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Browsing Law by Subject ""Loss of chance" and causation"
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Item Open Access Regsaanspreeklikheid voortspruitend uit medikasiefoute(University of the Free State, 2007) Jansen, Rita-Marie; Verschoor, T.English: Worldwide, the prescription, dispensing and administering of medication is the most common form of medical treatment. The number of medication errors made in a medical care system/institution is regarded as a good barometer of the general standard of care in that system or institution. The number of medication errors that come to light, however, is only the tip of the iceberg because such errors can be swept under the carpet more easily than, for instance, botched surgery. Research also indicates that the prescription of medication as form of treatment, is not regarded as the high risk activity that it really is. This research offers a comprehensive source regarding medication errors as seen from a legal perspective. The extent and occurrence of medication errors (prescription, dispensing and administration errors) are discussed with the aim of bringing these to the attention of both lawyers and health care workers. Doctors, pharmacists and nurses often experience uncertainty about their legal position and how to deal with problematic situations. Specific problematic areas are identified and solutions are offered including the following: • The more important legislation with regard to medication treatment is discussed. Interaction between the different statutes and regulations, as well as government policy declarations regarding the prescription and dispensing of medication, is apparently not sufficiently synchronised. This leads to uncertainty amongst health care professionals and increases the chances of medication errors. It is suggested that these aspects be revised and harmonised on an urgent basis. • The “off-label” use of medication is an international phenomenon and part of the generally accepted and lawful use of medication. The increased risk it poses to the patient, as well as to the medical practitioner (with respect to legal liability) is discussed. In South Africa no guidelines are supplied to doctors with regard to the “offlabel” use of medication. More assistance and balanced, objective information from government and pharmaceutical companies is imperative. An amendment to current legislation is suggested. • The problems surrounding the administration of pain medication and especially the failure to give sufficient pain medication, are identified and discussed as one of the most prevalent forms of medication errors. Proposals for legal liability are discussed. • Causation and “loss of a chance” with the focus mainly on examples of medication errors, are discussed and recommendations are made in this respect. • Suggestions regarding legislation with regard to training, legal liability and the use of technology and reporting systems in the prevention of medication errors, are discussed. The implementation of a system approach is discussed and recommendations are made in this regard.