SEARCH · PubMed Health

Results for “Litigation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,693 records · Page 94Linked to original sources

PubMed1997

Ethical issues of cardiopulmonary resuscitation: current practice among emergency physicians.

OBJECTIVE: To determine current practice and attitudes among emergency physicians (EPs) regarding the initiation and termination of CPR. METHODS: An anonymous survey was mailed to randomly selected EPs. Main outcome measures included respondents' answers to questions regarding outcome of resuscitation, and current practice regarding initiation, continuation, and termination of resuscitation for victims of cardiopulmonary arrest. RESULTS: The 1,252 respondents were from all 50 states, a variety of practice settings, and varying board certification. Most (78%) respondents honor legal advance directives regarding resuscitation. Few (7%) follow unofficial documents, or verbal reports of advance directives (6%). Many (62%) make decisions regarding resuscitation because of fear of litigation or criticism. A majority (55%) have recently attempted numerous resuscitations despite expectations that such efforts would be futile. Most respondents indicated that ideally, legal concerns should not influence physician practice regarding resuscitation (78%), but that in the current environment, legal concerns do influence practice (94%). CONCLUSIONS: Most EPs attempt to resuscitate patients in cardiopulmonary arrest, regardless of futility, except in cases where a legal advance directive is available. Many EPs' decisions regarding resuscitation are based on concerns of litigation and criticism, rather than their professional judgment of medical benefit or futility. Compliance with patients' wishes regarding resuscitation is low unless a legal advance directive is present. Possible solutions to these problems may include standardized guidelines for the initiation and termination of CPR, tort reform, and additional public education regarding resuscitation and advance directives.

Advance Directive Adherence↗

PubMed2004

Tort reform: an issue for nurse practitioners.

PURPOSE: To inform nurse practitioners (NPs) about the issues related to tort reform and its relationship to malpractice insurance costs. DATA SOURCES: Current journals, newspapers, professional newsletters, and Internet sites. CONCLUSIONS: NPs are paying more for their malpractice premiums, and many are losing their places of employment as clinics close due to the increased cost of premiums. One method proposed for curbing the flow of monies spent on premiums and litigation is tort law reform. California serves as an example; its Medical Injury Compensation Reform Act (MICRA) tort reform law was passed 25 years ago, and it has maintained stable malpractice premiums. Other states have proposed similar laws, but some have not had similar success. To curb litigation costs, not only should tort laws be reformed, but NPs and physicians should keep abreast of current practice standards in order to provide quality medical care. IMPLICATIONS FOR PRACTICE: Like physicians, NPs are affected directly by tort laws. These laws hold NPs accountable at the same level as physicians. In addition, many states limit NPs' practice to delegation of authority by a physician. Liability is therefore transferred from the NP to the physician and vice versa in cases of injury or wrongful act. In addition, many NPs are finding it increasingly difficult to locate insurers who will write policies for medical liability.

Federal Government↗

PubMed1988

A study of the effect of legal settlement on post-concussion symptoms.

Forty-four consecutive patients with concussion for whom a medico-legal report had been written were followed up for 3-4 years after their accidents. Three cases were still pending at the end of the study. Fifty-seven per cent complained of symptoms when the medico-legal reports were written (mean interval from accident 12.9 months), 39% had symptoms at the time of settlement (mean interval 22.1 months) and 34% had symptoms one year later. When these results were compared with a general series from the same department some years earlier, it was found that the symptoms at the time of writing the reports were not significantly different from symptoms at 6 weeks in the earlier series, but the symptoms one year after settlement were almost two-and-a-half times greater than the symptoms at 12 months in the general series. No evidence could be found to suggest any organic basis for the higher symptom rate in the litigation series. It is suggested that the litigation process itself is a factor in the persistence of symptoms and this effect continues after legal settlement has been reached. Early settlement of the cases might significantly reduce morbidity.

Accidents↗

PubMed1995

Responsibility to or for in the physician-patient relationship?

The threat of malpractice litigation in the United States is encouraging physicians again to assume responsibility for their patients. The fundamental ethical problem, however, is that this approach denies the patient's moral agency. In this essay, responsibility to patients, rather than for them, is discussed as an alternative to the emerging neo-paternalism. Responsibility to avoids the ethical problems of assuming responsibility for moral agents and could reduce the threat of litigation as well.

Decision Making↗

PubMed2005

Tobacco control implications of the first European product liability suit.

OBJECTIVE: To examine tobacco control implication of the first European product liability suit in Finland. METHODS: Systematic search of internal tobacco industry documents available on the internet and at the British American Tobacco Guildford Depository. RESULTS: Despite legal loss, the litigation contributed to subsequent tobacco control legislation in Finland. The proceedings revealed that the industry had concealed the health hazards of its products and, despite indisputable evidence, continued to deny them. The positions taken by the industry rocked its reliability as a social actor and thus weakened its chances of influencing tobacco policy. Despite fierce opposition from the tobacco industry, tobacco products were included in the product liability legislation, tobacco was entered on the Finnish list of carcinogens, and an extensive Tobacco Act was passed in Parliament. CONCLUSIONS: Tobacco litigation might not stand alone as a tool for public health policymaking but it may well stimulate national debate over the role of smoking in society and influence the policy agenda.

Attitude to Health↗

PubMed2005

Understanding Philip Morris's pursuit of US government regulation of tobacco.

OBJECTIVE: To investigate Philip Morris's support of US Food and Drug Administration (FDA) regulation of tobacco products and analyse its relationship to the company's image enhancement strategies. DATA SOURCES: Internal Philip Morris documents released as part of the Master Settlement Agreement. METHODS: Searches of the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) beginning with such terms as "FDA" and "regulatory strategy" and expanding to include relevant new terms. RESULTS: Philip Morris's support for government regulation of tobacco is part of a broader effort to address its negative public image, which has a damaging impact on the company's stock price, political influence, and employee morale. Through regulation, the company seeks to enhance its legitimacy, redefine itself as socially responsible, and alter the litigation environment. Whereas health advocates frame tobacco use as a public health policy issue, Philip Morris's regulatory efforts focus on framing tobacco use as an individual choice by informed adults to use a risky product. This framing allows Philip Morris to portray itself as a reasonable and responsible manufacturer and marketer of risky products. CONCLUSIONS: Philip Morris's ability to improve its image through support of FDA regulation may undermine tobacco control efforts aimed at delegitimising the tobacco industry. It may also create the impression that Philip Morris's products are being made safer and ultimately protect the company from litigation. While strong regulation of tobacco products and promotion remain critical public health goals, previous experiences with tobacco regulation show that caution may be warranted.

Government Regulation↗

PubMed1996

Psychotherapists' duties to third parties: Ramona and beyond.

OBJECTIVE: This paper explores the implications for psychotherapy of a series of court cases involving suspected childhood sexual abuse that have raised the question of when psychiatrists and other psychotherapists can be sued by third parties for their behavior in therapy. METHOD: The authors begin by considering traditional legal approaches that until now, with few exceptions, granted only patients the right to sue caregivers for negligence. Then they turn to Ramona v. Ramona, the most publicized of a new line of cases, in which the California courts allowed a father accused of abusing his daughter to sue his daughter's therapists. RESULTS: The rationale for the abandonment of the previous restrictions on liability in Ramona was that since the father was a "direct victim" of the therapists' negligence, traditional limitations on the therapists' duties toward him should not apply. Related cases have used similar logic. Inherently difficult for the courts to apply, the direct victim standard would leave therapists unclear as to how to avoid duties to third parties, other than by refusing to treat patients with family members who may be potential litigants. Moreover, aggrieved third parties essentially would have the power to bring effective treatment to a halt by filing suit or threatening to do so. CONCLUSIONS: Although concern about therapeutic practices related to memories of childhood abuse may be warranted, abandonment of traditional rules against suits by nonpatients would be ill-advised. In the meantime, therapists can take steps to lessen the probability of their becoming involved in such litigation.

Adolescent↗

PubMed1999

Predictive factors for outcome of nonepileptic seizures after diagnosis.

The aim of this study was to assess prognosis among adult patients with nonepileptic seizures (NES) and to determine predictor variables for resolution of NES after diagnosis. Six to 9 months after receiving a video-EEG-documented diagnosis of NES, 43 adults responded by telephone interview to a detailed, structured questionnaire probing history of the episodes, psychiatric factors, socioeconomic variables, relationships, reactions to receiving the diagnosis, and potential history of litigation. At follow-up, only 18.6% were episode-free, 55.8% had improved, 16.3% reported no change, and 9.3% reported greater frequency of episodes. Patients who reported having many friends currently or having good relationships with friends as a child were significantly more likely to be episode-free. Subjects with pending litigation were significantly less likely to experience a reduction in episodes.

Adult↗

PubMed1980

Mental health law and public policy.

Litigation has been a successful strategy in securing rights for the mentally ill. After early victories, however, limits of litigation began to emerge; implementation of court orders raised many policy questions. The translation of broad rights into complex public policy has led directly to the legislative and administrative policy processes, as can be seen with the proposed Mental Health Systems Act. The author uses the evolution of Title 3, a rights and advocacy amendment of the proposed act, as a case study in the formation of public policy.

Community Mental Health Services↗

PubMed1981

Deinstitutionalization of the retarded: trends in public policy.

Essential public policy features of the national movement to return institutionalized mentally retarded people to community settings include issues related to institutional census trends, class action litigation, cost "savings," and funding. The deinstitutionalization of retarded people is following a different course from that of the mentally ill; it started later and is occurring more gradually. Right-to-habilitation lawsuits in Alabama and Pennsylvania illustrate the class action suit; gains from litigation in the 1970s have been mixed, however. Comprehensive community care is not necessarily any cheaper than comparable institutional care. Trends in state construction expenditures, the Reagan Administration's proposal for block grants, and impending human services budget cuts are current funding issues. So that advocates of the disabled can more closely monitor future developments in state and federal policy, three continuing annual studies are proposed: a comparison of states' funding of programs for retarded people; and evaluation of nationwide data obtained in accreditation surveys; and a historical and contemporary description of the operations of each of the 50 state service systems.

Community Mental Health Services↗

PubMed1985

An overview of child custody laws.

The increasing divorce rate, the large number of women in the workforce, and the expanded role of fathers in parenting have led to a dramatic increase in child custody litigation. The law has responded to this growing problem in many ways, the foremost being to shift the emphasis of child custody laws from the rights of the parents to the needs of the child. The author traces the development of child custody laws from English common law, which granted custody to fathers, to the present best-interests-of-the-child standard. Criteria for evaluating the child's best interests, legislation to reduce postdecree litigation and child snatching, and approaches to ease the pain of family breakups, such as joint custody and divorce mediation, are among the many facets of present laws discussed by the author.

Adolescent↗

PubMed2001

Road-traffic accidents--a demographic and topographic analysis.

Injuries and fatalities occur in all forms of transportation, but numerically, road-traffic accidents account for the great majority worldwide. There is little that the autopsy surgeon can contribute to the elucidation of factors leading to the accident as it is largely the circumstantial and forensic laboratory evidence which is likely to reveal a non-accidental cause. However, the doctor's role in detecting the compatibility/incompatibility of the injuries with those usually sustained in traffic accidents (to detect any which are 'atypical', e.g. focal depressed fracture of the skull), distinguishing antemortem from postmortem injuries, demonstrating the presence of any disease capable of creating sudden incapacity and analysing samples for alcohol/drugs, etc., can go a long way in assigning roles to the human and to some extent vehicular and environmental factors. This warrants that a meticulous autopsy be conducted and not merely a catalogue of injuries. It must be appreciated that a fatal accident is likely to result in litigation and the extent of litigation cannot be anticipated at the time of the autopsy. One must, therefore, aim at the close study of any accident victim and a careful assessment of the case is always rewarding. The present study was undertaken in the Department of Forensic Medicine at (a) Government Medical College, Jammu (1991-93), (b) Mulana Azad Medical College, New Delhi (1993-95) and (c) Government Medical College, Chandigarh (1994-June 2000), with the object of doing a comparative analysis of the various aspects of the road-traffic accidents and accidental deaths in three topographically and demographically different cities in India and to suggest remedial measures to bring down the accident rate.

Accidents, Traffic↗

PubMed1992

The Hillsborough football disaster and claims for 'nervous shock'.

The article investigates the scope for 'nervous shock' claims consequent on negligently inflicted injury, in the light of the Hillsborough disaster. It analyses the existing case law, including the first instance and Court of Appeal judgments in litigation arising from the disaster (for the House of Lords judgment, see Addendum). Its main purpose is to show that several of the arguments and conclusions in these judgments are driven by considerations of policy rather than principle, and primarily by a concern to prevent the 'floodgates of litigation' from opening. It is submitted that greater attention to medical perspectives on psychiatric illness would reveal that this concern is overstated and that a more principled approach would not have the adverse consequences predicted.

Civil Disorders↗

PubMed1999

Psychological consequences of road traffic accidents.

Although accident-induced psychopathology was formerly considered as being associated with secondary gain, subsequent reports have refuted this contention. More recent studies have shown that road traffic accident-induced psychopathology can be a persistent and chronic disability, irrespective of whether the victim seeks compensation. This study describes the psychological assessment of 50 potential road traffic accident litigants referred by solicitors. They were all assessed within a hospital setting approximately three weeks after the receipt of the request for a psychological report. All participants completed measures of depression, anxiety, post-traumatic stress and subjective distress, and information was obtained about injuries sustained. The results suggest that the potential litigants who sustained an injury presented with significantly higher post-traumatic distress intrusion and avoidance scores, and that these scores are also influenced by the delay between the accident and the assessment. Furthermore, the sample showed intrusion, avoidance and perceived stress scores above normal population data. Reducing the delay between the accident and assessment has important clinical implications. However, it appears that solicitors rather than general practitioners initiate these referrals. Some implications for assessment prior to treatment are discussed.

Accidents, Traffic↗

PubMed2005

The influence of the current medicolegal climate on New South Wales anaesthetic practice.

A survey was posted to all New South Wales and Provisional Fellows of the Australian and New Zealand College of Anaesthetists to assess the influence of the current medicolegal climate on their anaesthetic practice. Information collected included demographics, opinions regarding the current medico-legal climate, medical defence organizations, and the implications for anaesthetic practice. The response rate was 78% (640/820). Nearly all (95.3%) were concerned about the current medical indemnity crisis and 80.5% felt concerned about the financial security of medical insurers. Of all these respondents 23.6% had personal experience of litigation and 73.6% expected to have a claim made against them during their career: Respondents spent an average of 8.3% of their gross annual income on medical insurance premiums and 47.2% are concerned about the viability of their practice given the rising costs of medical insurance. Obstetric anaesthesia was the most common area of practice to be ceased due to medicolegal concerns. In the next two years, 20.2% of obstetric anaesthetists who responded intend to cease practice. In the past two years, 3.1% of respondents retired due to their litigation concerns, while 12.8% (average age 56.7y) are intending to retire in the next two years for the same reasons. Changes to the conduct of the preoperative consultation were common. Other changes to practice included more thorough documentation of complications (50.8%) and a strong reluctance to perform neuraxial blocks (54%). This survey suggests that anaesthetists are concerned about the current medicolegal climate and as a result, some are retiring earlier and giving up high-risk areas of practice.

Anesthesia↗

PubMed1994

Children, psychiatrists and the courts: understanding the ambivalence of the legal profession. Part 1--General principles.

Psychiatrists and other mental health professionals are frequently involved as expert witnesses in court proceedings related to children and adolescents. Their testimony may be based on a therapeutic relationship, but frequently arises because of an assessment conducted specifically for the court process. This two part paper discusses some of the issues that arise when child psychiatrists are involved as expert witnesses in litigation, with specific focus on their role in child custody, sexual abuse and young offender cases. It also offers some practical advice for those who may be called as witnesses. There is controversy in the legal profession about the role of mental health professionals in the court process. While there is recognition of their expertise, there is also a concern about not wanting to have experts usurp the role of the courts. Legal professionals also question the "objectivity" of experts, and the reliability of their opinions. Frequently the opinions of psychiatrists about children and adolescents involved in litigation have inherently speculative and value based dimensions, and not "scientific". Participation in the court process by mental health experts is nevertheless a vitally important role, providing information, analysis and recommendations about what are often very difficult societal decisions. Part two of this paper starts on page 531.

Adolescent↗

PubMed1995

Tardive dyskinesia: a review.

OBJECTIVE: To review recent research findings on tardive dyskinesia (TD) with relevance to clinical practice. METHOD: TD is a syndrome of involuntary movements that can occur in association with chronic neuroleptic use. It is of unknown pathophysiology. It can be irreversible, is cosmetically disfiguring, and can be functionally disabling. RESULTS: There is as yet no treatment of demonstrated efficacy for TD. It is an iatrogenic disorder whose incidence is increased by age and total cumulative dose of typical neuroleptics. It has been the source of successful litigation in some jurisdictions but, until very recently, there has been no effective antipsychotic agent without this effect. CONCLUSION: This litigation in some jurisdictions has been a major impetus to the development of novel antipsychotic agents. It is less well known that a similar, possibly identical, movement disorder occurs spontaneously particularly in the elderly and in patients with schizophrenia, and that TD is often reversible.

Adult↗

PubMed1997

Courts and torts: the psychiatrist preparing for trial.

OBJECTIVE: To outline how a psychiatric expert can do an impartial assessment and medicolegal report and then give an effective presentation in court that can sustain cross-examination. METHODS: The legal principles of litigating emotional trauma are reviewed, including proving causation, characterizing emotional suffering, assessing disability, and determining a realistic prognosis. RESULTS: Psychiatrists must understand the interplay of legal and psychiatric principles when they are asked to assess litigants who are suing for monetary compensation for a widening range of emotional injuries resulting from motor vehicle accidents, slips and falls, incest and sexual abuse of children, discrimination, unlawful dismissal, malpractice, human-made disasters, product liability, and intentional torts, to name a few. CONCLUSION: The psychiatrist can prepare his or her attitude, knowledge, and skills to give a presentation in court that will be credible, trustworthy, and dynamic. With adequate preparation, the psychiatric expert can bring an informed psychiatric perspective to the court that will have a significant impact on the outcome of the judicial deliberations.

Affective Symptoms↗