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Promoting Individual Health Responsibility in the Welfare State 在福利国家促进个人健康责任
IF 0.8 Q2 LAW Pub Date : 2024-05-04 DOI: 10.1163/15718093-bja10128
Nicole Friedlein
The public health insurance in Germany will face huge economic challenges in the upcoming years. New diagnostic and therapeutic methods as well as the demographic change contribute to constantly rising expenditure. Although incentives for health-promoting behaviour or financial sanctions for an unhealthy lifestyle have been already discussed in the past, there has been a general reluctance to legally establish corresponding mechanisms for fear of eroding solidarity and increasing state control. In the course of the Coronavirus pandemic however, a stronger awareness rose to the fact that personal health-related life choices can have a huge impact on the stability of the healthcare system including public health insurance. Not only in Germany but throughout much of Europe, the pandemic led to a new and more fundamental debate about the relationship between individual responsibility for personal health and the wider responsibility for public health assumed by the community of solidarity.
未来几年,德国的公共医疗保险将面临巨大的经济挑战。新的诊断和治疗方法以及人口结构的变化导致支出不断增加。尽管过去已经讨论过对促进健康的行为进行奖励或对不健康的生活方式进行经济制裁,但由于担心破坏团结和加强国家控制,人们普遍不愿意在法律上建立相应的机制。然而,在冠状病毒大流行的过程中,人们更加意识到,与健康相关的个人生活选择会对包括公共医疗保险在内的医疗系统的稳定性产生巨大影响。不仅在德国,在欧洲大部分地区,大流行病都引发了一场新的、更根本的辩论,即个人对个人健康的责任与团结一致的社会对公共健康所承担的更广泛责任之间的关系。
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引用次数: 0
The Compatibility of Mandatory Vaccination with the European Convention on Human Rights: Implications for a National Vaccination Policy 强制疫苗接种与《欧洲人权公约》的兼容性:对国家疫苗接种政策的影响
IF 0.8 Q2 LAW Pub Date : 2024-05-04 DOI: 10.1163/15718093-bja10127
Rogier C. Simons, M. Corrette Ploem, Johan Legemaate
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. Additionally, this article discusses the legal framework underlying the Dutch vaccination policy, including developments therein since COVID-19. Furthermore, the role of the European Union in the context of vaccination is briefly discussed. The importance of an extensive societal and parliamentary debate before implementing a mandatory vaccination policy is stressed, as is the need for proportionality in enforcement.
本文通过分析《欧洲人权公约》的相关权利和欧洲人权法院 (ECtHR) 的相关判例法,探讨了强制疫苗接种是否符合《欧洲人权公约》。通过重点关注《欧洲人权公约》第 8 条(私人生活权)、第 2 条(生命权)和第 9 条(思想、良心和宗教自由),我们提出了强制疫苗接种立法合理的条件。因此,本分析旨在为国家立法者提供负责任的立法政策指导。此外,本文还讨论了荷兰疫苗接种政策的法律框架,包括自 COVID-19 以来的发展情况。此外,本文还简要讨论了欧盟在疫苗接种方面的作用。文章强调了在实施强制疫苗接种政策之前进行广泛的社会和议会辩论的重要性,以及在执行过程中保持相称性的必要性。
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引用次数: 0
EHDS and Free Movement of Patients: What EU Intervention is Needed? EHDS 和病人的自由流动:欧盟需要采取哪些干预措施?
IF 0.8 Q2 LAW Pub Date : 2024-04-13 DOI: 10.1163/15718093-bja10125
Johan van de Gronden, Marc Veenbrink
The European Commission issued a proposal for a Regulation on the European Health and Data Space to improve patient mobility. This EHDS Regulation lays down rules for the exchange of digital health data for primary use (treatment) and for secondary use (i.e. research, policymaking). This proposal has far-reaching implications for national healthcare systems. The question arises whether, with this draft, the Commission in fact proposes to overstep the powers of the European Union, as the delivery and organization of healthcare belongs to the competences of the Member States. Furthermore, the (lack of) exchange of digital health data is not the only hinderance for the free movement of patients. The current set-up of the Patient Directive and the Social Security Coordination Regulation also discourages patients from seeking treatment abroad. Therefore, a more integrated approach in the form of a new Patient Regulation is, in our view, needed.
欧盟委员会发布了《欧洲健康与数据空间条例》提案,以提高患者的流动性。该《欧洲健康与数据空间条例》规定了用于主要用途(治疗)和次要用途(即研究、决策)的数字健康数据交换规则。该提案对各国医疗保健系统具有深远影响。问题在于,由于医疗保健的提供和组织属于成员国的职权范围,欧盟委员会的这一草案是否事实上超越了欧盟的权力。此外,(缺乏)数字医疗数据交换并不是病人自由流动的唯一障碍。目前《患者指令》和《社会保障协调条例》的设置也阻碍了患者到国外就医。因此,我们认为需要以新的《患者条例》为形式,采取更加综合的方法。
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引用次数: 0
European Court of Justice. 欧洲法院。
IF 0.6 Q2 LAW Pub Date : 2024-04-01 DOI: 10.1163/15718093-12423563
Herman Nys
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引用次数: 0
European Court of Human Rights. 欧洲人权法院。
IF 0.8 Q2 LAW Pub Date : 2024-03-22 DOI: 10.1163/15718093-bja10126
Joseph Dute, Tom Goffin
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引用次数: 0
Paving the Path for Sustainable and Responsible Off-Label Use of Pharmaceutical Products in Europe 为在欧洲可持续和负责任地使用标签外医药产品铺平道路
IF 0.8 Q2 LAW Pub Date : 2024-03-13 DOI: 10.1163/15718093-bja10123
Miquel Díaz Hernández, Waltter Roslin, Juli Mansnérus
Off-label use of pharmaceuticals involves a wide array of aspects ranging from legal and regulatory ones to clinical to safety considerations. Access to off-label therapies is particularly relevant question for patients in areas of unmet medical need. Simultaneously, off-label use also triggers wider considerations relating to social and economic sustainability of health care systems and access to health. National authorities have adapted different regulatory approaches to off-label use of pharmaceuticals, ranging from (1) “regulatory silence”; to (2) allowing off-label use at the discretion of the treating physician; and to (3) a more stringent approach in which off-label use is subject to third party approval. This article provides a brief overview of these different regulatory approaches from a helicopter perspective, and it discusses benefits and shortcomings these approaches. Finally, it presents ideas for preconditions for sustainable and responsible off-label use of pharmaceutical products to ensure patient safety whilst ensuring their timely access to health.
药品的标示外使用涉及从法律和监管到临床和安全考虑等广泛方面。对于医疗需求未得到满足的患者来说,获得标示外治疗尤其重要。同时,标示外使用也会引发与医疗系统的社会和经济可持续性以及获得医疗服务有关的更广泛的考虑。各国当局对药品的标示外使用采取了不同的监管方法,包括(1)"监管沉默";(2)允许治疗医生自行决定标示外使用;以及(3)更严格的方法,即标示外使用须经第三方批准。本文从直升机的角度简要概述了这些不同的监管方法,并讨论了这些方法的优点和缺点。最后,文章提出了可持续和负责任的药品标示外使用的前提条件,以确保患者安全,同时确保他们及时获得医疗服务。
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引用次数: 0
Give Due Consideration …: Some Thoughts on Member States’ Obligations Under Article 13 of the HTA Regulation 适当考虑.....:关于会员国根据《HTA 条例》第 13 条所承担义务的几点思考
IF 0.8 Q2 LAW Pub Date : 2024-03-13 DOI: 10.1163/15718093-bja10122
Gisela Ernst, Karl Stöger

The new EU Regulation on health technology assessment (HTAR) provides for joint clinical assessments (JCA) of health technologies at EU level. When Member States carry out health technology assessments (HTA) at the national level, they shall give due consideration to the results of a JCA and comply with other obligations of the Regulation. This article aims to clarify what these obligations mean for the Member States and whether JCA results have to be considered outside a national health technology assessment as well. In this context, the question of which processes qualify as ‘national HTA’ and which requirements need to be fulfilled to trigger the obligations under Article 13 HTAR are discussed in more detail in this paper.

欧盟关于卫生技术评估 (HTAR) 的新条例规定在欧盟层面对卫生技术进行联合临床评估 (JCA)。成员国在国家层面开展卫生技术评估 (HTA) 时,应适当考虑联合临床评估的结果,并遵守条例规定的其他义务。本文旨在阐明这些义务对成员国的意义,以及在国家卫生技术评估之外是否也必须考虑联合评估的结果。在此背景下,本文将更详细地讨论哪些程序符合 "国家卫生技术评估 "的条件,以及需要满足哪些要求才能触发《医疗卫生技术评估条例》第 13 条规定的义务。
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引用次数: 0
European Court of Human Rights. 欧洲人权法院。
IF 0.8 Q2 LAW Pub Date : 2024-02-06 DOI: 10.1163/15718093-bja10120
Joseph Dute, Tom Goffin
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引用次数: 0
What are the Changes in 2023 for Access to Advanced Therapy Medicinal Products (ATMPs) in France? 2023 年法国先进治疗药物 (ATMP) 的使用情况会发生哪些变化?
IF 0.8 Q2 LAW Pub Date : 2024-01-29 DOI: 10.1163/15718093-bja10121
Blanka Bartos

ATMPs are the most expensive innovative treatments, thus they require special regulation. Past regulatory measures in France, such as limiting the growth of drug expenditures, the creation of a fund to finance pharmaceutical innovation, the use of performance-based contracts and greater emphasis on medico-economic evaluations in pricing have been contributing to having both universal access to innovative therapies and fair remuneration for innovation. The importance of transparency, public participation in healthcare evaluation, and the challenges of setting drug prices based on their value are not negligible either. Although further negotiations are still necessary to ensure equitable access to medicines and control rising healthcare costs, France has made pioneering steps recently which would be worthy to follow for other states. The Social Security Financing Act for 2023 introduces measures to control face prices, offers a new funding model, and encourages manufacturers to submit reimbursement claims for the full scope of marketing authorizations.

ATMP 是最昂贵的创新疗法,因此需要特殊监管。法国过去采取的监管措施,如限制药品支出增长、设立基金资助药品创新、使用基于绩效的合同、在定价中更加重视医疗经济评估等,都有助于实现创新疗法的普及和创新的公平报酬。透明度、公众参与医疗保健评估的重要性以及根据药品价值确定药品价格的挑战也不容忽视。尽管仍需进一步谈判,以确保公平获得药品和控制医疗成本的上升,但法国最近采取的开创性措施值得其他国家借鉴。2023 年社会保障融资法》引入了控制面值价格的措施,提供了一种新的融资模式,并鼓励制造商提交全部营销授权范围的报销申请。
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引用次数: 0
Bringing Climate Change to Strasbourg. The Convention and Healthy Environment Claims. 将气候变化带到斯特拉斯堡。公约与健康环境诉求。
IF 0.8 Q2 LAW Pub Date : 2024-01-24 DOI: 10.1163/15718093-bja10119
André den Exter

Climate change profoundly impacts all aspects of human life, including health. International fora and nation States recognise the importance of urgently cutting greenhouse gas emissions as a primary cause of global warming. States' commitment to alter climate change has resulted in several treaty documents referring explicitly to human rights obligations. But what exactly are States' obligations under climate change treaty law and other human rights treaties? And what is the judiciary's role when confronted with the right to health violations and systemic deficiencies relating to climate change? Can climate change litigation give individual citizens a remedy to right to health violations and reduce the impact of climate change?

气候变化深刻影响着人类生活的方方面面,包括健康。国际论坛和民族国家认识到,必须紧急减少温室气体排放,因为这是全球变暖的主要原因。各国对改变气候变化的承诺促使一些条约文件明确提及人权义务。但是,根据气候变化条约法和其他人权条约,各国的义务究竟是什么?司法机构在面对与气候变化有关的侵犯健康权行为和系统性缺陷时又该发挥什么作用?气候变化诉讼能否为公民个人提供健康权受到侵犯时的救济并减少气候变化的影响?
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EUROPEAN JOURNAL OF HEALTH LAW
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