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Introduction:Genomic research and its applications are no longer reserved for individuals and families with rare diseases. The military has begun to take a more active interest in the real-world insights genomics can give. For exa...
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Introduction:Genomic research and its applications are no longer reserved for individuals and families with rare diseases. The military has begun to take a more active interest in the real-world insights genomics can give. For example, genomics, combined with other health and -omics data, can further our understanding human performance under exigent conditions of heat, stress, sleep deprivation and more. Most notably, this has been the case with the US Air Force, whose MilSeq project is among the forerunners in examining the clinical, scientific and ethical issues that incorporating genomics into the military poses.Defence Research and Development Canada, a branch of the Canadian Armed Forces (CAF), has also begun incorporating genomics into their research activities. In this article, we are the first to examine the bioethical and legal norms that regulate human genomic research conducted by the CAF. We first detail the bioethical context of military genomics in Canada. We then outline issues relating to consent, privacy, genetic discrimination and the return of results. We conclude by reflecting on the increased protections Canadian law and ethics can offer to service members who participate in genomic research.Bioethical context:For genomic research with the CAF, there are two overarching concerns in understanding relevant ethical, legal and social issues. First is that bioethical norms largely have the civilian population in mind.2 Research with human participants undertaken under the auspices of the CAF follow the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS2). Second is that scholarship on the ethical and legal dimensions of military biomedical research does not take the Canadian context into account.
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From April 2022, current Deprivation of Liberty Safeguards (DoLS) will be replaced by Liberty Protection Safeguards (LPS). This review article outlines key information about these changes for patients, carers and healthcare profes...
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From April 2022, current Deprivation of Liberty Safeguards (DoLS) will be replaced by Liberty Protection Safeguards (LPS). This review article outlines key information about these changes for patients, carers and healthcare professionals, for whom a deprivation of liberty may be relevant.Deprivation of liberty occurs within healthcare settings when someone's freedoms are limited in order to meet their care needs and lack capacity to consent to these arrangements. DoLS, enacted in 2009, ensured that patients deprived of liberties in care settings have similar rights to patients held under the Mental Health Act 1983. However, DoLS have been extensively criticised and considered unfit for purpose, therefore are being replaced by LPS.LPS intend to provide a more robust protection to a wider group of vulnerable people. This includes changes to patient age, transferability between a wider range of care settings, a reduced number of assessments for authorisation and less frequent reauthorisations.
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There has been a significant increase in the use of section 136 of the Mental Health Act 1983 in England and Wales, particularly over the past 10 years, but the reasons for this increase remain unclear. This paper presents a histo...
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There has been a significant increase in the use of section 136 of the Mental Health Act 1983 in England and Wales, particularly over the past 10 years, but the reasons for this increase remain unclear. This paper presents a history of English mental-health legislation and the current evidence relating to the use of section 136. It suggests that changing police attitudes, socio-economic factors and diminished resources amongst both the police and mental-health services may have contributed towards its increase. The strain placed on health services may have also resulted in a greater reliance on the police force as an access point to NHS care and could result in the inappropriate use of section 136. With the principle of the 'least restrictive option' at the heart of the Mental Health Act, this advocates the need for reform.
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Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with eth...
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Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics.
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Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with eth...
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Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics.
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The role of medical practitioners in community safety area is huge. Especially huge responsibility medical practitioners have in medical treatment process from the point of view of treatment quality and legal liability. Medical pr...
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The role of medical practitioners in community safety area is huge. Especially huge responsibility medical practitioners have in medical treatment process from the point of view of treatment quality and legal liability. Medical practitioners are professionals regardless of territoriality. The mission and functions they perform do not depend on practice place. The responsibility is equal in both urban and rural level. To protect community safety from the medical practitioners’ perspectives they should know their own rights, as well as patient’s rights in healthcare. From the particular legal regulations arise duties and responsibilities of medical practitioners, which are described in the paper. The aim of the research is to study legislation that regulates medical practitioner‘s rights and duties in Latvia. The task of the paper is to study the characteristics of rights of medical practitioners in Latvia and the medical practitioner’s knowledge of patients’ rights in Latvia. In the research, the author has used general scientific methods such as analysis, synthesis, modelling, comparative method, inductive and deductive method, methods of interpretation of legal norms – grammatical, teleological, historical, as well as empirical method – survey. The paper describes the most important legal regulations in medical practitioner’s activity, as well as defines problems and provides potential solutions that are necessary to protect community’s safety. The results of the paper show that the regulatory framework exists in the field of healthcare of Latvia. Also in the field of professional activity, legal regulations exist, which govern the professional activity of medical practitioners. They are included in various law sectors (civil rights, labour rights, criminal rights, etc.). Apart from that, there exist a large number of legislative regulations of national level, which govern the professional activities of medical practitioners (special laws and Cabinet Regulations). It should be noted, that the competences of medical practitioners are not consolidated, but stipulated in separate legislative provision for each group of medical practitioners (for a doctor, doctor’s assistant, nurse, etc.). The medical practitioner’s knowledge of patients’ rights is not good enough, especially in rural areas of Latvia.
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Context: Pulmonary thromboembolism (PTE) is the severe end stage of many different diseases producing prolonged patient immobilization or a hypercoagulative state. Lethal PTE is also one of the most frequent topics for suspected m...
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Context: Pulmonary thromboembolism (PTE) is the severe end stage of many different diseases producing prolonged patient immobilization or a hypercoagulative state. Lethal PTE is also one of the most frequent topics for suspected medical malpractice, especially when dealing with patients originally affected by non-critical illnesses and suddenly killed by a non-prevented embolic event. The crucial forensic question about a lethal PTE is the following one: was this lethal PTE an unpreventable complication or was it a consequence of real medical malpractice? Materials and methods: The authors analyzed the 1999-2009 autopsy archive of the Institute of Forensic Medicine of Milan University and selected all the cases where PTE was the cause of death. For every selected case, the authors also collected all the available demographic and clinical data. Statistical analysis was performed using SPSS V.16.00. Results: In the period 1999-2009, 129 (1.25%) cases out of a total of 10,288 autopsies were diagnosed as having suffered lethal PTE. The male to female ratio was 1:2 (34.1% versus 65.9%). The mean age at death was 67±18 years. In 41% of cases the death occurred outside of the hospital and in the absence of any medical support; in 36.5% of cases it occurred during the territorial paramedical support or during the very first evaluation in the emergency; and in the remaining 22.5% of cases it occurred during a period of hospitalization. In 33.4% of the selected cases, a typical preliminary event was positively identified: a pure major trauma (18.6%); a trauma followed by a major surgery (7%); a major non posttraumatic surgery (7%); and a non-surgical delivery. Symptoms suggesting PTE were detected in 46 cases (35.7%). Nine cases underwent a judicial autopsy in the same original hypothesis of a medical malpractice for incorrect prophylaxis in acutely bed-restricted patients. Conclusions: Post-surgical PTE cannot be automatically labeled a consequence of medical malpractice. The combination of correct prophylaxis, careful diagnostic monitoring of the high-risk patient and the correct therapy surely reduces the occurrence of lethal PTE, but it does not completely erase such an insidious pathology. In the hypothesis of a causative medical malpractice, only careful analysis by an experienced forensic pathologist can make a reliable distinction between an unpreventable complication and real medical malpractice.
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Biological interventions to improve performance, such as amphetamines, have a long history of military use, and in the future may include more advanced biotechnologies. This article discusses the ethics of using biomedical enhance...
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Biological interventions to improve performance, such as amphetamines, have a long history of military use, and in the future may include more advanced biotechnologies. This article discusses the ethics of using biomedical enhancements in the military. The article begins by describing the distinction between biomedical enhancements and interventions intended to prevent, treat or mitigate disease. It then sets forth three principles to guide the ethical use of bioenhancements-proportionality, paternalism and fairness. The article applies these principles to concerns raised by military bioenhancement: safety, fairness in access to military reward, carryover effects to civilian life, whether service members can be ordered to use bioenhancements and when they may be permitted to do so voluntarily.
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This study aims to improve the organizational system of the Korean Medical Association by comparing its governance to that of the Austrian Medical Chamber. The Austrian Medical Chamber is a legal entity and an interest group, comp...
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This study aims to improve the organizational system of the Korean Medical Association by comparing its governance to that of the Austrian Medical Chamber. The Austrian Medical Chamber is a legal entity and an interest group, composed of the members of nine provincial Medical Chambers. The composition, authority, and duties of the Austrian Medical Chamber are detailed in the Medical Law, and its publicity as a self-regulatory institution is legally guaranteed, such as health care policy decisions and participation in the justice system. The Austrian Medical Chamber enhances the consistency and connectivity of its work with the provincial Medical Chambers through the obligatory participation of their board members. It allows the provincial Medical Chambers to responsibly perform their duties. The Austrian Medical Chamber and related medical laws can be a role model for the Korean Medical Association to achieve authority as a self-regulatory organization.
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For more than 20\xa0years, euthanasia in Belgium and The Netherlands is allowed for unbearable suffering caused by terminal or non-terminal illnesses, including psychiatric disorders. Although euthanasia numbers have been increasi...
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For more than 20\xa0years, euthanasia in Belgium and The Netherlands is allowed for unbearable suffering caused by terminal or non-terminal illnesses, including psychiatric disorders. Although euthanasia numbers have been increasing over the years, the percentage of cases involving people with a primary psychiatric diagnosis has remained stable (between 1 and 2%). For these cases, the Belgian and Dutch Euthanasia Laws operate similar due care criteria: a well-considered, repeated, and voluntary request from a legally competent adult; a medical condition without prospect of improvement; constant and unbearable suffering that cannot be alleviated; consultation of two independent physicians, including a psychiatrist; and a posteriori evaluation and control [1–3].
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