Current Medico-legal issues in Neonatology Practice .pptx

Current Medico-legal issues in Neonatology Practice

1. Medico-legal issues in Neonatology Practice

2. The practice of neonatology is constantly improving because of the technical advances. Newer and newer gadgets help in improving the outcome. But, unfortunately legal as well as ethical issues arise if there is mortality or significant morbidity. The last few years have seen marked increased in number of SCNUs and NICUs in our country. The issues vary from demographic conditions, economical background of the parents, lack of infrastructure, and approaches by consultants or policy makers. Proper facilities for care, timely referral, and transport of baby in warm environment are important factors. There is need to provides high quality care to critically sick neonates. Multi-disciplinary team approach shall be preferred. The parents, relatives or family members are important in the decision making team. Care at the age of viability, intact survival and neuro-developmental complications are basis for allegations by the parents or relatives.

3. Definitions: It is important to understand the various terminologies like preterm (PT), small for date (SFD), intrauterine growth retardation (IUGR), small vulnerable newborn (SVN), low birth weight (LBW) etc as the ultimate out-come or prognosis depends upon the gestation or birth weight of the baby. The concept of age of viability is changing very rapidly and hence needs special attention.

4. Age of Viability: The criteria for age of viability differs from country to country or even in different geographical parts of same country depending upon the infrastructure, quality of care, level of expertise and other facilities available. There are lots of discussions regarding the age of viability of a newborn baby. Discussions and debate continues about “how small is too small”. Various suggestions for age of viability include 22-26 completed weeks of gestation.

5. Consultant Neonatologist v. Neonatal Expert: A person who learns more and more about less and less is supposed to be a specialist and it includes ones qualification, skills and experiences. A neonatologist has special qualification or adequate experience and skill in managing a newborn. It is better and preferable to use the designation “ consultant neonatologist ” rather than “ expert in neonatology ”. The liabilities will increase if we claim ourselves to be expert in particular specialty. This concept of minimum standard practices or protocols followed by group of specialists or their organizations will be considered while deciding the allegations of medical negligence.