La protection des droits du patient est devenue à l’heure actuelle, une obligation juridique qui s’impose à tout Etat de droit. De ce fait, le Sénégal qui évolue vite, n’est pas à la traine dans le respect et la protection des droits du patient en particulier et les droits de l’Homme en général. C’est dans cette optique que le législateur sénégalais à adopté en 1998 deux lois complémentaires relatives à la réforme du système de santé afin de conférer au patient des droits, qui jusqu’à l’adoption de ces lois, étaient considérés comme des obligations déontologiques du médecin : la loi n°98-08 du 2 mars 1998 et la loi n°98-12 du 2 mars 1998. Depuis l’adoption de ces deux lois, les relations entre le médecin et le patient ont beaucoup évolué du moins en théorie car, sur le terrain, il est constaté que cette réforme hospitalière est inadaptée aux réalités locales. En réalité, même si la réforme du système de santé sénégalais est inefficace aux yeux de l’opinion publique, reste qu’elle a le mérite de doter le Sénégal d’un cadre juridique garantissant les droits du patient notamment le droit d’accès aux soins de qualité, le droit à une information claire et appropriée et le droit au consentement libre et éclairé. / The protection of the rights of the patient became at the moment, a legal obligation (bond) which is imperative upon any rule of law (State subject to the rule of law). Therefore, Senegal which evolves fast is not lagging behind in the respect and the protection of the rights of the patient in particular and the human rights generally. It is from this perspective that the Senegalese legislator adopted in 1998 two complementary (additional) relative laws which re-forms her (it) of the health system to confer on the patient’s rights, which until the adoption of these laws, were considered as ethical obligations (bonds) of the doctor: The law n°98-08 of March 2nd, 1998 and the law n°98- 12 of March 2nd, 1998. Since the adoption of these two laws, the relations between the doctor and the patient evolved a lot at least in theory because, on the ground, he (it) noticed that this re-form hospitable (hospital) is unsuitable for the local realities. In reality, even if it re-forms her (it) of the Senegalese health system is ineffective in the eyes of the public opinion, states that she (it) has the merit to endow Senegal of a legal framework guaranteeing the rights of the patient in particular the access right for quality care, the right (law) for clear and appropriate information and the right (law) for free and lit consent.

Through her texts depicting amorous adventures, Eliza Haywood engages with critical, contemporary discussions about power relations and consent in both social and legal constructs. Her texts resist the boundary between the private domain of interpersonal relationships and the public domain of political relations. Rather, her fiction engages in a wide-reaching discourse that explores the interrelations between power, agency, consent, and education, and lays bare the ways in which societal roles and expectations are reinforced in damaging ways. This thesis aims to prove that Haywood’s repetition of central motifs—including the continued tension between resisting and yielding to sexual pressure or temptation, and the line between seduction and rape—serves to question how these behaviours become normalized and naturalized. Through analyzing three categories of relationships—women and their fathers or guardians, women and their lovers, and women with other women—this thesis unpacks how women’s agency is stifled by parental relationships, transferred to male lovers, and finally empowered by female intimacy.

Le recours aux soins est chose quotidienne pour l'ensemble des individus. Ces derniers sont effectivement soumis dans leur quotidien à la contrainte médicale émanant du "droit-créance" à la protection de la santé prévu à l'alinéa 11 du Préambule de la Constitution de 1946. Néanmoins, parallèlement à ce développement de l'accès aux soins, s'est dégagé le droit subjectif à la santé qui interdit toute atteinte à la santé de l'individu. Ces deux acceptions du droit à la santé interagissent au point que la première devienne une véritable contrainte pour la seconde. Il est donc indispensable de trouver des solutions afin qu'un équilibre puisse s'établir entre ces deux conceptions. Le consentement aux soins du patient constitue valablement une conséquence de la conception subjective du droit à la santé. Consacré par la loi du 04 mars 2002, relative aux droits des patients, le droit au consentement ne dispose d'aucun rattachement à une norme fondamentale opératoire, pour l'heure. Il se trouve en réalité souvent atteint par le recours imposé aux soins. Cette étude s'attache donc à démontrer que le droit au consentement aux soins présente une effectivité relative et qu'il est alors indispensable de le rattacher à des droits fondamentaux préexistant / The appeal(recourse) to the care is daily thing for all the individuals. The latter are actually subjected(submitted) in their everyday life(daily paper) to the medical emanating constraint of "right-claim"("right-debt","law-claim") in the protection of the health planned in the paragraph 11 of the Introduction of the Constitution of 1946. Nevertheless, in a parallel to(at the same time as) this development of the access to healthcare, got free the subjective right(law) for the health which forbids any infringement(achievement) on the health of the individual. These two meanings of a word of the right(law) for the health interact to the point that the first one(night) becomes a real constraint for second. It is thus essential to find solutions so that a balance can become established between these two conceptions(designs). The consent in the care of the patient establishes(constitutes) validly a consequence of the subjective conception(design) of the right(law) for the health. Dedicated by the law of March 04th, 2002, relative to the rights of the patients, the right(law) for the consent arranges no fastening with an operating fundamental standard, for the moment. He(it) is in reality often reached(affected) by the appeal(recourse) compulsory for the care. This study thus attempts to demonstrate that the right(law) for the consent in the care presents a relative effectiveness and that it is then essential to connect him(it) with pre-existent fundamental right

This thesis addresses the question of how data protection law should respond to the challenges arising from the ever-increasing prevalence of big data. The investigation is conducted with the case study of online behavioural advertising (OBA) and within the EU data protection legal framework, especially the General Data Protection Regulation (GDPR). It is argued that data protection law should respond to the big data challenges by leveraging the regulatory options that are either already in place in the current legal regime or potentially available to policymakers. With the highly complex, powerful and opaque OBA network, in both technical and economic terms, the use of big data may pose fundamental threats to certain individualistic, collective or societal values. Despite a limited number of economic benefits such as free access to online services and the growth of the digital market, the latent risks of OBA call for an effective regulatory regime on big data. While the EU's GDPR represents the latest and most comprehensive legal framework regulating the use of personal data, it has still fallen short on certain important aspects. The regulatory model characterised by individualised consent and the necessity test remains insufficient in fully protecting data subjects as autonomous persons, consumers and citizens in the context of OBA. There is thus a pressing need for policymakers to review their regulatory toolbox in the light of the potential threats. On the one hand, it is necessary to reconsider the possibilities to blacklist or whitelist certain data uses with mechanisms that are either in place in the legal framework or can be introduced additionally. On the other hand, it is also necessary to realise the full range of policy options that can be adopted to assist individuals in making informed decisions in the age of big data.

O presente trabalho construiu-se a partir dos novos paradigmas que permeiam a relação médico-paciente. Se o profissional não mais se encontra em uma posição de superioridade (ao menos do ponto de vista fático) em face de seu paciente, que por sua vez está mais sensível em virtude das transformações oriundas da sociedade de massa, o elemento informação ganhou contornos importantíssimos, inserindo-se no núcleo principal da prestação, ao lado dos cuidados relativos à saúde propriamente ditos. Nesse contexto, foi proposta uma nova visão do dever de informar na relação médico-paciente, tratando a informação como uma obrigação autônoma, que gera de per se em caso de ausência ou vício responsabilização civil. A reparação, em tal perspectiva, surge a partir da violação do direito à liberdade: se a autodeterminação é um atributo da personalidade do paciente, a afronta a esse direito acarreta danos indenizáveis. Os limites do dever de informar, assim, desempenham relevante papel, pois demarcam a tênue linha que distingue a informação viciada (que ensejará responsabilização civil) daquela transmitida diligentemente. Assim, o conteúdo e a extensão da informação foram abordados, confrontando-se aspectos subjetivos, objetivos e buscando uma solução ao mesmo tempo viável (do ponto de vista prático), jurídica e justa. Como o trabalho trata essencialmente do dever de informar na relação médico-paciente e das consequências jurídicas derivadas do inadimplemento dessa obrigação, foram destrinchados todos os elementos que compõem esse complexo vínculo, passando por sua evolução histórica, pelos princípios, valores e direitos que permeiam e iluminam esta relação e, finalmente, pelos sujeitos que a compõem. Aspectos processuais atinentes à prova do cumprimento do dever de informação foram, ainda, examinados. Diversas questões polêmicas, tais como recusa de tratamento, direito a não saber, privilégio terapêutico, dentre outros, foram também debatidos. / This study is based on the new paradigms that permeate the doctor-patient relationship. If the medical professional no longer holds a superior position (at least from the factual point of view) vis a vis the patient who, on the other hand, is more aware to changes originating from doctor-patient relationship in the mass society, information availability has gained highly important contours, inserting itself into the core of services rendered, together with health care services themselves. In this context, this study proposes a new vision of the duty to inform in a doctor-patient relationship, treating information as an autonomous obligation, that, per se, results in liability in the case of its absence or flaws. The compensation, in such perspective, arises from breach of the right to autonomous choice: if self-determination is a characteristic of the patients personality, the disrespect of this right results in damages subject to indemnification. Therefore, the limits of the duty to inform perform a relevant role since they demarcate the fine line that distinguishes flawed information (that can incur liabilities) from that transmitted diligently. Thus, the contents and the extension of the information were addressed, comparing subjective and objective aspects and seeking a solution at the same time viable (from the practical viewpoint), legal and just. Since this study essentially deals with the duty to inform in the doctorpatient relationship and of the legal consequences derived from noncompliance of this duty, all factors that compose this complex link were carefully examined, reviewing its historical evolution, the principles, values and rights that permeate and elucidate this relationship and, finally, the parties involved. Legal evidential procedures related to fulfillment of the duty to inform were also examined. Various controversial topics such as the refusal to undergo treatment, the right to not be informed, therapeutic privilege, among others, were also discussed.

<p>Syftet med min analys är att ur femtio Bonapojkars brevmaterial, få en förståelse hur ungdomstiden gestaltade sig för dessa. Med analysen vill jag bidra till att utveckla metoder för att använda sig av privatpersoners brev i historieforskningen. Pojkarna var intagna på Bona uppfostringsanstalt under åren 1905-09 och 1946-48. Åldern på pojkarna var 15-18 år och de var dömda för ett mindre brott till tvångsuppfostran. Resultatet av analysen visade att få kommunicera med yttervärlden via brev var viktigt för pojkarna. Själva vistelsen på Bona upplevdes mycket olika mellan pojkarna. Från att vara något som de var tacksamma för till det värsta stället på jorden. Bona fyllde flera funktioner för pojkarna. Det kunde fungera både som en myndighet och en resurs för dem. Bona hade även drag av ett patriarkalt förhållande till pojkarna.</p>

Syftet med min analys är att ur femtio Bonapojkars brevmaterial, få en förståelse hur ungdomstiden gestaltade sig för dessa. Med analysen vill jag bidra till att utveckla metoder för att använda sig av privatpersoners brev i historieforskningen. Pojkarna var intagna på Bona uppfostringsanstalt under åren 1905-09 och 1946-48. Åldern på pojkarna var 15-18 år och de var dömda för ett mindre brott till tvångsuppfostran. Resultatet av analysen visade att få kommunicera med yttervärlden via brev var viktigt för pojkarna. Själva vistelsen på Bona upplevdes mycket olika mellan pojkarna. Från att vara något som de var tacksamma för till det värsta stället på jorden. Bona fyllde flera funktioner för pojkarna. Det kunde fungera både som en myndighet och en resurs för dem. Bona hade även drag av ett patriarkalt förhållande till pojkarna.

This thesis investigates what work ought to be like. The answer it presents consists of an outline of a liberaltheory of justice in the employment contract based on theory developed in the area of political philosophy. Thethesis also examines issues of efficiency—How should measures to improve working conditions be evaluated?—and the ethical implications of the economic theory of employment contracts and the neoclassical theory of themarket. Paper I: A theoretical framework is introduced for the evaluation of workplace inspections with respect totheir effects on working conditions. The choice of a concept of efficiency is discussed, and its relation to criteriafor a good working environment is clarified. It is concluded that in order to obtain reliable information onthe effects of different inspection methods, it is necessary to perform controlled comparative studies in whichdifferent methods are used on different workplaces. Paper II: This article outlines the structure of a Rawlsian theory of justice in the employment relationship.The theory answers three questions about justice and the workplace. What is the relationship between socialjustice and justice at work? How should we conceive of the problem of justice within the economic sphere?And, what is justice in the workplace? Reasons for a specific construction of a local original position are givenand arguments are presented in support of a principle of local justice in the form of a choice egalitarian localdifference principle. Paper III: The political philosophy of John Rawls is applied to the moral dilemma of whistleblowing, andit is shown that that the requirement of loyalty, in the sense that is needed to create this dilemma, is inconsistentwith that theory. In a discussion and rejection of Richard De George’s criteria on permissible whistleblowing,it is pointed out that the mere rejection of loyalty will not lead to an extreme position; harms can still be takeninto account. Paper IV: The case is made that if contemporary economics of the employment contract is correct, thenin order to explain the existence of employment contracts, we must make the assumption that the contractingparties are attempting to deal with decisiontheoreticignorance. It follows that the course of action that theemployer chooses to take when acting from authority cannot be justified by consent, since the informednesscriterion of consent cannot be satisfied under ignorance. It is then suggested that in order to achieve justificationof acts of authority, there must be in place a real possibility to contest employers’ decisions. Paper V: According to Ronald Dworkin’s theory of equality of resources, mimicking the ideal market fromequal starting points is fair. According to Dworkin, the ideal market should be understood as described in GérardDebreu’s influential work, which implies that we should conceive of trade as taking place under certainty. Thereare no choices under risk in such a market. Therefore, there is no such thing as option luck in the ideal market.Consequently, when mimicking this market, we cannot hold people responsible for option luck. Mimicking thismarket also implies that we ought to set up a social safety net, since rational individuals with perfect foresightwould see to it that they always have sufficient resources at each point in life. Furthermore, the idea of insuranceis incompatible with the ideal market. / QC 20100728

What role should trust have in biobank research? Is it a scarce resource to be cultivated, or does its moral significance lie elsewhere? How does it relate to the researcher’s individual responsibility? In this thesis I draw four general conclusions. First, trust is still very much present in at least some biobanking settings, notably in Sweden, but possibly also internationally. Second, a morally relevant conception of trust entails that to be trustworthy, researchers must consider the normative expectations that people have of them, and renegotiate expectations that are mistaken. Third, this conception differs from “public trust” assessed through surveys. The main use of the latter is to legitimate policy, not to identify moral duties. Fourth, in spite of ethics review, guidelines and informed consent procedures, ethical issues will always arise during the course of a research project. Researchers can therefore never avoid their individual moral responsibility. Ensuring that one is adequately trusted is one step towards conducting morally acceptable research. Study I indicates that few Swedes refuse storage of samples in healthcare-associated biobanks and their use in research. Study II suggests that people are somewhat more willing to donate samples than surveys indicate, especially when approached face-to-face by health care personnel. Relationships of trust might thus be important in people’s decision-making. Study III investigates trust as a moral concept. The trustee is often in a unique position to determine what the other’s trust amounts to. When it is mistaken, the trustee has an obligation to counteract it, compensate for it, or renegotiate the expectations that cannot be met. In Study IV, I critique the feasibility of guaranteeing the trustworthiness of the research apparatus through formal measures such as ethics review and guidelines. Not only are there limitations of such measures to consider. They also risk blinding researchers to ethical issues that are not covered by the rules, fostering moral complacency, and alienating researchers to ethics.

Purpose: Patients living with advanced heart failure experience dyspnea, fatigue, poor quality of life, depression and cognitive impairment which may threaten their ability to provide informed consent to undergo heart transplant (HTx) or mechanical support (LVAD). Using qualitative and quantitative methods, we asked how patients with advanced heart failure make decisions regarding HTx and LVAD. The variables chosen to reflect the elements of consent included quality of life and symptom severity (voluntariness), depression and cognitive impairment (capacity) and treatment preferences (decision-making). Methods: 76 patients enrolled in the quantitative arm completed the Minnesota Living with Heart Failure Questionnaire; Visual Analog scales for dyspnea, fatigue and overall health; Beck Depression Inventory; Montreal Cognitive Assessment; Standard Gamble and Time Tradeoff. Qualitative methods were used to discover concepts, relationships and decision-making processes described by 17 of the 76 patients considering HTx and LVAD. Results: Patients reported poor quality of life and high symptom severity scores which compelled them to consider surgery as a way to relieve unpleasant symptoms and improve quality of life. Although 30% of patients had evidence of depression and/or cognitive impairment, no patient was deemed incapable of decision-making. Patients were willing to take considerable risk (35%) and trade considerable time (4months) to improve their health. While heart failure-related concepts were important to the decision, entrustment emerged as the meaningful process for decision-making. Conclusions: Patients who participated in this study were capable of decision-making and understood the risks associated with the surgery. Voluntariness was diminished by disease but not absent, and decisions were free of coercion. These results suggest the entrustment model of decision-making is the dominant process for patients considering high-risk surgical procedures and meets criteria for informed consent. Understanding the process of decision-making will help clinicians support and enable treatment decisions made by patients living with advanced heart failure.