There has been a paradigm shift in terms of thinking about errors. In the aftermath of disasters, the lens of responsibility is being refocused away from people and towards (work) places. Institutions not individuals, processes rather than persons are becoming the focus of investigation. The search for scapegoats is beginning to look crass and ineffective. This is reflected in the formal responses to these events, such as public inquiries, which now routinely focus on system responsibility. Whilst systems analysis has obvious merits it also raises important and unresolved questions. In particular, what are the risks of this shift towards systems thinking? What are the implications for individual professional responsibility? Will the commitment to systems responsibility be meaningful in practice? First, however, we must sketch the contention and connotation of different descriptions of error episodes and appreciate the true toll of the error problem in medicine.
An out-of-hours doctor who killed a 70-year-old man by injecting him with an overdose of a painkiller could repeat the error, a panel has warned. Nigerian-born Dr Daniel Ubani, 67, injected David Gray, of Manea, Cambridgeshire, with 10 times the recommended dosage of a painkiller. A General Medical Council (GMC) panel is holding a hearing into the case. The panel said Dr Ubani's actions had "brought the profession into disrepute" and questioned his clinical competence.
A retired doctor has been struck off after giving excessively high doses of morphine to 18 dying patients. A disciplinary panel found that former County Durham GP Dr Howard Martin had not acted negligently but had "violated the rights of the terminally ill". He was cleared of murdering three of his patients five years ago. But he has been struck off by the General Medical Council (GMC) for "completely unacceptable" treatment of some patients.
A cardiac surgeon with an international reputation has been given a formal warning by the General Medical Council for undertaking an “adventurous” procedure for which he was not adequately trained and for which he did not obtain informed consent.
This End of life guidance covers three main issues: contemporaneous and advance refusal of treatment; withholding and withdrawing life-prolonging medical treatment; assisted dying - euthanasia and assisted suicide.
Some doctors are set to argue against moves towards an organ donation system of presumed consent in the UK. Under presumed consent all people are assumed to be willing to donate their organs unless they have opted out. No part of the UK has introduced such a system yet, although the Welsh assembly favours the idea. However, delegates at the British Medical Association's annual conference in Cardiff will debate later whether the move could damage trust in doctors. Those in favour of presumed consent, which has been supported by the BMA for the last 10 years, believe it would help boost UK donation rates, which, despite recent improvements, still lag behind many other countries.
The ‘elusive’ concept of ‘impairment’ was introduced into the General Medical Council's Fitness to Practise Procedures in 2002. Its function was ostensibly to bring all forms of fitness to practise allegations against doctors under a unifying concept and thereby reduce procedural complexity. This paper strives to illuminate the application of ‘impairment’ of fitness to practise with reference to a year of fitness to practise decision making by the General Medical Council (GMC). It concludes that impairment has brought with it a redemptive style of resolving matters of
Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues, MPs have recommended. In its first annual review of the functions of the General Medical Council, the House of Commons Health Committee has called for the regulator to send “a clear signal” to doctors that they are at as much risk of being investigated for failing to report concerns about a fellow doctor as they are from poor practice on their own part. Senior doctors and clinical team leaders in hospitals would be most accountable, but there would be “questions asked of everybody,” said Stephen Dorrell MP, chair of the health committee.
Un médecin du centre hospitalier de la côte basque, à Bayonne (Pyrénées-Atlantiques), soupçonné d'euthanasie active sur au moins quatre patients âgés, a été placé en garde à vue mercredi au commissariat de cette ville. Les faits, qui concernent des décès survenus au cours des cinq derniers mois, dont celui d'une patiente âgée de 92 ans le 3 août, se seraient déroulés dans le service des urgences de l'hôpital. Une information préliminaire a été ouverte pour "homicide volontaire avec préméditation". Tous les cas signalés concernent des personnes âgées ayant été admises aux urgences tout en étant classées "en fin de vie", dans l'attente d'un placement dans un service de soins palliatifs, a-t-il encore indiqué. Les faits ont été signalés par des agents du service des urgences à leur hiérarchie, qui a pris la décision d'alerter la police, selon un communiqué diffusé jeudi par l'hôpital.
A man who is almost completely paralysed is taking legal action in a bid to end his life. His solicitors have told the BBC that they believe his case could have major implications for the way prosecutors in England, Wales and Northern Ireland deal with assisted suicides.