Diabetes in childhood: are the laws obligations or resources? The Italian situation.
(17/85)
Two fundamental acts: "Provisions for the prevention and the cure of the diabetes mellitus" of 1987 and "Convention on the rights of the child, New York, 20 November 1989" of 1991, are a clear reference to the many laws promulgated in Italy protecting the special needs of children and adolescents with diabetes. In particular these acknowledge and emphasize the social value of the disease, the importance of the relationship with families and the infrequent need of hospital treatments. To give adequate answers to the need of self-management, it is essential to involve an integrated multidisciplinary team, adequately formed in order to supply an educational therapeutic intervention, based on medical aid and oriented on psycho pedagogy and social assistance. Cooperation and integration among health services of the territory, hospitals and social services for the complete protection of patients with diabetes--not only of their disease--are therefore necessary. Adequate laws can perhaps influence the quality of treatment and the quality of life in children with diabetes. (+info)
In the genes or in the stars? Children's competence to consent.
(18/85)
Children's competence to refuse or consent to medical treatment or surgery tends to be discussed in terms of the child's ability or maturity. This paper argues that the social context also powerfully influences the child's capacity to consent. Inner attributes and external influences are discussed using an analogy of the genes and the stars. (+info)
Ethical issues in youth surveys: potentials for conducting a national questionnaire study on adolescent schoolchildren's sexual experiences with adults.
(19/85)
OBJECTIVES: We evaluated ethical constraints concerning youth surveys on child sexual abuse (CSA). METHODS: We reviewed internationally published studies and Danish regulations concerning school-based surveys conducted without active parental consent. RESULTS: Ethical constraints concerning participants in youth community studies have been scantily assessed. Danish legislation accords minors the right to be heard on issues concerning themselves. The anticipated societal benefits of children's participation in community studies justify conducting anonymous surveys among schoolchildren based upon their own informed consent. CONCLUSIONS: No ethical or legal objections were found to conducting an anonymous survey in Denmark on CSA among 9th-grade pupils without parental consent, provided that the survey was accompanied by an offer of counseling. (+info)
How, and when, can I restrain a patient?
(20/85)
The need to restrain service users will vary according to the area of practice within which practitioners are employed. Many of the principles that relate to the issue of restraining service users are, however, applicable to all, or most, health and social care settings. While the emphasis should be on pre-emptive action, wherever possible, in order to prevent the need to restrain, there are some occasions on which the risks to the service user, or others, of inaction may outweigh those of taking action. Some of the key issues are discussed in this paper. (+info)
The Human Rights Act 1998 and medical treatment: time for re-examination.
(21/85)
There was much speculation about the potential impact of the Human Rights Act 1998 on established principles of health care practice. Now the statute has been "bedded in", predictions that existing good practice would not fall foul of the legislation provided it was demonstrable, have proved to be broadly accurate. This paper illustrates the approach of the courts to areas of difficulty related to medical treatment and highlights, in particular, possible challenges under the Act by the mature minor whose refusal of treatment has been overridden. This includes a discussion of those with learning disabilities, and reference is also made to the implications of the legislation in relation to confidentiality and child protection. (+info)
Rationalising circumcision: from tradition to fashion, from public health to individual freedom--critical notes on cultural persistence of the practice of genital mutilation.
(22/85)
Despite global and local attempts to end genital mutilation, in their various forms, whether of males or females, the practice has persisted throughout human history in most parts of the world. Various medical, scientific, hygienic, aesthetic, religious, and cultural reasons have been used to justify it. In this symposium on circumcision, against the background of the other articles by Hutson, Short, and Viens, the practice is set by the author within a wider, global context by discussing a range of rationalisations used to support different types of genital mutilation throughout time and across the globe. It is argued that in most cases the rationalisations invented to provide support for continuing the practice of genital mutilation--whether male or female--within various cultural and religious settings have very little to do with finding a critical and reflective moral justification for these practices. In order to question the ethical acceptability of the practice in its non-therapeutic forms, we need to focus on child rights protection. (+info)
One into two will not go: conceptualising conjoined twins.
(23/85)
This paper is written in response to controversial judicial decisions following separation surgery on conjoined twins "Jodie" and "Mary". The courts, it is argued, seem to have conceptualised the twins as "entangled singletons" requiring medical intervention to render them physically separate and thus "as they were meant to be", notwithstanding the death of the weaker twin, "Mary". In contrast, we argue that certain notions, philosophical and biological, of what human beings are intended to be, are problematic. We consider three compelling conceptualisations of conjoined twins and advocate a model that conceives them as two psychologically separate individuals who happen to share a body, the sharing of a body being integral to the individuality of each twin. While we reject an "essentialist" view of the conjoined state, a view which might render separation surgery unthinkable in all cases, we nevertheless argue against an "adversarial" interpretation of conjoined twins' respective best interests. We maintain that the physical entanglement should be regarded as a shared problem rather than one posed by one twin to the other. And if, after deliberation, separation surgery is deemed the "least detrimental alternative" or the "lesser of two evils", then there should be recognition of what conjoined twins will lose, as well as gain, through separation. The current drive to separate twins at all costs may evince a deeper unease with bodily configurations that appear to threaten the premium that the Western ethical and legal tradition places on personal sovereignty, and the physical circumscription that such sovereignty assumes. (+info)
Ignoring free, appropriate, public education, a costly mistake: the case of F.M. & L.G. versus Barbour County.
(24/85)
In 2000, the 11th Circuit Court provided the largest single award in special education history to date, approximately $2.5 million, to two teenaged students who were deaf. The students were judged to have been denied a free, appropriate public education (FAPE), having spent their academic careers in generic special education classes for students with multiple disabilities without the benefit of access to a communication system; the services of a certified, qualified teacher of the deaf; or related services. This article describes the case from the perspective of FAPE, least restrictive environment, and due process in the presence of guardians who did not understand the implications of the Individual Education Program (IEP) teams' decisions; presents a chronology of the case; explores the implications for various stakeholders; and discusses the catastrophic impact on the social, emotional, communication, and academic development and earning potential of the students. (+info)