The Covid-19 Home Care Commission has accepted the appeal. “The content of the ministerial memorandum imposing precise and binding treatment options on physicians is in contradiction to the professional activity that is delegated to the physician in the terms indicated by science and professional ethics.” A decision that appears to refer to an earlier order from Lazio TAR which suspended Aifa’s note on Covd home care in 2021. This ordinance, however, was later rescinded by the State Council. Sentence
17 years – The content of the memorandum issued by the Ministry of Health, on the home management of patients infected with SARS-CoV-2 virus, stipulates “watchful waiting” and the administration of NSAIDs and paracetamol “in contrast to professional activity as well as delegated to a physician in terms defined by professional science and ethics” .
Thus the Lazio TAR in a sentence accepts the appeal submitted by the Covid-19 Home Care Commission signed by the President Eric Grimaldi And the lawyer Valentina Periano, cancels part of the updated ministerial circular on April 26, 2021 for home treatment of patients with Covid.
These guidelines, for the Ministry of Health, constitute “merely exceptions”, i.e. a reason to exclude criminal liability in the event of unfavorable events. As for the TAR, on the other hand, “It is the primary duty of every healthcare professional to act in accordance with knowledge and conscience, and to take responsibility for the outcome of the treatment prescribed as a result of the professionalism and the specialized qualifications acquired. Prescription and thus, the AIFA, as borrowed from the Ministry della Salute, contrasts with the required professionalism of the physician and with his professional ethics, and in effect imposes a ban on the use of treatments which the latter may consider appropriate and effective compared to Covid-19 disease as it happens for every therapeutic activity.”
The ruling focusing on the freedom to prescribe a doctor refers to what actually happened in March 2021 by order, again from the Lazio TAR, with the same Eric Grimaldi and Valentina Piraino as defense counsel, to which the Aifa note with indications was suspended. For home care for covid patients. The matter was later rejected by the State Council, and approved the appeal of Efa and the Ministry of Health.
According to the opinion of the State Council at the time, “Aifa’s memorandum does not affect the doctors’ independence in prescribing, in science and conscience, for the treatment considered most appropriate, as his suspension until the determination of the judgment on the merits determines, on the contrary, the lack of guidelines, based on Scientific evidence documented in court, such as rendering aid (albeit not binding) to this space of mandatory autonomy, however guaranteed.”
It must be emphasized that this view is now explicitly referred to in the new sentence of TAR Lazio. But in the opinion of the administrative judges, the content of today’s ministerial circular “which imposes precise and binding treatment options on physicians, contradicts the professional activity that is delegated to a physician in the terms indicated by science and professional ethics.”
However, as previously recognized by the State Council of the AIFA Memorandum, even in the Ministry of Health Circular on Home Care that includes those contents, there is an express reference to “recommendations” and “indications” and they are never explicitly defined as binding. It must also be added that the freedom to prescribe a doctor is never absolute but there are precise limits set not by judges but by the professional professions themselves within Deongological law. There, in fact, Article 12 states that “a physician shall not approve or publish diagnostic or therapeutic practices for which there is no appropriate scientific and clinical documentation that can be evaluated by the professional community and the competent authority.” And finally: “Prescription should be based on available scientific evidence, on optimal use of resources and compliance with principles of clinical efficacy, safety and suitability.”
Given these precedents, a new negative decision of the State Council cannot be ruled out provided that the Ministry of Health decides to appeal the new ruling of the “Lazio” law as it did last year.
January 17 2022
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