MEDICINE AND LAW最新文献

The International Council of Nurses (ICN) defined nursing as a sphere integrating autonomous and collaborative care provided to the individual, family, and community within and outside of the care setting. Furthermore, the ICN noted that the profession comprises four major spheres of action: promoting health, preventing illness and treating patients, treating people with disabilities, and providing end-of-life care. The ICN's directives and recommendations for assimilating its Code of Ethics emphasized that the nursing staff and nursing students must understand its clauses, act according to them, discuss them with colleagues and others, and integrate its details in all spheres of action, teaching, administration, and research. Over the past half century since publishing the Code of Ethics, nursing as a care profession has developed broadly in terms of its essentials, expertise, and primarily academically. Despite the impressive growth of the profession, there is still extreme diversity in the public's perceptions and opinions of the profession and its professionals and in the knowledge of the fundamentals of its true function and spheres of engagement. The current study examines the existing knowledge among the general population regarding the nursing profession.

This paper examines narratives from young men seeking non-medical circumcision. Non-medical circumcision remains controversial, yet there are young men seeking elective circumcision. At our centre, young men 15 to 17 seeking elective circumcision were asked to write short pieces to reflect their understanding and reason(s) for wanting circumcision. Fourteen youth participated; four changed their minds about the procedure. Findings are described and evaluated within the medico-legal description of informed consent, and, from a narrative ethics perspective explicitly concerned with giving voice to patients. Persons are presumed capable of making their own health care decisions, yet, with youth, there may be a concern that an irrevocable decision may be coerced, or impulsive. Narrative reflections provide a means by which (i) misinformation/misunderstanding can be resolved (ii) coercion can be minimized and (iii) impulsivity mitigated. This paper describes our experience with narrative reflection and aims to facilitate informed decision-making for elective procedures among youth, and other potentially vulnerable populations.

In this article, the Author analyzes her own experience as a member of the IRB that approved a trial to determine the efficacy of a disobstruction procedure of extracranial veins by means of angioplasty in patients with multiple sclerosis (MS). The so-called "liberation therapy" was proposed by an Italian vascular surgeon, who theorized a condition called "chronic cerebrospinal venous insufficiency" (CCSVI) as playing a role in the pathogenesis of MS. This approval, given after an animated discussion amongst IRB members, lacked any solid scientific evidence of a causal relationship between CCSVI and MS, and was accepted despite the concerns about potential risks associated with the proposed therapy. Undoubtedly, considerable pressure was exerted on IRB by MS sufferers, who rushed off to get the surgery from the many clinics who offered liberation therapy.The remaining sense of bitter has raised a reflection on how to prevent similar future cases.

In Nigeria, just like in many other parts of the world, one of the most extensively discussed issues on the public agenda today is the increase in prison population. The aims of imprisonment are protection, retribution, deterrence, reformation and vindication. Investigations revealed that the prison services have been,neglected more than any other criminal justice agency in Nigeria. For example, most of the prisons were built during the colonial era for the purpose of accommodating a small number of inmates. Human Rights are the basic guarantees for human beings to be able to achieve happiness and self-respect; consequently, in most jurisdictions, the Human Rights Act confirms that these Rights do not stop at the prison gates. However, most States fail to meet the Human Rights obligations of their prisoners. As regards to health, for example, every prison should have proper health facilities and medical staff to provide dental and psychiatric care among others. This article discusses the Nigerian Prison System and challenges, trends and the related Human Rights and Ethical issues in Nigerian prisons. Some of the unmet needs of Nigerian prisoners which include, inter alia, living in unwholesome cells, delayed trial of inmates, lack of voting rights, access to information, lack of conjugal facilities for married prisoners, poor and inadequate nutrition, poor medical care, torture, inhumane treatment and the need to protect prisoners in a changing world. The present report has policy implications for reforming prison services in Nigeria, and countries that sing from the same song sheet with Nigeria on prison services, to conform to the Fundamental Human Rights of prisoners in the 21St century.

A recent United Nations' (U.N.) Resolution, "Intensifying Global Efforts for the Elimination of Female Genital Mutilations," urging all countries to enact legislation outlawing female circumcision or female genital ritual (FGR) signals a disturbingly new frontier in the polemic surrounding the ancient cultural practice. Never before has the apex global institution lent its imprimatur to a project whose foundation is profoundly muddled in uncertainties and murkiness. That the Resolution received an instantaneous and near-universal acclaim as a necessary protective weapon against supposed assault on the human rights of women is not news. After all, aside from essentially validating extant legislative frameworks in several countries, the proclamation fits seamlessly with decades-long agitations of activists, scholars and media pundits of one stripe or the other. What is absurd--indeed, the real news--is continued neglect of calls for a rethinking of the criminalization fervor currently gripping the world, for a reassessment of the evidence trumpeted by abolitionists as justificatory of their unbridled interference in what practicing communities revere as a sacred cultural rite. Relying on the premise that claims regarding harmful impact of FGR, the fulcrum upon which eradication forces depend for their activism, cannot be substantiated, this paper argues that prohibitory regimes based thereon, whether at the U.N. or country level, is per se a violation of the human rights of the women purportedly sought to be protected. Human rights (including, in this case, its self-appointed "apostles"), cannot, as a popular Igbo maxim admonishes, become "outsiders who wept louder than the bereaved." This is the prism from which this paper analyzes the on-going supranational crusade to suppress FGR. It is a critique of extant FGR legal and policy regimes, an instance of which is the U.N. Resolution, as unrepresentative of legitimate advancement of human rights.

The principle of informed consent, which requires a patient's fully-informed consent prior to the medical treatment, is closely connected with the value of human dignity. The realization and protection of a patient's dignity is not possible without his/her right to choose the character and scope of medical treatment. This goal cannot be adequately achieved within the traditional model of medical paternalism characterized by the physician's authoritative position. The first part of the article deals with the content and ethical significance of the informed consent doctrine. The legal framework of informed consent in Republic Srpska (RS), one of the two Bosnia and Herzegovina (BH)entities, is analyzed. Special reference is made to the relevance of the informed consent principle within the physical rehabilitation process. Although ethical aspects of physical rehabilitation are often overlooked, this medical field possesses a strong ethical dimension (including an appropriate realization of the patient's right to informed consent).

Next-Generation Sequencing has been used as a diagnostic tool in an increasing manner. Compared to conventional medical interventions, NGS, as a medical intervention, has its own special characteristics. NGS allows us to obtain a multitude of additional findings. However, their correct interpretation requires molecular biological expertise and is still unknown at the time of the sampling. These factors, when applying NGS, lead to a dynamic process of informational interference with the patients' rights. The physician-patient relationship that becomes successive, is loosened by involving non-physician researchers in the validation of the findings and by the fact that genetic data also gives information about the relatives of the patient. Moreover, dealing with risk information lays the burden on the patients and strengthens their responsibility. These challenges increase in international translational medicine and they demand solutions for the protection of the patients' rights.

Israel is a multicultural state that has absorbed, and is continually absorbing people of different cultures who immigrate to Israel, a situation that could create conflicts in the physician-patient relationship. In this article, I will present several cases in which diversity of culture can lead to conflict, and suggest a way of communication that can help prevent the conflicts arising from those situations.

The present work develops particular qualities in the psychic manifestations of the Traumatic Complex in burn patients with aftereffects, as a result of a disruptive factual event that modifies the coping capacities in the studied group, and the relevance of actions and decisions that health professionals make with the patients. From an analytic approach to the Trauma, it is possible to apply new strategic interventions, centered in the development of better emotional and adaptive responses and adequate recovery of the patients. For this purpose, it is necessary to emphasize interdisciplinary cooperation in clinic and surgical psychoprophylaxis areas working with patients that suffer this organic pathology, practice related to the fundamental principles of Bioethics assistance.

Background: Elder abuse is an increasingly important issue that must be addressed in a systematic and coordinated way.

Objective: Our objective was to evaluate the perceived feasibility of establishing an elder abuse care program at hospital-based sexual assault and domestic violence treatment centers in Ontario, Canada.

Method: In July 2012, a questionnaire focused on elder abuse care was distributed to all of Ontario's Sexual Assault/Domestic Violence Treatment Centre (SA/DVTC) Program Coordinators/Managers.

Results: We found that the majority of Program Coordinators/ Managers favored expansion of their program mandates to include an elder abuse care program. However, these respondents viewed collaboration with a large network of well trained professionals and available services in the community that address elder abuse as integral to responding in a coordinated manner.

Discussion: The expansion of health services to address the needs of abused older adults in a comprehensive and integrated manner should be considered as an important next step for hospital-based violence care programs worldwide.