Medicolegal Aspects

2019 ◽  
pp. 330-336
Author(s):  
Robert Mansel
Keyword(s):  
Breast Cancer ◽  
Correct Treatment ◽  
Medicolegal Aspects ◽  
Delay In Diagnosis ◽  
Common Complaint ◽  
Early Signs ◽  
Malpractice Claims ◽  
Breach Of Duty ◽  
The Law ◽  
Do So

Abstract: Breast cancer is the leading cause of malpractice claims for radiologists. The usual civil charge of negligence (malpractice) will be discussed. The most common complaint is delay in diagnosis. In symptomatic patients, this means failure to carry out the appropriate imaging investigation including biopsy. In screening, it usually means failure to detect the early signs of breast cancer. Three important principles in the law of civil negligence are present. There is the duty of the doctor for the treatment of his patient and his responsibility for giving the correct treatment. The failure to do so is judged by peers and is called breach of duty. The task of the patient to prove harm in a measurable way is called causation. Major differences in judicial structures and frequency of negligence claims exist between countries.

scholarly journals Breast Cancer Cell Re-Dissemination from Lung Metastases—A Mechanism for Enhancing Metastatic Burden

2021 ◽  
Vol 10 (11) ◽  
pp. 2340
Author(s):  
Lucia Borriello ◽  
John Condeelis ◽  
David Entenberg ◽  
Maja H. Oktay
Keyword(s):  
Breast Cancer ◽  
Cancer Cells ◽  
Cancer Cell ◽  
Metastatic Disease ◽  
Breast Cancer Cells ◽  
Lung Metastases ◽  
Primary Tumors ◽  
Metastatic Burden ◽  
First Time ◽  
Do So

Although metastatic disease is the primary cause of mortality in cancer patients, the mechanisms leading to overwhelming metastatic burden are still incompletely understood. Metastases are the endpoint of a series of multi-step events involving cancer cell intravasation, dissemination to distant organs, and outgrowth to metastatic colonies. Here we show, for the first-time, that breast cancer cells do not solely disseminate to distant organs from primary tumors and metastatic nodules in the lymph nodes, but also do so from lung metastases. Thus, our findings indicate that metastatic dissemination could continue even after the removal of the primary tumor. Provided that the re-disseminated cancer cells initiate growth upon arrival to distant sites, cancer cell re-dissemination from metastatic foci could be one of the crucial mechanisms leading to overt metastases and patient demise. Therefore, the development of new therapeutic strategies to block cancer cell re-dissemination would be crucial to improving survival of patients with metastatic disease.

Line Drawing in the Dark

2021 ◽  
Vol 22 (1) ◽  
pp. 111-136
Author(s):  
Adam J. Kolber
Keyword(s):  
Line Drawing ◽  
The Law ◽  
Do So

Abstract The law inevitably draws lines. These lines distinguish, for example, whether certain conduct reflects ordinary recklessness constituting manslaughter or more extreme recklessness constituting murder. There is no way to meaningfully draw such lines, however, absent shared ways of representing amounts of recklessness or at least knowledge of the consequences of drawing lines in particular places. Yet legal actors frequently draw lines in the dark, establishing cutoffs along a spectrum with little or none of the information required to do so in a way that suits the law’s goals. For example, jurors must decide whether some conduct constitutes extreme recklessness without knowing prior precedent nor the sentencing consequences of drawing cutoffs in particular places. Judges and lawyers cite line drawing precedents from other jurisdictions without considering whether the lines drawn in prior cases had the same consequences as those in the case at bar. And scholars argue about how to classify conduct without making clear what consequences they believe ought to attach once the classification is made, leaving it hard to tell when scholars have substantive or simply superficial disagreements. In this Article, I discuss some line drawing problems and briefly suggest ways we can add meaning to cutoffs. More generally, I argue, we can “smooth” certain features of the law to both reduce our vulnerability to line drawing in the dark and improve the fit between the law and what our best theories of law recommend. Even when we cannot easily smooth the law, thinking about the law in a smoother fashion can help reduce the jurisprudential pathologies I describe.

Guarding the Public Interest: England's Coroners and Organ Transplants, 1960–1975

2015 ◽  
Vol 54 (4) ◽  
pp. 926-946 ◽  
Author(s):  
Helen MacDonald
Keyword(s):  
Twentieth Century ◽  
Public Interest ◽  
Spare Part ◽  
Organ Transplants ◽  
Legal Requirement ◽  
The Public ◽  
The Law ◽  
Do So

AbstractFrom the mid-twentieth century, England's coroners were crucial to the supply of organs to transplant, as much of this material was gleaned from the bodies of people who had been involved in accidents. In such situations the law required that a coroner's consent first be obtained lest removing the organs destroy evidence about the cause of the person's death. Surgeons challenged the legal requirement that they seek consent before taking organs, arguing that doing so hampered their quick access to bodies. Some coroners willingly cooperated with surgeons while others refused to do so, coming into conflict with particular transplanters whom they considered untrustworthy. This article examines how the phenomenon of “spare part” surgery challenged long-held conceptions of the coroner's role.

Subtle signs of breast cancer as an important pitfall in mammographic interpretation. Establishing an accurate diagnosis in an equivocal case

2021 ◽  
pp. 1-6
Author(s):  
Nikolaos S. Salemis ◽  
Eleni Mourtzoukou ◽  
Michail Angelopoulos
Keyword(s):  
Breast Cancer ◽  
Imaging Modality ◽  
Benign Lesion ◽  
Imaging Features ◽  
Breast Cancers ◽  
Breast Clinic ◽  
Delay In Diagnosis ◽  
Delay Of Treatment ◽  
Equivocal Case ◽  
Related Mortality

Mammogram is the standard imaging modality for the early detection of breast cancer, and it has been shown to reduce disease-related mortality by up to 30%. Mammogram, however, has its limitations. It is reported that 10–30% of breast cancers may be missed on a mammogram. Delay in the diagnosis and treatment may adversely affect the prognosis of patients with breast cancer. We present a case of multifocal invasive early breast carcinoma, which was misinterpreted twice as intramammary lymph nodes, thus resulting in a delay in diagnosis for eighteen months. The tumors were detected incidentally after the patient presented to our Breast clinic for symptoms related to a concomitant benign lesion involving the same breast. We describe the tumors’ imaging features and discuss the possible reasons that likely led to repeated misinterpretation. Awareness of possible causes for missed breast cancer is necessary to avoid delay of treatment initiation that may adversely affect prognosis.

scholarly journals Culpability, Kingston and the Law Commission

2010 ◽  
Vol 74 (5) ◽  
pp. 434-471 ◽  
Author(s):  
Cath Crosby
Keyword(s):  
Justice System ◽  
Criminal Liability ◽  
Character Theory ◽  
Criminal Offence ◽  
Pragmatic Approach ◽  
House Of Lords ◽  
The Law ◽  
Court Of Appeal ◽  
Law Commission ◽  
Do So

This article considers the basis upon which a person should be held to be criminally liable, and to do so, it is necessary to examine the leading theories of character and choice that underpin the State holding a person to be culpable of a criminal offence, i.e. the link between culpability and fault. The case of R v Kingston1 is used to examine the application of these leading theories and it is observed that choice theorists would not excuse such a defendant from criminal liability even though his capacity to make a choice to refrain from law breaking was made extremely difficult by external factors beyond his control. Only character theory could possibly offer exculpation in such circumstances on the basis that the defendant acted ‘out of character’ and his deed did not deserve the full censure and punishment of the criminal law. The Court of Appeal in R v Kingston would have been prepared to excuse, but the House of Lords, and most recently the Law Commission have adopted a pragmatic approach to the involuntarily intoxicated offender. This case serves as a reminder that while justice is the aim of the criminal justice system, it is not an absolute standard.

The Law of International Criminal Procedure and Domestic War Crimes Trials

2006 ◽  
Vol 6 (4) ◽  
pp. 605-635 ◽  
Author(s):  
Göran Sluiter
Keyword(s):  
International Law ◽  
International Criminal ◽  
Criminal Procedure ◽  
War Crimes ◽  
Specific Context ◽  
National Courts ◽  
International Criminal Tribunals ◽  
War Crimes Trials ◽  
The Law ◽  
Do So

AbstractThis article deals with the question of possible effect of the law of international criminal procedure for domestic war crimes trials. With the increasing number of national prosecutions for war crimes this question will gain in relevance.The article starts with an exploration of the origin and development of the law of international criminal procedure, to reach the conclusion that because of the lack of a strong foundation it is difficult to discern firmly established rules in this field. Next, two areas are examined where the law of international criminal procedure is capable of producing effect for national trials: human rights and rules that have developed in the specific context of war crimes prosecutions.Whether rules of international criminal procedure are formally effective in the domestic legal order remains to be seen. There is no clear obligation under international law to do so. Furthermore, the law of international criminal procedure may be difficult to harmonise with domestic inquisitorial systems.In spite of these difficulties, the article concludes that national courts will increasingly face similar procedural problems in complex war crimes trials as international criminal tribunals and will be happy to learn from their experiences.

scholarly journals Civil Disobedience in Times of Pandemic: Clarifying Rights and Duties

2021 ◽  
Author(s):  
Yoann Della Croce ◽  
Ophelia Nicole-Berva
Keyword(s):  
Working Conditions ◽  
Healthcare Professionals ◽  
Medical Profession ◽  
Civil Disobedience ◽  
Duty Of Care ◽  
Normative Evaluation ◽  
The Law ◽  
Descriptive Sense ◽  
Public Demonstration ◽  
Do So

AbstractThis paper seeks to investigate and assess a particular form of relationship between the State and its citizens in the context of the COVID-19 pandemic, namely that of obedience to the law and its related right of protest through civil disobedience. We do so by conducting an analysis and normative evaluation of two cases of disobedience to the law: (1) healthcare professionals refusing to attend work as a protest against unsafe working conditions, and (2) citizens who use public demonstration and deliberately ignore measures of social distancing as a way of protesting against lockdown. While different in many aspects, both are substantially similar with respect to one element: their respective protesters both rely on unlawful actions in order to bring change to a policy they consider unjust. We question the extent to which healthcare professionals may participate in civil disobedience with respect to the duty of care intrinsic to the medical profession, and the extent to which opponents of lockdown and confinement measures may reasonably engage in protests without endangering the lives and basic rights of non-dissenting citizens. Drawing on a contractualist normative framework, our analysis leads us to conclude that while both cases qualify as civil disobedience in the descriptive sense, only the case of healthcare professionals qualifies as morally justified civil disobedience.

Evaluation of ER, PR, HER2 / neu Receptor Status in Breast Cancer - A Cross Sectional Study from Manipur

2021 ◽  
Vol 8 (29) ◽  
pp. 2595-2600
Author(s):  
Themthingla Zimik ◽  
Angelica Laiphrakpam ◽  
Deepa Longjam ◽  
Sushila Devi L
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Public Awareness ◽  
Progesterone Receptors ◽  
Cross Sectional Study ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Duct Carcinoma ◽  
Treatment Protocols ◽  
Screening Programs

BACKGROUND Breast cancer is the most common cancer in women worldwide and has surpassed cervical cancer in India. As a result of regular mammography screening programs and public awareness, early-stage breast cancer with better prognosis has occurred. Immunohistochemistry (IHC) is now a common practice in tumour evaluation which are of importance in diagnosis as well as for deciding the treatment and of prediction of prognosis in breast cancer. The present study was undertaken in view of correlating the histopathology of the tumour and IHC profile with respect to oestrogen receptor (ER), progesterone receptor (PR) and HER2 / neu. METHODS The study is a cross-sectional prospective analysis of patients with primary carcinoma of breast who are undergoing surgery over a period of 2 years from September 2017 to August 2019. All specimens were processed and stained with haematoxylin and eosin and immunohistochemistry was done for oestrogen and progesterone receptors and HER 2neu. RESULTS A total of 20 cases of breast carcinoma specimens were studied, whose age ranged from 24 - 72 years of age. All the 20 cases occurred in females. Infiltrating duct carcinoma was the most histological subtype noted in this study comprising 85 % (17 / 20) of cases. In the study 50 % (10/20) of the cases showed ER / PR positivity with negative HER2 / neu while 15 % (3/15) of cases were negative for ER / PR and HER2 / neu and only one case showed positivity for all three markers. 10 cases (50 %) had lymph node metastases in this study. CONCLUSIONS Breast cancer is the most commonly diagnosed malignancy in Indian women and is also the leading cause of cancer death in women worldwide. Assessment of receptor (ER, PR and HER – 2 / neu) status along with histopathological grading and staging will guide the clinicians to impart a correct treatment protocols to the patients. It will also be of great help in assessing the prognosis. KEYWORDS Breast Cancer, Histopathology, Immunohistochemistry

scholarly journals Male Breast Cancer- Report of Two Cases

1970 ◽  
Vol 21 (1) ◽  
pp. 80-82
Author(s):  
M Dayem Uddin ◽  
ABM Abdul Hannan
Keyword(s):  
Breast Cancer ◽  
Clinical Manifestation ◽  
Male Breast Cancer ◽  
Signs And Symptoms ◽  
Male Breast ◽  
Breast Cancers ◽  
Early Signs ◽  
Bangladeshi Population

Male breast cancer is rare. It accounts for 0.2% of all cancers, and 1% all breast cancers. Most patients present late for several reasons, including the absence of early signs and symptoms, and reduced awareness of the existence of such pathology among patients and physicians, Reporting these cases from among the Bangladeshi population, we tried to observe any differences in clinical manifestation from those reported in the literature, and aimed to increase the value assigned to male breast as a source of pathology among patients and physicians as well.   doi: 10.3329/taj.v21i1.3226 TAJ 2008; 21(1): 80-82

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