Medicine and law
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Decision-making capacity for treatment and research raises complex conceptual issues. Given the fact that both considerations of respect for patient autonomy and beneficence/harm prevention have moral relevance in many cases, in the practice of health care the need exists to balance both in a moral responsible way. The moral concept of (mental) capacity or decisional capacity has a role to play in this balancing process. ⋯ A first alternative focuses on issues of emotion and narrative; a second on identity and identification, and a third on dialogue and deliberation. By paying attention to the way in which people interprete their world (not only by cognition, but also by emotion), and how they shape their lives by processes of identification and communication, a broader perspective on capacity assessment in health care can be developed. Above that, these alternative approaches are less focused on the assessment of (in)capacity and more on enabling a person to become more competent through a process of empowerment, participation, and shared decision-making.
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The concept of informed consent in clinical trials is well understood, although when viewed from the perspective of legal consent and valid consent, problems arise. Legal consent can be as simple as the signing of a document of informed consent. ⋯ Since most pre-clinical data is based largely on animal experiments, and animal data cannot be extrapolated to human beings with any degree of confidence, valid consent cannot be provided by the participant. It is therefore suggested that animal experiments be replaced with human-based methodologies, which rely on modern methods of molecular biology and human genetics.
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This short paper examines developments in expert evidentiary procedures in forensic cases in Hungary. The basis of current practice is described and certain problems arising from this are discussed.
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Children are being abused in Greece at an alarming rate. This article aims to clarify the magnitude of the child abuse issue in Greece and to highlight medical and legal aspects that may play a contributory role in the existing defects in the revelation, prevention, and punishment of this type of crime.
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A person's right to control his or her own body, expressed through the concept of informed consent to medical treatment, has gained worldwide acceptance. Nevertheless, this right may conflict with the state's interest in preserving life in cases where patients refuse treatment in medical emergencies. This paper examines the management of treating acute anaemia in a Jehovah's Witness in Israel who refused blood transfusion on religious grounds. ⋯ This law established statutory ethics committees which may, under defined conditions of emergency or threat to life, approve treatment against the patient's will. This power, previously vested in the courts, should be used only in extreme circumstances while, in general, patients' wishes and beliefs must be respected. Sensitivity to the legal and ethical aspects involved deserves greater emphasis in medical school curricula.