工会参与医院医德医风建设的实践与思考

加强和改进医德医风建设是工会全面履行工会职能的具体体现。新时期工会组织应利用其优势,充分发挥群众性、广泛性的特点,把各种群众性活动作为进行医德医风教育的平台。把参与医德医风建设既视为履行职能,又看作是提升工会影响力的机遇,找准与医德医风建设工作的结合点、服务大局的切入点,发挥优势,搞好配合,使工会工作体现时代性、把握规律性、富于创造性。     

医疗纠纷的法医学鉴定

目的研究医疗纠纷法医学鉴定的特点,并讨论医疗纠纷法医学鉴定的重点及难点。方法将医疗缺陷分为责任性缺陷、技术性缺陷、管理性缺陷、学科性缺陷和其他缺陷,对36件案例分别进行分类并进行统计。其中把18例由医疗事故鉴定委员会鉴定的结论与我室的鉴定结果进行比较分析,其他18例另行统计。结果36例案件中存在医疗缺陷的占86.11%,其中技术性缺陷66.67%,责任性缺陷和管理性缺陷均占25%。18例由医疗事故鉴定委员会鉴定的结论与我室的鉴定结果进行比较,医疗缺陷的认定两者有明显差异(P<0.05),对于医疗缺陷已对患者造成不良影响的认定,两者具有显著性差异(P<0.01)。结论法医进行医疗纠纷的鉴定,对医疗纠纷诉讼案件的处理起着积极的作用。目前,医疗纠纷的法医学鉴定仍存在许多问题需要进一步讨论。     

人口老龄化与农村老年医疗保障制度

人口老龄化导致老年人医疗服务需要增加。然而,经济因素制约了老年人医疗服务需要向需求的转化,阻碍了老年人健康状况的改善。为实现世界卫生组织(W H O)提出的“健康老龄化”目标,促进全面建设小康目标的实现,必须为老年人尤其是收入低且几乎没有任何医疗保障的大量农村老年人建立医疗保障制度。建立制度面临筹资来源少、技术难度高、医疗卫生条件落后等制约因素,需要采取“低水平、广覆盖、采用多种模式、利用各方力量、加强配套设施”的发展策略。通过建立农村老年医疗救助、合作医疗、“时间储蓄”等多种制度,提供完善的医疗供方体系,保障农村老年人的基本医疗需求,促进其健康状况的改善。     

医疗纠纷处理制度之完善

现行医疗纠纷处理制度存在不少弊端.增强医疗事故技术鉴定委员会的公信度,是医疗纠纷妥善处理的根本前提;推行"双轨制",是医疗纠纷妥善处理的有效模式;统一执法是医疗纠纷妥善处理的关键.     

输血后病毒性肝炎的司法鉴定

本文综述了近年来输血后病毒性肝炎发生的病原变化及其影响因素,强调了按照国家法律,法规,采血部门严格筛查,供血单位规范生产,用血医院严把指征是防止输血后肝炎的重要强制性措施.受血病人或其家属输血前有知情权,并在理解后签署知情同意书.结合我国目前实际法律法规情况,简述了输血后肝炎司法鉴定工作的要点,以及各输血相关机构的职责.     

医疗事故罪的实体认定--兼与非法行医罪比较

医疗事故罪与非法行医罪是新刑法增设的两个罪名。关于这两个罪名的理解适用,学界有过一些探讨,但是探讨得不够深入。应结合与非法行医罪的比较,进行医疗事故罪的实体认定。     

司法精神病鉴定制度研究

我国的司法精神病鉴定制度存在着很多的问题,因此改革势在必行。改革我国的司法精神病鉴定制度,重点应统一名称、统一鉴定机构以及赋予当事人一定的启动司法精神病鉴定的权利。     

《医疗事故处理条例》及其他相关规定对受害方的法律保护

在《医疗事故处理条例》及其他相关规定中,拓宽了对医疗事故的界定、扩大了受害方的索赔权利、改变了医疗事故处理的方式、实行了新的证据制度,这都体现了对受害方的保护。     

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.     

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.