MEDICINE AND LAW最新文献

Following Portugal's bailout, several measures concerning the rationalization of resources of the national health system have been recommended, aiming to improve the efficiency of services and generate additional savings. Our purpose is to approach this issue by asking for its conformity with the Constitution of the Portuguese Republic, and by further characterizing and discussing the right to health as a typical social right, the implementation of which presupposes the "reserve of what is possible" (including its dependence on existing economic resources). By taking into account a critical overview of the legal / constitutional doctrine, our analysis will focus on the relevant constitutional precept (art. 64, d), No. 3,) - which remits to the principle of economy in the provision of public services - and on the methodological challenges concerning the sustainability of the welfare state. We arrive at the doctrine of the "essential core" of social rights, followed by the discussion of how to determine the "essential core" of the right to health. As an example, we will discuss the sensitive issue of drugs prescription, clinical guidelines and governance, and forms by which prescribing patterns may be built. According to our approach, the essential core of the right to health for all (protected by the Constitution) presupposes the improvement of efficiency and the principle of economy in the National Health System.

The current models for equity and access to new oncological treatments are under strain due to the economic and demographic crisis in Europe as well as the rising costs of innovative drugs. Cancer treatment needs a model of patient-centered care in which an interdisciplinary care plan, based on evidence-based practice is essential for patient wellbeing. Physicians should be focused in the doctor-patient relationship and informed consent is important, especially when new medicines are prescribed. Related with informed consent, there is therapeutic privilege. Moreover, utilitarianism and social justice have to be considered without compromising human dignity and the principle of economy cannot be ignored in the provision of public services. An interdisciplinary approach is essential for the new oncological drugs approval. Therefore, transdisciplinary decision between civil society, pharmaceuticals, healthcare professionals and policy makers is essential in order to assure quality, access to innovation and equity in oncological care.

Objective: The aim of this study is to investigate the relationship between attitudes, perceptions and behaviours associated with nursing students' academic dishonesty. A cross-sectional study was carried out on a convenience sample of 158 students at an academic college in one of the regular nursing programs taught in Israel. The research instrument was a self-report. Regression analysis was applied to the data. Results showed that about 44% of the students engaged in one or more dishonest activities. Students with a greater fear of dropping out and those with a higher perception of justification of academic dishonesty were more likely to engage in dishonest activities. Respondents with more condemnatory attitudes and those with higher perceived risk of being caught were less engaged in such activities. Nursing educators should enhance ethics education and focus on the values embodied in each country's nurses association's ethical code, as well as develop an appropriate integrity policy for each academic institution.

Breaking a moral rule in an autonomous state implies a deliberate and intentional cogitation vis-à-vis the given act. This constitutes. the moral fabric of imposing responsibility and accountability. Legal liability and culpability rests on a similar logic. However, pathological and non-pathological conditions, which create mental instabilities, challenge the notion of autonomous capacity and, consequently, nuance the notion of accountability for violations of civil or legal statutes under such states. On this note, this essay explores the neuroethical implications of crimes committed in the context of mental instabilities. Employing a hypothetical case involving battery under the influence of alcohol-withdrawal symptoms, the paper offers a neuroethical polemic for legal exculpation as well as how this warrants some changes in relation to the concept of mens rea.

Although the potential of eHealth in terms of improving quality, safety, efficacy and efficiency of health systems is known, the development of these new tools remains insufficient in Europe and also in France - the focus of the present article - due to the legal status of telemedicine and state involvement. National legislation should be harmonized by directives or standardized by regulations. European unification would considerably reduce the burden of administrative formalities that hold back telemedicine in France, and would lead to the emergence of community-based, non-hospital-dependent eHealth projects, in line with recommendations in the literature. The creation of cooperation protocols and the formal recognition of the patient's role via therapeutic education are valuable tools for achieving this goal. It would be an error to dismiss these tools because of the overly rigid regulations, especially now that financial incentives are shifting from cure to care.

In 2005, in an attempt to regulate care for patients expected to live no longer than six months, Israel enacted the Dying Patient Law. The law sets forth in detail actions that should be performed to respect the patient's wishes, and also defines treatment to be given to patients who have directed that there be no heroic measures taken to prolong life. In some terminal cases, such as a patient who stops breathing or has a cardiac arrest, health care providers are instructed not to perform cardiopulmonary resuscitation (CPR). However, most healthcare providers are unsure of exactly what the definition of the Do-Not-Resuscitate order (DNR) means. The research goal was to identify opinions held by nurses and physicians as to the meaning of the DNR directive. The study was of a descriptive correlational design, based on a convenience sample of 61 physicians and nurses. The research instrument comprised a structured self administrative questionnaire. The results showed differences in the opinions of the health care staff as to which actions should be performed on patients who signed DNR directives, and which should not. While a majority of the respondents agreed that heart massage and ventilation were considered actions that should not be performed on DNR patients, other actions were found to be the subject of differences of opinion. For example, about half the respondents considered imaging tests and other tests as actions that should not be performed if a DNR order is in place. The study emphasizes the need to set multiple parameters and not only a single-dimension definition of DNR. Nurses and physicians should have regularly scheduled meetings to discuss the DNR order of specific patients.

Aim: To obtain the opinions of health professionals' who work in emergency medical services on the application of basic attitudes like triage,ethics, legal rules; to popularize problems they have encountered or may experience while giving health services after natural disasters; and to develop further suggestions.

Material and method: In order to evaluate health service problems, laws, triage and ethics applications, a questionnaire tool was formulated. The poll that was taken included 133 emergency service workers, with and without earthquake experiences. Data were analyzed using descriptive statistics with statistical significance set at p<0.001. The frequency distributions taken into account and chi square test were applied to understand the difference between the employees who experienced an earthquake and the employees who did not.

Findings: 57.7% of participants in the survey were males and 42.3% females. Their average age was 29.8 %. 16.8% of them worked in the university hospital, 77.4 % in a state hospital and 5.8% in private hospitals. 51.1% of the participants were doctors, 43.1% nurses and 5.8% emergency medical technicians. 48.2% of the participants had experienced earthquakes, 52.6% had not. 27% of them were consulted on triage, 372% on both triage and legal rules, 31.4% on triage, laws and ethics and 4.4% on triage and ethical principles.

Conclusion: Results show that while ethical principles are less considered in medical services after natural disasters, triage and legal regulations play an essential role in resource allocation and medical service presentation. The results show that the inclusion of ethical training in natural disaster medicine education and its enhancement through regular rehearsals is essential.

Introduction: Israel Adoption Law requires absolute confidentiality. This type of adoption is basically prohibited by Islamic laws and thus creates a conflict between the State's Law and the Qur'an's directives.

Objective: (1) to study the attitudes and barriers with respect to adoption among Jewish and Muslim couples undergoing fertility treatments. (2) To describe adoption rates of children in Israel's sectors.

Method: A cross-sectional survey was conducted in fertility clinics among 204 Muslims and Jews treated for infertility. The participants were asked about their attitudes & knowledge concerning adoption. Additionally, national adoption rates, by sector, were retrieved from the Ministry of Welfare.

Results: Adoption rates among Jews were higher than among Muslims'. A prolonged period of fertility treatment was more common among Muslims than among Jews. A quarter of the Muslim couples pointed at the conflict between Quran Law and State law as a potential specific barrier.

Conclusions: It is important to deepen the understanding of the barriers against adoption among Muslims who failed fertility treatments, as well as to examine whether the change in State Law will encourage adoption of children among Muslims in Israel.

Institutional policies on research serve to guide graduate students in conducting research. Eight universities in Puerto Rico met the inclusion criteria, and were found to have research misconduct policies for conducting research. The policies were analyzed quantitatively to determine the extent to which these included relevant specific information on procedures needed to address issues that arise in a research misconduct allegation. Comparison of the eight policies revealed that five policies obtained a high score in all five dimensions analyzed. Well-covered topics in the policies included the content of the inquiry report and the content of the investigation report; while the least covered topics were pursuing the allegation, appeal process, and mentoring. Institutions need to revise their research misconduct policies and add more precise information; more institutions need to create these policies.

This article analyses the current situation of medically assisted reproduction in Italy after the issuance of Law 40 in 2004. This law is actually completely different from its first version. In fact, the controversial points, like reproduction for couples with genetic diseases, prohibition of heterologous fertilization, cryoconservation of embryos, obligation to perform just one and simultaneous implant of all the embryos produced, are definitively not in force today. This new situation can be explained not only by rules issued by Italian courts but, in particular, by changes introduced by the European Court of Human Rights and by questions of constitutional legitimacy raised by some Italian Courts. After ten years from the issue of this law, Italy has returned to the pre-existing situation. The old law was only full of prohibitions. Now, heterologous fertilization is possible and this article gives a picture of the present situation in hospitals for assisted procreation in Italy.