每年拯救成千上万的生命:重振同行评议特权。

Journal of law and health Pub Date : 2016-01-01
Alan G Williams
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引用次数: 0

摘要

医生犯错误——可预防的医疗错误——导致病人死亡或严重受伤。减少这些可预防错误的最好方法是通过医学同行评审过程,通常被称为“发病率和死亡率会议”。然而,在过去二十年中,联邦和州法院、州立法机构和州选民有效地破坏了发病率和死亡率会议(M+M)作为补救和预防工具的作用,导致每年数以万计的不必要死亡。医生需要我们的帮助来恢复M+Ms的有效性。国会已经创造了这样做的手段;现在,所有法院需要做的就是使用它。否则,过去二十年发生的事情还会继续下去——医生们会害怕M+M,要么不参加M+M,要么不充分参与,医疗错误不会得到彻底的调查和纠正,同样的可预防的医疗错误将继续发生,因为医生们害怕如果他们在M+M中承认自己犯了错误,那么在随后的医疗事故诉讼中,他们的供认将被用来证明他们的过失和责任。本文的第一部分总结了困扰美国医院的可预防死亡问题的严重程度——许多人称之为危机。第二部分解释了同行评议,在医生资格认证/雇用和M+M的背景下,以及在豁免、保密和特权规定下提供的法律保护。第三部分讨论了联邦和州法院的决定、州立法法规和选民倡议如何削弱了对同行评审的现有保护,特别是关于M+M。第四部分描述了PSQIA以及它如何能够——而且应该——成为可预防的医院死亡的解决方案。第五部分总结了这一论点,即法院利用PSQIA特权来保护M+M,医生和医院通过履行PSQIA的要求来履行其职责,以便他们可以援引其中所包含的特权。
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Save Thousands of Lives Every Year: Resuscitate the Peer Review Privilege.

Doctors make mistakes--preventable medical mistakes--that kill or seriously injure patients. The best way to reduce these preventable errors is through a medical peer review process typically referred to as a "morbidity and mortality conference." However, over the past twenty years, federal and state courts, state legislatures, and state voters have effectively gutted the morbidity and mortality conference (M+M) as a remedial and preventative tool, resulting in tens of thousands of unnecessary deaths every year. Doctors need our help restoring the effectiveness of M+Ms. Congress has created the means to do so; now, all the courts need do is use it. Otherwise, what has been happening over the last two decades will continue--physicians will fear the M+M, will either not participate in M+Ms or not participate fully, medical errors will not be thoroughly investigated and corrected, and the same preventable medical mistakes will continue to occur because physicians are scared if they admit during an M+M that they committed an error then, in a subsequent medical malpractice lawsuit, their admission will be used against them to prove negligence and liability. Part I of this essay summarizes the extent of the problem--many call it a crisis--of preventable deaths plaguing U.S. hospitals. Part II explains peer review, both in the context of physician credentialing/hiring and M+Ms, and the legal protections afforded under the provisions of immunity, confidentiality, and privilege. Part III discusses how federal and state court decisions, state legislative enactments, and voter initiatives have weakened existing protections for peer review, especially regarding M+Ms. Part IV describes the PSQIA and how it can--and should--be the solution to preventable hospital deaths. Part V concludes with a summation of the argument that courts employ the PSQIA privilege to protect M+Ms, and that physicians and hospitals do their part by fulfilling the requirements of the PSQIA such that they may invoke the privilege therein contained.

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