Pub Date : 2022-10-19DOI: 10.1163/15718093-bja10096
Irith Kist
In 2021, the European Commission published its Assessment of the EU Member States' rules on health data in the light of General Data Protection Regulation. The Commission concluded that the GDPR has been interpreted in many ways in the EU as regards health research, and national implementation legislation has resulted in a fragmented legal landscape. Several lawful bases are used as a legitimation for the secondary use of health data. I address the Dutch legislation on the re-use, or secondary use of health data for scientific research where explicit consent is the general rule. However, both the GDPR, the Dutch GDPR Implementation Act and sectoral health legislation leave room for alternatives. I conclude that a further review of these alternatives is required to enhance scientific health research with the secondary use of health data, and I sketch a few avenues for further exploration.
{"title":"Assessment of the Dutch Rules on Health Data in the Light of the GDPR.","authors":"Irith Kist","doi":"10.1163/15718093-bja10096","DOIUrl":"https://doi.org/10.1163/15718093-bja10096","url":null,"abstract":"<p><p>In 2021, the European Commission published its Assessment of the EU Member States' rules on health data in the light of General Data Protection Regulation. The Commission concluded that the GDPR has been interpreted in many ways in the EU as regards health research, and national implementation legislation has resulted in a fragmented legal landscape. Several lawful bases are used as a legitimation for the secondary use of health data. I address the Dutch legislation on the re-use, or secondary use of health data for scientific research where explicit consent is the general rule. However, both the GDPR, the Dutch GDPR Implementation Act and sectoral health legislation leave room for alternatives. I conclude that a further review of these alternatives is required to enhance scientific health research with the secondary use of health data, and I sketch a few avenues for further exploration.</p>","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":"30 3","pages":"322-344"},"PeriodicalIF":0.8,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10022040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.1163/15718093-bja10094
Regina Becker, Davit Chokoshvili, Giovanni Comandé, Edward S. Dove, Alison Hall, Colin Mitchell, Fruzsina Molnár-Gábor, Pilar Nicolàs, Sini Tervo, Adrian Thorogood
Contemporary biomedical research heavily relies on secondary use of personal health data that were obtained in a different clinical or research setting. Under the European Union’s General Data Protection Regulation (GDPR), data controllers processing personal data must comply with the principle of purpose limitation, which restricts further processing of personal data beyond the purpose for which the data were initially collected. However, “further processing” is not explicitly defined, resulting in considerable interpretive ambiguities as to whether “secondary use” of data by researchers constitutes “further processing” under the GDPR. This ambiguity is problematic as it exposes researchers to potential non-compliance risks. In this article, we analyse the term “further processing” within the meaning of the GDPR, elucidate important aspects in which it differs from “secondary use”, and discuss the implications for data controllers’ GDPR compliance obligations. Subsequently, we contextualise this analysis within a broader discussion of regulating scientific research under the GDPR.
{"title":"Secondary Use of Personal Health Data: When Is It “Further Processing” Under the GDPR, and What Are the Implications for Data Controllers?","authors":"Regina Becker, Davit Chokoshvili, Giovanni Comandé, Edward S. Dove, Alison Hall, Colin Mitchell, Fruzsina Molnár-Gábor, Pilar Nicolàs, Sini Tervo, Adrian Thorogood","doi":"10.1163/15718093-bja10094","DOIUrl":"https://doi.org/10.1163/15718093-bja10094","url":null,"abstract":"<p>Contemporary biomedical research heavily relies on secondary use of personal health data that were obtained in a different clinical or research setting. Under the European Union’s General Data Protection Regulation (<span style=\"font-variant: small-caps;\">GDPR</span>), data controllers processing personal data must comply with the principle of purpose limitation, which restricts further processing of personal data beyond the purpose for which the data were initially collected. However, “further processing” is not explicitly defined, resulting in considerable interpretive ambiguities as to whether “secondary use” of data by researchers constitutes “further processing” under the <span style=\"font-variant: small-caps;\">GDPR</span>. This ambiguity is problematic as it exposes researchers to potential non-compliance risks. In this article, we analyse the term “further processing” within the meaning of the <span style=\"font-variant: small-caps;\">GDPR</span>, elucidate important aspects in which it differs from “secondary use”, and discuss the implications for data controllers’ <span style=\"font-variant: small-caps;\">GDPR</span> compliance obligations. Subsequently, we contextualise this analysis within a broader discussion of regulating scientific research under the <span style=\"font-variant: small-caps;\">GDPR</span>.</p>","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":"373 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138542564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-27DOI: 10.1163/15718093-bja10093
Donato Vese
The WHO’s management of the pandemic has drawn sharp criticism. It has been suggested that there is an urgent need for a reform providing more intrusive administrative powers. By contrast, this paper argues that the WHO needs sharing powers rather than intrusive powers. Given that the main international norms have arguably designated the WHO as a “non-authoritarian” authority aiming at the highest possible level of health for individuals, the paper suggests that sharing of administrative powers should be incentivised by involving all the relevant actors in the decision-making process, namely through the participation in proceedings of all actors involved in the decision-making, namely governments, national health authorities, and other non-state actors.
{"title":"On the Administrative Powers of the WHO: A Lesson from the Pandemic","authors":"Donato Vese","doi":"10.1163/15718093-bja10093","DOIUrl":"https://doi.org/10.1163/15718093-bja10093","url":null,"abstract":"\u0000The WHO’s management of the pandemic has drawn sharp criticism. It has been suggested that there is an urgent need for a reform providing more intrusive administrative powers. By contrast, this paper argues that the WHO needs sharing powers rather than intrusive powers. Given that the main international norms have arguably designated the WHO as a “non-authoritarian” authority aiming at the highest possible level of health for individuals, the paper suggests that sharing of administrative powers should be incentivised by involving all the relevant actors in the decision-making process, namely through the participation in proceedings of all actors involved in the decision-making, namely governments, national health authorities, and other non-state actors.","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45035529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-13DOI: 10.1163/15718093-bja10092
Zoe L. Tongue
Early into the COVID-19 pandemic, abortion rights advocates highlighted the importance of maintaining access to abortion through telemedicine. It was argued that telemedical and self-managed abortion was, in the pandemic context, a human rights imperative. This article argues that providing for telemedical and self-managed abortion remains a human rights imperative beyond the duration of the pandemic. Telemedical and self-managed abortion is safe and effective, supports the pregnant person’s preferences and reproductive autonomy, and minimises many of the physical and structural barriers faced by pregnant people in accessing abortion services. International and European human rights standards access to abortion require states to take positive measures to guarantee access to abortion, and this article argues that such measures include telemedical and self-managed abortion.
{"title":"Telemedical and Self-Managed Abortion: A Human Rights Imperative?","authors":"Zoe L. Tongue","doi":"10.1163/15718093-bja10092","DOIUrl":"https://doi.org/10.1163/15718093-bja10092","url":null,"abstract":"\u0000Early into the COVID-19 pandemic, abortion rights advocates highlighted the importance of maintaining access to abortion through telemedicine. It was argued that telemedical and self-managed abortion was, in the pandemic context, a human rights imperative. This article argues that providing for telemedical and self-managed abortion remains a human rights imperative beyond the duration of the pandemic. Telemedical and self-managed abortion is safe and effective, supports the pregnant person’s preferences and reproductive autonomy, and minimises many of the physical and structural barriers faced by pregnant people in accessing abortion services. International and European human rights standards access to abortion require states to take positive measures to guarantee access to abortion, and this article argues that such measures include telemedical and self-managed abortion.","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45516398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1163/15718093-bja10091
Paulien Walraet, Sofia Palmieri, T. Goffin
The protection of whistleblowers in healthcare is necessary to ensure quality of care by raising concerns about suspected breaches of human rights and Union law. This protection has evolved over the years through initiatives from the European Council, which were also taken into account in two rulings of the European Court of Human Rights, and the European Parliament. However, these initiatives implement a general framework rather than focussing directly on healthcare. This article therefore starts from analysing the general protection. Hereinafter, the relevance for the healthcare sector will be examined for each of the involved initiatives.
{"title":"The Evolution of Whistleblowing Protection in Healthcare on a European Level","authors":"Paulien Walraet, Sofia Palmieri, T. Goffin","doi":"10.1163/15718093-bja10091","DOIUrl":"https://doi.org/10.1163/15718093-bja10091","url":null,"abstract":"\u0000 The protection of whistleblowers in healthcare is necessary to ensure quality of care by raising concerns about suspected breaches of human rights and Union law. This protection has evolved over the years through initiatives from the European Council, which were also taken into account in two rulings of the European Court of Human Rights, and the European Parliament. However, these initiatives implement a general framework rather than focussing directly on healthcare. This article therefore starts from analysing the general protection. Hereinafter, the relevance for the healthcare sector will be examined for each of the involved initiatives.","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49641877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-14DOI: 10.1163/15718093-bja10090
Joseph Dute, Tom Goffin
{"title":"European Court of Human Rights.","authors":"Joseph Dute, Tom Goffin","doi":"10.1163/15718093-bja10090","DOIUrl":"https://doi.org/10.1163/15718093-bja10090","url":null,"abstract":"","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":" ","pages":"1-11"},"PeriodicalIF":0.8,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10015078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-13DOI: 10.1163/15718093-bja10089
Caterina Di Costanzo
In this paper I have tried to identify and analyse some critical points that Regulation No. 526 of 2014 on clinical trials still presents. I have seen that in the face of a long gestation, the criticisms that have been made of the regulation have been various. If we think of the first criticism identified in the regulation, the so-called law shopping, we must affirm that the subject of experimentation is a very delicate matter since it has a direct and frontal impact on the guarantee of the right to health of European citizens and the use of law shopping does not provide adequate guarantees for the protection of the rights of those participating in a trial. Secondly, the marginalisation of the Ethics Committees whose role is decided at the level of the single national legal system does not ensure that components of independence and representation of the point of view of patients and their associations are guaranteed. This aspect is undoubtedly an important criticism of the regulation as the importance of the role played by the Ethics Committees in the assessment procedures for authorisation applications is not taken into fully consideration. Also, in this case, the economic need for simplification and speed of the evaluation procedure seem to prevail over the need to ensure a thorough and independent scientific and ethical review of authorisation applications. We believe that in the case of Regulation No. 536 of 2014, greater awareness of risks and opportunities will be achieved only by verifying in practice the possible distortions to which this legislation can lead. Only through serious monitoring and reporting of the effects of the regulation on the protection of patients’ rights will it be possible to identify and indicate targeted changes to the rules contained therein and, of course, to adopt the consequent measures to reduce possible damages. In this sense, also on the basis of a possible and foreseeable future phase of gestation of Regulation No. 534 of 2014, we believe that in the European area, in the field of clinical trials but not exclusively, that trend, developed above all in the French context, of the “experimentation of laws” should be further cultivated.
{"title":"The Problematic Path of Fundamental Rights in the European Union: Continuing the Journey on the Regulation on Clinical Trials","authors":"Caterina Di Costanzo","doi":"10.1163/15718093-bja10089","DOIUrl":"https://doi.org/10.1163/15718093-bja10089","url":null,"abstract":"\u0000In this paper I have tried to identify and analyse some critical points that Regulation No. 526 of 2014 on clinical trials still presents. I have seen that in the face of a long gestation, the criticisms that have been made of the regulation have been various. If we think of the first criticism identified in the regulation, the so-called law shopping, we must affirm that the subject of experimentation is a very delicate matter since it has a direct and frontal impact on the guarantee of the right to health of European citizens and the use of law shopping does not provide adequate guarantees for the protection of the rights of those participating in a trial. Secondly, the marginalisation of the Ethics Committees whose role is decided at the level of the single national legal system does not ensure that components of independence and representation of the point of view of patients and their associations are guaranteed. This aspect is undoubtedly an important criticism of the regulation as the importance of the role played by the Ethics Committees in the assessment procedures for authorisation applications is not taken into fully consideration. Also, in this case, the economic need for simplification and speed of the evaluation procedure seem to prevail over the need to ensure a thorough and independent scientific and ethical review of authorisation applications. We believe that in the case of Regulation No. 536 of 2014, greater awareness of risks and opportunities will be achieved only by verifying in practice the possible distortions to which this legislation can lead. Only through serious monitoring and reporting of the effects of the regulation on the protection of patients’ rights will it be possible to identify and indicate targeted changes to the rules contained therein and, of course, to adopt the consequent measures to reduce possible damages. In this sense, also on the basis of a possible and foreseeable future phase of gestation of Regulation No. 534 of 2014, we believe that in the European area, in the field of clinical trials but not exclusively, that trend, developed above all in the French context, of the “experimentation of laws” should be further cultivated.","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45115000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-18DOI: 10.1163/15718093-bja10086
David Albert Jones, Laura Palazzani, Franz-Josef Bormann, Stefan Hofmann
This paper deals with a series of legal cases in Italy, Germany, and Austria, between September 2019 and December 2020, which ruled that laws prohibiting or restricting assistance in suicide were unconstitutional. There are similarities between these three cases, all of which are influenced by the practice of assisted suicide in Switzerland, but also differences, not least because of the antecedent legal contexts. Each case is based on flawed reasoning. They have in common an exaggerated account of autonomy or self-determination, insufficiently qualified by the duty to protect human life or by other ethical constraints. The Italian and Austrian Courts also appeal to the principle of equality and to a supposed analogy with refusal of life-sustaining treatments, both of which raise concerns in relation to further expansion of the provisions. In responding to these flawed judgements, legislators should favour proposals that prevent the normalisation of assisted and non-assisted suicide.
{"title":"Legal Challenges to Restrictions on Assistance in Suicide in Italy, Germany and Austria: An Ethico-Legal Analysis.","authors":"David Albert Jones, Laura Palazzani, Franz-Josef Bormann, Stefan Hofmann","doi":"10.1163/15718093-bja10086","DOIUrl":"10.1163/15718093-bja10086","url":null,"abstract":"<p><p>This paper deals with a series of legal cases in Italy, Germany, and Austria, between September 2019 and December 2020, which ruled that laws prohibiting or restricting assistance in suicide were unconstitutional. There are similarities between these three cases, all of which are influenced by the practice of assisted suicide in Switzerland, but also differences, not least because of the antecedent legal contexts. Each case is based on flawed reasoning. They have in common an exaggerated account of autonomy or self-determination, insufficiently qualified by the duty to protect human life or by other ethical constraints. The Italian and Austrian Courts also appeal to the principle of equality and to a supposed analogy with refusal of life-sustaining treatments, both of which raise concerns in relation to further expansion of the provisions. In responding to these flawed judgements, legislators should favour proposals that prevent the normalisation of assisted and non-assisted suicide.</p>","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":"1 1","pages":"1-25"},"PeriodicalIF":0.8,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48963808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1163/15718093-bja10087
Noelia Martínez-Doallo
Informed consent has been inconsistently conceptualised as a right, an immunity or even a power in the hands of the patient, which leaves its legal definition as partially indefinite. From the norms of the CHRB, a legal theory stance and the proposals of celebrated authors - namely, W.N. Hohfeld, H. Kelsen and R. Alexy, I will provide a steady conceptual structure for the subjective legal positions of the parties involved in the healthcare relationship regarding informed consent.
{"title":"The Conceptual Legal Structure of The Patient's Right to Informed Consent.","authors":"Noelia Martínez-Doallo","doi":"10.1163/15718093-bja10087","DOIUrl":"10.1163/15718093-bja10087","url":null,"abstract":"<p><p>Informed consent has been inconsistently conceptualised as a right, an immunity or even a power in the hands of the patient, which leaves its legal definition as partially indefinite. From the norms of the CHRB, a legal theory stance and the proposals of celebrated authors - namely, W.N. Hohfeld, H. Kelsen and R. Alexy, I will provide a steady conceptual structure for the subjective legal positions of the parties involved in the healthcare relationship regarding informed consent.</p>","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":"1 1","pages":"1-24"},"PeriodicalIF":0.8,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42588127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-06DOI: 10.1163/15718093-bja10088
Emma Milne
{"title":"Women's Birthing Bodies and the Law: Unauthorised Intimate Examinations, Power and Vulnerability, edited by Camilla Pickles and John Herring.","authors":"Emma Milne","doi":"10.1163/15718093-bja10088","DOIUrl":"10.1163/15718093-bja10088","url":null,"abstract":"","PeriodicalId":43934,"journal":{"name":"EUROPEAN JOURNAL OF HEALTH LAW","volume":"1 1","pages":"1-2"},"PeriodicalIF":0.8,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43741970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}