Pressure Ulcers from the Medico‐Legal Perspective: A Case Report and Literature Review

Abstract: Introduction: The identification of professional liability profiles related to the development of pressure injuries is a very thorny issue from a medico‐legal perspective. This is because no matter how strict the applied prevention protocols applied may be, the development of such injuries is largely dependent on endogenous factors. This paper aims to investigate the medicolegal issues related to this topic through the exposition of one case of medico‐legal litigation and a traditional review of the literature. Methods: We performed a literature search using three databases (Pubmed, Scopus, and Web Of Science), restricting the search to the period between 2001 and 2021. We used “pressure ulcers” and “jurisprudence” as the main keywords. From an initial library of 236 articles, our selection resulted in 12 articles, which were included in the review. Results: We identified the ever‐increasing expectations of patients and the concept of automatic attribution of responsibility when a pressure ulcer develops as the primary reasons for the increase in litigation over the past 20 years. The related corrective measures are numerous: a strict adherence to guidelines, an adequate documentation of preventive measures, a risk assessment, family involvement, and a successful collaboration between physicians and government institutions. Conclusion: The biological complexity of the pathogenetic development of pressure ulcers makes the subject very delicate from the medico‐legal point of view. In principle, it is possible to state that a very large proportion of such injuries are preventable, but that there remains a percentage of them that cannot be prevented. In such cases, only a proper documentary demonstration of the adequacy of preventive measures can exclude liability profile

Freedom from the stigma of oncologic disease: legislative and ethical aspects of the right to be forgotten in oncology

Cancer diagnosis, treatment, and prevention advances have significantly improved European outcomes, but the stigma surrounding cancer survivorship remains challenging. Discrimination against cancer survivors has a negative impact on their quality of life, autonomy, and financial stability. While some European countries have implemented legislation recognizing the “right to be forgotten” for cancer survivors, Italy has no such protective measures. This leaves cancer survivors in Italy susceptible to discrimination based on their medical history. Both the European Union Cancer Plan and the European Parliament resolution stress the importance of safeguarding the rights of cancer survivors and preventing discrimination. Although implementation of legislation at the European level may take time, it is essential that national legislatures, including Italy’s, act quickly. This article explores the issue of discrimination against cancer survivors in Europe, focusing on the specific case of Italy. It examines existing legislative solutions and assesses their effectiveness in addressing discrimination. It also discusses the ethical considerations associated with the “right to be forgotten” in oncology, emphasizing its role in promoting equality and safeguarding the privacy of cancer survivor

Factors affecting mental health of seafarers on board merchant ships: A systematic review

Merchant ships represent a peculiar working environment with several challenges and risks. The specific situation on board of ships may affect the mental health of seafarers more remarkably than ashore workers. A systematic review of the literature has been carried out to identify the main causes of mood disorders among seafarers and the impact that these disorders have on their health. This review has analyzed the scientific literature published between January 2006 and December 2021 using the search engines PubMed, Web of Science (WoS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Social isolation, distance from families, fatigue, stress and long work shifts represent the main causes of mood disorders among seafarers. Strategies aimed at improving conditions of cohabitation on board, and a greater consideration of these problems are key for improving the mental health of workers at sea. © 202

Informed Consent in Paediatric Telemedicine: Challenge or Opportunity? A Scoping Review

The fundamental importance of informed consent as a prerequisite for the lawfulness of the medical act is an indisputable cornerstone of clinical practice. However, the provision of effective information and the collection of informed consent presents important critical issues in the underage patient, even considering that in general terms he or she does not have the power to directly express consent, which must be provided by parents or legal guardians. These critical issues are amplified in the context of telemedicine. The present study aims, through a scoping review of the literature of the past 10 years, to outline the operational practices adopted in the collection of informed consent from children in the context of telemedicine and to identify solutions devised to address the critical issues related to the provision of adequate information to the child in this particular care setting. The results of the research show that the activity of delivering adequate information to the child, itself complex, is made even more complex by the particular setting of telemedicine, which, however, could be effectively exploited to facilitate communication with the child patient

The role of digital literacy in achieving health equity in the third millennium society: A literature review

Healthcare in the third millennium is largely delivered through systems involving the use of the technological devices and services, foremost among them telemedicine. For the adequate delivery of digital medicine services, however, it is necessary for users to be digitally literate, that is, able to consciously make use of technology. In order to understand how relevant digital literacy is in determining the effectiveness of e-Health services, we performed a traditional literature review on 3 major databases by combining the terms “Digital Literacy” and “Computer Literacy” with the terms “Telemedicine” and “Telehealth”. Starting from an initial library of 1,077 papers, we selected 38 articles. At the outcome of the search, we found that digital literacy is a pivotal element in conditioning the effectiveness of telemedicine and digital medicine services in general, however, with some limitations

The importance of the postmortem interval for the diagnosis of Waterhouse–Friderichsen syndrome by Neisseria meningitidis in a series of forensic cases

The effective value of microbiological post-mortem examinations stands as fundamental in forensic cases involving microbiology. We ran these analyses on five victims, who suddenly died after showing persistent fever. The examinations were conducted between 48 hours and 10 days after death, and adrenal gland apoplexy was detected in all the cases. Microbiological examinations identified Neisseria meningitidis, which was accountable for Waterhouse–Friderichsen syndrome. Diplococci were isolated from three cadavers that underwent forensic dissection between 2 and 3 days after death. The remaining two cadavers showed polymicrobial contamination, and a polymerase chain reaction technique was necessary to identify the pathogen. We assumed that the microbial overlap could lead to diagnostic mistakes and conceal the identification of the lethal pathogen. Therefore, we suggest using molecular techniques for a postmortem interval (PMI) longer than 72 hours. Classical microbiological examination should be performed for PMI within 72 hours

The importance of the postmortem interval for the diagnosis of Waterhouse-Friderichsen syndrome by Neisseria meningitidis in a series of forensic cases

The effective value of microbiological post-mortem examinations stands as fundamental in forensic cases involving microbiology. We ran these analyses on five victims, who suddenly died after showing persistent fever. The examinations were conducted between 48 hours and 10 days after death, and adrenal gland apoplexy was detected in all the cases. Microbiological examinations identified Neisseria meningitidis, which was accountable for Waterhouse-Friderichsen syndrome. Diplococci were isolated from three cadavers that underwent forensic dissection between 2 and 3 days after death. The remaining two cadavers showed polymicrobial contamination, and a polymerase chain reaction technique was necessary to identify the pathogen. We assumed that the microbial overlap could lead to diagnostic mistakes and conceal the identification of the lethal pathogen. Therefore, we suggest using molecular techniques for a postmortem interval (PMI) longer than 72 hours. Classical microbiological examination should be performed for PMI within 72 hours