Case studies on the impact of ex-post legislative evaluations in Dutch healthcare: a within and cross-case analysis.

Globally, ex-post legislative evaluations are becoming increasingly important for understanding how laws function in practice and identifying their limitations and their effects upon stakeholders. This study delves into the impact of ex-post legislative evaluations within the Dutch healthcare system. Building upon insights from previous literature, we aim to refine existing ideas within the field through empirical data.

Factors influencing the impact of ex-post legislative evaluations: a scoping review.

This article explores the factors that influence the impact of ex-post legislative evaluations and suggests that these factors can be divided into three main categories: context, research quality, and interaction. Contextual factors, including the evaluation's initiation, it's place in the legislative process, the varied functions given by stakeholders, and the level of political or social attention, are beyond researchers' control. However, researchers can influence research quality and interaction with stakeholders, such as the evaluations' commissioner, as well as the society at large, thereby increasing the likelihood of achieving impactful results.

Involving Patients and/or Their Next of Kin in Serious Adverse Event Investigations: A Qualitative Study on Hospital Perspectives.

Background: The involvement of patients or next of kin (P/N) after a serious adverse event (SAE) is evolving. Beyond providing mandatory information, there is growing recognition of the need to incorporate their interests. This study explores practical manifestations of P/N involvement and identifies significant considerations for hospitals.

The Compatibility of Mandatory Vaccination with the European Convention on Human Rights: Implications for a National Vaccination Policy.

This contribution examines the compatibility of mandatory vaccination with the European Convention on Human Rights (ECHR) through an analysis of the relevant ECHR rights and related case law of the European Court of Human Rights (ECtHR). By focusing on Article 8 (Right to Private Life), Article 2 (Right to Life) and Article 9 (Freedom of Thought, Conscience and Religion) ECHR, we formulate conditions under which mandatory vaccination legislation is justified. With that, this analysis aims to provide national legislators with guidance on responsible legislative policy.

The Impact of Ex-Post Legislative Evaluations in Healthcare: A Mixed Methods Realist Evaluation Study Protocol for Conducting Case Studies.

Background: Recent studies on the impact of ex-post legislative evaluations show that there are different types of impact and different factors that can influence it. These include the context of a legislative evaluation, research quality, and interactions between researchers and other actors within the evaluation process. However, thorough empirical research in this area is lacking.

Towards a less voluntary vaccination policy in the Netherlands? Findings from an expert interview study.

Background: The Netherlands traditionally favours a voluntary approach to vaccination. However, during the COVID-19 pandemic multiple European countries drastically altered their vaccination policies, which fuelled societal and political debate about the need to make the Dutch vaccination policy less voluntary, particularly by utilising pressure or coercion.

Aim: To provide insight in expert's views on main normative issues concerning a less voluntary vaccination policy (for adults).

The impact of ex-post legislative evaluations: a scoping review.

In various countries, laws are increasingly being evaluated by examining the effects in practice once a law enters into force. No systematic overview currently exists on the impact of these ex-post legislative evaluations. Therefore, this scoping review systematically examines the various types of impact of ex-post legislative evaluations.

[The use of guidelines in medical disciplinary proceedings].

Guidelines of the medical profession play an important role in determining and developing the quality of care and they further define the general legal provisions in this area. This means that guidelines also have a certain legal significance. Guidelines play a role in disciplinary proceedings in various ways.

Hidden bedside rationing in the Netherlands: a cross-sectional survey among physicians in internal medicine.

Background: Healthcare rationing can be defined as withholding beneficial care for cost reasons. One form in particular, hidden bedside rationing, is problematic because it may result in conflicting loyalties for physicians, unfair inequality among patients and illegitimate distribution of resources. Our aim is to establish whether bedside rationing occurs in the Netherlands, whether it qualifies as hidden and what physician characteristics are associated with its practice.

Legal perspectives on black box recording devices in the operating environment.

Background: A video and medical data recorder in the operating theatre is possible, but concerns over privacy, data use and litigation have limited widespread implementation. The literature on legal considerations and challenges to overcome, and guidelines related to use of data recording in the surgical environment, are presented in this narrative review.

Methods: A review of PubMed and Embase databases and Cochrane Library was undertaken.

[Amendments of medical disciplinary law].

In the first half of 2019, the Dutch medical disciplinary law will be amended. Changes include court fees to be paid by people filing complaints, the introduction of an information officer and the possibility to order a health professional to stop his activities during disciplinary proceedings. Some of these amendments are mainly intended to prevent 'complaints of minor importance' from being filed with the disciplinary court.

A decade of litigation regarding surgical informed consent in the Netherlands.

Objective: An inadequate surgical informed consent process (SIC) may result in a medical malpractice claim or medical disciplinary board (MDB) complaint. Aim of this study was to analyse characteristics of a decade of malpractice claims and MDB decisions regarding SIC in the Netherlands.

Methods: A retrospective analysis of malpractice claims and MDB decisions concerning SIC disputes in four major surgical specialties was conducted based on company data from the largest medical malpractice insurance company and two public available online MDB databases.

['Just Culture': legal potential and limits].

In the context of patient safety, the concept of 'Just Culture' is of the utmost importance. Just Culture implies that quality systems in health care should focus on learning from incidents and errors rather than on blaming individuals; however, the basic assumptions of Just Culture cannot always be upheld in certain specific circumstances. This article focuses on the importance and the limits of Just Culture from a legal perspective.

[Video recording and data collection in the operating room: the way to a 'just culture' in the OR].

The Academic Medical Center, Amsterdam, has started a trial to evaluate the usefulness to team debriefings of performance reports generated by a medical data recorder (MDR) in the operating room (OR). Outcome performance reports in structured debriefings in a secure, non-punitive environment are likely to heighten the level of situational awareness of OR teams. This may prevent future error.

Challenging the knowledge base and skillset for providing surgical consent by orthopedic and plastic surgeons in the Netherlands: an identified area of improvement in patient safety.

Background: Successfully completing a surgical informed consent process is an important element of the preoperative consult. A previous study of Dutch general surgeons demonstrated that the implementation of SIC did not meet acceptable standards. However, the quality of the SIC process in the orthopedic surgical or plastic surgical arena is unknown.

[Disclosing medical errors: the current situation].

Recent broadly-supported guidelines stipulate that physicians and other care providers should be open and honest about incidents, i.e. medical errors.

[Preoperative medical record-keeping can be improved: new informed consent form assists both physicians and patients].

Adequate record-keeping is an important part of the surgical informed consent (IC) process. Standardization can enhance the quality of this process but is incomplete and qualitatively insufficiently implemented in current surgical practice. The introduction of well-designed tools would improve daily practice.

[Position of guidelines under new law: consequences of new legislation on health care quality].

Recent legislation in the Netherlands has led to the creation of an institute for health care quality ('Zorginstituut Nederland'). This institute maintains a public register of medical practice guidelines. The legislation does not influence the legal position of these guidelines, but may lead to problems with regard to the process of developing guidelines, and to the authority of the institute to accept guidelines without the full cooperation of the medical profession.

Informing family members of individuals with Lynch syndrome: a guideline for clinical geneticists.

The diagnosis of Lynch syndrome can lead to the prevention of colorectal cancer through periodic colonoscopies and removal of premalignant lesions in susceptible individuals. Therefore, predisposed individuals identified by mutation analysis are advised to inform their at-risk relatives about the options of predictive DNA testing and preventive measures. However, it has now been established that more than half of these relatives do not receive the necessary information.

A survey of the current practice of the informed consent process in general surgery in the Netherlands.

Unlabelled: Additional non-English language abstract (in Dutch)

Background: A properly conducted surgical informed consent process (SIC) allows patients to authorize an invasive procedure with full comprehension of relevant information including involved risks. Current practice of SIC may differ from the ideal situation. The aim of this study is to evaluate whether SIC practiced by Dutch general surgeons and residents is adequate with involvement of all required elements.

Concurrence between complaints procedures in the Dutch healthcare system.

There are various ways in which complaints about healthcare providers' performance can be handled in The Netherlands. In practice, situations occur relatively frequently in which one and the same treatment by a provider results in various different complaints procedures being instigated or, in other words, in concurrence between complaints procedures. Dutch periodicals published information on a total of 42 cases of concurrence between 1997 and 2007.

[Criminal prosecution for medical errors].

A policy document providing instructions on the decision to prosecute in medical errors came into effect on November 1st 2010. In this document the Dutch Public Prosecution Service has attempted to make clear which criteria should be adopted when deciding to prosecute in the case of a medical error. There have also been other recent developments in this context: the public prosecutor can now demand access to medical files in certain, highly exceptional circumstances, such as when patients are themselves suspected of committing a criminal offence; and the Dutch Health Care Inspectorate may only pass on a patient's medical file to the public prosecutor if the prosecutor is already in possession of a copy of it.

[Who really 'owns' images made of patients?].

Images made of patients as part of the delivery of care (photographs, x-rays, scans, histopathological images) are part of a patient's file. All legal rules pertaining to a medical record also apply to these types of images, including the patient's right to obtain a copy as well as the right to have the record (partially) destroyed. It is not useful to speak about images in terms of ownership.