Darbo tikslas. Įvertinti pacientų nuomonę apie konfidencialumo principo taikymą gydymo įstaigoje. Uždaviniai. Įvertinti pacientų informuotumą apie konfidencialumo principo taikymą sveikatos priežiūros įstaigoje. Išaiškinti pacientų požiūrį į konfidencialumo principo taikymą sveikatos priežiūros įstaigoje ir nustatyti ryšį su pacientų lytimi ir išsimokslinimu. Tyrimo metodika. N sveikatos priežiūros įstaigoje atlikta anoniminė anketinė 303 pacientų apklausa (atsako dažnis – 86,6 proc.) Duomenų analizei naudotas SPSS 13.0 statistinės analizės paketas. Diagramos ir lentelės parengtos Microsoft Excel 2007 programa. Rezultatai. 56,8 proc. tyrimo dalyvių teigė, jog perskaitė visas pasirašyti pateiktas formas, 28,7 proc. respondentų tvirtino, kad perskaitė kai kurias jiems pateiktas informavimo/sutiki-mo formas. 66,7 proc. respondentų teigė, kad prieš pasirašydami visiškai aiškiai žinojo dėl ko duoda sutikimą, 19,1 proc. respondentų prisipažino, jog kai kas buvo neaišku, ir 14,2 proc. respondentų nurodė, jog nesuprato su kuo sutinka, tačiau pasirašė, nes taip reikia. 52,5 proc. skaičiusių informavimo formas respondentų nurodė, jog pateiktoje informuoto sutikimo formoje buvo aiškūs visi teiginiai, 36,7 proc. respondentų dauguma teiginių buvo aiškūs. Mažiau nei pusė respondentų (45,9 proc.) manė, jog informacija apie ligą ir medicininius tyrimus yra įslaptinta, su šiuo teiginiu nesutiko 26,1 proc. respondentų. Nustatytas statistiškai reikšmingas ryšys tarp pacientų išsimokslinimo ir... [toliau žr. visą tekstą] / Aim of the study. To evaluate patients' opinion about the application of confidentiality principle in medical institution. Objectives. To evaluate patients' awareness about the application of confidentiality principle in health care institution. To find out patients‘ attitude towards the application of confidentiality principle in health care institution and to determine its relationship with patients‘ gender and education. Methods. An anonymous survey of 303 patients using questionnaires (response frequency – 86.6 %) ¬was carried out in the health care institution N. Data analysis used the SPSS 13.0 statistical analysis package. Charts and tables were prepared using Microsoft Excel 2007. Results. 56.8 % of the survey participants told that they had read all the forms presented to be signed, 28.7 % of the respondents claimed that they had read some of the forms of information/consent presented to be signed. 66.7 % of the respondents affirmed, that before signing they knew absolutely clearly why they had given their consent, 19.1 % of the respondents admitted that some things were unclear, and 14.2 % of the respondents told that they had not understood why they had given their consent; however, they had signed the form because it was necessary. 52.5 % of the respondents who had read the forms of information claimed that all the propositions of the form of informed consent were clear, 36.7 % of the respondents had understood most of the propositions. Less than half of the... [to full text]

Les registres médicaux sont des banques de données, ayant des caractéristiques spécifiques, rassemblant tous les cas d'une maladie sur un territoire précis. Ces informations permettent la mise en place de politiques de santé publique ainsi que l'étude de maladies afin de faire progresser la recherche médicale. La question se pose donc de savoir comment la réglementation concernant le respect de la vie privée s'applique aux particularités des registres. La législation actuellement en vigueur au Québec prévoit l'obligation d'obtenir le consentement du patient avant d'inclure les données le concernant dans le registre. Ces renseignements personnels de santé recueillis dans le registre doivent être protégés afin de respecter la vie privée des participants. Pour cela, des mesures concernant la confidentialité et la sécurité des données doivent être mises en place en vue de leur conservation et durant celle-ci. Après l'utilisation principale de ces données, il est possible de se servir à nouveau de ces renseignements personnels à d'autres fins, qu'il faille ou non les transférer vers une autre banque de données, nationale ou étrangère. Néanmoins cette utilisation secondaire ne peut se faire qu'à certaines conditions, sans porter atteinte au droit des participants concernant le respect de la vie privée. / Medical registries are databases which record aIl cases of a specifie disease found in a given area. Registries provide vital information for public health research and for the implementation of appropriate public policies. The question is : How does the regulation of privacy apply to registries? Legislation currently in force in the province of Quebec requires the consent of a patient in order to inc1ude personal information in the registry. Personal health data in a registry have to be protected to preserve the privacy of research subjects. To ensure data security and confidentiality sorne measures must be taken during their conservation. Secondary use of data is possible under certain conditions aimed at protecting the right to privacy. It is possible to use such personal information again for other purposes even if the data need to be transferred to another national or foreign database. / "Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de Maîtrise en LL.M. Droit - Recherche option Droit, Biotechnologies et Sociétés"

The dissertation aims to analyse the problem of informed consent in clinical drug trials. Understanding of the provided information is one of the basic components of a person’s sound and informed decision to participate in a clinical trial. Our research evaluated informedness about clinical trials of patients participating in clinical drug trials in Lithuania, with emphasis on the informedness about key elements of clinical trial design (placebo-control, double-blindness, and randomisation). An anonymous survey of patients participating in clinical drug trials was conducted for the purposes of this study. The results of the study reveal that the legal framework sets the basis for adequate informedness about clinical trials of clinical trial participants, however, patients participating in placebo-controlled clinical trials are insufficiently informed about clinical trials. Patients participating in placebo-controlled clinical trials are better informed about the rights of clinical trial participants than about clinical trial design, however, informedness about design is a more important condition for overall informedness. The majority of placebo-controlled clinical trial participants do not understand at least one of the three key elements of clinical trials design and they tend to interpret the scientific methods used in clinical trials therapeutically. / Disertacijoje analizuojama informuoto asmens sutikimo įgyvendinimo klinikiniuose vaistinio preparato tyrimuose problema. Pateiktos informacijos supratimas yra viena svarbiausių asmens apsisprendimo dalyvauti klinikiniame tyrime sąlygų. Moksliname darbe vertinamas pacientų, dalyvaujančių placebu kontroliuojamuose klinikiniuose vaistinio preparato tyrimuose Lietuvoje (toliau – klinikinių tyrimų dalyviai), informuotumas apie klinikinius tyrimus, akcentuojant informuotumą apie klinikiniuose tyrimuose taikomus mokslinius metodus (placebo kontrolę, dvigubą aklumą, atsitiktinį tiriamųjų grupių sudarymą). Klinikinių tyrimų dalyvių informuotumas buvo tiriamas atliekant anoniminę apklausą. Mokslinio darbo rezultatai parodė, kad teisinis reglamentavimas sudaro prielaidas klinikinių tyrimų dalyvių informuotumui, tačiau jų informuotumas yra nepakankamas. Respondentai buvo geriau informuoti apie klinikinių tyrimų dalyvių teises nei apie klinikinių tyrimų metodologiją, tačiau informuotumas apie klinikinių tyrimų metodologiją yra svarbesnė prielaida bendram informuotumui. Dauguma klinikinių tyrimų dalyvių nesuprato vieno ar daugiau iš trijų pagrindinių klinikiniuose tyrimuose taikomų mokslinių metodų (placebo kontrolės, dvigubo aklumo, atsitiktinio tiriamųjų grupių sudarymo) ir buvo linkę suteikti jiems terapinę reikšmę. Tyrimo rezultatai sudaro prielaidas kryptingam klinikinių tyrimų dalyvių informuotumo gerinimui, informacijos apie klinikinius tyrimus viešinimui.

Disertacijoje analizuojama informuoto asmens sutikimo įgyvendinimo klinikiniuose vaistinio preparato tyrimuose problema. Pateiktos informacijos supratimas yra viena svarbiausių asmens apsisprendimo dalyvauti klinikiniame tyrime sąlygų. Moksliname darbe vertinamas pacientų, dalyvaujančių placebu kontroliuojamuose klinikiniuose vaistinio preparato tyrimuose Lietuvoje (toliau – klinikinių tyrimų dalyviai), informuotumas apie klinikinius tyrimus, akcentuojant informuotumą apie klinikiniuose tyrimuose taikomus mokslinius metodus (placebo kontrolę, dvigubą aklumą, atsitiktinį tiriamųjų grupių sudarymą). Klinikinių tyrimų dalyvių informuotumas buvo tiriamas atliekant anoniminę apklausą. Mokslinio darbo rezultatai parodė, kad teisinis reglamentavimas sudaro prielaidas klinikinių tyrimų dalyvių informuotumui, tačiau jų informuotumas yra nepakankamas. Respondentai buvo geriau informuoti apie klinikinių tyrimų dalyvių teises nei apie klinikinių tyrimų metodologiją, tačiau informuotumas apie klinikinių tyrimų metodologiją yra svarbesnė prielaida bendram informuotumui. Dauguma klinikinių tyrimų dalyvių nesuprato vieno ar daugiau iš trijų pagrindinių klinikiniuose tyrimuose taikomų mokslinių metodų (placebo kontrolės, dvigubo aklumo, atsitiktinio tiriamųjų grupių sudarymo) ir buvo linkę suteikti jiems terapinę reikšmę. Tyrimo rezultatai sudaro prielaidas kryptingam klinikinių tyrimų dalyvių informuotumo gerinimui, informacijos apie klinikinius tyrimus viešinimui. / The dissertation aims to analyse the problem of informed consent in clinical drug trials. Understanding of the provided information is one of the basic components of a person’s sound and informed decision to participate in a clinical trial. Our research evaluated informedness about clinical trials of patients participating in clinical drug trials in Lithuania, with emphasis on the informedness about key elements of clinical trial design (placebo-control, double-blindness, and randomisation). An anonymous survey of patients participating in clinical drug trials was conducted for the purposes of this study. The results of the study reveal that the legal framework sets the basis for adequate informedness about clinical trials of clinical trial participants, however, patients participating in placebo-controlled clinical trials are insufficiently informed about clinical trials. Patients participating in placebo-controlled clinical trials are better informed about the rights of clinical trial participants than about clinical trial design, however, informedness about design is a more important condition for overall informedness. The majority of placebo-controlled clinical trial participants do not understand at least one of the three key elements of clinical trials design and they tend to interpret the scientific methods used in clinical trials therapeutically.

Quelles sont les conditions sous lesquelles nous pouvons dire qu’un acte sexuel est moralement permissible? Plus précisément, quel est le rôle qui doit être accordé à la notion de consentement des partenaires dans la détermination de l’acceptabilité morale des actes sexuels? Dans un premier temps, je tâcherai d’exposer la nature même du consentement, en soulignant son caractère performatif ainsi que ses composantes essentielles, sans la présence desquelles le consentement serait invalide. Sur cette base, j’établirai trois schémas possibles quant à la fonction du consentement, selon qu’on en fasse une condition de la permissibilité morale qui soit a) suffisante et nécessaire, b) non suffisante mais nécessaire, c) ni suffisante ni nécessaire. Je tenterai ensuite de voir quelles peuvent être les autres conditions qui complètent ou remplacent la nécessité du consentement. Dans cette perspective j’examinerai plus scrupuleusement une position conforme au deuxième schéma, soit celle que Raymond Belliotti a développée dans son ouvrage Good Sex (1993). Pour conclure, j’avancerai l’hypothèse que plusieurs des conditions qui complètent ou remplacent la nécessité du consentement en matière sexuelle peuvent être conçues soit comme une redondance, au sens où ces conditions sont déjà implicites dans la définition même du consentement, soit comme une limitation aux libertés individuelles, telles qu’on les conçoit dans un esprit libéral. / What are the conditions under which we can say that sexual acts are morally permissible? More specifically, what role should consent play in determining the moral permissibility of sexual acts? I will first expose the nature of consent and outline its performative character as well as its essential components, whose absence would invalidate consent. On this basis, I will then establish three possible structures: the first structure takes consent to be a sufficient and necessary condition of the moral permissibility of sexual acts; the second structure considers that consent is necessary but not sufficient to moral permissibility; and, according to the third structure, consent is neither sufficient nor necessary to moral permissibility. I will then try to see what other conditions are required to complement or replace the condition of consent. More specifically, I will discuss a theory that Raymond Belliotti proposed in his 1993 book Good Sex, a theory that seems to comply with the second structure. To conclude, I will argue that most conditions that complement or replace the condition of consent in the sexual realm could be thought of either as redundant because they are already included in the initial definition of consent, or as a restriction of the individual freedom inherent to liberal ethics.

The swedish law against female genital mutilation (FGM) prohibits procedures that removes parts of the female genitalia and thereby makes permanent changes in the body. The problem with the wording of the law is that it may also apply to the western phenomenon cosmetic genital surgery. This paper therefore examines if cosmetic genital surgery should be covered by the swedish law against FGM, by making a critical comparing analysis. The paper begins with comparing FGM with cosmetic genital surgery to prove that there are more similarities than differences between the procedures. By using the theoretical perspectives universalism and postcolonialism, the paper then examines why, particularly in the West, there is a different approach to FGM than to cosmetic genital surgery, regardless of the similarities of the procedures. Further the paper also examines consent and why consent to FGM is seen as illegitimate while consent to cosmetic genital surgery is seen as legitimate. On basis of the critical comparing analysis the paper then argues: that the procedures cosmetic genital surgery and FGM are very much alike; that cosmetic genital surgery is accepted over FGM because it is more familiar in the West and; that consent should be as illegitimate when given to cosmetic genital surgery as when given to FGM. Thus the conclusion of the paper is that cosmetic genital surgery should be covered by the swedish law against FGM.

Purpose: Patients’ perspectives of informed consent for chiropractic care have not been investigated. This study explored how patients of chiropractors perceived the exchange of risk information during informed consent. Methods: Interviews were conducted with 26 participants, recruited from chiropractic clinics. Interview transcripts were analyzed using a constant comparative method of analysis. Findings: Participants experienced informed consent as an on-going process where risk perceptions were shaped throughout four distinct stages. In the first stage information acquired prior to arriving at the clinic for treatment shaped perceptions of risk. In the second stage participants assessed the perceived competence of the practitioners. Participants then signed the consent form and discussed the risks with t heir practitioner. Finally, they communicated with their practitioners during treatment to ensure their pain threshold was not crossed. Conclusion: These findings suggest that patients perceive informed consent as a social process involving on-going communication with their practitioners.

The purpose of this writing is to analyses the doctrine of informed consent. Person exercises his autonomy by making informed and reasonable decisions. The writing attempts to disclose a theoretical and practical role of the informed consent institute and its influence on physician’s civil liability. This work consists of five parts. First of all is given ethical importance of informed consent doctrine. In the following parts of the work it is analyzed national and international regulations on informed consent. There is short Lithuanian case law on informed consent overview. At the end it is concluded that there are some gaps in Lithuanian law concerned with informed consent.

This thesis identifies and analyzes the legal barriers faced by ethno-racial psychiatric consumer/survivors in Ontario, through an analysis of the Consent and Capacity Board (CCB). I employ interdisciplinary research to test the hypothesis that factors such as race, ethnicity, culture, poverty and social exclusion are not fully addressed by the CCB. To critique the CCB, I developed a theoretical framework using the grounded theory approach, in combination with tenets of disability theory, critical race theory and intersectionality. I used the theoretical framework to analyze qualitative research involving twenty interviews of stakeholders including lawyers, psychiatrists, CCB adjudicators, mental health service providers and ethno-racial psychiatric consumer/survivors. The analysis revealed the procedural, systemic/structural and discretionary barriers within the CCB’s pre-hearing, hearing and post-hearing process. Barriers were the result of cultural misunderstandings, misdiagnosis, complex familial relationships, culturally inappropriate care, institutional racism, poverty, discrimination and the CCB’s “color blind approach.” I conclude with prioritized recommendations.

This thesis identifies and analyzes the legal barriers faced by ethno-racial psychiatric consumer/survivors in Ontario, through an analysis of the Consent and Capacity Board (CCB). I employ interdisciplinary research to test the hypothesis that factors such as race, ethnicity, culture, poverty and social exclusion are not fully addressed by the CCB. To critique the CCB, I developed a theoretical framework using the grounded theory approach, in combination with tenets of disability theory, critical race theory and intersectionality. I used the theoretical framework to analyze qualitative research involving twenty interviews of stakeholders including lawyers, psychiatrists, CCB adjudicators, mental health service providers and ethno-racial psychiatric consumer/survivors. The analysis revealed the procedural, systemic/structural and discretionary barriers within the CCB’s pre-hearing, hearing and post-hearing process. Barriers were the result of cultural misunderstandings, misdiagnosis, complex familial relationships, culturally inappropriate care, institutional racism, poverty, discrimination and the CCB’s “color blind approach.” I conclude with prioritized recommendations.