Darbo tikslas – įvertinti pacientų nuomones apie teisės į informaciją užtikrinimą stacionarinėse asmens sveikatos priežiūros įstaigose. Tyrimo metodika. Atliekant tyrimą naudotas duomenų rinkimo metodas buvo anoniminė anketinė pacientų apklausa. Naudojant anoniminę anketą apklausti atsitiktinės atrankos metodu atrinkti keturių Kauno apskrities ligoninių pacientai. Buvo apklausiami tyrimo dieną Vidaus ligų ir Chirurgijos profilių skyriuose hospitalizuoti pacientai. Iš viso apklausti 264 pacientai (atsako dažnis 69,1 proc.). Statistinei duomenų analizei panaudoti 261 tinkamai užpildytos anketos duomenys. Statistinė duomenų analizė atlikta naudojant „IBM SPSS Statistics 21“ programą. Rezultatai. Dauguma pacientų (70,5 proc.) teigė, kad jiems buvo suteikta informacija apie jų ligą. 64 proc. apklaustųjų atsakė, jog jiems buvo suteikta informacija apie medicininių tyrimų rezultatus. Apie savo ligos gydymo metodus buvo informuoti kiek daugiau nei pusė pacientų (52,5 proc.). Su galimomis teigiamomis ir neigiamomis gydymo pasekmėmis buvo supažindinta taip pat tik pusė (50,6 proc.) pacientų. Net penktadaliui (20,3 proc.) apklaustų pacientų nebuvo suteikta informacija apie gydymo pasekmes. Didelė dalis (65,5 proc.) respondentų supranta visą pateiktą informaciją apie gydymą, tyrimus ir pan. Iš 34,5 proc. apklaustųjų, kurie iš dalies suprato arba visai nesuprato jiems pateiktos informacijos, tik 62,2 proc. pasakė gydytojui ko nesuprato. Savo nuomonę gydytojui, kai priimami gydymo... [toliau žr. visą tekstą] / Aim of the study – to analyze patients’ opinions about their right to information assurance while receiving hospital treatment. Methods. Data for the study was collected by getting patients to fill out anonymous questionnaires. Four randomly selected Kaunas region hospitals were picked by probabilistic selection. Hospitalized patients from Internal medicine and Surgical departments were questioned. Total of 264 patients were questioned (response rate – 69.1%). 261 questionnaires were filled out correctly and were used in statistical analysis. Data analysis was performed with „IBM SPSS Statistics 21“ package. Results. Most of the patients (70.5%) claimed that they had received all information about their disease. 64% stated that they were informed about medical test results. 52.5% were informed about the methods of treatment. Only half of the patients (50.6%) were informed about health risks and benefits of their treatment. 20.3% were not informed about possible outcomes of the treatment. 65.5% of the patients reported that they understand all provided information about the treatment. Out of 34.5% of patients, who partially understood or did not understand the information given to them, only 62.2% informed the doctors about the lack of understanding. Only 28% of patients expressed their opinion about the treatment to the doctor when decisions are made. 54.4% did not participate in the decision making at all. Out of those, who participated in the decision making, 59.7%... [to full text]

For everyone hospitalization represents a change accompanied by various restrictions. Anyway, this cannot mean a change in rights. Each patient is unique {--} they have specific needs, unchangeable principles, a value system of their own. A patient can be defined as a person under medical care, as an ill person undergoing treatment. The term {\clq}qpatient is derived from the Latin word {\clq}qpatiens`` {--} patient, suffering. The patients' rights are laid down in the Code of Patients' Rights which became effective in the Czech Republic in 1992. It is the knowledge of rights that is important before all for the strengthening of an equal relationship between the doctor and the patient The risks which represent a threat during the hospitalization can be lowered by consistent observation of the patients' rights as well as the patient's satisfaction with the care provided can be heightened. The basic individual rights of the patients include the right to silence to be preserved about the facts that the health worker became familiar with in connection with medical care or treatment, the right to being informed about their state of health, the right to gaining necessary information in order to be able to make a decision before a new diagnostic or therapeutical procedure is started up. The other rights include refusing a treatment and being informed about the consequences of the decision, the right to privacy during medical care or treatment and to a considerate, sensitive and worthy approach during the treatment. The thesis comprises the present state of problems in question, the aims of the thesis, determination of hypotheses, methodology, the results of the research, discussion, conclusion, the list of sources used, key words and supplements. The present state portrays the history of ethical codes, legal standards and the problems of medical law, the patients' rights, individual patients' rights, accreditation standards of the patients' rights. The aim of the thesis is to find out whether the patients are made acquainted with their rights after being taken to hospital, whether they are informed about the character of the disease, about suggested treatment and possible treatment alternatives. To map out whether there is the need of education being taken into account with each patient and whether the nurses keep notes in the documentation and find out the nurses' knowledge in the sphere of the patient's immobility. here have 7 hypotheses and 5 statistical hypotheses been specified in the thesis. Quantitative research approach was applied for the research. Questioning was used as a method, a questionnaire as a technique. The questionnaire for the patients was anonymous and included 26 questions. It focused on making the patient acquainted with their rights, on awareness of the state of health, the character of the disease and the suggested treatment, on the education of the patient by the nurse and on respecting the patient's intimacy. It included closed and semi-closed questions. At the end of the questionnaire the patients had a chance to express their possible comments, suggestions, impulses concerning the problems in question. The questionnaire for the nurses was anonymous and included 32 questions. It had its focus on observing the patients' rights, the informed patients' consent, their education, on the problems of restricting the patient on the bed and on respecting the patient's intimacy. The questionnaire included closed and semi-closed questions. The representative sample was made up of 218 patients and 205 nurses. The results were compiled in tabular and chart form, and subsequently processed by means of the SPSS statistical programme. The discussion includes a summary of the research knowledge in comparison with the sources used.

The Charter of rights of children in hospital (the EACH Charter) is an international document authored by the European Association for Children in Hospital (EACH) in the eighties of the twentieth century. The Charter can be perceived as a response to the fact that a child's stay in hospital - and paediatric hospital as an institution - is strongly influenced and formed by economical, technological and administrative aspects prevailing over the ethical ones. The Charter highlights specific situations where the health care profession - by neglecting children's needs and ignoring and/or tolerating avoidable suffering - becomes unethical. The aim of my thesis is to scrutinize the ethical appeal of the EACH Charter and to explore the Charter's ethical implications for contemporary paediatric practice in the Czech Republic.

A internação involuntária é uma medida controversa que pode levar a violação de vários direitos humanos. Nessa perspectiva, faz-se necessária uma legislação para definir e limitar as circunstâncias em que isso pode ocorrer. Políticas e leis bem formuladas podem promover o desenvolvimento de serviços acessíveis na comunidade, estimular campanhas de sensibilização e de educação, e estabelecer mecanismos legais e de supervisão para prevenir violações aos direitos humanos. Nesse contexto, este estudo descritivo-comparativo apresentou como objetivo analisar as semelhanças e diferenças entre as legislações em saúde mental relacionadas à internação psiquiátrica involuntária no Brasil e Inglaterra/País de Gales. Utilizou-se para o levantamento de dados de pesquisa bibliográfica e pesquisa documental. A análise foi realizada a partir da Lista de Checagem da Organização Mundial da Saúde (OMS) para a Legislação de Saúde Mental. Para a etapa de comparação dos dados das duas jurisdições, foi utilizado o método comparativo. Sobre os resultados da comparação da Lista de Checagem da OMS com as legislações do Brasil e Inglaterra/País de Gales, na legislação brasileira foram encontrados 52 (31,32%) dos 166 padrões da OMS, enquanto que na legislação da Inglaterra/País de Gales foram encontrados 90 (54,2%). A partir da análise foi possível concluir que: a legislação da Inglaterra/País de Gales traz procedimentos mais claros e detalhados sobre \"internação involuntária\" e possui \"mecanismos de fiscalização\" mais eficazes do que o Brasil; apesar das lacunas quanto aos procedimentos para apelações contra decisões de incapacidade e a revisão da necessidade de um tutor, a legislação apresenta uma boa cobertura sobre \"competência, capacidade e tutela\", tema de elevada importância, principalmente após a ratificação da CDPD, e que o Brasil não aborda em sua legislação; a legislação brasileira elenca um rol maior de \"direitos fundamentais\", porém não prevê \"penalidades\" quanto ao descumprimento desses direitos. Já a Inglaterra/País de Gales cobre amplamente essa questão. As principais semelhanças entre Brasil e Inglaterra/País de Gales referem-se aos padrões que necessitam de revisão: \"Pacientes voluntários\", situações de emergência\", direitos econômicos e sociais\", \"questões civis\" e \"grupos vulneráveis\". Ambas jurisdições também apresentam o mesmo nível de cobertura quanto a \"pesquisa clínica e experimental\", e \"tratamentos especiais, isolamento e restrições\". Em suma, a análise das legislações de saúde mental apresentada neste trabalho sugere que documentos internacionais de direitos humanos, como o Livro de Recursos OMS, são instrumentos importantes e que podem nortear a construção de legislações. É necessário também que a formulação de leis e políticas de saúde mental esteja articulada com os documentos internacionais de direitos humanos como a CDPD. Espera-se que o presente estudo traga a tona a reflexão das autoridades competentes sobre a necessidade de solicitar auditorias mais profundas no âmbito da legislação nacional de saúde mental, realizadas por comitês multidisciplinares, como recomendado pela OMS. A legislação de saúde mental deve estar num processo de constante evolução, centrada na busca da consolidação dos direitos das pessoas com transtornos mentais / Involuntary admission is a controversial measure that can lead to violation of various human rights. From this perspective, legislation must define and limit the circumstances in which this may occur. Well-formulated policies and laws can promote the development of accessible services in the community, stimulate awareness and education campaigns, and establish legal and supervisory mechanisms to prevent human rights violations. In this context, this descriptive- comparative aimed at analyzing the similarities and differences between the mental health\' laws related to involuntary psychiatric admission in Brazil and England/Wales. In order to collect data, the author used bibliographic and documentary research. The analysis was based on the World Health Organization\'s Checklist on Mental Heallth Legislation. To compare data from the two jurisdictions, the author used the comparative method. Results comparing the WHO Checklist with the laws from Brazil and England/Wales showed that the Brazilian legislation meets 52 (31.32%) of the 166 WHO standards, while legislation in England/Wales meets 90 (54.2%). Some conclusions resulted from the analysis: the law from England/Wales establishes clearer and detailed procedures for \"involuntary admissions\" and has \"oversight and review mechanisms\" more effective than Brazil; despite the shortcomings in the procedures for appeals against disability decisions and the review of the need for a guardian, the legislation presents a medium compliance of \"competence, capacity and protection\", a subject of high importance, especially after the ratification of the CRPD, and Brazil does not address these issues in its legislation; Brazilian establishes a larger list of \"fundamental rights\", but does not provide \"penalties\" for the breach of those rights, while England/Wales meets WHO criteria in relation to this issue. The main similarities between Brazil and England/Wales refer to standards that require review: \"voluntary patients\", \"emergency treatment\", \"economic and social rights\", \"civil issues\" and \"protection of vulnerable groups.\" Both jurisdictions also have the same level of compliance regarding \"clinical and experimental research\", and \"special treatments, seclusion and restraint\". In sum, the analysis of mental health legislation presented in this paper suggests that international human rights documents, such as the WHO Resource Book, are important tools which can guide the construction of legislation. It is also necessary that the formulation of mental health laws and policies are articulated with international human rights documents such as the CRPD. In this sense, this study may bring light for a reflection from competent authorities on the need to have audits for national mental health legislations, carried out by multidisciplinary committees, as recommended by WHO. Mental health legislation should be in a process of constant evolution, focusing on the search for the consolidation of rights of people with mental disorders

O direito à informação em saúde é um direito que se legitima a partir da informação mediada pelo profissional de saúde, permitindo com que o paciente se empodere desta informação, com a possibilidade de gerar conhecimento e, conseqüentemente, facilitar o exercício de sua cidadania. Esta pesquisa qualitativa de caráter exploratório, com orientação analítico-descritiva, apresentou como objetivo identificar o conhecimento de usuários do setor de Clínica Médica de uma Unidade Básica de Saúde (UBDS) de Ribeirão Preto sobre o seu direito à informação especificado no art. 2º, incisos VI, VII, VIII, e XI da Lei Estadual 10.241/1999: direito a informações claras e objetivas sobre diagnósticos, exames e quaisquer procedimentos realizados pela equipe de saúde, direito de consentir ou recusar procedimentos, direito ao acesso ao seu prontuário médico em caso de necessidade e, por fim, direito a receber receitas médicas legíveis, com assinatura e registro do médico. Utilizou-se para a coleta de dados de entrevista semi-estruturada e a análise dos dados foi realizada a partir da análise de conteúdo. As entrevistas foram realizadas logo após a consulta médica, com 22 usuários de uma UBDS, na tentativa de coletar os dados durante o ato reflexivo do paciente sobre o momento vivido recentemente. Os resultados demonstram que, apesar do estudo ter apontado lacunas na comunicação entre os profissionais de saúde e os usuários do serviço, as necessidades informacionais dos usuários quanto à diagnóstico, exames, medicamentos, riscos e benefícios do tratamento estão sendo supridas parcialmente, o que denota o início do estabelecimento de relações democráticas entre profissional de saúde e paciente. Em relação ao consentimento esclarecido do usuário, pequeno número dos entrevistados foram consultados se consentiam com os procedimentos e tratamentos propostos, contudo, nenhum usuário teve acesso físico ao documento. Sobre o acesso ao prontuário, este direito não se concretizou nesta pesquisa, já que todos os respondentes nunca vivenciaram este acesso, e a maioria dos entrevistados desconheciam este direito. No que diz respeito ao acesso legível às receitas médicas, poucos disseram entender as prescrições, criticando as letras dos médicos. Algumas dificuldades foram relatadas em relação ao acesso a informações, quais sejam: o desequilíbrio nas relações de poder, a falta de acesso a informações verdadeiras e de qualidade sobre sua saúde, as dificuldades na relação interpessoal com o paciente em virtude da rapidez nos atendimentos, problemas para a concretização do cuidado humanizado à saúde, a dificuldade de exercer o direito de escolha do paciente quanto ao profissional que irá atendê-lo e o excesso de burocracia no sistema. Facilidades em relação ao acesso foram evidenciadas já que houve um grande índice de satisfação dentre pacientes que são usuários efetivos do SUS. Outra facilidade foi confirmada já que a grande maioria dos entrevistados reconhece os medicamentos genéricos e apontam que os recebem na própria UBDS. Conclui-se assim que, apesar das lacunas e desafios existentes, o estudo apontou indícios e possibilidades de mudança para a construção conjunta de relações mais democráticas, em que o usuário, como sujeito, exerce direitos, mas também tem consciência de suas obrigações como cidadão, especialmente no que diz respeito à sua relação com o profissional e o serviço de saúde. / The right to health information is legitimized based on information mediated by health professionals, who empower patients with this information, which in turn permits the generation of knowledge and, consequently, facilitates the exercise of citizenship. This qualitative and exploratory study with an analyticaldescriptive approach investigates the knowledge of users from the medical clinic of a Basic Health Unit (BHU) in Ribeirão Preto, SP, Brazil concerning their right to information provided in Article 2, Items VI, VII, VIII, and XI of State Law 10.241/1999: the right to clear and objective information about diagnoses, exams and any procedures performed by the health team; the right to consent or refuse procedures; the right to access medical records in case of need; and finally, the right to receive legible medical prescriptions with the physician\'s signature and registration. A semi-structured interview was used to collect data, analyzed via content analysis. Interviews were carried out right after medical consultations with 22 users of a BHU in an attempt to collect data through the reflections of patients concerning their recent experience. Even though the study evidenced that there are gaps in the communication between health professionals and users, results revealed that the users\' information needs concerning diagnosis, exams, medication, risks and benefits of treatment are partially met, which shows that democratic relationships between health professionals and patients are being established. In regard to the users\' informed consent, a small number of users were asked to consent to the proposed procedures and treatments, though, no user had physical access to any form. Access to medical records was not evidenced in this study since none of the respondents ever had such access and most of them were unaware of this right. Concerning legible medical prescription, few reported understanding their prescriptions; physicians\' handwriting was criticized. Some difficulties were reported in relation to access to information as follows: unbalanced power relations, lack of access to truthful and quality information concerning users\' health, difficulties in patients\' interpersonal relationships due to the rapidity with which consultations are performed, difficulties in the concretization of humanized health care, difficulty in exercising their right of choice in relation to the professional who will provide care and the system\'s excessive bureaucracy. Facilities in relation to access were evidenced since a high level of satisfaction was apparent among patients, the effective users of SUS. Another facility was confirmed since most of the respondents acknowledged generic medications and report receiving them in the BHU itself. The conclusion is that despite existent gaps and challenges, the findings indicate that there are possibilities to jointly construct more democratic relationships in which users, as subjects, exert their rights but are also aware of their obligations as citizens, especially in regard to their relationship with professionals and the health service.

Gydytojo ir paciento santykiai visais laikais buvo medicinos dėmesio centre. Naujų technologijų taikymas leido gydytojui turėti objektyviais duomenimis pagrįstą paciento sveikatos būklės vaizdą, todėl gydytojas mažiau linkęs gilintis į subjektyvius paciento išgyvenimus. Gydytojų-pacient�� santykių etinių problemų sprendimas neįmanomas be valstybės ekonominių, politinių ir teisinių veiksmų. Darbo tikslas. Įvertinti Prienų PSPC gydytojų ir pacientų santykių etinius aspektus pacientų požiūriu. Tyrimo metodai. 2007m. sausio – vasario mėn. buvo atlikta Prienų PSPC pacientų, kurie apsilankė pas BPG (n=304), anketinė apklausa. Duomenų analizė atlikta naudojant statistinės analizės paketą SPSS (9,0). Dviejų požymių priklausomumas buvo tiriamas naudojant χ² kriterijų. Nulinė hipotezė buvo atmetama, kai p<0,05. Rezultatai. Didžioji vyriausios bei jauniausios amžiaus grupės, turinčių pradinį bei aukštąjį išsimokslinimą bei dideles pajamas pacientų dalis buvo patenkinti gydytojo bendravimu su jais bei palankiai vertina gydytojo ir paciento santykių administravim����, o nepasitenkinimą nurodė vidutinio amžiaus, vidurinio išsimokslinimo, mažas pajamas turintys respondentai. Labiausiai pritaria teisiniams klausimams vyriausios bei jauniausios amžiaus grupės miesto respondentai, turintys dideles pajamas. Nepatenkinti teisiniais santykiais vidutinio vyresniojo amžiaus mažų pajamų kaimo pacientai. Išvados. Pacientai patenkinti juos aptarnaujančio šeimos (BPG) gydytojo bendražmogiškomis... [toliau žr. visą tekstą] / The relationship between a physician and a patient has always been a centre of medical attention. Application of modern technologies enables a physician to receive a clear picture of a patient’s health rather than become concerned about his/her personal feelings. The solution of physician–patient ethical problems is not possible without state economical, political and legal measures. Aim of the study. To assess the ethical aspects of physician-patient relationship of Prienai Primary Health Care Centre from the patients’ attitude. Methods. In January – February 2007, a survey was conducted in order to receive the opinion from Prienai district residents, who visited a GP (n=304). Statistical analysis package SPSS (9.0) was used to analyse the data. Dependence of two symptoms was researched with of the Chi-Square test (χ²). Zero hypothesis was rejected, when p<0,05. Results. A greater part of elderly and young people who have a higher or primary education and high income were satisfied with physician–patient relationship and gave favourable assessment of the administration of the relationship. Middle-aged people who have secondary education and low income were most dissatisfied with the above mentioned. Most favourable opinion about the legal matters was provided by the oldest and youngest group of the city respondents who have high income, whereas middle-aged senior country people who have low income were dissatisfied with the legal matters. Conclusions. The patients were... [to full text]

O direito à informação em saúde é um direito que se legitima a partir da informação mediada pelo profissional de saúde, permitindo com que o paciente se empodere desta informação, com a possibilidade de gerar conhecimento e, conseqüentemente, facilitar o exercício de sua cidadania. Esta pesquisa qualitativa de caráter exploratório, com orientação analítico-descritiva, apresentou como objetivo identificar o conhecimento de usuários do setor de Clínica Médica de uma Unidade Básica de Saúde (UBDS) de Ribeirão Preto sobre o seu direito à informação especificado no art. 2º, incisos VI, VII, VIII, e XI da Lei Estadual 10.241/1999: direito a informações claras e objetivas sobre diagnósticos, exames e quaisquer procedimentos realizados pela equipe de saúde, direito de consentir ou recusar procedimentos, direito ao acesso ao seu prontuário médico em caso de necessidade e, por fim, direito a receber receitas médicas legíveis, com assinatura e registro do médico. Utilizou-se para a coleta de dados de entrevista semi-estruturada e a análise dos dados foi realizada a partir da análise de conteúdo. As entrevistas foram realizadas logo após a consulta médica, com 22 usuários de uma UBDS, na tentativa de coletar os dados durante o ato reflexivo do paciente sobre o momento vivido recentemente. Os resultados demonstram que, apesar do estudo ter apontado lacunas na comunicação entre os profissionais de saúde e os usuários do serviço, as necessidades informacionais dos usuários quanto à diagnóstico, exames, medicamentos, riscos e benefícios do tratamento estão sendo supridas parcialmente, o que denota o início do estabelecimento de relações democráticas entre profissional de saúde e paciente. Em relação ao consentimento esclarecido do usuário, pequeno número dos entrevistados foram consultados se consentiam com os procedimentos e tratamentos propostos, contudo, nenhum usuário teve acesso físico ao documento. Sobre o acesso ao prontuário, este direito não se concretizou nesta pesquisa, já que todos os respondentes nunca vivenciaram este acesso, e a maioria dos entrevistados desconheciam este direito. No que diz respeito ao acesso legível às receitas médicas, poucos disseram entender as prescrições, criticando as letras dos médicos. Algumas dificuldades foram relatadas em relação ao acesso a informações, quais sejam: o desequilíbrio nas relações de poder, a falta de acesso a informações verdadeiras e de qualidade sobre sua saúde, as dificuldades na relação interpessoal com o paciente em virtude da rapidez nos atendimentos, problemas para a concretização do cuidado humanizado à saúde, a dificuldade de exercer o direito de escolha do paciente quanto ao profissional que irá atendê-lo e o excesso de burocracia no sistema. Facilidades em relação ao acesso foram evidenciadas já que houve um grande índice de satisfação dentre pacientes que são usuários efetivos do SUS. Outra facilidade foi confirmada já que a grande maioria dos entrevistados reconhece os medicamentos genéricos e apontam que os recebem na própria UBDS. Conclui-se assim que, apesar das lacunas e desafios existentes, o estudo apontou indícios e possibilidades de mudança para a construção conjunta de relações mais democráticas, em que o usuário, como sujeito, exerce direitos, mas também tem consciência de suas obrigações como cidadão, especialmente no que diz respeito à sua relação com o profissional e o serviço de saúde. / The right to health information is legitimized based on information mediated by health professionals, who empower patients with this information, which in turn permits the generation of knowledge and, consequently, facilitates the exercise of citizenship. This qualitative and exploratory study with an analyticaldescriptive approach investigates the knowledge of users from the medical clinic of a Basic Health Unit (BHU) in Ribeirão Preto, SP, Brazil concerning their right to information provided in Article 2, Items VI, VII, VIII, and XI of State Law 10.241/1999: the right to clear and objective information about diagnoses, exams and any procedures performed by the health team; the right to consent or refuse procedures; the right to access medical records in case of need; and finally, the right to receive legible medical prescriptions with the physician\'s signature and registration. A semi-structured interview was used to collect data, analyzed via content analysis. Interviews were carried out right after medical consultations with 22 users of a BHU in an attempt to collect data through the reflections of patients concerning their recent experience. Even though the study evidenced that there are gaps in the communication between health professionals and users, results revealed that the users\' information needs concerning diagnosis, exams, medication, risks and benefits of treatment are partially met, which shows that democratic relationships between health professionals and patients are being established. In regard to the users\' informed consent, a small number of users were asked to consent to the proposed procedures and treatments, though, no user had physical access to any form. Access to medical records was not evidenced in this study since none of the respondents ever had such access and most of them were unaware of this right. Concerning legible medical prescription, few reported understanding their prescriptions; physicians\' handwriting was criticized. Some difficulties were reported in relation to access to information as follows: unbalanced power relations, lack of access to truthful and quality information concerning users\' health, difficulties in patients\' interpersonal relationships due to the rapidity with which consultations are performed, difficulties in the concretization of humanized health care, difficulty in exercising their right of choice in relation to the professional who will provide care and the system\'s excessive bureaucracy. Facilities in relation to access were evidenced since a high level of satisfaction was apparent among patients, the effective users of SUS. Another facility was confirmed since most of the respondents acknowledged generic medications and report receiving them in the BHU itself. The conclusion is that despite existent gaps and challenges, the findings indicate that there are possibilities to jointly construct more democratic relationships in which users, as subjects, exert their rights but are also aware of their obligations as citizens, especially in regard to their relationship with professionals and the health service.

This thesis deals with the perceptions of health care in healthcare facilities in South Bohemia as seen by the public. The theoretical part defines health care and health; it also informs about the quality of health care and its evaluation. It deals with health services, healthcare policy and reforms in this sector. It describes the current legislation, part which is international treaties or laws. As an example of a treaty, the thesis mentions Convention on the Protection of Human Rights and the Dignity of the Human Being with regard to the application of biology and medicine, or the Charter of Fundamental Rights and Freedoms. The section about laws mentions particularly Act No. 20/1966 Coll. on Public Health Care. In protecting the rights of patients, the Code of Patients? Rights plays an important role in. An essential part of theory is also the system of healthcare facilities, health services, healthcare professionals and the rights and obligations of various actors in the provision of health care. The objective of the thesis was to map client satisfaction with health care provided in healthcare facilities of South Bohemia. The research part, preceded by a preliminary study, was conducted by means of a quantitative questionnaire survey. The basic research group consisted of persons from the general public living in South Bohemia. In the end, two out of three hypotheses were conformed. They are: (1) health care in South Bohemia was perceived positively by the clients of healthcare facilities and (2) women perceive health care in South Bohemia more critically than men. The third hypothesis, the one that was not confirmed, showed that the clients of healthcare facilities in South Bohemia have not noticed any improvement of health care during the last five years. With regard to the outcome of the third hypothesis, a question can be brought forward as to whether health care is developing in the right direction. Therefore, it would be appropriate to pay more attention to this issue. The results can be published in professional journals and they can serve as inspiration for healthcare professionals. They may also contribute to public awareness of health care and health services in South Bohemia.

The thesis on the topic "Implementation of Elements of the Code of Ethics for Nurses and Patients' Rights in Practice" has the characteristics of a research. The thesis is divided into two parts, theoretical and practical. There were four objectives in the practical part of the thesis, the purpose of which was to determine the following: whether patients receive enough understandable information about the diagnostic, therapeutic and nursing care from doctors and nurses, whether intimacy and patients´ feelings of embarrassment are being respected by doctors and nurses, whether patients have the space to voice their views and decisions for therapeutic, diagnostic and nursing care, and whether patients perceive the approach of medical staff to other patients as dignified.

A internação involuntária é uma medida controversa que pode levar a violação de vários direitos humanos. Nessa perspectiva, faz-se necessária uma legislação para definir e limitar as circunstâncias em que isso pode ocorrer. Políticas e leis bem formuladas podem promover o desenvolvimento de serviços acessíveis na comunidade, estimular campanhas de sensibilização e de educação, e estabelecer mecanismos legais e de supervisão para prevenir violações aos direitos humanos. Nesse contexto, este estudo descritivo-comparativo apresentou como objetivo analisar as semelhanças e diferenças entre as legislações em saúde mental relacionadas à internação psiquiátrica involuntária no Brasil e Inglaterra/País de Gales. Utilizou-se para o levantamento de dados de pesquisa bibliográfica e pesquisa documental. A análise foi realizada a partir da Lista de Checagem da Organização Mundial da Saúde (OMS) para a Legislação de Saúde Mental. Para a etapa de comparação dos dados das duas jurisdições, foi utilizado o método comparativo. Sobre os resultados da comparação da Lista de Checagem da OMS com as legislações do Brasil e Inglaterra/País de Gales, na legislação brasileira foram encontrados 52 (31,32%) dos 166 padrões da OMS, enquanto que na legislação da Inglaterra/País de Gales foram encontrados 90 (54,2%). A partir da análise foi possível concluir que: a legislação da Inglaterra/País de Gales traz procedimentos mais claros e detalhados sobre \"internação involuntária\" e possui \"mecanismos de fiscalização\" mais eficazes do que o Brasil; apesar das lacunas quanto aos procedimentos para apelações contra decisões de incapacidade e a revisão da necessidade de um tutor, a legislação apresenta uma boa cobertura sobre \"competência, capacidade e tutela\", tema de elevada importância, principalmente após a ratificação da CDPD, e que o Brasil não aborda em sua legislação; a legislação brasileira elenca um rol maior de \"direitos fundamentais\", porém não prevê \"penalidades\" quanto ao descumprimento desses direitos. Já a Inglaterra/País de Gales cobre amplamente essa questão. As principais semelhanças entre Brasil e Inglaterra/País de Gales referem-se aos padrões que necessitam de revisão: \"Pacientes voluntários\", situações de emergência\", direitos econômicos e sociais\", \"questões civis\" e \"grupos vulneráveis\". Ambas jurisdições também apresentam o mesmo nível de cobertura quanto a \"pesquisa clínica e experimental\", e \"tratamentos especiais, isolamento e restrições\". Em suma, a análise das legislações de saúde mental apresentada neste trabalho sugere que documentos internacionais de direitos humanos, como o Livro de Recursos OMS, são instrumentos importantes e que podem nortear a construção de legislações. É necessário também que a formulação de leis e políticas de saúde mental esteja articulada com os documentos internacionais de direitos humanos como a CDPD. Espera-se que o presente estudo traga a tona a reflexão das autoridades competentes sobre a necessidade de solicitar auditorias mais profundas no âmbito da legislação nacional de saúde mental, realizadas por comitês multidisciplinares, como recomendado pela OMS. A legislação de saúde mental deve estar num processo de constante evolução, centrada na busca da consolidação dos direitos das pessoas com transtornos mentais / Involuntary admission is a controversial measure that can lead to violation of various human rights. From this perspective, legislation must define and limit the circumstances in which this may occur. Well-formulated policies and laws can promote the development of accessible services in the community, stimulate awareness and education campaigns, and establish legal and supervisory mechanisms to prevent human rights violations. In this context, this descriptive- comparative aimed at analyzing the similarities and differences between the mental health\' laws related to involuntary psychiatric admission in Brazil and England/Wales. In order to collect data, the author used bibliographic and documentary research. The analysis was based on the World Health Organization\'s Checklist on Mental Heallth Legislation. To compare data from the two jurisdictions, the author used the comparative method. Results comparing the WHO Checklist with the laws from Brazil and England/Wales showed that the Brazilian legislation meets 52 (31.32%) of the 166 WHO standards, while legislation in England/Wales meets 90 (54.2%). Some conclusions resulted from the analysis: the law from England/Wales establishes clearer and detailed procedures for \"involuntary admissions\" and has \"oversight and review mechanisms\" more effective than Brazil; despite the shortcomings in the procedures for appeals against disability decisions and the review of the need for a guardian, the legislation presents a medium compliance of \"competence, capacity and protection\", a subject of high importance, especially after the ratification of the CRPD, and Brazil does not address these issues in its legislation; Brazilian establishes a larger list of \"fundamental rights\", but does not provide \"penalties\" for the breach of those rights, while England/Wales meets WHO criteria in relation to this issue. The main similarities between Brazil and England/Wales refer to standards that require review: \"voluntary patients\", \"emergency treatment\", \"economic and social rights\", \"civil issues\" and \"protection of vulnerable groups.\" Both jurisdictions also have the same level of compliance regarding \"clinical and experimental research\", and \"special treatments, seclusion and restraint\". In sum, the analysis of mental health legislation presented in this paper suggests that international human rights documents, such as the WHO Resource Book, are important tools which can guide the construction of legislation. It is also necessary that the formulation of mental health laws and policies are articulated with international human rights documents such as the CRPD. In this sense, this study may bring light for a reflection from competent authorities on the need to have audits for national mental health legislations, carried out by multidisciplinary committees, as recommended by WHO. Mental health legislation should be in a process of constant evolution, focusing on the search for the consolidation of rights of people with mental disorders