Stalking,harassment and aggressive/intrusive behaviours towards general practitioners: (2) associated factors,motivation, mental illness and effects on GPs

Seventy per cent of general practitioners (GPs) were found in an earlier study to have been subject to aggressive/intrusive behaviours by patients, with nearly 20% stalked and 20% harassed. Using the same sample, an exploration was undertaken of patterns of behaviour, patient characteristics, including mental illness and motivation, GP characteristics, and effects upon them of aggression/intrusion. There were significant differences in patterns of behaviour between stalking and harassment. Nearly half the patients involved were suspected to be mentally ill, including 54.5% of stalking cases. Stalking was significantly associated with intimacy-seeking motivation, and harassment with resentful motivation. No significant associations emerged between sex of patients or GPs and aggressive/intrusive behaviours. Measures of GP time-at-risk were associated with higher prevalence of individual behaviours. GPs’ responses to aggressive/intrusive behaviours included increasing security and changing routines, with small minorities afraid to go out or be at home alone, and a proportion experiencing adverse effects on personal relationships.     

域外视野：中国医闹之医疗纠纷解决机制探讨-兼与哥伦比亚大学李本教授商榷

医闹成了中国近二十年来重要的社会问题。李本教授在大量实证研究的基础上,从中国制度演变的角度对医闹进行了深入研究,认为患者对正式制度的信任缺失是医闹的重要根源,法律是在抗议与暴力的影响下发挥作用。法院审理医疗纠纷的过程中,判决许多没有过错的案件让医院承担责任折射出强烈的公正问题。中国政府在“医闹”中的过度回应及回应不足反映了改革后我国政府的作用及法律作用的不确定性。这些研究成果对我国当前医闹的治理及未来的制度改革都具有非常重要的参考价值。但笔者也认为,医疗纠纷审理中出现的一些不公正结果,不仅仅是中国问题,也是美国问题,过分强调中国体制或改革的原因无助于对中美两国共同问题的合理解释,究其原因,这在一定程度上与医疗证据认定的专业性及医疗专家对医疗过错认定的不确定性密切相关。     

医疗损害司法鉴定应坚持同行鉴定原则

《侵权责任法》第七章第五十四条规定了医疗损害责任的基本归责原则是过错责任原则。对于医疗机构而言,在诊疗过程中是否存在过错需要由专业鉴定机构进行判定。医疗行为的专业技术性和医疗行为发生场所的特殊性,决定了医疗损害技术鉴定机构需要体现出公平公正性和医疗行业的专业性。本文通过对涉及医疗损害司法鉴定四个案例的比较及分析,提示司法鉴定机构及司法鉴定人对临床专家在此类鉴定中的地位和作用的认知,从而使司法鉴定意见更接近事实,提高司法鉴定的公信力。     

略论我国医疗损害概念变化简

医疗损害概念随着医疗卫生服务的市场化而出现,随着市场化程度的深入而扩展。当今,医疗损害的外延已扩展到与医疗有关的各种人身和财产损害。随着医疗卫生服务重回＂公益性＂,医疗损害的外延也应重新确定。     

对生前预嘱相关问题的探讨

生前预嘱是指人在意识清楚时签署一份文书来事先表达出自己在生命末期的医疗意愿。本文针对生前预嘱的理解和适用中存在的相关问题作出探讨。本文以尊严死在我国的提出以及生前预嘱在我国的推广现状为基础,从法律的视角分析了生前预嘱的合法性和必要要件,并阐明了在目前的法律框架下生前预嘱还不是生效的法律文件,生前预嘱的落实还需要亲属的同意。本文借鉴其他国家和地区对生前预嘱的立法状况并结合我国的实际,提出了对于放弃治疗和尊严死的理解,以及针对医疗实践中放弃治疗的困惑提出了对放弃治疗应该严格遵循的原则。     

对《侵权责任法》第五十六条的理解与释义

目前,学界对《侵权责任法》第五十六条的释义基本上仍停留在字面解释,造成实际工作中难以操作。医疗机构在紧急情况下虽然抢救了患者,但仍可能需要承担违约赔偿责任。尝试对该条款进行扩充和限制解释,指导医疗机构在不能获得患者和其近亲属知情同意时,能把握好使用这种医疗特权的尺度。     

医患纠纷的法律与人文思考

医患纠纷已成为一个十分突出的社会问题,其主要原因有医学自身发展的局限性、医疗行为的高度风险性和非确定性,社会诸多矛盾在医疗领域的体现,以及医方、患方和社会等多种成因。在法律方面应进一步完善相关医事法律,保护医务人员、患方多方权益及其维权的快捷有效,并加强医方在人文领域的培养和教育,加快医疗体制改革,医疗机构应进一步采取切实有效的措施,从而减少医患纠纷,建立和谐医患关系和良好医疗公共安全环境。     

Working with children and young people with harmful sexual behaviours: exploring impact on practitioners and sources of support

Abstract

Although practitioner impact and support in the adult sex offender field has gained increasing research recognition, less is known about these issues in work with children and young people with harmful sexual behaviours which is the focus of this study. Using qualitative methods, 16 practitioners from one organisation took part in semi-structured interviews. Quantitative data were also obtained via a subsequent postal questionnaire. Findings revealed that positive effects far outweighed negative impact. Furthermore, practitioners identified organisational factors as being more directly related to negative impact. It was concluded that meaningful supervision and support involve various key components. Whilst recognising essential case management and accountability requirements, supervision (ideally by a manager experienced in sexual behaviour work) should be practitioner led and focused and support for employees should be trusted, confidential and separate from organisational procedures (i.e. performance appraisal). External clinical supervision by an experienced supervisor was also suggested as helpful.     

交叉学科背景下医事法方向法律硕士课程设置的优化

我国医事法方向法律硕士培养自1986年以来经过30多年的发展,历经萌芽、发展与逐渐规范化阶段,迄今已经形成综合院校模式、医学基础模式与医法融合模式三类模式.但目前作为硕士能力培养基础的医事法方向法律硕士课程设置却依然存在逻辑失明、内容紊乱和支撑乏力的问题,应基于逻辑基点、具体进路、师资保障三个角度对其进行系统优化.     

蓬莱市社会保障事业发展存在的问题及对策

劳动和社会保障事业是维护社会稳定、促进经济发展的重要条件。蓬莱市的社会保障事业经过一定时期的发展已经取得了很大的成就,形成了集养老、医疗、失业、工伤、生育“五保合一”的社会保险体系,比较完善,但还存在许多问题需要改进。