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Journal Article

Citation

Sendler DJ. Forensic Sci. Int. 2018; 285: 29-37.

Affiliation

Laboratory of Forensic Sexology, Legal Medicine, and Digital Ethnography, Felnett Health Research Foundation, 175 Zoe St, Staten Island, NY, 10305, United States; Program in the Study of Sexual Minorities and Health Policy, Felnett Health Research Foundation: Division for Eastern Europe, Warsaw, Poland. Electronic address: djs508@nyu.edu.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.forsciint.2018.01.019

PMID

29428450

Abstract

INTRODUCTION: The intoxicated person may cause harm to others, often requiring expert evaluation for the determination of guilt. The primary aim of this study was to determine the mechanisms of mistakes that led 17 doctors accused of working under the influence of alcohol to face malpractice. We also wanted to clarify what were the legal, professional, and financial consequences - depending on specific patient outcomes.

METHOD: We based analysis on the review and meta-analysis of the past forensic evaluation reports of institution-run forensics programs. Furthermore, we apply thematic analysis using combination of grounded theory and Pierre Bourdieu's theoretical framework.

RESULTS: During the 2010-2016 timeframe, the regional forensic service opinionated on 17 physicians (3F, 14M) subjected to disciplinary action due to providing treatment under the influence of alcohol. In total, there were 157 patients potentially affected by malpractice - out of those, four were harmed; only one qualified for compensation. In the remaining 153 patients - only 11 persons reported having had awareness about the doctors' intoxication and apparent inability to perform the job, yet they agreed to receive care. Overall, in over 90% of patients, the physician did not harm anyone to a degree threatening patient's life. The supporting staff did not report experiencing distress either. The results of a blood test for the presence of alcohol were available for only four cases. Therefore, it was impossible to analyze the correlation between intoxication level and performance in providing care. All in all, in our analysis - less than 10% of 157 patients' care were compromised by provider's intoxication, either due to a mistake in diagnosis, medical procedure, or lacking communication skills.

CONCLUSION: For physicians, working under the influence of alcohol is an uncommon phenomenon, but when it occurs - patients are at risk for receiving poor treatment. Presented analysis indicates that patients - just as much as supporting staff - frequently agree to receive supervision and care from a drunk doctor, despite possible harm. Therefore, it is evident that patients as much as supporting staff fear retaliation, leading to underreporting of these cases.

Copyright © 2018 Elsevier B.V. All rights reserved.


Language: en

Keywords

Forensic evaluations; Intoxicated physicians; Malpractice; Medical ethics; Standard of care

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