FORENSIC MEDICAL ASSESSMENT OF PHARMACOTHERAPY IN EXPERTISE OF «MEDICAL CASES»

Deviatkin O. E.

LITERATURE REVIEWS

Scentific article

The doctor who made a mistake, is exposed not only to the negative moral and ethical assessment from the surrounding, but also civil, legal, and sometimes criminal liability. An act of a physician is considered to be a criminal act, if he or she by virtue of the circumstances has not foreseen the consequences of his (her) actions, has shown frivolity or negligence. We allocate professional medical crimes; official medical crimes, official crimes in the field of non-medical activity; other crimes in the field of non-medical activity. Professional medical crimes are inextricably related to «medical cases», which remain one of the most difficult commission forensic medical expertises. The purpose of the work is to analyze modern approaches to conducting commission forensic expertises of «medical cases» and, in particular, to assess the correctness of pharmacotherapy. Main content. According to scientific literature, «medical cases» arise when patients, their family members or other interested persons initiate an investigation into the actions of physicians accused of adverse consequences of treatment or death of the patient. According to the current legislation of Ukraine, initially appoint an initial expertise to establish a health disorder or fact of a death, then appoint an additional expertise, which should determine the possibility of any spontaneous harm to the health of the victim. If it is proved that the damage to health could have been provoked by a physician, a commission assessment is made to detect errors in the actions of the physician and establish a causal relationship between these actions and the negative consequences. The provided medical treatment, including pharmacotherapy, is being analyzed in accordance with existing standards of treatment, as the criteria, standards and standards of the structure of the process and the result of medical care are developed and implemented in the health care system of Ukraine. However, the specificity of medicine lies in the fact that on the basis of clinical symptoms, the doctor makes an independent decision, based on his knowledge and experience, when the features of the organism and the pathological process are forced to depart from the protocol. The lawfulness of such deviations, in particular, in pharmacotherapy, should be assessed in the light of the special circumstances and circumstances where accurate protocol follow-up increases the risks to the patient (the principle of the appropriateness of indication). At the same time, the expert specialty «forensic medicine pharmacologist» is especially useful, as it is in other countries. Forensic pharmacology focuses on knowledge of the action and interaction of chemical compounds and drugs in a living organism and their application to legal issues. Usually, problems with the use of drugs in clinical practice are adverse reactions to drugs, drug interactions, systematic medical mistakes, unforeseen deficiencies or problems with drug quality. We know that Pharmacovigilance deals with the adverse effects of drugs. It can be used in forensic medical cases related to injury or death in the form of adverse reactions to drugs caused by counterfeiting, contamination, or falsification of medicinal products. Conclusion. Consequently, the medical error or the criminal actions of medical professionals are considered in forensic medicine by conducting commission expertise, the so-called «medical cases». Such examinations require high professional competence, needs careful study of medical records, and comparisons of performed diagnostic and treatment measures with well-known standards for the provision of medical care. Taking into account the experience of foreign countries, for the proper assessment of pharmacotherapy, one should consider the expediency of creating and listing in the register of experts such as forensic pharmacologists and specialists in forensic pharmacovigilance.

«medical case», medical mistake, professional crime in medicine, pharmacotherapy

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«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 24-28 pages, index UDK 615:616-035.7:34

10.29254/2077-4214-2019-1-1-148-24-28