Hasil untuk "Medical legislation"

Amélia Cohn, Josué Souza Gleriano

Este artigo teve como objetivo discutir os desafios para a Reforma Sanitária Brasileira e para o Sistema Único de Saúde na  atualidade. Resgatou-se a literatura mais atual sobre o tema, recuperaram-se alguns de seus traços fundamentais  enquanto processo histórico e de seus atores e remeteu-se à conjuntura política atual no que diz respeito ao Sistema  Único de Saúde. A partir de um estudo exploratório de corte histórico fundado na literatura pertinente, o propósito foi  fomentar reflexões sobre o tema baseadas naquelas análises sobre o movimento sanitário, contribuindo com novos olhares para a questão da saúde como direito frente aos desafios que o Sistema Único de Saúde enfrenta. Reconheceram-se os avanços do movimento sanitário na construção do sistema, com a ampliação do acesso e da cobertura à atenção à saúde segundo os preceitos da saúde como direito, ao mesmo tempo em que se sinalizaram as limitações históricas para  o alcance de seus princípios e diretrizes e as disputas políticas e sociais da atualidade, com vistas a apontar novas  possibilidades para a Reforma Sanitária Brasileira. Concluiu-se pela urgência da atualização das propostas originais da  reforma, da recuperação de sua dimensão de luta política, da ampliação de alianças com diferentes segmentos sociais em  defesa do Sistema Único de Saúde e de retomar a saúde enquanto questão social no interior dos movimentos de  resistência democrática, buscando-se novos espaços e sujeitos políticos em defesa do Sistema Único de Saúde.

R. Inez, A. Figueiredo, I. M. Costa et al.

AbstractIntroduction Nowadays, it has been observed an increase consumption in vitamins and food supplements (FS). In Portugal, in 2018, more than 2 million individuals reported the intake of these products [1]. Media has been given a particular attention to the high prevalence of vitamin D (VitD) deficiency, which may explain its highest consumption [2]. This vitamin increases intestinal calcium absorption and plays a central role in its homeostasis. Although vitD toxicity is uncommon, being a fat-soluble vitamin, excessive supplementation may result in body accumulation and toxicity [3]. The aim of this study is to evaluate if daily dose of vitamin D claimed in FS labels is in conformity with the recommended daily allowances (RDA) for this vitamin defined by European Union Directive and Portuguese legislation [4].Materials and methods A total of 65 FS sold in Portuguese pharmacies, health shops, supermarkets and on the internet were examined for indicated daily intake and dosage of vitamin D. Selection criteria included: oral liquid pharmaceutical forms, for adults or paediatric consumption containing vitD in its composition, as mentioned in the label, regardless of the purpose of the FS.Results 35 (54%) FS presented vitD label doses above RDA and six (9%) of them indicated a daily dose ≥ the tolerable upper intake level defined by EFSA (UL = 100 μg/day) (Figure 1).[Figure: see text]Discussion and conclusions VitD label dose far exceeded RDA value in most of the FS evaluated and some exceeded UL defined by EFSA. Currently, the economic operators who place FS on the market are the responsible for the safety and the authenticity of label data. Attending that these products are often taken without any medical supervision or counselling and vitD excess may trigger adverse effects and also considering that some of these liquid formulations are for children consumption, it increases the concern about FS safety, it is imperative that the daily doses of this vitamin are reviewed in FS, in accordance to RDA values. FS should be under the same quality control of pharmaceuticals, regarding FS consumers health.

Adam A. Ambroziak

The COVID-19 pandemic has been an extraordinary event for the EU Member States and a period wherein EU legislation and the efficiency of EUinstitutions have been put to the test. The crisis triggered by the decisions made by governments in Europe (which were motivated by their wishes to protect the health and lives of their peoples and to satisfy the rapid demand for drugs, personal protective equipment, and medical devices) disrupted market forces. Although most of these measures were based on both domestic and EU legislation, they seriously hindered the smooth functioning of the EU Single Market, including the free movement of goods. This paper aims to find out whether EU legislation succeeded in coping with the challenges triggered by COVID-19 in the field of international trade and whether measures taken by the European Commission with a view to complying with the rules of the EU Single Market adequately took care of the needs stemming from the COVID-19 outbreak and whether it properly tackled protectionist instruments adopted by the Member States. We have focused on international trade and the free movement of goods within the EU as they both constitute the cornerstone of EU economic integration. We found that although EU legislation was not tailored specifi cally for the times of a COVID-19 pandemic, in the area of international trade (including intra-EU trade), as well as in the field of placing goods on the market, it provided extraordinary solutions. Apparently, the explanations and guidelines provided by the Commission have limited the scope of individual protectionist and interventionist actions of the Member States.

Federica Gobbo, Diletta Fornasiero, Maria Alessandra De Marco et al.

The increasing involvement of wild waterfowl in H5 Highly Pathogenic Avian Influenza Virus (HPAIV) circulation continues to pose a threat to animal and public health worldwide. In winter 2020–2021, two field surveillance activities were carried out on a weekly basis, through virological and serological analyses, in 823 hunted and 521 trapped migratory aquatic birds in northeast Italy. Sixty Eurasian teals were recaptured several times, which allowed us to follow the progression of the HPAI H5 infection in naturally infected wild waterfowl. Oropharyngeal, cloacal, and feather swabs (OS, CS and FS) were collected from each duck and tested by real time rRT-PCR Type A influenza. The identified viruses were characterized and pathotyped by sequencing. Several viruses belonging to three different HPAI H5 subtypes were detected: H5N8, H5N5, and H5N1. High prevalence of infection with HPAI H5 clade 2.3.4.4b during November–December 2020 (up to 27.1%) was observed in captured Eurasian teals, while infection rates in hunted dabbling ducks, mainly Eurasian wigeons, showed the highest prevalence of infection in November 2020 (8.9%) and January 2021 (10.2%). All HPAI positive birds were also clinically healthy when recaptured weeks apart. The OS and FS showed the highest detection efficiency of HPAIV. Our results highlight that HPAI passive surveillance should be complemented by a targeted active surveillance to more efficiently detect novel HPAI viruses.

Jenna Uusitalo

Emergency medical service (EMS) forms a sub-category of the internationally recognized right to health. However, despite the codification of the right to health in various human rights conventions which have been implemented in national legislation, EMS still seems to be regarded as an economic expense or a political decision rather than a legal norm or a human right. This paper evaluates the causes for such a misunderstanding, primarily through Scandinavian Legal Realism which emphasizes the social contextualization of law. Supplementary scholarly views, as well as a history of human rights, are also applied to support the main arguments. Essentially, the paper claims that the challenge of recognizing EMS as a legal norm is associated with the relatively abstract and impersonalized nature of emergency care.

R. Gauld, C. Atmore, Joanne Baxter et al.

Brenno Mazzariol, Antonella Pastorini, Alessandro di Luca et al.

Epilepsy is a condition that comprises a group of neurological disorders characterized by seizures. Forms of epilepsy that produce abrupt bouts that cause lapses in consciousness may pose a major road safety problem for drivers who, while going through a seizure, could seriously harm themselves as well as others. A fundamental strategy for the purpose of reducing the risk of car accidents caused by epileptic drivers is constituted by prevention, in addition to adequate pharmacological therapies. In that respect, forensic medicine plays a pivotal role, since it deals with the set of requirements that must be met by those who have been diagnosed with epilepsy in order to get a driver’s license, and with the obligation to signal such individuals to the national Driver and Vehicle Licensing Agency (in Italian: Motorizzazione Civile). In that regard, the Italian legislative framework is partly hazy in some respects, which the authors have set out to analyze herein, taking into account recently issued European norms. The aim of this paper was to better understand the current Italian legislation in the matter of epilepsy and driver’s license requirements, especially regarding the medical criteria that must be met in order to obtain the driving license. The importance of those criteria is underlined by the fact that they directly influence (and are influenced by) the safety for the drivers and for the persons involved in car accidents. Thus, we can consider the issue not only strictly of medico-legal relevance but also from the standpoint of primary prevention. The analysis was conducted by reviewing the most recent documents of medico-legal relevance, in the light of European Union legislation. The authors have ultimately stressed the need for clearer and straightforward regulations, given that professional liability may arise whenever a driver’s license is issued, in disregard of legal norms, to an individual who then causes a road accident.

S. C. Bodley

The College of Physicians and Surgeons of Ontario (CPSO) was at the forefront of policy development as the legislation on medical assistance in dying (MAiD) was coming into force. We provided much-needed guidance to the profession on this important issue after consulting broadly with the public and

Editores Revista de Direito Sanitário

Decisões sobre temas relacionados ao direito à saúde de tribunais da Argentina, Colômbia, Peru e Uruguai.

Святослава Юрнюк, Світлана Савка, Алла Ткач

Святослава Юрнюк, Светлана Савка, Алла Ткач Исторические аспекты развития медицинского права. Резюме. Интенсификация развития общественных отношений обусловливает необходимость правового регулирования различных сфер жизни и возникновения новых отраслей права в правовой системе Украины. Наличие самостоятельной отрасли медицинского права наиболее важная как для общества в целом, так и для самих медицинских работников и пациентов. Реалии последних 10-15 лет обусловили возможность и необходимость выделения ее как самостоятельной отрасли права. Этому способствовали и социально-экономические преобразования в нашей стране (касались здравоохранения) и разработки теоретико-правового характера (наличие необходимых атрибутов и возможность существования медицинского права). В статье акцентируется внимание на развитии национальной правовой системы и формирования новой отрасли права Украины - медицинского права. Ключевые слова: медицинское право, общественные отношения, медицинская помощь, отрасль права, здравоохранение. Svyatoslava Yurnyuk, Svitlana Savka, Alla Tkach Historical aspects of medical law development. Abstract. Intensification of public relations development stipulates the necessity of legal settlement of various spheres of life and emergence of newest branches of law in the Ukrainian legislation system. An independent branch of medical law available is an important thing both for the whole society and medical workers and patients themselves. The reality of the recent 10-15 years has stipulated the possibility and necessity to isolate it as an independent branch of law. It was promoted by social-economical transformations in our state (concerning public health), theoretical-legislative guidelines (essential attributes available and possibility of medical law existence). In recent decades considerable changes have occurred in medical law in Ukraine. Nowadays during economic and social changes caused by transition from the previous system to socially regulated market economy new kinds of social relations appear requiring legal regulation and their investigation. Thus, the human right for health care and medical aid is guaranteed by the Constitution. Correspondingly, an issue is set in front of our Government to create a separate comprehensive branch of medical law. The issues of juridical support of medical activity in Ukraine have become of a special topicality. Undoubtedly, it is connected with the development of private medical practice, elaboration of normative-legal bases concerning the introduction of general compulsory state social medical insurance, application of advanced medical scientific technology and improvement of management in public health care. The article focuses its attention on the development of the national legal system and formation of a new branch of law in Ukraine – medical law. Scientific-theoretical substantiation of the medical law development and introduction of a separate branch – medical law in Ukraine. Medical law is a branch of science associated with investigation of a number of juridical issues in medical work. This scientific subject should be defined as a package of legal, medical and other postulates revealing the main principles and values of medical law. Key words: medical law, public relations, medical aid, a branch of law, health care.

Patricia Cuenca Gómez, María del Carmen Barranco Avilés, María Laura Serra et al.

Article 12 of the Convention on the Rights of Persons with Disabilities provides that persons with disabilities are entitled to full legal capacity on an equal basis with others and obliges State Parties to provide access to the support that they may require exercising this legal capacity. This paper analyzes the main implications of this Article and its impact on Qatar´s legal system, focusing on the general regulation of legal capacity and provisions in the domain of Private Law, including Family Law. We examine how Qatar´s legislation needs to be adapted to the new paradigm of the CRPD, overcoming preconceptions based on the medical model and assistencialism, which is focused on protection, and moving towards the social model and the human rights approach, aimed at promoting the autonomy of persons with disabilities. To comply with Article 12, Qatar must review the legal provisions that allow the deprivation or restriction of legal capacity on the basis of disability and that require “be[ing] of sound of mind” as a condition to perform legal acts or to exercise rights. Qatar must also take action to replace regimes of substituted decision-making with supported decision-making – extending some support mechanisms available in current legislation – and to ensure the respect of the person’s will and preferences.

M. Y. Park, S. Jung

Medical radiation is a very important part of modern medicine, and should be only used when needed and optimized. Justification and optimization of radiation examinations must be performed. The first step of reduction of medical exposure is to know the radiation dose in currently performed examinations. This review covers radiation units, how various imaging modalities report dose, and the current status of radiation dose reports and legislation. Also, practical tips that can be applied to clinical practice are introduced. Afterwards, the importance of radiology exposure related education is emphasized and the current status of education for medical personal and the public is explained, and appropriate education strategies are suggested. Commonly asked radiation dose related example questions and answers are provided in detail to allow medical personnel to answer patients. Lastly, we talk about computerized programs that can be used in medical facilities for managing patient dose. While patient dose monitoring and management should be used to decrease and optimize overall radiation dose, it should not be used to assess individual cancer risk. One must always remember that medically justified examinations should always be performed, and unneeded examinations should be avoided in the first place.

L. Trasande

Diane de Kock

C. Giorgetti, L. Ferrito, F. Zallocco et al.

BackgroundThe incidence of type 1 diabetes in childhood is increasing by 3 % per year, placing growing demands on healthcare professionals and medical expenditures. Aim of this study wars to assess the organization of care to children with diabetes in Italy.MethodsDuring 2012 a structured questionnaire was sent to all of the members of Italian Society of Paediatric Endocrinology and Diabetology (ISPED). Questions examined organizational structure of Centers, personnel dedicated to the care of children with diabetes, number of subjects followed, local legal legislation supporting centres.ResultsA total of 68 centers taking care to 15,563 children and adolescents with diabetes under 18 years of age were identified with a prevalence of 1.4 per 1,000 people. A wide variation in the organizational background was also reported. Fourty-four centers were organized as outpatient departments, 17 as simple units, 5 as complex units and 2 as simple departmental structures. Most centers had a multidisciplinary team. Ten out of twenty Italian regions had introduced supportive regional legislation, but it was fully applied only in six of them.ConclusionGreat differences between regions were found in organizational structures, staffing levels and supportive legislation. The national legislation on diabetes was broadly implemented throughout the country regions. Further efforts are needed to improve standards and consistency of pediatric diabetes care in Italy.

B. Ilse, B. Alt-Epping, I. Kiesewetter et al.

BackgroundIn 2009, palliative medicine became an integrated and compulsory part of undergraduate training in Germany by legislation. After a transitional period, all medical faculties were required to provide adequate teaching with an according examination and certification procedure. In parallel, we conducted bi-annual surveys on all medical faculties in Germany to examine for potential discrepancies between the implementation process and their intended consequences on teaching time and content.MethodsFour consecutive bi-annual surveys (2006, 2008, 2010, 2012) of all 36 medical faculties in Germany were performed, using purposively for this study developed questionnaires. Likert scales and closed questions were analyzed descriptively.ResultsMedical Faculty response rate increased from 50 % in 2006 to 88.9 % in 2012. Teaching coordinators in palliative medicine primarily had an anesthesiology or internal medicine background. There was a noted increase over time of the involvement of specialized palliative care units (PCUs) as providing the setting for education. The number of faculties that were able to offer a complete 16 weeks of training in palliative medicine during the “final year” rose steadily. In addition, increased patient-centered teaching formats have been implemented over time. The faculties which offered innovative teaching formats with actors as patients (standardized patient interaction) increased, as did the total number of mandatory examinations. The number of faculties that provided compulsory teaching in a condensed manner within a single academic year increased sharply from 3 of 31 responding faculties in 2010 to 19 of 32 responding faculties in 2012.ConclusionsUntil now, teaching conditions and structures in palliative medicine in Germany have proven to be extraordinarily heterogeneous. Although professorships (“Chairs”) in palliative medicine proved to be particularly beneficial and supportive in curricular and structural development, only a minority of faculties provide leading academic positions in palliative medicine.

Singh Anjali, Choksi Maulik

Recognition of right to health is an essential step to work towards improvement of public health and to attain highest standard of physical and mental health of the people. Right to health in India is implicit part of right to life under Article 19 mentioned in the Constitution of India but is not recognized per se. Universal Health Coverage adopts rights based approach and principles of universality, equity, empowerment and comprehensiveness of care. The Universal Coverage Report of India makes recommendations in six identified areas to revamp the health systems in order to ensure right to health of Indians. These areas are: health financing and financial protection; health service norms; human resources for health; community participation and citizen engagement; access to medicines, vaccines and technology; management and institutional reforms. This paper attempts to determine the ways in which Universal Health Coverage can make a contribution in realizing right to health and thus human rights in developing countries.

M. Burge, D. Schade

M. Waggoner

C. Harvey