[Autom. eng. transl.] The case judged by the sentence of the Court of Cassation n. 8254/2011 is emblematic of the frequent litigation concerning the decision of doctors to discharge a patient. The affair concerned a patient, hospitalized for an extended anterior myocardial infarction complicated by acute pulmonary edema and subjected to coronary angiography with implantation of a stent on the anterior descending branch, which was discharged in the ninth day from hospitalization, asymptomatic, in stable conditions, despite a reduced fraction of ejection, and in the absence of signs of ventricular electrical instability and which died a few hours after hospital discharge. The sentence generated new concerns among doctors because, after recalling that in the exercise of the medical profession the interest of the patient's health and life must be a priority and prevailing over needs of another nature, and having underlined the non binding of the guidelines that modern medicine elaborates and updates frequently to help doctors operate according to shared criteria, screened by the scientific community, alludes to the hypothesis that in the case under examination the health care professionals in the decision to discharge the patient obeyed guidelines dictated from "mercantile" logic. The sentence then offered the opportunity to examine the problem of hospital discharge and guidelines from a general point of view, but at the same time led the authors to ask themselves which guidelines, in terms of discharge, referred to the Supreme Court, which seems rather to have operated an improper overlap between individual care needs and those aimed at the functioning of the national health system. A further medical-legal problem that characterizes these cases is then represented by the ascertainment of the causal link, which implies, especially in cases with poor evolution, an assessment of the predictability and avoidability of the harmful event and therefore of the possible resolving effectiveness of the medical services that , in case of failure to discharge, they could have been provided to the patient.
|Translated title of the contribution||[Autom. eng. transl.] THE CLINICAL AND MEDICAL-LEGAL PROBLEM OF HOSPITAL DISMISSIONS|
|Number of pages||19|
|Journal||RIVISTA ITALIANA DI MEDICINA LEGALE|
|Publication status||Published - 2011|
- responsabilità medica