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Legal aspects of patient enlightenment (therapeutic consent) from a surgeon's point of view (German)
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SELECTED ABSTRACTS EVALUATION
1) Measuring patients' opinions about hospitalization using the client satisfaction scale GLENN, R. N. Commonwlth. Psychiat. Cent., Richmond, Va., U.S.A. Hosp. Comnmnity Psychiatry 29(3), 158-161, 1978 Recently, there has been increasing recognition of the importance of psychiatric patients' opinions about their hospitalization. However, many large psychiatric hospitals, particularly state hospitals, have neither the staff nor the resources to set up programs to examine patients' attitudes comprehensively. In early 1976 such a program was undertaken at Central State Hospital in Petersburg, Virginia, funded in part by a Hospital Improvement Program grant from the National Institute of Mental Health. The patients' responses provided the hospital with valuable information about its strengths and weaknesses. The lack of a quiet place to be alone is a frequent complaint by critics of state hospitals. Rarely have quiet or semiprivate areas been built into state hospital buildings. However, greater privacy and emphasis on individuality is becoming more possible with the census reduction in many state hospitals. Vacant patients' rooms can be converted into private lounges and quiet areas. Locked drawers and lockers in paients' rooms can also be provided inexpensively. Treatment staff must also make greater efforts to inform patients of their progress and of the therapeutic effects, side effects, and dosage of their medication. 2) Does patient satisfaction correlate with success? EDWARDS, D. W., YARVIS, R. M., MUELLER, D. P., and LANGSLEY, D. G. Dept. Psychiat., Univ. California, Davis, Calif., U.S.A. Hosp. Cmnmunity Psychiatry 29(3), 188-190, 1978 The authors studied the relationship between patient satisfaction and success of treatment in a group of outpatients consecutively admitted to two community mental health centers in California in 1975. The study is based on the patients' ratings of their satisfaction with treatment and the success of treatment at the second visit, the last vis!t, and follow-up, as well as on the therapists' ratings of treatment success at the second visit and the last visit. At both times the therapists' mean ratings of treatment success were significantly lower than the pa-
tients'. Significant but low correlations between satisfaction and success indicate that satisfaction ratings cannot replace success ratings on other outcome indicators in assessments of quality care. L E G A L ASPECTS
3) The legal perspective SOUTHWICK, A. F. Dept. Business Law Hosp. Adm., Univ. Michigan, Ann Arbor, Mich., U.S.A. Trustee 31(1), 9-15, 1978 For more than two decades, various professional associations have made recommendations, which hospitals have often implemented, that certain hospital-based patient care services be made the subject of exclusive contracts between the hospital and a single physician or a small group of physicians organized as a partnership or professional corporation. The author discusses the implications under U.S. law of this kind of arrangement.
4) Legal aspects of patient enlightenment (therapeutic consent) from a surgeon's point of view (German) MAGISTRIS, F. Chir. Abt., Allg. Krankenh., Hollabrunn Wien. Kiln. Wochenschr. 90(17), 639-647, 1978 The doctor-patient relationship has undergone considerable changes over recent years. An increase in public discussion of real or supposed malpractice has led to an increasingly critical attitude in patients, who are no longer prepared to accept the doctor's instructions unquestioningly. Every doctor, surgeons in particular, should therefore strive to restore a satisfactory relationship with his patient, since this is an essential precondition for ensuring therapeutic success. The doctor is obliged to explain to his patient (or legal spokesman) the risks involved in therapy and give him adequate insight into his condition. Only then can the patient make an adequate decision about acceptance or refusal of therapy, which is legally binding (written consent in the case of operations). Absolute priority must be given to uninhibited maximum efficiency of the doctor. Legal safety should be only of secondary importance.
SELECTED ABSTRACTS EVALUATION
1) Measuring patients' opinions about hospitalization using the client satisfaction scale GLENN, R. N. Commonwlth. Psychiat. Cent., Richmond, Va., U.S.A. Hosp. Comnmnity Psychiatry 29(3), 158-161, 1978 Recently, there has been increasing recognition of the importance of psychiatric patients' opinions about their hospitalization. However, many large psychiatric hospitals, particularly state hospitals, have neither the staff nor the resources to set up programs to examine patients' attitudes comprehensively. In early 1976 such a program was undertaken at Central State Hospital in Petersburg, Virginia, funded in part by a Hospital Improvement Program grant from the National Institute of Mental Health. The patients' responses provided the hospital with valuable information about its strengths and weaknesses. The lack of a quiet place to be alone is a frequent complaint by critics of state hospitals. Rarely have quiet or semiprivate areas been built into state hospital buildings. However, greater privacy and emphasis on individuality is becoming more possible with the census reduction in many state hospitals. Vacant patients' rooms can be converted into private lounges and quiet areas. Locked drawers and lockers in paients' rooms can also be provided inexpensively. Treatment staff must also make greater efforts to inform patients of their progress and of the therapeutic effects, side effects, and dosage of their medication. 2) Does patient satisfaction correlate with success? EDWARDS, D. W., YARVIS, R. M., MUELLER, D. P., and LANGSLEY, D. G. Dept. Psychiat., Univ. California, Davis, Calif., U.S.A. Hosp. Cmnmunity Psychiatry 29(3), 188-190, 1978 The authors studied the relationship between patient satisfaction and success of treatment in a group of outpatients consecutively admitted to two community mental health centers in California in 1975. The study is based on the patients' ratings of their satisfaction with treatment and the success of treatment at the second visit, the last vis!t, and follow-up, as well as on the therapists' ratings of treatment success at the second visit and the last visit. At both times the therapists' mean ratings of treatment success were significantly lower than the pa-
tients'. Significant but low correlations between satisfaction and success indicate that satisfaction ratings cannot replace success ratings on other outcome indicators in assessments of quality care. L E G A L ASPECTS
3) The legal perspective SOUTHWICK, A. F. Dept. Business Law Hosp. Adm., Univ. Michigan, Ann Arbor, Mich., U.S.A. Trustee 31(1), 9-15, 1978 For more than two decades, various professional associations have made recommendations, which hospitals have often implemented, that certain hospital-based patient care services be made the subject of exclusive contracts between the hospital and a single physician or a small group of physicians organized as a partnership or professional corporation. The author discusses the implications under U.S. law of this kind of arrangement.
4) Legal aspects of patient enlightenment (therapeutic consent) from a surgeon's point of view (German) MAGISTRIS, F. Chir. Abt., Allg. Krankenh., Hollabrunn Wien. Kiln. Wochenschr. 90(17), 639-647, 1978 The doctor-patient relationship has undergone considerable changes over recent years. An increase in public discussion of real or supposed malpractice has led to an increasingly critical attitude in patients, who are no longer prepared to accept the doctor's instructions unquestioningly. Every doctor, surgeons in particular, should therefore strive to restore a satisfactory relationship with his patient, since this is an essential precondition for ensuring therapeutic success. The doctor is obliged to explain to his patient (or legal spokesman) the risks involved in therapy and give him adequate insight into his condition. Only then can the patient make an adequate decision about acceptance or refusal of therapy, which is legally binding (written consent in the case of operations). Absolute priority must be given to uninhibited maximum efficiency of the doctor. Legal safety should be only of secondary importance.