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The Romanian Sanitas Federation reacted to the scandal at Bucharest’s San Pantelimon Hospital – where two doctors were arrested on charges of premeditated murder for the death of a patient who died from a reduced dose of noradrenaline – and referred to a bulletin of the Romanian Social Association “Anesthesia and Intensive Care” that states that the question of premeditated murder cannot be raised and that data provided by the Prosecutor’s Office show that the accusation is based on complete ignorance of the medical aspects of the case. The Sanitas Federation believes that there is still a long way to go to support such an accusation and ultimately to a clear conviction. “The magistrate bears no legal responsibility for his wrong decision”, the union members said. “When, say, you have x grams of a drug for 30 patients, but you have to use it for 60, the doctor at the end of the chain (in this case) needs to make a choice, and he is the one who …
The Romanian Sanitas Federation issued a statement on its Facebook page on Saturday, saying that magistrates are not legally responsible for wrong decisions. “Justice is not mathematics! This is one of the reasons why magistrates are not legally responsible for their wrong decisions, except in some special cases, and let’s face it, very difficult to prove, which presuppose the existence of a clear mistake or their intention. Similarly, medicine is not mathematical. Medicine, like law, is based on decisions on the border between objective reality and subjective reality, which depends on intuition, grace, preparation, etc. This is why some say that medicine, like law, is an art! This is why the greatest doctors are also true artists”, said the Sanitas Federation. The Federation representative believes that the responsibility of doctors is greater than that of magistrates.
“The only difference between a magistrate and a doctor lies in the possible consequences of a mistake. This difference makes the doctor’s responsibility greater than that of a magistrate, but, regardless of the degree of ex post facto responsibility, the ex ante decision-making process is the same, i.e., based on data from objective reality and internal subjective factors. Sometimes, as in the case of the magistrate, external factors interfere with the doctor’s decision-making process, affecting the quality of the decision. Professional workload is just one example of such disruptive factors,” the source said.
The Sanitas Federation claims that the San Pantelimon Hospital has become like a veritable field hospital. “However, the San Pantelimon Hospital is an instructive example. San Pantelimon is not an isolated case among Romanian hospitals for reasons that could be the subject of an in-depth analysis and that, in our opinion, should represent the starting point for a new vision of the Romanian hospital system. It ended up being like a real field hospital, that is, an overcrowded field hospital, where the ATI wards were filled not only with cases that needed ATI supervision and treatment, but also with cases that had no chance of receiving palliative care. We repeat that this hospital, the doctors of the ATI, who have an obligation to provide palliative care and whose role, in fact, is to try to save lives, must be analyzed systematically (that is, at the system level) and objectively. Conditions that are curable, and not those that are recognized according to the current medical situation, then have no chance. The reasons are manifold, among which it is well known that there is a lack of hospitals and clinics that offer palliative care to those who no longer have any chance,” said the representative of the Sanitas Federation. They argue that when you have to treat 60 patients with resources meant for only 30, the problem lies in the quality of the physicians’ decisions. “In situations where, for example, the department has 30 beds and the medical resources are only enough for these 30 beds, but the doctor has to treat 60 patients with the same resources, you inevitably have to ask questions about the quality of the decisions made by the doctor, especially if they have time to deal with the bureaucracy required for the practice of medicine (filling out medical records, etc.). The cynicism of this situation reveals the fact that in this situation, doctors have to make life-or-death decisions, sometimes in a split second, and they have to make a choice whether they want to or not. But we must recognize that they, the doctors, are only the last in a chain of systemic errors, and the whole pressure falls on their shoulders, and all the ills of the system are reflected on them from beginning to end. When, let’s say, you have x grams of a drug for 30 patients, but you have to use it for 60 patients, the doctor at the end of the chain (in this case) needs to make a choice, and he is the one who … The accusation is serious, but for now it is only an accusation. However, public opinion, like a real moral ad hoc judge, rushes to a moral verdict, influencing the avant-garde before a clear verdict appears, which can only be affected (and therefore, not even completely eliminated) after a clear verdict. Conviction: The right to dignity of the accused doctor. At the moment, our position as prosecutors is that, based on the opinion of the National Anti-Corruption Bureau and other evidence (which has not yet been substantively analyzed by the judge and defense lawyers), it is considered that a crime has been committed. On the other hand, we have the communiqué of the Romanian Association of Anesthesia and Intensive Therapy, signed by two well-known experts, which argues that the question of premeditated murder cannot be raised, and the data provided by the Prosecutor’s Office show that Sanitas also stated that this accusation is based on complete ignorance of the medical aspects of the case. The Sanitas Federation believes that it is a long and difficult road to complete such an accusation and ultimately to convict. “We believe that there is still a long way to go to support such an accusation and to end it with a clear conviction. His course involves proving three extremely complex things, namely: the fact that the medical practice was wrong, the fact that there was a medical causal relationship between the death and the medical practice, and the fact that there was an intention to kill. If only one of the three elements is not proven, the whole accusation disappears. If these elements are proven, the doctor will be convicted. Until then, we ask the public not to express any opinions, to remain reserved, and to abandon bloody means, if not in the name of the legal principle of the presumption of innocence, at least in the name of universal wisdom. The guidelines tell us that it is wisest and most dignified not to express any opinions when the situation is unclear”, the Sanitas Federation also stated. They charged that before the final conviction, the idea that there was a doctor who deliberately killed the patient was recognized. “Public opinions are useful and necessary, but they do not justify any opinion in any case, especially when competent experts take the opposite position. Let us let them reveal themselves and in the end we will enjoy the results, even if justice will never be mathematical, or perhaps precisely because of it. Of course, there can be incompetent doctors not only in Romania, but also elsewhere. But we have not yet encountered doctors who deliberately ended the lives of their patients in Romania and we hope that this will not happen in the end. But until then, we believe that the real crime is to spread in public opinion, before the final conviction, the idea that some doctors deliberately kill their patients, thus damning everyone,” the statement added. The Sanitas Federation also said that it does not allow itself to pass judgment, even moral judgment, on the guilt of the persons involved. “Justice is not mathematics, but it is not literature either. Metaphorical expressions like the ‘Lady with the Sickle’, even if real, are transferred from the criminal investigation to the public space through a procedure that can become the object of analysis, without any other meaning than to arouse the indignation of public opinion. And also to satisfy the tabloids and their extraordinary needs. But it is not useful for justice, only for accusations! That is why we do not allow ourselves to pass judgments, even moral ones, on the guilt of the persons involved, because we want that in the end, whatever the solution given to you, we can be sure that we have preserved intact the right to dignity. Not only that of the accused, but first of all ours”, concludes the statement of the Sanitas Federation.
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