Occupational health nursing and the quest for professional authority.

Occupational health nurses provide most of the in-plant health care services in U.S. industry but have dubious credentials to provide care for many of the injuries and illnesses they encounter.

Codes of ethics (conduct).

Some international organizations and many societies of health and safety professionals have codes of ethics (conduct). The intent is to promote ethical behavior, though compliance is voluntary and enforcement is generally not possible. It is important that all occupational health and safety professionals adopt and live up to the same code.

Some legal decisions significant for ophthalmology.

The court decisions included in this article reflect judicial attitudes towards medicolegal cases in most states. The courts have defined and amplified issues of informed consent, the physician's duty to warn patients and protect third parties, the limitations of the "Good Samaritan" statute, the responsibility of the physician to prepare insurance reports, and the denial of coverage by third party payers. Several cases regarding these issues are reviewed and their implications for ophthalmologists are discussed.

Radiology malpractice lawsuits: California jury verdicts.

In 1983, 16 out of every 100 U.S. physicians were sued for medical malpractice.

Radiologists and informed-consent lawsuits.

A national survey on informed-consent lawsuits that resulted from studies using contrast material revealed that 123 (8%) of 1,513 radiologists surveyed or others in their groups had been involved in informed-consent lawsuits. In response to a detailed follow-up questionnaire, 67 radiologists anonymously provided additional information regarding their lawsuits, which most often involved excretory urography (37%) or angiography (38%), with death or neurologic impairment the most common patient injuries. As a result of these lawsuits, many radiologists provide more detailed information to patients.

The physician's duty to warn: a new twist.

It has long been accepted that it is a physician's duty to warn the patient of medical conditions that create a risk of injury to the patient. A recent California Court decision suggests that the physician may also be liable for damages to a person injured by a patient who was improperly warned of a debilitating medical condition. The case of Myers v.

Nosocomial medicolegal problems.

Most incidents resulting in medicolegal claims occur in the hospital setting, partly because of the numerous surgical procedures which take place there, but also because of the complexity of communication and shared responsibility among physicians, house staff, nurses, technicians, and lay employees. Various situations likely to pose medicolegal problems are described, particularly those related to the giving and documenting of medical orders and the delegation of responsibility. Guidelines for avoiding medicolegal problems in the hospital setting, and for handling them should they occur, are given.

Some medicolegal tips.

The purposes for each type of medical record are critical legal determinants for its content. Deposition is the most important single step in the litigation process. The uses for a deposition greatly exceed the mere discovery of fact.

Common misconceptions.

Certain misconceptions about the law are common among physicians. The purpose of the legal system is to resolve disputes rather than dispense "justice." The rules of law are neither stable nor clear.