Travel medicine is a truly multidisciplinary specialty, and the extent to which non-clinical agents, including commercial airlines and travel agencies, may be responsible for providing pre-travel health advice has already been highlighted.12 There is currently a lack of legislation in this area. Physicians providing medical assistance in non-clinical non-conventional settings, such as on board an airliner or cruise ship, should be aware of the potential legal risks associated with providing care in these environments.13,14 In the event of an in-flight medical emergency, the country in which the aircraft is registered determines jurisdiction over civil procedures. Some European countries require doctors to provide medical assistance in case of medical emergencies during air travel. The U.S. Congress passed legislation known as the Aviation Medical Assistance Act,15 which provides greater immunity from civil suits in such scenarios, except in cases of gross negligence or intentional harm. A medical passenger on board an aircraft would be considered gross negligence if, for example, treating an intoxicated patient. The physician must be aware of the need to carefully document the medical incident16 and to balance physician-patient confidentiality with the responsibility to assist in decision-making regarding the continuation of the flight transit.17 In order to prove an allegation of negligence, four basic facts must be established individually.4 First and foremost: The travelling physician must owe a duty of care to the patient. On the other hand, it is not necessary for that professional to have attained a recognized level of practice in the provision of such care. Third, the patient must have suffered physical, financial, psychological and/or other loss. Finally, the loss must have been legally caused by the absence of an accepted standard of care. The onus is on the plaintiff (i.e..dem the patient) to prove negligence, and if the evidence for all four aspects is not accepted by the court, the charge of negligence is not upheld.
The administration of travel vaccines involves many medico-legal risks. The travel physician should have a well-formulated consent procedure to promote informed consent. It may be necessary to complement the discussion about the risks and benefits of vaccination by providing reading materials and time for the patient to make an informed decision. In some cases, it may be necessary to postpone vaccination to a later consultation to give the patient sufficient time to consider available options. While the use of informed consent is recommended, a signed informed consent form does not automatically mean that informed consent has been obtained.8 Careful documentation of the patient`s decision-making process is recommended. This is especially important if a patient refuses vaccinations or other treatments that the travel physician deems necessary. The extent to which pre-existing conditions are taken into account in light of vaccination decisions is of concern. Failure to consider an immunocompromised disease, such as prior to yellow fever vaccination, could have serious consequences and, after weighing the probability, would likely be considered negligent practice if an adverse patient outcome occurs. If in doubt, the pregnancy status should be questioned and/or effectively verified in the travellers prior to administration of the vaccine. Management of breastfed travellers also poses a potential medico-legal risk, particularly with respect to failure to vaccinate due to concerns about vaccine safety for the breastfed child.
It is generally accepted that breastfeeding is not a contraindication to vaccination, except in the case of smallpox vaccination.9 Good doctors apply clinical knowledge in a way that is legally and ethically correct – but all doctors can slip. Here are survival tips for the top five medico-legal risks for young doctors. If the attending physician does not document that something happened, it is difficult to prove that it happened. An accurate and complete account can help understand what happened to the patient. In addition, it will help answer due diligence questions if a filing is called months or years after an event. You cannot rely on their memory when it comes to the facts. Regardless of the system used, the purpose of documentation from a legal perspective is always to accurately and comprehensively record patient care and response to that care. Documentation has legal credibility if it is timely, accurate, truthful and appropriate. [20] The Supreme Court has cautioned police against arresting or harassing doctors unless the facts clearly meet the parameters established in the Jacob Mathew case. The police were even threatened that if they did not comply with these orders, they would have to count themselves in legal action.
The Supreme Court continued: „To sue a physician for negligence, it must be proved that the defendant did or omitted to do something that no physician in his usual sense and prudence would have done or omitted to do in the given facts and circumstances. The danger that the accused physician accepts should be such that the resulting injury was most likely imminent. [30] The Supreme Court has sought to allay fears that prevent health care professionals from fulfilling their duty to a person who is suffering. Almost all doctors can specialize in forensics. Discover the UK`s leading medical specialists here. The legal meaning of informed consent is that it can be a defense against negligence claims. If a patient consents to treatment knowing that they are at risk of complications, they cannot plead negligence in the incident, provided that health care professionals have taken reasonable precautions to avoid the complication. 24.
Vera Lúcia Raposo. Telemedicine: The legal framework (or lack thereof) in Europe. GMS Health Technol review. (2016) 12:3. doi: 10.3205/hta000126 Medical law establishes the right code of conduct, the responsibilities of health care providers and the rights of patients. If a health care provider is suspected of medical malpractice and causing unnecessary harm to a patient, they risk legal action by that patient. Criminal law also applies to the medical world to ensure that health care providers do not engage in criminal activity in their practice. There are cases where test results are not received by the prescribing physician. In other cases, patients do not perform the tests as directed or the results are filed before the doctor examines them and the patient is not informed of the results. It is important that physicians and their staff are able to track the status of these prescriptions to ensure that none are overlooked or forgotten.
Another aspect of care that requires better follow-up is referral to specialists. Each step must be documented, not only to avoid medico-legal problems, but also for good patient care. [11] The two should not be confused, although some cases may involve both, e.g. when a physician is summoned as an expert witness in a malpractice case against another health care provider.