Il problema della medicina difensiva. Una proposta di riforma in materia di responsabilità penale nell'ambito dell'attività sanitaria e gestione del contenzioso legato al rischio clinico.

[Autom. eng. transl.] The volume illustrates the different phases of a research conducted by the Authors, within the research activity of the Centro Studi federico Stella on Criminal Justice and Criminal Policy, on the theme of defensive medicine. This term indicates the behavioral modality of healthcare professionals who, in order to minimize their risk of future civil and criminal legal disputes, arrange treatments that they themselves deem useless for the patient (positive or active defensive medicine) or avoid undertaking risky therapeutic activities from which the patient may nevertheless benefit (negative or passive defensive medicine). The investigation - which started from a qualitative-quantitative empirical research, coordinated by prof. Catino, aimed at precisely determining the dimensions of the phenomenon in Italy - outlines the possible regulatory intervention strategies to counter the spread of such behavior and, also through a comparative analysis of the most avant-garde foreign legislations in relation to the issue, proposes a Comprehensive reform project, operating along the following lines: 1) normative definition of medical-surgical treatment; 2) redefinition of the profiles of culpable liability of the healthcare professional for the crimes of homicide and injury, through the inclusion of a specific provision dedicated to this case (art. 590ter criminal code); 3) reform of the regulations in force regarding the selection of technical consultants and experts in criminal proceedings concerning cases of medical negligence; 4) elaboration of an articulated system of restorative justice programs in the health sector; 5) elaboration of an overall reform of the rules on civil liability insurance in the health sector; 6) enhancement of the activity of the clinical risk management units, through a series of rules aimed at guaranteeing the procedural unusability of the incident reporting and risk self-assessment activities. The reform project, accompanied by an analytical explanatory report, was submitted to the validation of some of the scholars who have dealt with the theme more closely, during a round table whose results are reported in the volume. Following this validation, the authors modified the initial Project in some points, fully accounting for the amendments made in a second accompanying report. As part of the group's activity, coordinated in all its phases by prof. Strong, Prof. D'Alessandro has particularly taken care of the more strictly criminal aspects of the Project, in addition to the section relating to civil liability, prof. Mazzucato has taken care of the broad and complex profiles pertaining to restorative justice, while prof. Varraso dealt with the many procedural implications connected with the disciplinary choices adopted in the Project.