Revista Espanola de Medicina Legal最新文献

英文中文

Comportamientos inadecuados de connotación sexual en el ejercicio profesional: denuncias ante el Tribunal de Ética Médica (Uruguay, 2012–2024) 职业中不适当的性行为：向医学伦理法庭提出的申诉（乌拉圭，2012 - 2024年）

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-04-01 DOI: 10.1016/j.reml.2025.500434

Evangelina Pérez Real, Jessica Filosi Piedrahíta, Natalia Bazán Hernández, Hugo Rodríguez Almada

Introduction

Sexual violence is a globally prevalent phenomenon that impacts all sectors, including the medical profession. Several publications have raised concerns about inappropriate sexual behavior in professional practice. This is the first Uruguayan report, aimed at systematically organizing the complaints submitted regarding these sexual transgressions to the official tribunal responsible for the ethical oversight of the profession.

Method

This is a retrospective, observational study examining the judgments issued since 2012.

Results

Complaints related to this issue constituted 11.77 % of the total. All physicians reported were male. Psychiatrists and gynecologists were the most frequently cited specialists and received the most severe sanctions. Nearly all complainants were women. Many complaints involved physical contact and verbal abuse and almost all complaints resulted in sanctions against the physicians, including professional suspensions.

Conclusions

The limited number of cases requires caution in conclusions. From the data we report, based on all reported cases, the following emerges: 1) Inappropriate sexual behaviors in professional settings are not exceptional. 2) They are underrepresented within the realm of complaints related to breaches of medical ethics. 3) These behaviors reflect gender inequality and are exacerbated by other asymmetries inherent in the clinical relationship and hierarchical structures. 4) Users of mental health and gynecological services are particularly vulnerable. 5) Despite evidentiary challenges, legal proceedings succeed in overcoming the presumption of innocence and sanctioning offenders. 6) A lack of national regulations with greater specificity for such transgressions was observed.

性暴力是一种全球普遍现象，影响到所有部门，包括医疗行业。一些出版物对专业实践中的不当性行为提出了担忧。这是乌拉圭的第一份报告，目的是有系统地组织向负责职业道德监督的官方法庭提出的关于这些性侵犯的控诉。方法回顾性观察研究2012年以来的判决。结果与该问题相关的投诉占投诉总数的11.77 %。所有报告的医生均为男性。精神科医生和妇科医生是被引用次数最多的专家，受到的处罚也最严厉。几乎所有投诉者都是妇女。许多投诉涉及身体接触和言语虐待，几乎所有投诉都导致对医生的制裁，包括停职。结论病例数量有限，结论需谨慎。根据我们报告的数据，基于所有报告的案例，可以得出以下结论：1)职业环境中的不当性行为并不罕见。2)在与违反医疗道德有关的投诉领域，她们的代表人数不足。3)这些行为反映了性别不平等，并因临床关系和等级结构中固有的其他不对称而加剧。4)心理健康和妇科服务的使用者尤其脆弱。尽管存在证据方面的挑战，但法律程序成功地克服了无罪推定并制裁了违法者。6)对这类违法行为缺乏更具体的国家规定。

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引用次数: 0

Análisis médico-legal de las reclamaciones por responsabilidad patrimonial en atención primaria y urgencia extrahospitalaria de la Comunidad de Madrid 马德里地区初级保健和医院外紧急情况中财产责任索赔的医学-法律分析

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-04-01 DOI: 10.1016/j.reml.2025.500453

Fernando León Vázquez , Ángel Nieto Sánchez , Andrés S. Santiago-Sáez

Introduction

Primary care (PC) and out-of-hospital emergency services (SUMMA112) are high-risk areas for malpractice claims due to their volume of activity and inherent uncertainty. Compensation claims that do not involve criminal liability require a preliminary administrative procedure. We analyzed the reasons and outcomes of these resolutions.

Materials and methods

This is a cross-sectional observational study of advisory opinions issued by the Legal Advisory Commission of the Community of Madrid regarding compensation claims for out-of-hospital healthcare liability between 2013 and 2022. The variables analyzed included administrative, clinical, judicial, temporal, and compensatory factors.

Results

A total of 616 rulings, 75 (12.2%) were related to out-of-hospital care: 43 (57.3%) in family medicine in PC and 28 (37.3%) in SUMMA112. Of these 42.7% were partially or fully upheld. The median compensation was €37,744 (range €600–€370,000). The 34 (45.3%) patients who died received more favorable outcomes (55.9% vs. 31.7%) with higher compensations (€47,900 vs. €22,900). The average delay between the claim and the opinion was 775 days. Reasons for claims included delayed or erroneous diagnosis in 42 cases (50,6%), treatment errors in 14 (16,9%), malpractice in 10 (12%), informed consent issues in 9 (10,8%) and adverse treatment effects in 7 (8,4%). The most frequent diseases were acute cardiovascular conditions (27%, including myocardial infarction and stroke), oncological diseases (16%), vaccine-related incidents (8%), and trauma (8%).

Conclusions

Acute cardiovascular and oncological pathologies generated the highest number of claims. Diagnostic delay or error was the primary reason cited, often linked to the loss of opportunity. Less than half of the claims were upheld, with compensation amounts significantly lower than those requested, and higher amounts awarded in cases involving patient death. Resolution times exceeded two years.

初级保健（PC）和院外急救服务（SUMMA112）是医疗事故索赔的高风险领域，因为它们的活动量和固有的不确定性。不涉及刑事责任的赔偿要求需要初步行政程序。我们分析了这些决议产生的原因和结果。材料和方法这是一项对马德里共同体法律咨询委员会发布的关于2013年至2022年院外医疗责任索赔的咨询意见的横断面观察研究。分析的变量包括行政、临床、司法、时间和补偿因素。结果616例病例中，75例（12.2%）与院外护理相关，其中PC区43例（57.3%）与家庭医学相关，SUMMA112区28例（37.3%）与院外护理相关。其中42.7%部分或完全维持。薪酬中位数为37744欧元（600欧元至37万欧元）。34名（45.3%）死亡患者获得了更有利的结果（55.9%对31.7%），获得了更高的赔偿（47,900欧元对22,900欧元）。从提出索赔到发表意见的平均延迟时间为775天。索赔原因包括延误或误诊42例（50.6%），治疗错误14例（16.9%），医疗事故10例（12%），知情同意问题9例（10.8%），治疗不良反应7例（8.4%）。最常见的疾病是急性心血管疾病（27%，包括心肌梗死和中风）、肿瘤疾病（16%）、疫苗相关事件（8%）和创伤（8%）。结论急性心血管和肿瘤病变引起的索赔数量最多。诊断延误或错误是被引用的主要原因，通常与失去机会有关。不到一半的索赔得到支持，赔偿数额大大低于所要求的数额，而在涉及病人死亡的案件中，给予的赔偿数额更高。解决时间超过两年。

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引用次数: 0

Lesionología maxilofacial en violencia de género: Estudio descriptivo de casos de Valparaíso, Chile 性别暴力中的颌面损伤学：智利瓦尔帕莱索案例描述研究

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-04-01 DOI: 10.1016/j.reml.2025.500458

Denisse Lagos Tissie , Marcos Faúndes Pinto , Jesús Silva Melo , Alejandra Montoya Barrena , Camila Contreras Vicencio

Violence against women is one of the most widespread violations of human rights globally. In these cases, it is common to find injuries in the maxillofacial area, which can leave various types of sequelae.

Objective

To characterize maxillofacial injuries from the examinations carried out under the Gender Protocol at the Valparaíso Legal Medical Service, Chile.

Methodology

A qualitative retrospective study was conducted using data collected from maxillofacial injury reports conducted between 2020 and 2023.

Results

A total of 51 examinations were analyzed: the age of the victims ranged from 21–73 years, with the majority being homemakers and unmarried. In most cases, the aggressions were perpetrated by the women's current partners at their shared residence. In nearly a third of the cases, the aggression occurred in the presence of minors. The most commonly used injurious mechanisms were blunt and asphyxiation. There were injuries to soft tissues and hard tissues. The medicolegal prognosis in the majority of cases was less severe.

Discussion

The evaluation of maxillofacial injuries by a dentist is fundamental, especially to assess intraoral injuries. Dentists should be familiar with forensic dentistry in these contexts, in order to accurately document injuries and contribute to the administration of justice. Professionals who tend to these victims should do so in an environment that provides support and comfort to the female victims, as the verification of injuries is often their first interaction with institutional authorities and can be decisive in their decision to proceed with legal action.

对妇女的暴力行为是全球最普遍的侵犯人权行为之一。在这些情况下，通常会在颌面区域发现损伤，这可能会留下各种类型的后遗症。目的在智利Valparaíso法律医疗服务处根据《性别议定书》进行的检查中确定颌面部损伤的特征。方法采用定性回顾性研究，收集2020 - 2023年颌面部损伤报告数据。结果共分析51份检查报告，年龄21 ~ 73 岁，以家庭主妇、未婚居多。在大多数情况下，侵犯行为是由妇女目前的伴侣在她们共同居住的地方实施的。在近三分之一的案件中，侵犯行为发生在未成年人在场的情况下。最常用的伤害机制是钝器和窒息。软组织和硬组织均有损伤。大多数病例的医学预后较轻。牙医对颌面部损伤的评估是至关重要的，尤其是对口腔内损伤的评估。在这些情况下，牙医应该熟悉法医牙科，以便准确地记录伤害并有助于司法行政。照顾这些受害者的专业人员应该在一个为女性受害者提供支持和安慰的环境中这样做，因为对伤害的核实往往是他们与机构当局的第一次互动，对他们是否采取法律行动的决定可能是决定性的。

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引用次数: 0

Intervención médico-forense en las inundaciones de Valencia de octubre de 2024 2024年10月瓦伦西亚水灾的法医干预

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-04-01 DOI: 10.1016/j.reml.2025.500471

Eneko Barbería , Marta Grijalba

引用次数: 0

Condiloma acuminado oral en una menor de 7 años. Controversias médico-legales en su vía de transmisión 7岁以下儿童口腔增厚性疾病。正在发生的医疗-法律纠纷

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-01-01 DOI: 10.1016/j.reml.2024.09.003

Carlos Chérrez Bermejo , María Ilundáin Cabedo , Guillermo Cabero López , Isabel Ibarrola Hermoso de Mendoza , Raquel Amatriain Pileño , María Muñiz Lorenzo

引用次数: 0

Carta al editor sobre el articulo Coloración visceral post mortem debido al azul de metileno 致编辑的信，内容涉及《亚甲蓝导致的内脏尸斑》一文

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-01-01 DOI: 10.1016/j.reml.2024.08.002

Christoph G. Birngruber, Stefanie Plenzig, Constanze Nieß, Johannes Baumgarten

引用次数: 0

Nota del publisher 出版商注

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-01-01 DOI: 10.1016/S0377-4732(25)00016-1

Beatriz Mas

引用次数: 0

Muertes en custodia: Un problema complejo 羁押中的死亡：一个复杂的问题

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-01-01 DOI: 10.1016/j.reml.2025.500444

Sonsoles Castro Herranz

引用次数: 0

El reto del relevo generacional desde la gobernanza robusta en los institutos de medicina legal y ciencias forenses de España. Un ejemplo de liderazgo y gestión pública en el Instituto de Medicina Legal y Ciencias Forenses de Alicante 西班牙法律医学和法医学研究所健全治理的代际转变的挑战。阿利坎特法律医学和法医学研究所的领导和公共管理典范

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-01-01 DOI: 10.1016/j.reml.2024.10.003

Mar Pastor-Bravo , Miquel Salvador-Serna , Rosana Marcos-Ramos , Eneko Barbería-Marcalain , Marta Grijalba-Mazo , Rafael Bañón-González , César Casado-de Santiago , Antonio Jesús Sánchez-Padial

Currently, the Institutes of Legal Medicine and Forensic Sciences (IMLCF) are in a turbulent environment favored by the emergence of new challenges and different professional categories and demands, all of this linked to the generational change and the imminent change in the qualification requirements for access to the Corps of Forensic Doctors. Beyond the need for greater resources, the convenience of exploring the capacities of the IMLCF to face these challenges is raised. From the emerging paradigm of robust governance, articulated from four institutional capacities (strategic, management, relational and analytical) a scheme is proposed that allows the articulation of change proposals to promote the systematic reinforcement of the IMLCF.

To do this, an operating model based on flexibility with adaptive capacity must be implemented, but which integrates the essential stability to maintain its basic activities.

It is proposed to plan and give proposals for improvement that help to successfully face the challenge of generational change in forensic medicine professionals taking the IMLCF of Alicante as an example.

目前，法律医学和法医学研究所（IMLCF）处于一个动荡的环境中，新的挑战和不同的专业类别和需求的出现有利于这些环境，所有这些都与代际变化以及进入法医学军团的资格要求即将发生变化有关。除了需要更多资源之外，还提出了探索IMLCF应对这些挑战的能力的便利性。根据从四个机构能力（战略能力、管理能力、关系能力和分析能力）阐述的新出现的强有力的管理模式，提出了一项计划，该计划允许提出变革建议，以促进有系统地加强管理和管理基金。要做到这一点，必须实施一种基于灵活性和适应能力的运营模式，但它集成了维持其基本活动的必要稳定性。以阿利坎特市法医学专业人员代际变化为例，提出规划和改进建议，有助于成功应对法医学专业人员代际变化的挑战。

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引用次数: 0

Sumisión química. Evaluación del grado de conocimiento de los profesionales sanitarios 化学的屈服。评估卫生专业人员的知识水平

Q3 Medicine

Revista Espanola de Medicina Legal

Pub Date : 2025-01-01 DOI: 10.1016/j.reml.2024.08.001

Esperanza López Hidalgo, María Victoria Villalba Soria, Desirée Ruiz Ruano

Introduction

Chemical submission is a phenomenon that has become increasingly important in recent years and doctors who care for a victim should have enough knowledge about it. Our objective is to determine the degree of knowledge of doctors who, in their professional condition, could assist to a chemical submission victim.

Material and methods

We have carried out a survey among health workers who can assist to a chemical submission victim in order to determine their level of knowledge in this matter.

Results

The results show that doctors think they don't have enough knowledge about chemical submission.

Conclusions

Specific training programs in chemical submission should be implemented.

化学品提交是近年来变得越来越重要的一种现象，照顾受害者的医生应该对此有足够的了解。我们的目标是确定医生的知识程度，在他们的专业条件下，可以帮助化学品提交的受害者。材料和方法我们在能够帮助化学品受害者的卫生工作者中进行了一项调查，以确定他们在这方面的知识水平。结果调查结果显示，医生认为自己对药品申报的了解不够。结论应实施具体的化学品申报培训方案。

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Revista Espanola de Medicina Legal

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