Health professionals ethical and legal liability on patient’s inadequate clarification in order to obtain free and informed consent

It is required that patients are provided information about therapeutic possibilities, showing the risks, benefits, prognosis and costs of each possible and indicated alternative. This is an ethical and legal resolution. However, health professionals possess the clinical/technical/scientific knowledge and determine what information will be (or not) provided. The patient in question decides to undergo a treatment, providing his/her free and informed consent on the basis of the data presented. Unfortunately, some professionals may not provide all the information necessary for making an informed decision or, after obtaining the consent of the patient, may provide him information that causes the patient to give up on the treatment initially accepted. Such information, if relevant, and not a supervening fact, should have been provided initially. However, the information may not be entirely true, and bring the patient, for instance, to decide based on inadequately presented risks. The craniofacial rehabilitation of the temporomandibular joint (TMJ) by means of TMJ prosthesis, is indicated in many situations. Often, patients in need of such prostheses have aesthetic and functional problems and the rehabilitation expectations run high. This work presents a case and discusses ethical and legal issues, including the liability of partial and inadequate information to a patient.

Legal liability of coaches: a UK perspective

Attracting more coaches is fundamental to achievement of the European dimension in sport and the further promotion of sport in the European Union. Given the emerging relationship between the law and sports coaching, recruitment of such volunteers may prove problematic. Accordingly, this article critically considers the legal liability of sports coaches. To inform this debate, the issue of negligent coaching is critically scrutinised from a UK perspective, uncovering a number of distinct legal vulnerabilities facing volunteer coaches. This includes the inherent limitations of ‘objective reasonableness’ when defining the standard of care required in the particular circumstances. More specifically, fuller analysis of the justification of customary practice, and the legal doctrine of in loco parentis, reveals important ramifications for all organisations providing training and support for coaches. In short, it is argued that proactively safeguarding coaches from professional liability should be a priority for national governing bodies, and, following the recently published EU Work Plan for Sport for 2014–2017, the Expert Group on Human Resource Management in Sport. Importantly, given the EU’s supporting, coordinating and supplementing competence in developing the European dimension in sport, a Commission funded project to address the implications of the ‘compensation culture’ in sport is also recommended.

Internet of things: legal liability of IoE devices in the home

This thesis is about the smart home, a connected ambience that will help consumers to live a more environmentally sustainable life and will help vulnerable categories of consumers to live a more autonomous life, thanks to the pervasive use of the Internet of Things (IoT) technology. In particular, civil liability for the malfunctioning of the smart home is the filter through which the research is carried out. I analyse whether the actual legal liability rules are ready or not to adapt to this new connected environment, such as the IoT-powered smart home. Through careful mapping of the technical and legal state of the art, the thesis argues that the EU rules on product liability contained in the Product Liability Directive (PLD) will apply consistently to these objects. This holds true even if at the time of the drafting of the thesis, the proposal on the update of the PLD had not been published yet. Through the analysis of past PLD cases, new American products liability case-law on domestic IoT objects and the latest legal scholarship’s contributions and policy inputs it was possible to anticipate some of the contents of the newly published EU PLD Update proposal.

Commercial property loan valuations in the UK : the changing landscape of practice and liability

This paper is the first of two which aim to examine the major legal liability implications of changes to the commercial property loan valuation process caused by the recession in the UK property market and to make recommendations to valuers and their professional institutions to improve the quality of the process and the result. This paper identifies the market background to commercial property lending and discusses the implications of the falls in value for lenders and valuers. These include two major strands; first, the outcome of discussions between the representative bodies of these two groups and, second, the increasing litigation caused by lenders suing valuers for professional negligence. The discussions between representative groups have driven a debate on the valuation process leading to a number of reports and guidance notes. This paper discusses the outcomes paying particular attention to the basis of valuation for loan purposes and the provision of additional information in valuation reports. This paper also reviews the legal framework which influences the relationship between the lenders and valuers and discusses the duty of care. The role of instructions in the valuation process, the significance of the identity of the person to be advised and the possibility of a conflict of interest arising are all considered. The paper also addresses the issue of the standards required of a commercial loan valuer, including how this is interpreted by the courts and the legal status of professional guidance notes. The paper concludes by identifying potential areas for dispute within the loan valuation process and raising a number of research questions concerning the operation of this process which are addressed in a following paper.

Commercial property loan valuations in the UK : implications of current trends in practice and liability

This paper is the second of two papers which aim to examine the major legal liability implications of changes to the commercial property loan valuation process caused by the recession in the UK property market and to make recommendations to valuers and their professional institutions to improve the quality of the process and the result. The objectives of this paper are to address a number of the practical implications of changes to the loan valuation process within the context of legal liability. The results of an interview survey of lenders and valuers are reported and analysed. The survey examined the loan valuation process including the selection and instruction of valuers, bases of valuation and valuation reporting. In the selection and instruction process, the findings of the survey reveal two potential problems within the valuer/lender relationship. First, valuers still occasionally accept instructions from borrowers and this could lead to a conflict of interest as lenders may rely on the survey. Second, the occasional lack of formal instructions prior to the delivery of reports casts doubt on the valuer’s ability to correctly identify the needs of clients. Regarding the basis of valuation, it was found that valuers are providing valuations on bases which they do not think are appropriate. Valuers may be legally liable if they do not inform clients of their reservations and this situation must be urgently addressed. The survey also confirms previous research that valuation reports are considered to be light on contextual information concerning markets. The paper concludes by making a number of specific recommendations concerning possible improvements to the commercial property loan valuation process.

Profile evaluation of orthodontic professionals as for their legal actions

Objective: Evaluate the legal actions and behavior in the doctor/patient relationship, used by dental surgeons practicing orthodontics. Methods: The population sample of the present study consisted of dental surgeons, active in the field of orthodontics, and registered with Dental Press Publishing Company - Maringá/PR, Brazil, with a total sample size of 525 professionals. The research was conducted using a 17-question survey forwarded to these professionals. Results and Conclusions: The majority of participants in our study are specialized in orthodontics; 75% of professionals use some sort of contract at the office/clinic; 73.7% of professionals periodically request maintenance X-rays; a large percentage of professionals (58.9%) keep patient records on file for life. The interviewed professionals demonstrate good knowledge of the Brazilian Code of Ethics in Dentistry, especially of Chapter XIV - on Communication.

WAML World Congress: Direito Médico Mundial em Portugal

Eis que existem boas notícias científicas em Portugal. O WAML World Congress é o maior e mais prestigiado congresso mundial de direito médico. E, desta vez, vai ter lugar em Portugal, mais em concreto na Cidade capital do Mondego, Coimbra, entre os próximos dias 2 e 7 de Agosto de 2015. O seu Presidente ou Chairman, será o especialista português em direito médico, professor da Faculdade de Direito da Universidade de Coimbra, Doutor André Gonçalo Dias Pereira. Especialista que já esteve a fazer um excelente Seminário em Barcelos, Escola Superior de Gestão do Instituto Politécnico do Cávado e do Ave, no dia 26 de Maio de 2014, com o título de “O Direito da Concorrência: análise de um caso real”. Tema que relacionou com a poderosa indústria farmacêutica, entre outros aspectos conexos. § Behold, there are good scientific news in Portugal. The WAML World Congress is the largest and most prestigious world congress of medical law. And this time, will take place in Portugal, more specifically in the Mondego capital city, Coimbra, between 2nd and August 7, 2015. The President or Chairman, will be the Portuguese expert in medical law professor Faculty of Law, University of Coimbra, Doctor André Gonçalo Dias Pereira. Specialist who has been doing an excellent Seminar in Barcelos, School of Management Cávado Polytechnic Institute and Ave, on May 26, 2014, with the title "The Competition Law: analysis of a real case." Theme related to the powerful pharmaceutical industry, and other related aspects.

Evaluación Psicológica de la Toma de Decisiones Éticas de Riesgo en Entorno Organizacional: Revisión Teórica

Este trabajo de investigación explora el proceso de toma de decisiones fundamentado desde la perspectiva psicológica. El campo de interés está centrado en la toma de decisiones éticas a nivel organizacional y las consecuencias que las zonas grises o las conductas de riesgo repercuten en las dinámicas económicas y sociales. Con base en el análisis de los escándalos financieros más importantes de Europa, Estados Unidos y Colombia, y la literatura ofrecida por las ciencias sociales, la ética y las ciencias económicas se reconstruye una recopilación teórica de los aportes que los modelos psicológicos aplicados pueden dar al campo de la consultoría y el funcionamiento organizacional como también al estudio y análisis de los comportamientos anti éticos en empresas.

Nível de conhecimento dos cirurgiões dentistas sobre a qualidade dos prontuários odontológicos para fins de identificação humana

Objective: The aim of this research was to determine the knowledge level of 400 dentists registered in the Regional Dental Council of Cuiabá, through a questionnaire about the importance of records in the process of human identification. Results: We observed that 48.36% of them dispense between 10 and 20 minutes. Only 13.1% of the surveyed dentists did not have the habit of writing down the oral conditions of their patients before starting treatment and 42.62% have only one odontogram filled. From the 122 participants, 11.11% reported that the documentation had no utility to establish the patients identity. To make the situation worse, 33.6% of them said they did not keep the records of patients updated. Conclusion: We conclude that the dentist of Cuiabá has enough knowledge on preparing, maintaining and importance of dental records before the death in the identification process for establishing the patient identity. But, always he did not properly fills the dental records, thus it has been reducing their clinical, administrative and legal value.

A study of nurses' perceptions of and participation in the resolution of treatment dilemmas for critically ill newborns

This study was an exploratory investigation of variables which are associated with neonatal intensive care nurses' perceptions of and participation in life-sustaining treatment decisions for critically ill newborns. The primary purpose of the research was to examine the extent to which assessment of infants' physical and mental prognoses, parents' preferences regarding treatment, and legal consequences of non-treatment influence nurses' recommendations about life-saving treatment decisions for handicapped newborns. Secondly, the research explored the extent and nature of nurses' reported participation in the resolution of treatment dilemmas for these critically ill newborns. The framework of the study draws upon the work of Crane (1977), Blum (1980), and Pearlman (1982) who have explored the sociological context of decision-making with critical care patients.^ Participants in the study were a volunteer sample of eighty-three registered nurses who were currently working in neonatal intensive care units in five large urban hospitals in Texas. Data were collected through the use of intensive interviews and case study questionnaires. Results from the study indicate that physical and mental prognoses as well as parent preferences and concerns about legal liability are related to nurses' treatment recommendations, but their levels of significance vary according to the type of handicapping condition and whether the treatment questions are posed in terms of initiating aggressive therapy or withdrawing aggressive therapy.^ The majority of nurses reported that the extent of their participation in formal decision-making regarding handicapped newborns was fairly minimal although they provide much of the definitive data used to make decisions by physicians and parents. There was substantial evidence that nurse respondents perceive their primary role as advocates for critically ill newborns, and believe that their involvement in the resolution of treatment dilemmas should be increased. ^

SUPERFUND: AN ANALYSIS OF IMPLEMENTATION FAILURE (CERCLA, HEALTH LAW POLICY)

In December, 1980, following increasing congressional and constituent-interest in problems associated with hazardous waste, the Comprehensive Environmental Recovery, Compensation and Liability Act (CERCLA) was passed. During its development, the legislative initiative was seriously compromised which resulted in a less exhaustive approach than was formerly sought. Still, CERCLA (Superfund) which established, among other things, authority to clean up abandoned waste dumps and to respond to emergencies caused by releases of hazardous substances was welcomed by many as an important initial law critical to the cleanup of the nation's hazardous waste. Expectations raised by passage of this bill were tragically unmet. By the end of four years, only six sites had been declared by the EPA as cleaned. Seemingly, even those determinations were liberal; of the six sites, two were identified subsequently as requiring further cleanup.^ This analysis is focused upon the implementation failure of the Superfund. In light of that focus, discussion encompasses development of linkages between flaws in the legislative language and foreclosure of chances for implementation success. Specification of such linkages is achieved through examination of the legislative initiative, identification of its flaws and characterization of attendant deficits in implementation ability. Subsequent analysis is addressed to how such legislative frailities might have been avoided and to attendant regulatory weaknesses which have contributed to implementation failure. Each of these analyses are accomplished through application of an expanded approach to the backward mapping analytic technique as presented by Elmore. Results and recommendations follow.^ Consideration is devoted to a variety of regulatory issues as well as to those pertinent to legislative and implementation analysis. Problems in assessing legal liability associated with hazardous waste management are presented, as is a detailed review of the legislative development of Superfund, and its initial implementation by Gorsuch's EPA. ^

Nurse likelihood to report a pediatric medication error: Examination of the "pre-reporting" period

Each year, hospitalized patients experience 1.5 million preventable injuries from medication errors and hospitals incur an additional $3.5 billion in cost (Aspden, Wolcott, Bootman, & Cronenwatt; (2007). It is believed that error reporting is one way to learn about factors contributing to medication errors. And yet, an estimated 50% of medication errors go unreported. This period of medication error pre-reporting, with few exceptions, is underexplored. The literature focuses on error prevention and management, but lacks a description of the period of introspection and inner struggle over whether to report an error and resulting likelihood to report. Reporting makes a nurse vulnerable to reprimand, legal liability, and even threat to licensure. For some nurses this state may invoke a disparity between a person‘s belief about him or herself as a healer and the undeniable fact of the error.^ This study explored the medication error reporting experience. Its purpose was to inform nurses, educators, organizational leaders, and policy-makers about the medication error pre-reporting period, and to contribute to a framework for further investigation. From a better understanding of factors that contribute to or detract from the likelihood of an individual to report an error, interventions can be identified to help the nurse come to a psychologically healthy resolution and help increase reporting of error in order to learn from error and reduce the possibility of future similar error.^ The research question was: "What factors contribute to a nurse's likelihood to report an error?" The specific aims of the study were to: (1) describe participant nurses' perceptions of medication error reporting; (2) describe participant explanations of the emotional, cognitive, and physical reactions to making a medication error; (3) identify pre-reporting conditions that make it less likely for a nurse to report a medication error; and (4) identify pre-reporting conditions that make it more likely for a nurse to report a medication error.^ A qualitative research study was conducted to explore the medication error experience and in particular the pre-reporting period from the perspective of the nurse. A total of 54 registered nurses from a large private free-standing not-for-profit children's hospital in the southwestern United States participated in group interviews. The results describe the experience of the nurse as well as the physical, emotional, and cognitive responses to the realization of the commission of a medication error. The results also reveal factors that make it more and less likely to report a medication error.^ It is clear from this study that upon realization that he or she has made a medication error, a nurse's foremost concern is for the safety of the patient. Fear was also described by each group of nurses. The nurses described a fear of several things including physician reaction, manager reaction, peer reaction, as well as family reaction and possible lack of trust as a result. Another universal response was the description of a struggle with guilt, shame, imperfection, blaming oneself, and questioning one's competence.^

Reconhecimento, mensuração e evidenciação do passivo judicial trabalhista

A má avaliação do passivo judicial pode impactar de modo negativo as disponibilidades financeiras da organização, com consequencias para sua liquidez e para a continuidade das atividades operacionais. O presente trabalho teve como objetivo verificar se o reconhecimento, a mensuração e a evidenciação do Passivo Judicial Trabalhista atendem aos pressupostos da literatura contábil e do direito natural, no que toca ao conceito de fair value. No contexto metodológico, apresentou-se o arcabouço teórico-jurídico do reconhecimento, da mensuração e da evidenciação. Em seguida, dentre as empresas listadas nos segmentos Nível 1, Nível 2 e Novo Mercado da BM&FBovespa foram selecionadas, para a amostra, as 40 empresas com maior quantidade de ações em tramitação no TST. Foram analisadas as Notas Explicativas dessas companhias e verificou-se que, a maior parte não divulga informações alusivas à origem do passivo judicial trabalhista, à forma de mensuração das provisões, à quantidade de ações e ao cronograma de desembolsos. Assim, as práticas adotadas por tais empresas não estão em conformidade plena com os pressupostos da literatura contábil e do direito natural pois as determinações contábeis (CPC 25) tem sido observadas em sua forma menos ampla. Também foi constatado que há possibilidade de melhoria no processo de reconhecimento, mensuração e evidenciação eis que há boas práticas, pontuais, nas companhias examinadas que podem ser generalizadas para as demais.

Developing brownfields ranking models using decision analytic methods

The redevelopment of Brownfields has taken off in the 1990s, supported by federal and state incentives, and largely accomplished by local initiatives. Brownfields redevelopment has several associated benefits. These include the revitalization of inner-city neighborhoods, creation of jobs, stimulation of tax revenues, greater protection of public health and natural resources, the renewal and reuse existing civil infrastructure and Greenfields protection. While these benefits are numerous, the obstacles to Brownfields redevelopment are also very much alive. Redevelopment issues typically embrace a host of financial and legal liability concerns, technical and economic constraints, competing objectives, and uncertainties arising from inadequate site information. Because the resources for Brownfields redevelopment are usually limited, local programs will require creativity in addressing these existing obstacles in a manner that extends their limited resources for returning Brownfields to productive uses. Such programs may benefit from a structured and defensible decision framework to prioritize sites for redevelopment: one that incorporates the desired objectives, corresponding variables and uncertainties associated with Brownfields redevelopment. This thesis demonstrates the use of a decision analytic tool, Bayesian Influence Diagrams, and related decision analytic tools in developing quantitative decision models to evaluate and rank Brownfields sites on the basis of their redevelopment potential.

Summary and Risks of ABS Transactions Under EU and US Law

This chapter examines the legal concept of summary in terms of its potential legal liability and other types of risks under EU and US disclosure laws.