• 6 months ago
(Adnkronos) - “Si deve combattere cercando di prevenire l’errore lavorando in maniera sinergica”. Così Paola Frati, professore ordinario Medicina Legale università Sapienza di Roma ai microfoni di Adnkronos Salute in occasione del convegno ‘La colpa medica, le linee guida e il ruolo delle società scientifiche’, organizzato a Roma dal Collegio Italiano dei Chirurghi (Cic) e dall’università degli Studi di Roma Tor Vergata.

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00:00The problem of defensive medicine is a complex problem, it has been discussed for years, it is not only discussed under the profile of costs that are obviously urgent, because defensive medicine involves, we can say, direct and indirect costs.
00:18Indirect costs are, perhaps, the extension of duties or going to exams that are not appropriate for the diagnostic and therapeutic situation of the patient.
00:30So how to fight defensive medicine? It must be fought under a double profile. First of all, and in this regard, the law 24, the so-called white-yellow law, but even more, the current decree that completes the law, enhance and center the profile and the importance of clinical risk.
00:51What does it mean then? To try to prevent the error, in a synergistic way we must work within the sanitary structures, where the component of the legal medicine must collaborate with the hygienists and other specialties, therefore identify virtuous paths that lead to the non-verification of the adverse event.
01:12So this is a profile to implement. The law 24, in the initial part, stresses all these aspects, establishes virtuous mechanisms to achieve clinical risk. I repeat, the operating decrees return to this aspect, but we are the ones who have to make them operational.
01:31The importance then of the identification of the adverse event, to find what are the causes that have determined the adverse event and, allow me to say, the corrections that must necessarily be put into practice. The importance of the audit, therefore, not to identify the culprit, but also here to understand why an adverse event has happened and what must be done to ensure that this adverse event is no longer verified.
01:56So, first of all, the importance of clinical risk. Clinical risk is not only of the legal medicine, it is not only of the hygienists, the clinical risk is of everyone. All professionals must cooperate with the clinical risk structures effectively.
02:11The problem of contentious management. This is a thorny problem, because the Italian courts are submerged by civil requests for damages, in prison, therefore, obviously, by judicial heathens turned to identify the profile of the culpability or not.
02:27In other countries, there is an important answer that we must begin to undertake here too. What is the answer? First of all, the pre-contentious value on the part of screening panels, therefore, of competent people, which goes to the attainability of the judicial procedure. So, an antecedent filter.
02:49Allow me to say, and this is a problem that we stress as an Italian society, but that other societies also stress, the quality of consultants and deputies. A procedure, a process of sanitary responsibility, deeply resents the work of consultants and deputies.
03:04Sentences are rarely discussed, so we must work as legal medicine, the obligatory college for law 24, but also with other societies to train, prepare and provide expert consultants. So, clinical risk, I said, on the side of sanitary responsibility, we try to move from a culture of litigation at all costs to a culture of negotiation and we work on the quality and preparation of consultants and deputies.

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