thesis

Dalla <i>blame culture</i> alla <i>just culture</i>: l’errore umano come opportunità d’insegnamento nella responsabilità penale del medico

Abstract

The exasperated tendency to search for the guilty person for all harmful acts derived from the exercise of activities with high intrinsic risk factors (blame culture), has led healthcare professionals, expecially doctors, to the adoption of defensive medicine behaviours. As a remedy, it is often recommended to catalogue the informations collected to improve health security, using human errors as a learning opportunity to avoid repeating the same mistakes, improving the just culture concept, economically more sustainable. Work begins with the phenomenological analysis of medical errors, in order to evaluate the usefulness of the objective prediction of medical risk by means of precautionary rules. From the organizational flaws and the most common deficits in healthcare facilities (hospitals infections and contagious diseases from blood transfusion), to the analysis of the assumptions of criminal liability of the organization (D. Lgs. n. 231/2001) with a short excursus on female genital mutilation. The importance of the human factor in the health sector has been studied in comparison with the model of aeronautical law. The phenomenon of “defensive medicine” has been examined as well as the proposals for its reduction, the Balduzzi law (L. 189/2012) and the recent Gelli Bianco law (L. 24/2017). A final analysis of the guidelines leads to a brief reflection on the effectiveness and efficacy of penal sanctions against health professionals

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