This volume provides a comprehensive analysis of the history, development and other legal aspects relating to International Medical Law and covers issues arising from not only the physician-patient relationship, but also with many wider juridical relations involved in the broader field of medical care in the international arena.00After a general introduction, the book examines the evolution of medical law in different civilizations that existed all over the world. It systematically describes the sources of this law from conventions, (...) treaties along with discussing the important role played by the courts, international institutions and other bodies related to the medical field. The comprehensive coverage includes public health law, international spread and prevention of diseases. This volume covers medical ethics and clinical ethics; considerations to facets of the medical professionals and patients relationship such as rights and responsibilities of the physicians, beneficence, consent, privacy, rights of patients and risk management. Also covered are issues of international concern like medical criminal activities, human and drug trafficking, trade in human organs, human medical research, as well as matters dealing with bio-technology in relation to bio-safety, bio-security, bio-genetics, bio-ethics, and the role of medical personnel in armed conflicts. (shrink)

This article presents an analysis of contractual relations in sport from the standpoint of the Croatian legislative system. Due to the complexity of the subject matter, the author considers only a small fragment of it - the significance and the role of sport in Croatian society and the law of contracts „as a cornerstone on which „sports law“ has been built and which is of primary importance in most areas where there is an interface between sport and the law, irrespective (...) of whether the sport is being played at an elite level or at a more humble one“. Bearing in mind the limited extent of this article, the autor tries to provide some clarifications and some guidance on how to deal with the designation and the determination of the applicable law for contracts in the sporting context. Considering that there are different legal regimes which may come into play with regard to the designation of the law applicable to contracts in the sporting context, the author first presents the determination of the applicable law according to the Rome I Regulation and then according to the Croatian Arbitration Act, Swiss Private International Law Act and the CAS Code of Sports-related Arbitration, as the most common in sports practice. Then, the author deals with contracts concluded with minor athletes and the determination of the law applicable to some preliminary questions. Finally, the author presents her perception of the problems encountered and some suggestions for the improvement of the existing legal framework. (shrink)

Introduction: making the invisible visible -- The nobility of the material -- Research at war -- The guilded age of research -- The doctor as whistle-blower -- New rules for the laboratory -- Bedside ethics -- The doctor as stranger -- Life through death -- Commissioning ethics -- No one to trust -- New rules for the bedside -- Epilogue: The price of success.

Womit beschäftigt sich die medizinische Wissenschaft? Ich verstehe ja natürlich nichts davon, aber sie beschäftigt sich doch mit dem Menschen. Und die Juristerei, die Gesetzgebung und Rechtsprechung? Auch mit dem Menschen.

Rhetoric -- Paradox -- Space -- Time -- Utopia -- Progress -- Art -- Ethics.

It is reasonable to consider and trust that information taken from us about our medical health and history will be protected by rules on confidentiality and consent. Apart from very rare cases, perhaps of major public interest or for public health reasons, this information will not be shared with others without our consent. However, both a number of reforms in National Health Service patient data management policy (now enshrined in legislation) and developments in the general law on privacy (...) challenge this traditional view of our control and choice over our medical information, as this article will show. In doing so, it analyses the question as to whether in spite of the rhetoric do any of us now really have choice over the access to and use of our medical data? In reality, our choices are limited and in any relationship of trust and shared decision making this ought to be transparent. (shrink)

Recently, Australia became the second jurisdiction worldwide to legalize the use of mitochondrial donation technology. The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 allows individuals with a family history of mitochondrial disease to access assisted reproductive techniques that prevent the inheritance of mitochondrial disease. Using inductive content analysis, we assessed submissions sent to the Senate Committee as part of a programme of scientific inquiry and public consultation that informed drafting of the Bill. These submissions discussed a range of bioethical (...) and legal considerations of central importance to the political debate. Significantly, submissions from those with a first-hand experience of mitochondrial disease, including clinicians and those with a family history of mitochondrial disease, were in strong support of this legislation. Those in support of the Bill commended the two-staged approach and rigorous licencing requirements as part of the Bill’s implementation strategy. Submissions which outlined arguments against the legislation either opposed the use of these techniques in general or opposed aspects of the implementation strategy in Australia. These findings offer a window into the ethical arguments and perspectives that matter most to those Australians who took part in the Senate inquiry into mitochondrial donation. The insights garnered from these submissions may be used to help refine policy and guidelines as the field progresses. (shrink)

The repeal of the Eighth Amendment was a turning point in Irish social history, especially in relation to the Catholic Church. But abortion is not a settled matter and it will continue to generate controversy. Likewise, issues such as surrogacy and assisted dying will give rise to sharp differences of opinion. Legislation that seeks to address bioethical issues such as these will inevitably provoke demands for amendments or repeal. By examining developments in biomedical science, Irish law and some central (...) aspects of Catholic moral teaching, Don O'Leary builds a thorough analysis of the controversies relating to: contraception, abortion, IVF, surrogacy, human embryonic stem cell research, assisted suicide, church control of healthcare services. Biomedical Controversies in Catholic Ireland is essential reading for anyone who wishes to understand the historical background, ethical arguments and scientific advances that will inform debates about morality and social policy in the coming years. -- (from amazon.com). (shrink)

The British Parliament stated that health services would be covered by the Disability Discrimination Act 1995 . However, when people with disabilities are at their most vulnerable, for example when in hospital or subject to medical procedures, the antidiscrimination law fails them. A review of cases indicates that when people with disabilities are subject to medical treatment, the legislative protections are allowed to vanish. Instead, medical decisions are justified on obscure notions such as “best interests”, often with (...) irreversible or even terminal results. This article examines the relevant provisions and limitations of the act, the features of notable non-treatment decisions, and the act's potential to guide future decision making. It argues that antidiscrimination legislation should be assertively applied to protect vulnerable people. (shrink)

This book discusses feature films that enrich our understanding of doctor-patient dilemmas. The book comprises general clinical ethics themes and principles and is written in accessible language. Each theme is discussed and illuminated in chapters devoted to a particular film. Chapters start with a discussion of the film itself, which shares details behind the making of the film; critical reception; casting and other facts about production. The chapter situates the film in a history of medicine and medical sociology context, (...) analyzes ethical issues raised in the film from a clinical ethics lens, and explains to readers how to use each film as a teaching aid for clinical ethics. Readers will understand how each film in this collection served to bring particular clinical ethics issues to the public’s attention, or reflected medico-legal issues that were part of the public discourse. The book is a perfect instructor's guide for anyone teaching bioethics, healthcare ethics, medical sociology, medical history, healthcare systems narrative medicine, or nursing ethics. (shrink)

This comprehensive historical exploration investigates the intricate relationship between religion and the evolution of civil laws. Throughout human history, the interplay between religious beliefs and legal systems has profoundly shaped societies and governance structures. From ancient civilizations to the modern era, religious authorities and teachings have acted as catalysts in shaping civil laws, often with the goal of promoting social justice. This article embarks on a journey through time, unraveling the multifaceted connections between religion and the development of (...) legal frameworks. In numerous societies, religious doctrines formed the cornerstone of civil laws and regulations. The majority of civilizations witnessed priests assuming pivotal roles as lawmakers, effectively coupling civil laws and religious practices. By examining various historical civilizations, this study illustrates how religious norms and practices were intertwined with legal codes, revealing instances where religious teachings played a crucial role in promoting adherence to laws. The transition to modern times witnessed the emergence of alternative means for law enforcement, yet religion’s role persisted as an internal driving force for fostering law-abiding behavior. Drawing from examples such as the Code of Hammurabi, Islamic legal traditions, and the Roman Twelve Tables, this article showcases historical instances where religious values contributed to legal principles centered around equity, justice, and morality. Additionally, the study explores how religion’s influence shifted over time, from early religious leaders acting as legislators to the establishment of more secular legal systems. (shrink)

We should now be able to come to some general conclusions about the main lines of Cuvier's development as a naturalist after his departure from Normandy. We have seen that Cuvier arrived in Paris aware of the importance of physiology in classification, yet without a fully worked out idea of how such an approach could organize a whole natural order. He was freshly receptive to the ideas of the new physiology developed by Xavier Bichat.Cuvier arrived in a Paris also torn (...) by many overlapping debates on the nature of classification, and in particular that between the natural and artificial systems. The very validity of the enterprise of classification was questioned in many quarters. Cuvier's achievement on his entry into the Parisian world of science was not simply to establish himself as a highly competent anatomist: far more important, he also began to use ideas from many different specialties to change completely the notion of what was involved in natural history.124 At the same time that he himself swung away from the guiding image of the field naturalist as the ideal of the specialty, he took ideas from the new physiology to answer questions about the order of the animal world, and from comparative anatomy to resurrect extinct creation — and to come to conclusions from that creation about the history of the forms of life and the manner of their succession. He showed himself able to alter the relationships between natural history and many other fields of study in a way that implied, rightly or wrongly, his own complete mastery over such a movement. Partly he was able to do this because the ideas he borrowed were not themselves logically articulated and thus could be easily adapted and refocused for many different specific purposes. The value of the heuristic possibilities inherent in the idea of life, for example, far outweighed its inability to generate full systems of classification. Cuvier also consistently refused to consider in science matters relating to the first causes of events. Freed from the consideration of first-order phenomena, he was able to use second-order explanations across a far wider field of applicability. Personal doubts about the validity of a theology that had used science in order to bolster its own claims were combined here with the strong influence of the Kantian critique of the limits of human reason.125Cuvier's characteristic mode of procedure was that of intellectual appropriation and a bold capacity for altering the relationships between different fields of knowledge, rather than, with the exception of taxonomy, the technique of expanding their subject matter. His claims to originality came, first, from this reappropriation and reorientation and, second, from the sheer scope of his work, which aimed at nothing less than the cataloging and classification of all animate objects.126 They rested also on his acute use of his assertion of a certain relationship with the past of his subject. Very often he would present this history in such a way as to obscure his own intellectual genealogy, and often too he would give differing accounts of the priority of use of an idea in order to distract attention from the questionable exactitude of his own claims to originality. Cuvier came to Paris at precisely the time when society and institutions were most profitably malleable for a newcomer; it was also a time when many scientific disciplines had reached a stage advanced in terms of their factual content, yet relatively inadequate in conceptual organization. They were ripe for takeover by large-scale organizing ideas such as the animal economy and the subordination of characteristics. Paleontology is a particularly good example of a specialty in this particular form of underdevelopment in 1795.Cuvier paid a high price for his initial success. His electic applications of large-scale organizing ideas tended to mean that little of his own work had complete coherence at all levels. Ideas, as we have seen, that proved capable of providing a complete reform of the larger groups of the animal kingdom were incapable of producing its detailed working-out in the taxonomy of smaller groups, which had to be supplied from observed analogical correlations. Further, his physiological approach to classification involved the breakdown of strict correspondence between organs and functions, which left the way open for workers such as Geoffroy St. Hilaire gradually to tilt the balance away from the study of the correlations of hierarchies of functions, and toward morphology as the basis of the order of nature. Cuvier's brilliant appropriations from physiology from the beginning, therefore, contained the seeds of conflict with Geoffroy.Cuvier's eclectic approach made it very nearly impossible for him to present a clear idea of the ways in which the life sciences could be said to be lawful. In spite of his efforts to assimilate them to the position of the physical sciences in this respect, he was forced in the end to accord only an ambiguous status as “laws” to observational correlations. From this area of failure came much of the attempt to give his own two laws — the correlation of parts and the subordination of characteristics — predictive qualities, particularly in relation to paleontological research.It is not surprising that Cuvier's title as the “legislator” of natural history should represent more a claim than a reality. How, then, was he able to emerge as the leading French naturalist of his day? First of all must be adduced the sheer scale of his undertakings. Then comes his expertise as a practical anatomist, and the range of different topics toward which he turned his interest. His collaborators cannot be given credit for his output nor, as we have seen, for slavish adherence to his ideas. Cuvier was able to successfully claim to have dominated the underdeveloped specialties, such as paleontology, and turned them into a major heuristic input into both geology and comparative anatomy; but in other fields, such as physiology, he appropriated concepts and encouraged research but made little impact on the field himself. His attempts in 1812 to head off, or neutralize and absorb the growth of morphological studies landed him in a dangerously rigid position, which despite his encouragement of the new physiological research under the Restoration made further elaboration of his own conceptual underpinnings almost impossible.Cuvier's authority in the scientific world would in any case have been great because of his substantive achievement in taxonomy, but the rest of his work had enough ambiguities and dislocations for it to need the support of his political and social power. Cuvier's detractors seized on a vital fragment of the truth when they accused him of finding the political dimension all-important: it obscured the disjunctions in his theories and at the same time gave him the authority to make new claims for the status of the observational sciences - and for their relations of power with their surrounding specialties. Cuvier's science both thrived on and was halted by the power games of intellectual appropriation, manipulation of the past to confirm the present, and continual claims for hegemony. (shrink)

The main question explored by the book is: How can cross-border access to human genetic resources, such as blood or DNA samples, be governed in such a way as to achieve equity for vulnerable populations in developing countries? The book situates the field of genomic and genetic research within global health and research frameworks, describing the concerns that have been raised about the potential unfairness in exchanges during recent decades. Access to and sharing in the benefits of human biological resources (...) are aspects not regulated by any international legal framework such as the Convention on Biological Diversity, which applies only to the exchange of plants, animals and microorganisms, as well as to associated traditional knowledge. Examples of genetic research perceived as exploitative are provided in order to illustrate the legal vacuum concerning the global governance of human genetic resources. The main conclusions drawn from the legal and ethical analysis are: - Benefit sharing is crucial in order to avoid the exploitation of developing countries in human genetic research. - With functioning research ethics committees, undue inducement is less of a concern in genetic research than in other areas of medical research (e.g. clinical trials). - Concerns remain over research involving indigenous populations; accordingly, recommendations are provided. In drawing these conclusions, the book addresses in detail a highly pressing topic in global bioethics and international law. In this regard, it combines bioethical arguments with jurisprudence, in particular with reference to the law of equity and the legal concepts of duress (coercion), unconscionable dealing, and undue inducement. (shrink)

The Patient Protection and Affordable Care Act, passed in 2010, is considered by many to be the most significant healthcare overhaul since the 1960s, but part of its promise — improvement of population health through requirements for non-profit hospitals to provide “community benefit” — has not been met. This paper examines the history of community benefit legislation, how community benefit dollars are allocated, and innovative practices by a few hospitals and communities that are addressing primarily non-medical factors that (...) influence health such as social disadvantage, attitudes, beliefs, risk exposure, and social inequalities. (shrink)

This classic textbook focuses on medical law and its relationship with medical practice and modern ethics. It provides thorough coverage of all of the topics found on medical law courses, and in depth analysis of recent court decisions, encouraging students to think analytically about the subject.

Australia is second only to Israel in being the world’s most culturally diverse nation, based largely on high levels of immigration in the second part of the 20th century. From the 1970s onwards, Australia formally recognized the massive social changes brought about by postwar immigration, and provided legislation to incorporate cultural diversity into everyday lives. One such ‘legislative’ enactment saw the establishment of multicultural broadcasting in Australia, as arguably a world-first, both in its comprehensiveness and diversity. Today, Australia has (...) a public sector corporation, the Special Broadcasting Service, administering five radio services in 68 languages. Also, the Community Radio sector produces multicultural programming in 100 languages through a number of its 330 broadcast and 207 narrowcast stations. This article examines the relationship between radio and its communities. It argues that despite the ‘profile’ of SBS television, radio is much closer to its constituent communities, and therefore plays a greater role in enabling those communities to speak their own histories, beyond the confines of a consensual Anglophile paradigm. (shrink)

HIV-related state laws are being created transnationally though the use of omnibus model laws. In 2004, the US Agency for International Development funded the creation of one such guidance text known as the USAID/Action for West Africa Region Model Law, or N'Djamena Model Law, which led to the rapid spread of HIV/AIDS laws, including the criminalisation of HIV transmission, across much of West and Central Africa . In this article, I explicate how an epidemic of highly problematic (...) legislation spread across the region as a result of a text-mediated work process enabled through model laws. I theorise the textual genre of model laws arguing that these texts are best understood as ‘preoperative documents’ which, when activated, can lead to swift legislative reform in and beyond the field of HIV/AIDS governance. The legislative process being investigated was made visible through participant observation, archival research, textual analysis and informant interviews with national and international stakeholders . This involved ethnographic research in Canada, the USA, Switzerland, Austria, South Africa and Senegal . The untold policy processes and narratives explored in this article make evident how the work of contesting problematic HIV/AIDS model laws and newly drafted state laws involves both creating new texts and contesting the legitimacy and efficacy of others. (shrink)

This book offers a new perspective on advance directives through a combined legal, ethical and philosophical inquiry. In addition to making a significant and novel theoretical contribution to the field, the book has an interdisciplinary and international appeal. The book will help academics, healthcare professionals, legal practitioners and the educated reader to understand the challenges of creating and implementing advance directives, anticipate clinical realities, and preparing advance directives that reflect a higher degree of assurance in terms of implementation.

The role of physicians in armed conflict -- International humanitarian law -- International criminal law -- Customary status of international humanitarian law -- The relevant human rights norms applicable to the work of physicians in armed conflict -- The interpretation of the reference to medical ethics and generally accepted medical standards pursuant to the Vienna Convention on the Law of Treaties -- Medical ethics in international law -- A pluralistic approach to medical ethics -- The documents (...) by the World Medical Association (WMA) -- Conclusion, recommendations and outlook. (shrink)

Genetic discrimination is becoming an increasingly important problem in the United States. Information acquired from genetic tests has been used by insurance companies to reject applications for insurance policies and to refuse payment for the treatment of illnesses. Numerous states and the United States Congress have passed or are considering passage of laws that would forbid such use of genetic information by health insurance companies. Here we argue that much of this legislation is severely flawed because of the (...) difficulty in distinguishing genetic from nongenetic tests. In addition, barring the use by insurance companies of a genetic test but not a nongenetic test (conceivably for the same multifactorial disease) raises issues of fairness in health insurance. These arguments suggest that ultimately the problems arising from genetic discrimination cannot be solved by narrowly focused legislation but only by a modification of the entire health care system. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:preface This issue of Feminist Studies explores the ways institutions—legal, governmental, medical, educational, and household—participate in the gendering of bodies and are themselves gendered. At any given historical moment, dominant and resistant meanings of “women,” “gender,” and “sexuality” are socially and politically constituted in institutions through cultural struggles. The authors in this issue discuss how birth control, assisted reproduction, transsexual transition, hegemonic masculinity, abortion, and domestic violence are (...) each articulated and contested in imperial law and economic discourses (Sreenivas), in medical procedures (Whitehead et al. and DasGupta), in university research regulations (Barnes and Munsch), and in the official practices of presidents (Mattingly ). Our authors elucidate how such institutions are gendered, not just in terms of staffing by males, females, and nongender conforming people, but also in the ways they constitute gender relations in their everyday operations. The articles point to the continuing need for institutional histories and ethnographies that are feminist in conception and design. They also provide openings into more progressive gender and sexuality politics by underscoring the contradictions within all institutions. Mytheli Sreenivas’s “Birth Control in the Shadow of Empire: The Trials of Annie Besant, 1877–1878” visits the contradictory history of institutions of reproduction control. She traces Besant’s contraception advocacy in the 1870s, reminding us of its intimate and unsavory entanglements with the politics of empire. Annie Besant is a complicated figure. South Asianists familiar with her later campaign against British colonialism in India might well be surprised by this earlier incarnation, but Sreenivas demonstrates how and why the early Besant held contradictory positions. As an individual, Besant questioned gender norms and challenged the inequality of women in marriage and divorce. She recognized sexual desire as “natural” (albeit only properly expressed via heterosexual marriage). Yet a signature feature of her political writing 504Preface was an embrace of neo-Malthusianism. Over the course of her activist life, Besant redirected her attention from poverty and women’s health in Britain to contraception as the solution to starvation and overpopulation in India. She did so in “a broader context in which a defense of empire and class-race hierarchy enjoyed far greater legitimacy than a critique of gender and sexual norms.” The repercussions of her actions were global: “Besant’s efforts rendered contraception into a sexual technology that claimed to address the economies of impoverishment in an emerging imperial world. Birth control thus emerged as both an imperial responsibility and as a demonstration of British humanitarianism in support of starving colonized populations.” Sreenivas explicates what the Besant trials reveal about the multiple histories of reproduction control and the conditions under which birth control continues to be both a technology for large-scale population control and “a vehicle for women’s reproductive freedom and gender justice.” Institutions are saturated with power, but they are also arenas where political struggles between different social groups are staged. This is especially evident in White House politics in the United States. In the late 1970s, President Jimmy Carter appointed a large number of women to bureaucratic offices. Many were feminists. Why did they fail to deliver gender justice? This is the puzzle Doreen J. Mattingly seeks to answer in “The Limited Power of Female Appointments: Abortion and Domestic Violence Policy in the Carter Administration.” The article is set in the broader context of a moment in history when the US feminist movement was moving from the streets to state bureaucracies, when women of color had broadened the movement’s mandate, and when the need for government programs to support poor women was a clearly articulated feminist goal. There was an excitement about transforming gender relations as feminists populated multiple organizations and came together to collaborate. However, two important legislative efforts—government funding for abortions for poor women and a national anti-domestic violence bill—failed. Mattingly traces the back and forth between Carter and his Assistant Secretary for Public Liaison, Margaret “Midge” Costanza, drawing on new archival sources. Mattingly’s article underscores how women in public office can be discursively valorized as symbols of change even while politically powerful men oppose meaningful policy that would provide women greater autonomy over their reproductive or violently transgressed bodies. Mattingly’s careful reconstruction... (shrink)

This 12-chapter text prepares students to understand the legal and ethical issues inherent to working in an ambulatory health care setting. It features pertinent legal cases, anecdotes, and sidebars related to health-related careers. Content has been updated and special attention has been paid to legislation affecting health care.

Tax law is a technical area of law which does not seem to be culturally specific. It is thus seen as easily transferable between different societies and cultures. However, tax law is also based on definitions and notions which are not universal. So, is tax law universal or particular? Is it indeed easily transferable between different societies? And in what ways does tax law reflect ethnic or cultural rather than economic differences? This Article seeks to answer these questions by analyzing (...) one specific example — the history of income tax legislation in Mandatory Palestine. This history reveals the dual nature of income taxation. On the one hand, the Income Tax Ordinance which was enacted by the British in Palestine in 1941 was based on a one-size-fits-all colonial model, and the lawyers involved in its enactment, in Palestine and in the Colonial Office in London, made relatively little effort to adapt it to local conditions. On the other hand, other actors — the officials, politicians and businessmen involved in the initial debate about the imposition of income taxation in Palestine in the 1930s, and the administrators involved in the application of the specific rules of the Ordinance after it was enacted in the 1940s — were aware of the need to adapt the law to the specific conditions of Palestine. Thus, while on a formal level the Ordinance seems to represent a process in which the tax law of Palestine converged with that of other British colonies, once we expand our framework and examine not just law in the books, but also law in action, and actors such as politicians and administrators, we discover that particular local conditions were an important factor in the enactment and application of the Palestine Income Tax Ordinance. The study of the process of transplantation, the Article concludes, should therefore focus not only on the formal norms being transplanted, but also on the role of the different non-legal actors involved in the process. (shrink)

After briefly sketching an historical account of criminal law that emphasizes its longstanding reach into social, commercial and personal life outside the core areas of criminal offenses, this paper explores why criminal law theory has never succeeded in limiting the content of criminal codes to offenses that fit the criteria of dominant theories, particularly versions of the harm principle. Early American writers on criminal law endorsed no such limiting principles to criminal law, and early American criminal law consequently was substantively (...) broad. But even with the rise of theories in the mid-nineteenth century that sought to limit criminal law’s reach, codified offenses continued to widely and deeply regulate social life and exceed the limits of those normative arguments. This essay suggests that this practical failure of criminal law theory occurred because it was never adopted by an institutional actor that could limit offense definitions in accord with normative commitments. Legislatures are institutionally unsuited to having their policy actions limited by principled arguments, and courts passed on the opportunity to incorporate a limiting principle for criminal law once they began, in the Lochner era, actively regulating legislative decisions through Constitutional law. The one avenue through which criminal law theory has had some success in affecting criminal codes is through the influence of specialized bodies that influence legislation, especially the American Law Institute advocacy of the Model Penal Code. But the institutional structure of American criminal law policymaking permits an unusually small role for such specialized bodies, and without such an institutional mechanism, criminal law theory is likely to continue to have little effect on actual criminal codes. (shrink)

Abstractabstract:Cardinal Sforza Pallavicino, SJ (1607–67), conceived a procedure for determining natural moral laws by voting under a veil of ignorance. Behind this veil, imagined possible people who are ignorant of their social position, personal characteristics, nation, and the historical period in which they live vote as equals. These possible people are asked to establish a moral law in pursuit of their own and collective happiness, which they are obligated by God to follow. This article discusses Pallavicino's innovative approach to (...) natural law and examines its reception in Southern Germany and (what is now) Austria. (shrink)

Determining appropriate legal responses to the conduct of health care workers who endanger patients continues to provoke fierce debate. This is particularly true in the context of criminal law, which offers punishment as an obvious strategy. In the first of three papers which make up this issue's extended Health Care Law feature, Professor Alexander McCall Smith and Dr Alan Merry argue against the prosecution of health care workers except in circumstances where there is very dear evidence of a culpable frame (...) of mind. They do so against the backdrop of their description of proposed changes in New Zealand legislation on medical manslaughter. The catalyst for this change was a judge's refusal to countenance the prosecution of an anaesthetist for manslaughter for inadvertent error. In the authors' opinion the intervention by the New Zealand judge has given rise to a long overdue review of a harsh penal measure. However, in a commentary on McCall Smith and Merry's paper, Ron Paterson argues that all is not what it seems and that--in the light of New Zealand's 'no fault' system of compensation for medical accident--the present system should be maintained. (shrink)

Medical laws and legislation; comparative study.

Drawing from a wide range of primary historical and sociological sources, this book presents medical ethics in China from a Chinese-Western comparative perspective, and in doing so it provides a fascinating exploration of cultural differences and commonalities exhibited by China and the West in medicine and medical ethics. The book focuses on a number of key issues in medical ethics including: attitudes towards foetuses; disclosure of information by medical professionals; informed consent; professional medical ethics; and (...) human rights. This careful examination not only provides insights into Chinese viewpoints, but also sheds light on the appropriate methods for comparative culture and ethical research. Through its analysis, Jing-Bao Nie seeks to put forward a theory of "transcultural bioethics", an ethical paradigm which upholds the primacy of morality whilst resisting cultural stereotypes, and appreciating the internal plurality, richness, dynamism and openness of medical ethics in any culture. Medical Ethics in China will be of particular interest to students and academics in the fields of Medical Law, Bioethics and Medical Ethics as well as Chinese/Asian Studies and Comparative (Chinese-Western) Cultural Studies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Brief History of Medical Ethics Code in PolandJacek A. Piątkiewicz (bio)On March 15, 1934 a Parliamentary Act authorized the General Medical Chambers, a body incorporating all Polish physicians, to establish general rules of medical ethics. These rules governed medical conduct in Poland until 1950, when the Communist government dissolved the General Medical Chambers.From 1950 to 1989 the only medical organization in Poland (...) tolerated by the Communist government was the Polish Medical Association, which included about 30% of the country's physicians. In 1967 this group produced the "Collection of Ethico-deontological principles of the Polish Physician" which constituted a kind of code of medical ethics. This collection was a compromise between objective ethical principles and the demands of the Communist regime. For example, Principle 1 of the Collection stated that the physician "had to observe the ethico-deontological principles obligatory in socialist society."During round-table talks in early 1989 with representatives of the Communist government, the Solidarity movement argued for the revival of autonomous medical organizations like the Medical Chambers. On May 17, 1989 an Act of Parliament re-established the group. The Act (article 33, part 1) also stipulated that the National Congress of Physicians, the legislative body of Medical Chambers, establish rules of medical ethics. The Act (article 15, part 1) also states that all practicing Polish physicians are obliged to observe these rules.When the revived Chambers began its work in January 1990, its governing body—the General Medical Council—created a Commission to prepare a draft of a medical ethics code. After a year and a half of work, the Commission completed its draft, which received preliminary acceptance by the General Medical Council. [End Page 361]On December 13-14, 1991 the Extraordinary Second National Congress of Physicians was held in Bielsko-Biala (South Poland) and one of the main items on the agenda was the Code. Every article of the Code was discussed exhaustively throughout the second day of the meeting, and close to midnight the Code, including the Physician' Oath, was approved by an overwhelming majority (449 for, 75 against, 58 abstaining).Some of the liveliest discussion centered on Article 37, which relates to abortion. The delegates realized that the Code was inconsistent with a 1956 Act on abortion then under discussion in the Parliament which was not as restrictive as the Code. They decided to defer implementation of the Code for five months, until May 3, 1992. As described in the following text by Robert Baker, Article 37 has now been appealed and a decision resolving the discrepancy would have to come from Poland's Constitutional Tribunal or its Parliament. [End Page 362]Jacek A. Piątkiewicz Jacek A. Piątkiewicz, M.D., Ph.D., is Chairman of the Legislative Commission of the General Medical Council of Poland in Warsaw.Copyright © 1993 The Johns Hopkins University Press... (shrink)

The law has therefore had two conflicting impacts on medical ethics: the positive effect of eroding paternalism and replacing it with a patient-centered ethic; and the negative effect of encouraging physicians to be more concerned with avoiding litigation than doing the "right" thing.

Background: The Albanian medical system and Albanian health legislation have adopted a paternalistic position with regard to individual decision making. This reflects the practices of a not-so-remote past when state-run facilities and a totalitarian philosophy of medical care were politically imposed. Because of this history, advance directives concerning treatment refusal and do-not-resuscitate decisions are still extremely uncommon in Albania. Medical teams cannot abstain from intervening even when the patient explicitly and repeatedly solicits therapeutic abstinence. The Albanian (...) law on health care has no provisions regarding limits or withdrawal of treatment. This restricts the individual's healthcare choices.DiscussionThe question of 'medically futile' interventions and pointless life-prolonging treatment has been discussed by several authors. Dutch physicians call such interventions 'medisch zinloos' (senseless), and the Netherlands, as one of the first states to legislate on end-of-life situations, actually regulates such issues through appropriate laws. In contrast, leaving an 'advance directive' is not a viable option for Albanian ailing individuals of advanced age. Verbal requests are provided during periods of mental competence, but unfortunately such instructions are rarely taken seriously, and none of them has ever been upheld in a legal or other official forum.SummaryEnd-of-life decisions, treatment refusal and do-not-resuscitate policies are hazardous options in Albania, from the legal point of view. Complying with them involves significant risk on the part of the physician. Culturally, the application of such instructions is influenced from a mixture of religious beliefs, death coping-behaviors and an immense confusion concerning the role of proxies as decision-makers. Nevertheless, Albanian tradition is familiar with the notion of 'amanet', a sort of living will that mainly deals the property and inheritance issues. Such living wills, verbally transmitted, may in certain cases include advance directives regarding end-of-life decisions of the patient including refusal or termination of futile medical treatments. Since these living wills are never formally and legally validated, their application is impossible and treatment refusal remains still non practicable. Tricks to avoid institutional treatment under desperate conditions are used, aiming to provide legal coverage for medical teams and relatives that in extreme situations comply with the advice of withholding senseless treatment. (shrink)

In an effort at ethical reform, Taiwan recently revised the Hospice Palliative Care Law authorising family members or physicians to make surrogate decisions to discontinue life-sustaining treatment if an incompetent terminally ill patient did not express their wishes while still competent. In particular, Article 7 of the new law authorises the palliative care team, namely the physicians, to act as sole decision-makers on behalf of the incompetent terminally ill patient's best interests if no family member is available. However, the law (...) fails to provide guidance as to what constitutes the patient's best interests or what specific procedures the treating physicians should follow, and so has raised constitutional concerns. It may be difficult to translate ethical reform into law but it is not impossible if essential requirements are carefully followed. First, there must be substantial nexus between the purpose of the statute and the measures provided under the statute. Second, advocates need to convince the public that futility or waste has amounted to a public health emergency so as to justify lower procedural requirements. Third, a remedy or compensation should be available if the surrogate decisions have not been appropriately made. Fourth, minimum procedural safeguards are necessary even though the statute is intended to reduce the procedural burdens of making surrogate decisions on behalf of incompetent patients who lack family members and did not express their wishes while still competent. (shrink)

Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action (...) to address variation in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)

Today the medical community faces a number of pressing issues. Molecular and high-tech medicine, despite their tremendous successes, also burden us with new ethical dilemmas: when and how to die, whose life to preserve, whether to modify genes and to create life, and how to pay for it all. Furthermore, alternative methods appear to work at least for certain disorders. They are popular and definitely cost less, while the spiraling costs of conventional medicine have led to the development of (...) managed care and health economy assessments with controversial consequences. An international symposium in Berlin, in September 1999, sought to address some of these issues by sparking an interdisciplinary discussion gathering leading experts in the field of genetics, robotic surgery, medical ethics, preventive health and health economics, history, and law. This book contains all the contributions and seeks to involve scholars and medical practitioners who are interested in shaping the future of medicine. (shrink)

Policy‐makers, bioethicists, and patient advocates have been engaged in a fierce battle about the merits and potential harms of a federal right‐to‐try law. This debate about access to investigational medical products has raised profound questions about the limits of patient autonomy, appropriate government regulation, medical paternalism, and political rhetoric. For example, do patients have a right to access investigational therapies, as the right‐to‐try movement asserts? What is government’s proper role in regulating and facilitating access to drugs that are (...) still in development? In this review, we analyze the history of the right‐to‐try movement, review the arguments put forth by supporters and opponents of the legislation, and consider the movement’s consequences. Two possible scenarios may emerge. One is that the right‐to‐try pathway may fail to meaningfully increase patient access to investigational products. Alternatively, certain companies may attempt to rely on the federal right‐to‐try legislation to sell investigational products, taking advantage of the provision that allows for direct costs, as there is currently no clear mechanism for enforcement or monitoring of cost calculations. (shrink)

Medical ethics is a realm where four important subjects of philosophy, medicine, theology and law are covered. Physicians and philosophers cooperation in this area will have great efficiency in the respective ethical rules formation. In addition to respect the autonomy of the patient, physician's obligation is to ensure that the medical intervention has benefit for the patient and the harm is minimal. There is an obvious conflict between duty of confidentiality and duty of mandatory reporting. Professional confidentiality is (...) one of the basic components in building a constant physician-patient relationship which nowadays, beside the novelty, it is the subject of discussion. Legal obligation of confidentiality is not absolute. In physician-patient relationship, keeping patient's secrets and maintaining confidentiality is a legal and ethical duty, and disclosure of such secrets is mainly through specific statutes. Thus, there are a number of situations where breach of confidentiality is permitted in different legal systems. One of the situations where breaching confidentiality is permitted is the medical mandatory reporting to the relevant authority which is in accordance with many countries' legal systems. Some situations are considered in many countries legal systems' such as notification of births and deaths, infectious diseases, child abuse, sport and relevant events, medical errors, drug side effects and dangerous pregnancies. In this paper, we will examine and discuss medical mandatory reporting and its ethical and legal aspects in the judicial and legal system of Iran and few other countries. Finally we will suggest making Medical Mandatory Reporting Law in Iran. (shrink)

This book discusses how Plato, one the fiercest legal critics in ancient Greece, became – in the longue durée – its most influential legislator. Making use of a vast scholarly literature, and offering original readings of a number of dialogues, it argues that the need for legal critique and the desire for legal permanence set the long arc of Plato’s corpus—from the Apology to the Laws. Modern philosophers and legal historians have tended to overlook the fact that Plato was (...) the most prolific legislator in ancient Greece. In the pages of his Republic and Laws, he drafted more than 700 statutes. This is more legal material than can be credited to the archetypal Greek legislators—Lycurgus, Draco, and Solon. The status of Plato’s laws is unique, since he composed them for purely hypothetical cities. And remarkably, he introduced this new genre by writing hard-hitting critiques of the Greek ideal of the sovereignty of law. Writing in the milieu in which immutable divine law vied for the first time with volatile democratic law, Plato rejected both sources of law, and sought to derive his laws from what he called ‘political technique’. At the core of this technique is the question of how the idea of justice relates to legal and institutional change. Filled with sharp observations and bold claims, Platonic Legislations shows that it is possible to see Plato—and our own legal culture—in a new light “In this provocative, intelligent, and elegant work D. L. Dusenbury has posed crucial questions not only as regards Plato’s thought in the making, but also as regards our contemporaneity.”—Giorgio Camassa, University of Udine “There is a tension in Greek law, and in Greek legal thinking, between an understanding of law as unchangeable and authoritative, and a recognition that formal rules are often insufficient for the interpretation of reality, and need to be constantly revised to match it. Dusenbury’s book illuminates the sophistication of Plato’s legal thought in its engagement with this tension, and explores the potential of Plato’s reflection for modern legal theory.”—Mirko Canevaro, The University of Edinburgh. (shrink)

World Health Organization [WHO] -- Australia -- Belgium -- Bulgaria -- Canada -- [People's Republic of] China -- Czech Republic -- France -- Hellas [Greece] -- Hungary -- Ireland -- Israel -- Malaysia -- The Netherlands -- Nigeria -- Peru -- Poland -- Singapore -- South Africa -- Spain -- Sweden -- United Kingdom -- United States of America -- Uruguay.

This volume illustrates to the public, and legal experts, the basic principles of the field of neuroscience, that commonly goes under the name of Neurolaw. First, it illustrates the relationship between neuroscience, natural sciences and social sciences. Furthermore, it highlights numerous problems concerning the fundamental philosophical concepts used by Neurolaw and evaluates the validity of the method and the limits of a neuroscientific approach to the problems of law and justice. The volume explores the possibility of application of these concepts (...) on the fundamentals of the general theory of law and legal dogmatics. It also examines the main problems of Neurolaw in relation to public, private, criminal and procedural law. In conclusion, the book follows a systematic method that makes it an thorough manual for the introduction to Neurolaw. (shrink)

_The Blackwell Guide to Medical Ethics_ is a guide to the complex literature written on the increasingly dense topic of ethics in relation to the new technologies of medicine. Examines the key ethical issues and debates which have resulted from the rapid advances in biomedical technology Brings together the leading scholars from a wide range of disciplines, including philosophy, medicine, theology and law, to discuss these issues Tackles such topics as ending life, patient choice, selling body parts, resourcing and (...) confidentiality Organized with a coherent structure that differentiates between the decisions of individuals and those of social policy. (shrink)

The use of medical records in research can yield information that is difficult to obtain by other means. When such records are released to investigators in identifiable form, however, substantial privacy and confidentiality risks may be created. These risks become more common and more serious as medical records move to an electronic format. In 1996, the state of Minnesota enacted legislation with respect to consent requirements for the use of medical records in research. This legislation (...) has been widely criticized because—it is claimed—it creates an unnecessary impediment to research. In this article, we show that these arguments rest upon misinterpretation and/or misrepresentation of the 1996 legislation. A consent requirement had actually been present in Minnesota since 1976 (though codified in a patient rights statute rather than a privacy statute). The 1996 law does not require specific consent, as often claimed, but rather only a general authorization. The campaign against the Minnesota legislation appears to have been motivated by concern with respect to the then impending federal privacy rule. The HIPAA rule, as enacted, is in fact less stringent with respect to consent than the Minnesota consent law. On the other hand, the Minnesota consent law has not been effectively applied or enforced. As we change the way we manage sensitive medical information, new efforts are needed to provide protection against the confidentiality risks in research. Patient consent is an important tool in this regard. New instrumentalities are needed to solicit and document consent. (shrink)

Polish medical law does not explicitly regulate the possibility of off-label use of medicines. Such procedures therefore raise doubts in medical practice, where medicines are often prescribed beyond the Characteristic of Medicinal Product. This phenomenon particularly affects the treatment of children, as there is a lack of registered medicines in this age group, but they are registered for use in adults. Since such treatment goes beyond the scope of registration, a dilemma arises as to whether it is permissible (...) and, if so, under what conditions and whether sanctions are imposed on the medical professional using the off-label medicine. These issues are addressed in an article by Dr Maria Gutowska-Ibbs, entitled 'Off label - practical consequences of unclear legislation". The present study complements these considerations and is in part an ad vocem statement. The article attempts to differentiate between the use of off-label medicines and medical experiments, following the criterion of the purpose for which a given medical action is performed. The limits of admissibility of such actions under criminal law are also discussed in more detail. Off-label treatment is considered through the prism of the required precautionary rules, compliance with which is the antithesis of inadvertence. It is assumed that if the drug was administered in accordance with current medical knowledge and the treatment is adequate to the patient's condition, there is no violation of these rules, which excludes the imputation of inadvertence. An extensive section of the study is devoted to the issue of the patient's consent to treatment outside the indications. Above all, it emphasises the need to explain in detail to the patient the circumstances of prescribing such a drug and, on this basis, to obtain informed consent. It also stresses the importance of the written form of consent, which can have a significant evidentiary impact in potential litigation. (shrink)

Natural death act legislation which is intended to assist patients who wish to refuse or limit medical treatment may actually erode patients' rights. By use of a 'living will' the legislation intends to extend the patients' role in decision-making to the time when patients can no longer speak for themselves. However, the legislation erodes and constricts the right of refusal. The erosion is the result of two sets of conditions found in the legislation. The first (...) requires that the patient be qualified and certified by others before interventions can be withdrawn or withheld. The second delineates the physical condition which must be present before a living will can be followed. Patients have had to seek the assistance of the courts to enforce their common law rights of refusal of treatment against these requirements. Legislation is needed, but greater care must be taken to avoid the creation of a Kafkaesque legal nightmare for those we intend to assist. (shrink)

In Elements of Legislation, Neil Duxbury examines the history of English law through the lens of legal philosophy in an effort to draw out the differences between judge-made and enacted law and to explain what courts do with the laws that legislatures enact. He presents a series of rigorously researched and carefully rehearsed arguments concerning the law-making functions of legislatures and courts, the concepts of legislative supremacy and judicial review, the nature of legislative intent and the core principles (...) of statutory interpretation. (shrink)

This paper is not about the medical condition of AIDS. Nor is it about the history of the condition since it was first reported in Atlanta, Georgia in 1981. It looks rather, at the catalogue of legislative and other legal responses to the spread of AIDS. The paper analyses the AIDS condition in its historical context. The hysteria accompanying the outbreak of AIDS is contrasted with the similar hysteria associated with other previous epidemics experienced in Australia over the past (...) two centuries. The paper categorises the responses of lawmakers to the condition, according to the approach taken; from 'full blast', through 'moderate heat' to 'low key' or an attempt to avoid or minimise legal intervention. It is suggested that the appropriate response should depend upon such factors as the present magnitude of the condition, its likely future course, the availability of cures and protections against its spread and objectives being sought by intervention. Unless these factors are taken into account gross over-reaction can occur, causing social disruption and much personal injustice. (shrink)