Medicolegal file. Amendments to child protection legislation. New legal accountability for physicians.
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In Ontario's past and present child protection legislation, physicians are included in the list of professionals designated to protect children and report their beliefs, suspicions, or knowledge of child abuse and neglect. Ontario's recent legislative amendments broaden the definition of child abuse and thereby widen the scope of the duty to report. (+info)
Some considerations concerning multimedia-multipollutant risk assessment methodology: use of epidemiologic data for non-cancer risk assessment in Russia.
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The highly industrialized small town of Verkhnyaya Pyshma (in the Urals region of Russia) was chosen as the site of a multimedia-multipollutant risk assessment using the U.S. Environmental Protection Agency methodology. The assessment was based on routine environmental pollution monitoring data for ambient air, soils, drinking water, and food, and the international environmental epidemiology literature. Using an a priori set of the preliminary health-based criteria, we selected nine pollutants for risk assessment: total suspended particles (TSP), sulfur dioxide, nitrogen dioxide, benzo(a)pyrene (BaP), ammonia arsenic, copper, cadmium, and lead. We used dose-response functions derived from epidemiologic studies to assess individual and population risks for TSP, SO2, NO2, As, Cd, and Pb. We assessed both cancer (for BaP, As, and Cd) and non-cancer (for all the chosen pollutants but BaP) responses, but in this paper we discuss only the assessments of noncarcinogenic risks due to TSP, SO2, NO2, Pb, and Cd as examples of how the quantitative estimates of health effects can be produced by using a risk function approach. We also schematically present a modified conceptual model of multimedia-multipollutant risk assessment taking into account the experience gained with this study. (+info)
Pending resolution: the question of who owns DNA.
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With the emergence of the Human Genome Project and its private counterparts, the U.S. Patent and Trademark Office has begun receiving applications for the patenting of genes and genetic sequences. Earlier patent decisions regarding similar scientific advances limited patents to organisms "made by the hand of man," which would seem to remove discovered genes from patent protection. But many applicants have been successful in attaining patents for genes based on their ability to demonstrate the ultimate utility of the gene, for instance in medicine. One controversy regarding genomic patenting, however, is that patents apparently have been granted for mere gene fragments devoid of much demonstrable utility. Furthermore, critics fear that gene patenting will retard research by squelching scientists' ability to share findings freely. (+info)
Authors, editors, policy makers, and the impact factor.
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Some aspects of the "impact factor", a quantitative measure of journals' influence on journals in scientific fields, were discussed in the preceding issue of the Croatian Medical Journal by Dr Eugene Garfield, one of its devisers. This factor can be of interest to authors, journal editors, and policy makers, but they should keep in mind the complexity of the determinants of impact factors while using them in coming to their particular kinds of decisions. A clearer picture of the influence a journal may have in its own scientific field rather than among all scientific journals could come from a variant of the impact factor, "the scope-adjusted impact factor". The calculation of this variant impact factor is described. A table presents some sample data from this calculation and shows how the relative positions of some major journals shift when they are ranked by this factor rather than the unadjusted impact factor. The possible value of this variant factor may merit further testing. (+info)
Slovenian experience on health insurance (re)introduction.
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A period of changes in what had previously been public health insurance began in Slovenia in 1992. A new legislation introduced a mixed public-private insurance, the share of GDP allocated for health care insurance in Slovenia equaled the EU average, and the financing of the public health insurance has been balanced up - until now. For the first time since Slovenia gained independence, the compulsory health insurance is planning a 6% reduction in its income. The way to the solution of the problem lies in a political consensus on the public health issues in Slovenia, but it is still unclear whether it can be reached. A successful political agreement on the adequate amount of health care, granted to the Slovenian citizens by the public health insurance, should secure its balanced financing, which is about to be disturbed. (+info)
Physician-assisted suicide: the legal slippery slope.
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BACKGROUND: In Oregon, physicians can prescribe lethal amounts of medication only if requested by competent, terminally ill patients. However, the possibility of extending the practice to patients who lack decisional capacity exists. This paper examines why the legal extension of physician-assisted suicide (PAS) to incapacitated patients is possible, and perhaps likely. METHODS: The author reviews several pivotal court cases that have served to define the distinctions and legalities among "right-to-die" cases and the various forms of euthanasia and PAS. RESULTS: Significant public support exists for legalizing PAS and voluntary euthanasia in the United States. The only defenses against sliding from PAS to voluntary euthanasia are adhering to traditional physician morality that stands against it and keeping the issue of voluntary euthanasia legally framed as homicide. However, if voluntary euthanasia evolves euphemistically as a medical choice issue, then the possibility of its legalization exists. CONCLUSIONS: If courts allow PAS to be framed as a basic personal right akin to the right to refuse treatment, and if they rely on right-to-die case precedents, then they will likely extend PAS to voluntary euthanasia and nonvoluntary euthanasia. This would be done by extending the right to PAS to incapacitated patients, who may or may not have expressed a choice for PAS prior to incapacity. (+info)
The role of outbreaks in developing food safety policy: population based surveillance of salmonella outbreaks in Wales 1986-98.
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In developing public policy on food safety, systematic identification and thorough investigation of all general outbreaks is necessary in order to avoid bias towards highly publicised outbreaks. In Wales, from 1986 to 1998, 87 general foodborne outbreaks of salmonellosis were identified. Most outbreaks occurred at functions or were associated with small catering outlets such as bakeries and sandwich bars. In 50 outbreaks, a vehicle of infection was confirmed microbiologically and/or epidemiologically. The most common food vehicles were those containing shell eggs. Salmonella enteritidis outbreaks were significantly more likely than outbreaks of other serotypes to be associated with vehicles containing shell eggs, suggesting that eggs were also the source of infection in many outbreaks. The routine use of analytical epidemiological studies to identify vehicles in outbreaks is recommended. (+info)
Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination.
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Quantifying the local burden of disease is an important step towards the introduction of new vaccines, such as Haemophilus influenzae type b (Hib) conjugate vaccine. We adapted a generic protocol developed by the World Health Organization for population-based surveillance of bacterial meningitis. All hospitals that admit paediatric patients with meningitis in the National District, Dominican Republic were included in the system and standard laboratory methods were used. The system identified 111 cases of confirmed bacterial meningitis. Hib was the leading cause of bacterial meningitis, followed by group B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hospital-based case series, this population-based system was able to calculate incidence rates. The incidence of Hib meningitis was 13 cases per 100,000 children < 5 years old. The data from this study were used by the Ministry of Health to support the introduction of routine Hib vaccination and will be used to monitor its effectiveness. (+info)