Medical malpractice is a topic that recurs regularly in the media. Krzysztof Makuch, vice president of the District Medical Council in Warsaw and a member of the Supreme Medical Council, explains what can be considered a medical error, how to understand the lack of diligence in medical procedures and how to prove that you have been a victim of a doctor's error.
Incorrect diagnosis, delaying caesarean section, surgical scarf left in the abdomen - from time to time you hear about suchmedical malpractice . Can they be proved and what are the chances of the patient to claim his rights?
The quality of medical care in Poland can be said to be very good and very bad. If healing heals us, we praise the doctors to heaven. When things don't go our way, we blame them for neglecting, making a mistake, or disregarding our disease. When can we talk about malpractice and when the unsatisfactory effects of therapy are the result of advanced changes in our body? We are discussing this with Krzysztof Makuch, vice-president of the District Medical Council in Warsaw.
What is a medical malpractice?
Krzysztof Makuch:It is a situation in which medical management - regardless of whether it concerns diagnostics or treatment - is inconsistent with generally accepted principles of operation.
What is the lack of due diligence in medical proceedings?
K.M.:There are three cases of conduct that is inconsistent with the principles of medical art and criminal liability of a physician. The first - when it does not heal, and it should. This is a situation where symptoms indicate the need for medical action and the doctor will not implement them. Then we talk about abandonment. The second case - the doctor implements medical procedures, but does it incorrectly. Then we are talking about a lack of diligence or an error in art. The third relates to a situation where a doctor starts treatment, and he should not do it, because, for example, he does not have the appropriate powers or makes decisions for which he is not substantially prepared. In turn, the very distinction of a mistake in art from the lack of due diligence in every situation requires a thorough analysis of events.
What makes a doctor's action a malpractice?
K.M.: It's very complicated. A doctor may make a mistake when he is not properly prepared to perform his or her work, does not follow news, does not learn, etc. Currently, we often deal with situations that result from improper organization of work in a team. Modern medicine has moved away from a one-person decision about the fate of a patient. Let me give you an example. Someone makes a wrong diagnosis, and another doctor, e.g. a surgeon, decides to perform the operation without confirming the previous diagnosis. After its execution, it turns out that the diagnosis was incorrect. In such a situation, the surgeon is held responsible, although it is known that the mistake was made earlier in the diagnostic process. Bad work organization is also often the cause of making medical mistakes. For example, the doctor will not provide the nurse with all information about the implemented therapy, recommendations, the doctor on duty will not inform his colleague about new test results, etc. permanent damage.
I have the impression that medical malpractice is still a taboo subject …
K.M.:I do not agree with this statement. Often we doctors are more critical of ourselves, less indulgent than patients realize. First of all, you need to answer two questions. First, when malpractice or omission is made. And secondly - when the patient's expectations regarding the improvement of his he alth exceed the possibilities of modern medicine. Unfortunately, it is not that we can cure everyone, that we can save everyone. That is why, when assessing the doctor's conduct, it is considered whether he made all due diligence to improve the he alth condition, and whether all procedures were followed. The achieved or unattained healing effect remains somewhat in the background. I know society's feelings are different. We often hear - he went to the hospital, they operated on him and he died. The bitterness and pain that accompany any such event does not take into account that, for example, the disease was so advanced that death was not affected by surgery. The history of patients with burns during irradiation, known from Białystok, did not result from the ill will of doctors. It was a consequence of the fact that we often work with outdated equipment. Another example - old mammography machines showed no changes in the breasts. Based on the photos, the doctor decided about further treatment. Who in such a situation should be blamed for delayed treatment, which determines the chances ofexperience?
Apparently 50-80 percent medical malpractice in Poland is covered up?
K.M.:I don't really know how to cover up a medical malpractice. If that were the case, we would be dealing with a crime punishable by concrete punishment, including imprisonment. Yes, such opinions circulate in society, but they have little to do with reality, with deliberately concealing the facts. Indeed, many people die each year and this can be somehow related to the healing process. But, what I want to emphasize clearly, this is not a consequence of making mistakes, but rather a general situation in he alth care. Today it is difficult to get to specialists, many patients do not receive modern drugs, they wait for a place in the hospital, the start of targeted therapies, organ transplants, sometimes even for the arrival of an ambulance. If it all ran smoothly, we would probably save more sick people. This does not mean, of course, that I am defending my environment indiscriminately. Errors in art, lack of diligence or neglect happen, for example because of overwork. Nobody allows a truck driver to drive longer than required by the regulations. But the doctor can admit more patients, stay on the night shift after a day's work.
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