Advance directives in Canada are instructions made by capable adults that pertain to future healthcare treatment choices at a time of incapacity. My experience as an ethicist working in an Ontario long-term care facility that provides medical treatment to patients with Alzheimer’s Dementia portrays a range of important ethical concerns that arise out of the use of advance directives, at least in terms of their current use. In this thesis I analyze composite case studies to identify the more prominent challenges that exist and I turn to the literature to seek ways to more clearly understand these problems and to determine if they can be overcome. What I conclude is that the use of advance directives with the Alzheimer’s Dementia population in long-term care, as it is currently used, is fraught with problems that are mainly irresolvable. I offer clinical and policy recommendations that are aligned with this view.

Advance directives in Canada are instructions made by capable adults that pertain to future healthcare treatment choices at a time of incapacity. My experience as an ethicist working in an Ontario long-term care facility that provides medical treatment to patients with Alzheimer’s Dementia portrays a range of important ethical concerns that arise out of the use of advance directives, at least in terms of their current use. In this thesis I analyze composite case studies to identify the more prominent challenges that exist and I turn to the literature to seek ways to more clearly understand these problems and to determine if they can be overcome. What I conclude is that the use of advance directives with the Alzheimer’s Dementia population in long-term care, as it is currently used, is fraught with problems that are mainly irresolvable. I offer clinical and policy recommendations that are aligned with this view.

<p>There is a growing interplay of competing realities facing the international community in the general areas of innovation, technological advancement and overall economic development. The highly industrialised wealthy nations, largely located on the Northern hemisphere are on the one hand undoubtedly at the forefront in global research, technology and infrastructure development. The developing and least developed countries on the other hand are mostly situated on the Southern hemisphere. They are not as wealthy or technologically advanced as their&nbsp / Northern counterparts, but are naturally endowed with unique variations of plant, animal and micro-organism species occurring in natural ecosystems, as well as the traditional knowledge on&nbsp / how to use these unique species. This knowledge has been adjudged to be responsible for the sustainable maintenance of the earth&rsquo / s biodiversity. Increasing exploitation of biodiversity,&nbsp / spurred on by the competing realities identified above, has left the earth in a present state of alarm with respect to the uncontrolled loss of biodiversity. The traditional knowledge of local&nbsp / peoples has significantly offered leads to research institutes from the North in developing major advancements in drugs, cosmetics and agriculture. Little or no compensation has however been seen to go back to the indigenous&nbsp / communities and countries that provide resources, and indicate various possibilities through their traditional knowledge to the use of such resources. Efforts by some biodiversity rich countries to&nbsp / ddress this trend through legislation developed in accordance with the principles of the Convention on Biological Diversity have been frustrated due to the inability to enforce their domestic laws outside their borders. Theft of genetic resources and its associated traditional knowledge&nbsp / from such countries has therefore remained a major challenge. Against this backdrop, and on the&nbsp / insistence of biodiversity-rich developing countries, an international regime on access and benefit sharing was negotiated and its final text adopted in 2010. This international regime is as&nbsp / contained in the Nagoya Protocol. This research sets out to examine whether the Nagoya Protocol offers a final solution to the protection of traditional knowledge associated with biodiversity in&nbsp / biodiverse countries. It further examines the importance of domestic legislation in achieving the objectives of the Protocol. The research has been tailored to African biodiverse countries, and&nbsp / seeks these answers within the context of Africa.<br /> &nbsp / </p>

Darbo tikslas- įvertinti pacientų teisių užtikrinimą pirminės sveikatos priežiūros lygmenyje, pacientų ir sveikatos priežiūros specialistų požiūriu. Darbo uždaviniai: 1. Įvertinti pacientų teisių užtikrinimą pirminiame sveikatos priežiūros lygmenyje pacientų požiūriu. 2. Įvertinti pacientų teisių užtikrinimą pirminiame sveikatos priežiūros lygmenyje sveikatos priežiūros specialistų požiūriu. 3. Palyginti pacientų teisių užtikrinimą pacientų ir sveikatos priežiūros specialistų požiūriu.Tyrimo metodika: tyrimas atliktas 2014 m. kovo- balandžio mėnesiais anoniminės apklausos būdu Vilniuje, atsitiktiniu atrankos būdu parinktoje pirminės sveikatos priežiūros įstaigoje. Tyrimo metu apklausti 48 bendrosios praktikos gydytojai, 54 slaugytojai ir 223 pacientai. Tyrimo rezultatai: 81,5 proc. pacientų žino savo teises. 49,5 proc. pacientų informaciją apie tyrimo rezultatus, 50,5 proc. ligos prognozę, 58,3 proc. gydymo eigą, suprato tik iš dalies. 62,3 proc. pacientų įvardijo, jog gydytojai, slaugytojai nepakankamai skiria laiko informavimui. Apie 50 proc. sveikatos priežiūros specialistų požiūriu, informacija apie ligos diagnozę, gydymo eigą, komplikacijas turi būti visiškai konfidenciali. 69,9 proc. pacientų manė, jog jų teisės užtikrinamos tik iš dalies. Tyrimo išvados: 1. Didžioji dauguma respondentų žinojo savo teises, tačiau daugiau kaip pusė respondentų teigė, kad nebuvo pakankamai informuoti apie savo ligą, o 34,7 proc. respondentų nebuvo įtraukit į sprendimų priėmimą, susijusį... [toliau žr. visą tekstą] / Aim of study: to evaluate an assurance of the patients` rights in the primary health care. Objectives: 1. To evaluate an assurance of the patients` rights in the primary health care from a patients` point of view. 2.To evaluate an assurance of the patients` rights in the primary health care from a health care proffessionals` point of view. 3.To compare an assurance of the patients` rights from the patients` and health care proffessionals` point of view. Methods: the cross-sectional study was performed at one Vilnius PHC institution, in 2014 March-April. The anonymous questionnaire was used in survey. There were 48 physicians, 54 nurses and 223 patients. Completed questionnaires were suitable for further investigation and statistical analysis. An anonymous questionnaire was used, which was developed according to literature analysis. Results: 81,5% of the patients knew their rights. 49,5% patients about medical examination results, 50,5% - disease prognosis and 56,5% - treatment process understood just partially. 62,3% of the patients identified, that physicians, nurses for the information share not enough time. About 50% of health care professionals` attitude related to information about diagnosis, treatment course, complications must be kept absolutely confidential. 69.9% patients felt that their rights are guaranteed only in part. Conclusions: 1. The majority of a respondents were aware of their rights, but more than half of them said that they were not sufficiently informed... [to full text]

The dualist paradigm, which has been criticized by sources in both the Catholic tradition and feminism for alienating persons from their bodies and allowing the treatment of persons as objects and property, has greatly influenced the development and practice of medicine. Particularly now, with the advent of modern molecular biology techniques as well as the potential for commercial profit-making from human biomaterials, the use of patient-derived tissue in biomedical research brings forth many questions for discussion. The notion of embodiment, what it means to have and to be a body, can be seen as a useful perspective from which to gain insight into these questions concerning person's bodies. Although stated in different terms and employing different methodologies, many sources from both the Catholic and feminist traditions of thought on embodiment converge on a holistic understanding of the person, one that counters pervasive dualistic tendencies. Within the Catholic tradition, a person is considered to be an integrated unity of body and soul; as Pope John Paul II has said, 'touch the body, touch the person.' Within the feminist perspective, the classic 'our bodies, ourselves,' is a reference to the fundamental understanding of the self as incorporating the body in an essential sense. (Abstract shortened by UMI.)

Zugl.: Bern, Univ., Diss., 2007

The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on April 1, 2010). Vita. Thesis advisor: Lawrence H. Ganong. "May 2008" Includes bibliographical references

Magister Legum - LLM (Mercantile and Labour Law) / Traditional Knowledge (TK) has previously been considered a 'subject' in the public domain, unworthy of legal protection. However, the last few decades have witnessed increased discussions on the need to protect the knowledge of indigenous peoples for their economic sustenance, the conservation of biodiversity and modern scientific innovation. Questions remain as to how TK can best be protected through existing, adapted or sui generis legal frameworks. Based on an examination of the formal knowledge-protection mechanisms (i.e. the existing intellectual property system), this mini-thesis contends that these existing systems are inadequate for protecting TK. As a matter of fact, they serve as veritable platforms for incidences of biopiracy. It further argues that the many international initiatives designed to protect TK have so far failed owing to inherent shortcomings embedded in them. Furthermore, a comparative assessment of several national initiatives (in New Zealand, South Africa and Kenya) supports an understanding that several domestic efforts to protect TK have been rendered ineffective due to the insurmountable challenge of dealing with the international violations of local TK rights. It is therefore important that on-going international negotiations for the protection of TK, including the negotiations within the World Intellectual Property Organisation's Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore (IGC), do not adopt similar approaches to those employed in previous initiatives if TK must be efficiently and effectively protected. This mini-thesis concludes that indigenous peoples possess peculiar protection mechanisms for their TK within the ambit of their customary legal systems and that these indigenous mechanisms are the required anchors for effective global protections.

Magister Legum - LLM (Mercantile and Labour Law) / Traditional Knowledge (TK) has previously been considered a 'subject' in the public domain, unworthy of legal protection. However, the last few decades have witnessed increased discussions on the need to protect the knowledge of indigenous peoples for their economic sustenance, the conservation of biodiversity and modern scientific innovation. Questions remain as to how TK can best be protected through existing, adapted or sui generis legal frameworks. Based on an examination of the formal knowledge-protection mechanisms (i.e. the existing intellectual property system), this mini-thesis contends that these existing systems are inadequate for protecting TK. As a matter of fact, they serve as veritable platforms for incidences of biopiracy. It further argues that the many international initiatives designed to protect TK have so far failed owing to inherent shortcomings embedded in them. Furthermore, a comparative assessment of several national initiatives (in New Zealand, South Africa and Kenya) supports an understanding that several domestic efforts to protect TK have been rendered ineffective due to the insurmountable challenge of dealing with the international violations of local TK rights. It is therefore important that on-going international negotiations for the protection of TK, including the negotiations within the World Intellectual Property Organisation's Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore (IGC), do not adopt similar approaches to those employed in previous initiatives if TK must be efficiently and effectively protected. This mini-thesis concludes that indigenous peoples possess peculiar protection mechanisms for their TK within the ambit of their customary legal systems and that these indigenous mechanisms are the required anchors for effective global protections.

Law / LL.M.