Disaster documentation: improving medical information-sharing in sudden-onset disaster scenarios

Abstract

This study investigates clinical practitioners’ use of medical documentation during sudden-onset disasters in order to better understand how we can improve practice. Thirteen participants, representing nine nationalities and six clinical disciplines (with the collective working experience of at least 15 different organisations providing disaster response), underwent semi-structured interviews using an inductive approach based in grounded theory. The initial codes and themes were analysed over four coding rounds and developed into selective codes. The findings suggest that documentation is overwhelmingly de-prioritised in disasters due to competing demands; there is little incentive to complete documentation at an organisational or government level; practitioners acknowledge the importance of and need for adequate documentation; paper documentation still has its place whilst electronic approaches have both benefits and drawbacks; and disasters require bespoke documentation solutions. Development of the emergency medical team (EMT) ‘data management’ role within EMTs may be one way to focus teams on key areas of improvement.     

医疗合同附随义务的概念界定

近年来,医疗纠纷成为我国突出的社会问题.医患关系紧张、矛盾加剧、纠纷增多,不仅有损患者利益,同时也威胁着医生的正常执业活动及医疗机构的正常运作.究其原因,与当今的法律、法规对于医患双方的权利与义务规定不够明确和全面,导致人们认识上、行为上的混乱不无关系.医疗合同附随义务的存在及其价值判断,对引起立法者、司法实务人员、医...     

政府在公立医院回归公益性改革中的主导作用探析

在市场经济大潮的冲击下,作为我国医疗机构主体的公立医院公益意识逐渐淡化,趋利行为日益突出。新医改方案明确了公立医院要遵循公益性质和社会效益原则。对照西方和我国以往经验,公立医院公益性淡化的突出原因是政府责任的缺失和错位。本文提出,政府在新医改过程中应采用多种措施主导公立医院回归公益性。     

医疗损害赔偿案件中若干问题的思考

《侵权责任法》关于医疗损害责任的归责原则、免责事由、医疗机构实施过度医疗的责任以及患者知情权和隐私权的保护做出了更为明确和系统的规定,这在医疗损害赔偿立法史上是一个巨大的进步,对于维护医患双方的合法权益必将发挥重要的作用。     

At the Bottom of the Heap: Socioeconomic Circumstances and Health Practices and Beliefs among Garbage Pickers in Peri-Urban China

This article explores the health, disease and socioeconomic circumstances of garbage collectors in Guiyang, southwestern China. It aims to contribute to medical anthropology and understandings of Chinese society by examining garbage collectors’ understandings of waste picking, pollution and the health risks and diseases associated with their struggles for survival at the “bottom of the heap” of peri-urban society in contemporary China. Drawing on one month of ethnographic fieldwork, it provides new insights into the oft-neglected subjectivity of individuals struggling for survival at the margins of Chinese society, and how this subjectivity is shaped by their structural position as well as by their own agency in making sense and making the best of their lives.     

浅论人文社会科学与高等医学教育

针对目前我国医学院校中人文精神的缺失,文章探讨了人文社会科学与高等医学教育的关系,回顾了国内外医学教育中人文社会科学教育的近况,最后提出了人文社会科学在医学院校中的定位。     

Aortic Dissection and Sudden Unexpected Deaths: A Retrospective Study of 31 Forensic Autopsy Cases

Acute aortic dissection (AAD) is the most common cause of sudden unexpected death related to aortic diseases. A retrospective study of 31 sudden unexpected deaths caused by AAD was conducted at Xi'an Jiaotong University Forensic Center from 2001 to 2012. We summarized the forensic characteristics of AAD and assessed the clinically diagnostic accuracy of AAD. The characteristics of sudden unexpected death due to AAD were male predominant (male: female = 6.7:1), relatively young with the mean age of 44, and predominance of type A dissection (77.4%). Cardiac tamponade was the most frequent cause of sudden death (87.1%). Of the 31 cases, 26 (83.9%) patients were not recognized clinically and were misdiagnosed with acute myocardial infarction, coronary artery disease, cholecystitis, acute gastroenteritis, renal/urinary lithiasis, or acute pancreatitis. In summary, AAD can be difficult to recognize, diagnosis is therefore sometimes delayed or missed. The medicolegal death investigation can help physicians have a better understanding of AAD.     

Secondary Iatrogenic Harm: Claims for Psychiatric Damage Following a Death Caused by Medical Error

The purpose of this paper is to investigate the feasibility of claims for psychiatric damage following the death of a family member, where that death has been caused by medical error. ¹ The relative's position is a subject of heightened interest since the exposure of the plight of the parents involved in the UK organ scandal, ² and in the case of an iatrogenic death it is, of course, the family who are essentially the focus of the law's attempts to provide redress. Whilst the cases of deceased patients' relatives seeking damages for mental harm are inherently problematic in light of the restrictive secondary victim criteria applicable to psychiatric damage claims, a close look at the rules which permeate this area of compensation reveals that denying compensation to the relative suffering psychiatric harm is difficult to sustain. ³     

对新《刑法》第18条的理解与运用

本文就我国新刑法第18条中精神病的涵义,精神病患者刑事责任能力评定,精神病的医学鉴定以及对精神病人的监护治疗问题谈个人看法。供执法者和鉴定工作者在处理有关精神疾病案件时参考。