentration over the legal limit. Alcohol was found both in combinations with medicinal drugs, with illegal drugs and with both. Based on the saliva or blood concentrations, we estimate that there is a strong suspicion of impairment in 9 out of 23 cases, and in another six cases it was likely that the drivers were impaired.     

Competence in caring in legal practice

This article is concerned with the stories of female solicitors working in Queensland, Australia, and their account of ethics in practice. These narratives were sought and made in the context of our project investigating complaints received against practitioners in this jurisdiction. Our interviews with female lawyers were intended to provide more insight into complaints matters. Yet this discussion revealed broader insights into ethical questions about the nature of lawyer–client relationships and legal professionalism. This article considers these accounts by reflecting on the concept of ‘care’ and its fit with legal practice requirements today. In doing so, we consider the difficult gendered question of the relationship between caring and ‘women's’ practice. We do not assert a true woman's working style; we seek to contextualise our empirical research by tracing the complex effect of gender on lawyering roles. Finally, we suggest that the adoption of caring practice is a valid approach to lawyering and call for a caring approach to be re-valued in the legal professional context as an ethical proposition.     

Differences in female and male involvement in lethal violence in Russia

Relatively little is known of the distributions of homicide event characteristics in non-Western nations in which women relative to men are involved. This article utilizes unique homicide narratives drawn from Russian court and police records to compare homicide victim, offender, and event characteristics by sex of victim and separately by sex of offender. Results from logistic regression show that homicides in which a female was the victim or offender were more likely to occur between intimates and to occur in the home, whereas homicides involving males were more likely to occur in a public place, to be alcohol-related, to involve a firearm, and to involve a victim and offender who did not know each other well. These results not only present an important first glimpse at women as homicide victims and offenders in Russia specifically, but also provide a point of comparison with findings from similar analyses undertaken in the West, and present further initial observations upon which to construct a cohesive theory about female involvement in serious violent events.     

Trustees in Cyprus regulated in 2007

Trust and company service providers in Cyprus are followingin the footsteps of their European counterparts and will toobe regulated at the beginning of 2007.