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Professional Misconduct In The Medical Domain


Individuals claim that no one was harmed so nothing deviant or wrong has occurred ... In the Grey's Anatomy clip, Dr. Burke is dealt with leniently, do you feel that ... – PowerPoint PPT presentation

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Title: Professional Misconduct In The Medical Domain

Professional Misconduct In The Medical Domain
  • By Sylvia Mal and Ayla Mittelholtz

  • Medical Malpractice
  • An act or omission by a health care provider
    which deviates from accepted standards of
    practice in the medical community and which
    causes injury to the patient

  • Up to 100,000 US patients die each year because
    of preventable adverse effects
  • Proportion of hospitalized patients affected by
    medical errors estimated to be 5-10 - it has
    approached 50 in some studies
  • Mizrahi found that 47 of internal medicine
    residents reported making serious errors during
    their training

Techniques of NeutralizationSykes and Matza
1. Denial of Responsibility
2. Denial of Injury
3. Denial of the Victim
4. Condemnation of the Condemners
5. Appeal to Higher Loyalties
Denial Of Responsibility
  • The act is justified because the individual has
    no control over it

Denial Of Injury
  • Individuals claim that no one was harmed so
    nothing deviant or wrong has occurred

Denial Of The Victim
  • The individual argues that whoever is harmed by
    the deviance deserves the harm

Condemnation Of The Condemners
  • The Individual claims that those who disapprove
    of the act are hypocrites who have done much

Appeal To Higher Loyalties
  • The individuals attachments to norms other than
    those of the larger society hold preeminence

Four Models of the Physician-Patient
1. The Paternalistic Model
2. The Informative Model
3. The Interpretive Model
4. The Deliberative Model
The Paternalistic Model
  • The physician-patient interaction ensures that
    patients receive the intervention that best
    promote their health and well-being
  • Doctors try to find medical tests and treatments
    that are most likely to restore patients health
  • Promoting the patients well-being independent of
    the patients current preferences

The Informative Model
  • The physician presents all relative information
    to the patient and the patient selects the
    medical intervention he/she wants

The Interpretive Model
  • Supplying relevant information
  • Helps to define patient values by suggesting what
    medical interventions should be given

The Deliberative Model
  • Aim of the physician-patient interaction is to
    help the patient determine and choose the best
    health related values
  • Physician and patient engage in deliberation on
    what kind of intervention should take place
  • Physician is seen more as a friend

5th Model of Physician-Patient ModelThe
Instrumental Model
  • The patients values are irrelevant
  • The physician aims for some goal independent of
    the patient
  • E.g. Furtherance of scientific knowledge
    (Tuskegee syphilis experiment)

  • Trust provides moral foundation for any
    physician-patient relationship
  • There is a need for patients to trust their
    physicians because of the knowledge gap that
    exists between them
  • Society tends to trust physicians to understand
    the need to respect patients and act in their
    best interest

Informed Consent
  • Seen as not merely a legal requirement and not
    merely a formality it is a substantial
    requirement of morality (Baylis et al., 2004)
  • Medically valid consent includes giving the
    patient all the information required in order to
    make a responsible decision

Misdiagnosis Case
  • Darrie Eason Misdiagnosed with cancer
  • Because of mislabeled tissue sample that led to a
    misdiagnosis, Darrie had both of her breasts
    removed to save her from a cancer that she never

Surgical Errors
  • A second major issue within medical malpractice
    is when patients leave the hospital with surgical
    instruments inside them
  • Some studies have discovered that leaving
    instruments inside people is more likely to
    happen under stressful situations such as
    emergency operations
  • It is believed that there could be many cases
    that never get reported because patients never
    find out and are unaware of the medical mistake

Surgical Errors - Case
  • Victor Hutchinson
  • 76 year old
  • Father of five
  • Heart bypass surgery in September 2003

(No Transcript)
Theoretical Perspectives
  • Labeling Theory (Gomme Chapter 6)
  • Patients who enter medical hospitals and
    especially mental hospitals tend to be
    stigmatized into a deviant sick role
  • Throughout the process of stigmatization patients
    gain a notion of having a master status of a sick
  • With this master status comes a feeling of
    dependency on doctors and health care providers

Theoretical Perspectives
  • Quinneys Conflict Theory (Gomme Chapter 8)
  • 3 of the 6 propositions
  • Crime is a definition of human conduct that is
    created by authorized agents in society
  • Criminal definitions describe behaviors that
    conflict with the interests of the segments of
    society that have the power to shape public
  • Criminal definitions are applied by the segments
    of society that have the power to shape the
    enforcement and administration of criminal law

Theoretical Perspectives
  • Functionalism Durkheim (Gomme Chapter 4)
  • Crime is functional in society because it
    promotes solidarity, collective consciousness,
    and change
  • When medical malpractice occurs it forces society
    to change the way the health care system is run
  • It forces doctors of all kinds to be more
    cautious throughout all stages of medical

Medical Malpractice
Discussion Questions
  • In the Greys Anatomy clip, Dr. Burke is dealt
    with leniently, do you feel that this happens
    frequently when doctors make mistakes?
  • Do you think there should be stricter protocols
    when medical errors occur?
  • Do you feel that something should be done to
    break the physician-patient barrier? Do you feel
    doctors should be more attentive to their
    patients needs?