ObjectiveTo understand patients’ cognition of third-party mediation model for medical disputes, analyze the factors influencing the trust of patients on third-party mediation, and propose recommendations for building third-party mediation mechanisms. MethodsFrom November 2013 to April 2014, we referred past literature to design a relevant questionnaire on the cognition of third-party mediation for medical disputes. Patients who had reached the end of the treatment were surveyed by random cluster sampling. The raw data were put into the computer for statistical analysis by SPSS 18.0. ResultsAfter giving out 500 questionnaires, we acquired 486 effective questionnaires. The result showed that 61.52% of the patients knew of third-party mediation; 55.35% of the patients considered that thirdparty mediation should be set in and supervised by the court or judicial administrative department; if the mediation failed, 57.41% of the patients chose to resolve the dispute through legal channels, and 67.90% of the patients tended to confirm the force of mediation conclusion by arbitration; 70.58% of the patients considered that mediators should have professional background of medicine and law; 73.05% of the patients tended to take conclusions of forensic identification as the basis for mediation; 64.81% of the patients were biased to take Tort Liability Act as the basis for determining the compensation; 53.70% of the patients believed that financial allocations could solve the fund problems of third-party mediation, while 38.48% of the patients thought the funds should be provided by insurance companies; 91.15% of the patients thought the medical institutions should purchase medical liability insurance, and 54.32% of the patients thought insurance companies should not intervene the process of meditation. Conclusions Government should provide financial allocations to ensure the funds of third-party mediation. Besides, medical insurance should be brought in as a supplement. Medical institutions should purchase medical liability insurance to solve problems caused by medical disputes. Third-party mediation should be set in and supervised by the court or the judicial administrative department. Mediators should have professional background of medicine and law. Conclusions of forensic identification should be the basis for third-party mediation.
目的 从法医学角度探讨儿科医疗纠纷案件特点及成因。 方法 对四川华西法医学鉴定中心2002 年1月－2011年12月受理的184例儿童死亡并进行尸检的儿科医疗纠纷案件的法医学鉴定资料进行回顾性研究。 结果 儿科医疗纠纷呈逐年升高趋势，年龄以新生儿为主，死因以呼吸系统疾病为主；临床-尸检符合率低（55.23%），医疗过错率高（60.47%），且两者呈负相关。 结论 儿科医疗纠纷临床-尸检符合率比所有年龄段人群低，医疗过错率比所有年龄段人群高，且呈现出临床-尸检诊断符合率越低，医疗过错率越高的特征。
目的：从法医学角度探讨医疗纠纷的成因并提出相关防范措施。方法：对2000年～2005年四川大学华西法医学鉴定中心鉴定的共288例医疗纠纷资料进行回顾性整理分析。结果：近年来医疗纠纷有逐年增多的趋势。医疗纠纷的常见原因有医德医风问题、医疗技术或设备不过关、医务人员的失职或失误等。低级别医疗机构医疗纠纷所占比例相对较高。外科、妇产科等科室医疗纠纷所占比例较高。结论：通过增强医德修养，提高医务人员技术水平，强化医务人员自我保护意识，改善医患关系等措施，能够减少医疗纠纷发生。
目的:了解我院输血申请单规范填写的情况,分析其中存在的问题,以便采取积极有效的预防措施,规范输血申请单填写,提高临床输血安全性,防范因输血导致的医疗纠纷。方法:对2008年10月至2009年3月临床输血申请单(包括手术备血输血申请单)进行调查,以项目填写完整、字迹清楚工整、有经治医生和审核医生签字者为合格。结果:共调查7863份输血申请单,其中规范填写共6391份,占81.3%,未规范填写1 472份,占18.7%。结论:通过对临床输血申请单超填写的调查,分析其中存在的问题,以提高医务人员对规范填写输血申请单及临床输血相关的法律法规的认识,提高临床输血安全性,防范因输血导致的医疗纠纷。
目的 分析心脏手术相关医疗纠纷的临床及法医学特点，并就发生原因进行剖析及提出相应防范措施。 方法 对2002年1月－2011年12月四川华西法医学鉴定中心受理的四川省各级医疗机构发生的17例与心脏手术相关的医疗纠纷法医学鉴定资料进行回顾性分析。 结果 17例心脏手术相关医疗纠纷中，12例进行了尸体解剖死因鉴定，死亡原因有心脏传导系统出血，术后感染，低心排量综合症、肺动脉高压、失血性休克致死等。其余5例加上尸体解剖2例在内共7例进行了医疗过错鉴定，存在的医疗过错包括术前检查不完善，告知不充分，手术操作不细致，术后观察、处理不足，医疗记录不完整等。 结论 心脏手术相关医疗纠纷与术后并发症关系密切，医护人员应重视对心脏术后并发症的防治。尸体解剖对解决心脏术后死亡引起的医疗纠纷具有重要意义。
As a new discipline, the cardiac surgery has a great development in the modern age, but still faces many problems and disputes. The emergence of the evidence-based medicine (EBM), which emphasizes the best evidence, and combines the doctor’s clinical experience to make the best judgment, gives the development of the cardiac surgery a new thinking. Four systematic reviews published in The Cochrane Library (Issue 3, 2004) have interprated the importance of EBM on how to resolve the actual problems in different field of the cardiac surgery.
ObjectiveTo provide references in the forensic identification of injury and cerebrovascular malformation involved death cases, and to reduce the relevant medical dispute by exploring the forensic pathological features, identification of medical dispute as well as relationship between injury and disease. MethodsWe collected 33 cases of cerebrovascular malformation from January 2006 to December 2014 in West China Center of Forensic Medicine, including details of cases, clinical medical record and forensic pathology examination, and then the cases were retrospectively analyzed. ResultsIn the 33 cases, the average age of the individuals was 37.4 years old, and the male/female ratio was 23/10. Nineteen patients (57.6%) died within 1 hour. Seventeen patients with mixed pathological type of cerebrovascular malformation dominated (51.5%). Medical dispute happened in 7 cases (21.1%), 4 of which were identified to be led by medical fault and 3 with no medical fault. Relationship between injury and disease was analyzed in 11 cases (33.3%), in which injury was identified to take full responsibility in 1 case, inductive cause of death in 9 cases, and no relationship between injury and death in 1 case. ConclusionComprehensive and systematic investigation of forensic pathology plays an important role in the proper settlement of medical disputes as well as the identification of cause of death and relationship between injury and disease.
Family members are crucial for medical disputes. From the psychology and social perspective, the paper analyzes a specific medical dispute case, and discusses the psychological care for (potential) " shidu” (loss of the only child) family. Based on the current social context, an early intervention suggestion is proposed, that is to provide the whole-process psychological intervention to the special patients’ families. The intervention includes: regular psychological evaluation and psychological support if necessary; providing disease knowledge and death education; providing continuous psychological care by the hospital and community; offerring more psychological care for " shidu” family by society.