<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>

University of Macau / Faculty of Law

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>Some scholars argue that the principle of voluntary informed consent is rooted in the Western ethos of liberal individualism; that it would be difficult to implement this requirement in societies where the norms of decision-making emphasize collective rather than individual decision-making (for example, Sub-Saharan Africa); that it would amount to “cultural imperialism” to seek to implement the principle of voluntary informed consent in non-Western societies. This thesis rejects this skepticism about the possibility of implementing the informed consent requirement in non-Western environments and argues that applying the principle of voluntary informed consent in human subjects’ research in Sub-Saharan African communal culture could serve as an effective measure to protect vulnerable subjects from possible abuses or exploitations. The thesis proposes the “multi-step” approach to informed consent as the best approach to the implementation of the principle in the African communal setting. The thesis argues that the importance of the “multi-step” approach lies in the fact that it is one that is sensitive to local culture and customs. On the question of whether the principle of voluntary informed consent should be made compulsory in research, the thesis answers that we have no choice in the matter.</p>

This thesis seeks to demonstrate, by way of a multidisciplinary study, that consent is, despite its legal definition which refers to the free and enlighted expression of individual will, in fact, at times limited if not eliminated, by social considerations, arising from the medical, economic and legal context. These considerations reflect what one might call the social norm. An appropriate understanding of consent serves, therefore, to express the social norm as a constraint, which, in turn, acts as a measure of what it means to belong in society. Thus, while consent is often presented as the fundamental principle to be respected in biomedical research, it is in reality, merely one principle to respect among others. These limitations connected to consent are exacerbated in emergency situations where consent is sometimes reduced to mere signature, and in some cases it has been recognized that research can be undertaken without the subject's prior consent.

<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