Thursday, April 26, 2012

Clinical Standards and The Law

The section that really interested me in the book The Gold Standard by Stefan Timmermans and Marc Berg was about the relation between clinical practice guidelines and the law. This was particularly outstanding to me because of all the legal implications there are behind medicine. I knew there were things like malpractice for doctors but I did not realize how complex it was. Referencing another comment by a student, the extent of my medical knowledge is probably Grey's Anatomy, which is not even real life. The medical and legal world can have two completely different interpretations on what happened in a particular case that is being brought into question. In my opinion, I feel like it is hard to judges and people in court to determine the outcomes of cases like these because they do not understand all the practicalities of medicine and the patient that is being dealt with, and they won't bee sure if the evidence was not completely accurate. There is a quote stating "Indeed, the different interpretation of 'evidence' in the legal and medical realm points to the risk of equating evidence-based medicine with the legal standard of care," (Timmermans, Berg 109). There is much debate over the way courts interpret the medical information they are given, and the way they set the legal standards for the hospital being accounted for. I find this a little odd because they set a certain standard of judgment which a particular practice is held to and that although it is beneficial to a point seems a little bit limiting in the types of treatments that the doctors can give on certain patients. This results in a lowering of the creativity that the doctors can use in their treatments because if they go against these guidelines they can be penalized and brought to court for it.

He also states that "physicians might not want to develop or adopt guidelines out of fear of liability consequences," (111). This statement is reasonable to me because it would be damaging to any physicians career if they agree to these guidelines and then come across a case where they can't follow them as strictly as they are set and the patient makes a complaint. Even if it is not directly the doctors fault, they were just working out of experience or trying to think out of the box, the can be severely punished. There are so many rules and regulations that these doctors have to follow it is like they are being held back by a certain "red tape," because a lot of things are already determined for them like how they allocate their resources to which department, rules to limit the clientele, etc. According to the book, some people view all of these third party external reinforcements of the hospitals and practices as unprofessional and an autonomous way to run a profession.

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