Issues in Law & Medicine最新文献

Background: Nowadays, the quality of medical care and health care measures is considered the main target function of the health care system and at the same time the determining criterion for its activities.

Objective: The article examines state regulation of medical care quality post- COVID and during martial law, identifying improvement areas. It emphasizes state roles in healthcare standardization, continuous feedback monitoring, and studying patient satisfaction. Interrelationships among Ukraine's state regulation mechanisms are determined, highlighting the need to enhance tools such as criteria and quality indicators for medical care assurance.

Methods: The authors of this article utilize various scientific methods, including analysis, synthesis, induction, and deduction, as well as historical and legal, formal legal, and comparative legal methods to examine the state regulation of ensuring the quality of medical care during martial law in Ukraine.

Results: The article considered the interrelationships of mechanisms and instruments of state regulation of quality assurance of medical care in Ukraine.

Conclusions: The state should enhance medical care quality regulation, drawing on international experiences from the EU and the USA and adapting best practices to national circumstances. The resilience of the healthcare system depends on effective quality assurance, ensuring preparedness, stability, and ongoing improvement prospects.

Fetal tissue research refers to research using several types of tissue, including but not limited to samples obtained from aborted fetuses, cell lines derived from aborted fetuses, and in rarer cases, living previable neonates who have survived an abortion attempt. The ethical questions surrounding each type of tissue procurement are not identical, but do share similarities.

This guideline on fetal tissue research discusses the moral status of the human fetus, the state of ethics for medical research on vulnerable subjects, aspects of medical research using human fetal tissue, and the necessity of including fetuses as a protected class under vulnerable populations in research. The debates connected to embryo stem cell research and other research related to embryos are beyond the scope of this document.

Chemical abortions, otherwise known as "medication-induced" abortions, were approved by the FDA in September 2000, and now account for over 50% of abortions in the United States. Women are being encouraged to order and carry out their own abortion, without in-person supervision by health care professionals, contributing to increased risks of complications. This paper describes the use of synthetic chemicals to induce abortion and the complications faced by women who obtain care in a medical setting, including hemorrhage and incomplete abortions that may require surgical intervention. Additionally, it describes the increased risks for those women who use telemedicine or the Internet to obtain their chemical abortion, especially when those abortions are completed without physician supervision (self-managed). The risks may include an undiagnosed ectopic pregnancy, increased complications due to underestimated or understated gestational age, Rh isoimmunization, and undiagnosed infection. Intimate partner violence, reproductive coercion, and human trafficking are also less likely to be suspected in the absence of an in-person medical evaluation. The American College of Pediatricians strongly encourages health care professionals, policy makers, and women of all ages and their families to understand the serious risks associated with chemical abortions, especially when self-managed. Additionally, pregnant women with regrets after starting chemical abortions need to be informed about the potential for abortion pill reversal.

Can sexual activity, alcohol and drug use, violent video games, pornography and other activities, including use of social media, damage adolescent minds? Early high-risk behaviors appear to have significant harmful effects on the brain's development. Evidence suggests that the hormones and neural patterns triggered may lead to addictive, and other high-risk behaviors, social withdrawal, and depression. Compounding these concerns are the immature decision-making processes during adolescence. Fortunately, parents can positively impact the brain development of adolescents as they assist in decision-making, provide structure to the adolescent's environment, and monitor the adolescent's activities.

Crucial to the fight against sex trafficking¹ is understanding the experiences of victims and survivors. Survivor surveys have illuminated key areas to address, but a clear gap in the research is in the reproductive, gynecological, and procreative health issues of victims and survivors. This article opens the door to research and dialogue by publishing the findings of a pilot survivor survey focused on survivors' sexual and reproductive health. The retrospective survey offers preliminary findings for a larger national study underway in 2023 that will enable healthcare providers, service providers and other first responders to identify and better meet the unique needs of victims and survivors of human trafficking in this area.

Adult stem cells dominate worldwide stem cell clinical trials. We investigated factors that may explain levels of stem cell research across different countries. Stem cell trials from clinicaltrials.gov were counted and categorized based on the country, the type of stem cell used, and whether that type is ethically controversial. The trial data were compared with characteristics of the countries such as population and GDP. We looked at the general ethical position of the countries by ranking their favorability toward abortion via their legislation. We found GDP, which may be indicative of the interest and means a nation can put toward research, to be the most predictive measure of stem cell use. No correlation was found with national abortion legislation, which is an indicator of ethical positions on life issues in a country. Thus, it would seem that the use of stem cells, namely the significantly greater use of adult stem cells over other more controversial types, is likely to be more influenced by their scientific utility and not by other social or ethical opinions. In addition, ESC and other ethically controversial research does not appear to be necessary for the US to dominate worldwide stem cell research.

A complex biological and psychological series of events commence at fertilization and continue through parturition between the preborn human organism and his or her mother, which extends far beyond the physical connection between an adult patient and contained tissue. This guideline reviews evidence in support of various aspects of this bond and its implications for care of the maternal patient.

The research review, "Three Decades of Research: The Case for Comprehensive Sex Education," by Goldfarb and Lieberman (2021), purports to show "strong support" for the effectiveness of school-based comprehensive sex education (CSE) at producing many benefits beyond its original goals of preventing teen pregnancy and STDs. We reviewed the evidence the study cites in support of these claims, item by item, and found that 1) 80% of the sources cited as supporting evidence for CSE are not studies of CSE programs and 2) of the few cited studies of actual CSE programs, roughly 90% do not meet recommended scientific standards for evidence of program effectiveness. Important to note, contrary to its claims, the study does not show scientific evidence that comprehensive sex education helps prevent child sex abuse, reduces dating/intimate partner violence or homophobic bullying, or that it should be taught to young children in the early grades. Rather than making "the case for CSE," Goldfarb and Lieberman's review gives the appearance of scientific support to a new CSE agenda that the authors articulate and endorse, which includes early sex education, gender ideology, and social justice theory. However, they do not present scientifically reliable confirmatory evidence for that agenda.

The American College of Obstetricians and Gynecologists (ACOG) released a Committee Opinion in November 2007 titled "The Limits of Conscientious Refusal in Reproductive Medicine." This document, claiming to speak on behalf of the entire profession of Obstetrics and Gynecology, proposed that conscience rights of healthcare professionals have limits with regard to certain aspects of patient care. Despite calls for revision from many within the profession, this document was reaffirmed in 2016, unchanged. This document provides a detailed analysis of the ethical flaws in ACOG Committee Opinion 385.

Many people worldwide, particularly those with disabilities and the elderly, suffered greatly not only as a result of the Covid-19 pandemic but also as a result of the lockdowns. In this article we set out widely-accepted ethical criteria for assessing when coercive public health measures are justified. We then review the empirical evidence, not least concerning the benefits and costs of the lockdowns, and conclude that lockdowns as instituted in the UK (and, presumptively, in many other jurisdictions) appeared to breach those criteria. We conclude that any future proposal to lockdown should be subjected to the strictest ethical scrutiny, and that a lockdown should not be contemplated unless it could be convincingly demonstrated that the benefits would substantially outweigh the harms; that it would be proportionate, and that legal coercion would be strictly necessary.