Ethical and legal perspectives on inherited cancer susceptibility

Il existe des interactions complexes entre les perceptions du public, les demandes et les attentes envers les professionnels de la santé par rapport au dépistage des gènes de susceptibilité au cancer et aux services médicaux offerts. Ce chapitre étudie les aspects éthiques et juridiques de ces interactions avec une emphase sur le consentement, la confidentialité, l’emploi, l’assurance et le dépistage chez les mineurs et les majeurs inaptes. Ce chapitre conclu sur la prise en compte d’enjeux entourant la propriété de l’information génétique et les brevets et propose des principes pouvant servir de base pour une responsabilité partagée quant à la participation des patients dans le développement de lignes directrices encadrant le dépistage des gènes de susceptibilité au cancer.

Finding a way through the ethical and legal maze : withdrawing medical treatment and euthanasia

This article examines Finnis' and Keown's claim that the intention/foresight distinction should be used as the basis for the lawfulness of withholding and withdrawing medical treatment, rather than the act/omission distinction which is currently used. I argue that whilst the intention/foresight distinction is sound and can apply to palliative pain relief hastening death, it cannot be applied to withholding and withdrawing medical treatment. Instead, the act/omission distinction remains the better basis for the lawfulness of withholding and withdrawal, and law reform is consequently unnecessary.

Retrospective research: What are the ethical and legal requirements?

Retrospective research is conducted on already available data and/or biologic material. Whether such research requires that patients specifically consent to the use of "their" data continues to stir controversy. From a legal and ethical point of view, it depends on several factors. The main criteria to be considered are whether the data or the sample is anonymous, whether the researcher is the one who collected it and whether the patient was told of the possible research use. In Switzerland, several laws delineate the procedure to be followed. The definition of "anonymous" is open to some interpretation. In addition, it is debatable whether consent waivers that are legally admissible for data extend to research involving human biological samples. In a few years, a new Swiss federal law on human research could clarify the regulatory landscape. Meanwhile, hospital-internal guidelines may impose stricter conditions than required by federal or cantonal law. Conversely, Swiss and European ethical texts may suggest greater flexibility and call for a looser interpretation of existing laws. The present article provides an overview of the issues for physicians, scientists, ethics committee members and policy makers involved in retrospective research in Switzerland. It aims at provoking more open discussions of the regulatory problems and possible future legal and ethical solutions.

Populational Genetic Databases Is a Specific Ethical and Legal Framework Necessary?

Recent scientific advances and new technological developments, most notably the advent of bio-informatics, have led to the emergence of genetic databases with particular characteristics and structures. Paralleling these developments, there has been a proliferation of ethical and legal texts aimed at the regulation of this new form of genetic database.

Development and legal aspects of general insurance in the Caribbean with special reference to the OECS countries

Examina y analiza los principales asuntos legales relacionados al desarrollo y operación de las compañías de seguros generales en el Caribe, con especial referencia a los países de la Organización de Estados del Caribe Oriental.

Health professionals ethical and legal liability on patient’s inadequate clarification in order to obtain free and informed consent

It is required that patients are provided information about therapeutic possibilities, showing the risks, benefits, prognosis and costs of each possible and indicated alternative. This is an ethical and legal resolution. However, health professionals possess the clinical/technical/scientific knowledge and determine what information will be (or not) provided. The patient in question decides to undergo a treatment, providing his/her free and informed consent on the basis of the data presented. Unfortunately, some professionals may not provide all the information necessary for making an informed decision or, after obtaining the consent of the patient, may provide him information that causes the patient to give up on the treatment initially accepted. Such information, if relevant, and not a supervening fact, should have been provided initially. However, the information may not be entirely true, and bring the patient, for instance, to decide based on inadequately presented risks. The craniofacial rehabilitation of the temporomandibular joint (TMJ) by means of TMJ prosthesis, is indicated in many situations. Often, patients in need of such prostheses have aesthetic and functional problems and the rehabilitation expectations run high. This work presents a case and discusses ethical and legal issues, including the liability of partial and inadequate information to a patient.

Ethical and legal considerations of patient care /

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Practical and legal aspects of consignment marketing,

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Some economic and legal aspects of fixed prices.

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The remote subdivision : economic and legal aspects of land sale promotion /

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Reflecting on ethical and legal issues in wildlife disease

Disease in wildlife raises a number of issues that have not been widely considered in the bioethical literature. However, wildlife disease has major implications for human welfare. The majority of emerging human infectious diseases are zoonotic: that is, they occur in humans by cross-species transmission from animal hosts. Managing these diseases often involves balancing concerns with human health against animal welfare and conservation concerns. Many infectious diseases of domestic animals are shared with wild animals, although it is often unclear whether the infection spills over from wild animals to domestic animals or vice versa. Culling is the standard means of managing such diseases, bringing economic considerations, animal welfare and conservation into conflict. Infectious diseases are also major threatening processes in conservation biology and their appropriate management by culling, vaccination or treatment raises substantial animal ethics issues. One particular issue of great significance in Australia is an ongoing research program to develop genetically modified pathogens to control vertebrate pests including rabbits, foxes and house mice. Release of any self-replicating GMO vertebrate pathogen gives rise to a whole series of ethical questions. We briefly review current Australian legal responses to these problems. Finally, we present two unresolved problems of general importance that are exemplified by wildlife disease. First, to what extent can or should 'bioethics' be broadened beyond direct concerns with human welfare to animal welfare and environmental welfare? Second, how should the irreducible uncertainty of ecological systems be accounted for in ethical decision making?

Tutorial on Computing: Technological Advances, Social Implications, Ethical and Legal Issues

Computing and information technology have made significant advances. The use of computing and technology is a major aspect of our lives, and this use will only continue to increase in our lifetime. Electronic digital computers and high performance communication networks are central to contemporary information technology. The computing applications in a wide range of areas including business, communications, medical research, transportation, entertainments, and education are transforming local and global societies around the globe. The rapid changes in the fields of computing and information technology also make the study of ethics exciting and challenging, as nearly every day, the media report on a new invention, controversy, or court ruling. This tutorial will explore a broad overview on the scientific foundations, technological advances, social implications, and ethical and legal issues related to computing. It will provide the milestones in computing and in networking, social context of computing, professional and ethical responsibilities, philosophical frameworks, and social, ethical, historical, and political implications of computer and information technology. It will outline the impact of the tremendous growth of computer and information technology on people, ethics and law. Political and legal implications will become clear when we analyze how technology has outpaced the legal and political arenas.

Expert report writing in toxicology:forensic, scientific and legal aspects

Every year throughout the world, individuals' health is damaged by their exposure to toxic chemicals at work. In most cases these problems will resolve, but many will sustain permanent damage. Whilst any justified claim for compensation requires medical and legal evidence a crucial and often controversial component of this process is the establishment of a causal link between the individual's condition and exposure to a specific chemical or substance. Causation, in terms of how a substance or substances led the claimant to his or her current plight, can be difficult to establish and the main purpose of this book, is to provide the aspiring expert report writer with a concise, practical guide that uses case histories to illuminate the process of establishing causation in occupational toxicity proceedings. In summary: A practical, accessible guide to the preparation of balanced, scientifically sound expert reports in the context of occupational toxicology. Focuses on the scientist's role in establishing a causal link between exposure to toxins and an individual's ill health. Includes real-life case histories drawn from the Author's 15 years experience in this area to illustrate the principles involved. Expert Report Writing in Toxicology: Forensic, Scientific and Legal Aspects proves invaluable to scientists across a range of disciplines needing guidance as to what is expected of them in terms of the best use of their expertise and how to present their findings in a manner that is authoritative, balanced and informative.

An Ethical and Legal Framework for Physicians as Surrogate Decision-Makers for Their Patients.

In Western industrialized countries, it is well established that legally competent individuals may choose a surrogate healthcare decision-maker to represent their interests should they lose the capacity to do so themselves. There are few limitations on who they may select to fulfill this function. However, many jurisdictions place restrictions on or prohibit the patient's attending physician or other provider involved with an individual's care to serve in this role. Several authors have previously suggested that respect for the autonomy of patients requires that there be few (if any) constraints on whomever they may appoint as a proxy. In this essay we revisit this topic by first providing a survey of current state laws governing this activity. We then analyze the clinical and ethical circumstances in which potential difficulties could arise. We take a more nuanced and circumspect view of prior suggestions that patients should have virtually unfettered liberty to choose their healthcare proxies. We suggest a strategy to balance the freedom of patients' right to choose their surrogates with fiduciary duty of the state as regulator of medical practice. We identify six domains of possible concern with such relationships and suggest straightforward methods of mitigating their potential negative effects that could be plausibly be incorporated into physician practice.

Legal, Ethical and Professional Issues

The chapter addresses the professional, legal and ethical issues associated with medicines management and the role of the nurse. To ensure safe practice it is imperative safeguards are recognised and applied; therefore pertinent legislative frameworks, policy and professional regulation are discussed. Safeguarding patients when administering prescribed medicines means the nurse must have up-to-date knowledge and skill and a key aspect of this is to ensure consent to treatment from the service user is secured; for this reason drawing on relevant legislation, the consensual process is reviewed. Not infrequently medicine management provokes ethical and legal challenges for the health care professional; these demand reflection and careful consideration; consequently in this chapter legal and ethical parameters and professional boundaries are appraised.