OBJETIVO: Analisar a frequência da submissão do protocolo de pesquisa aos Comitês de Ética em Pesquisa e da aplicação do Termo de Consentimento Livre e Esclarecido do projeto intitulado “Protocolo Brasileiro para o Tratamento de Pacientes com Tumores da Família de Sarcoma de Ewing”. MÉTODOS: Trata-se de estudo transversal retrospectivo. Através das fichas clínicas dos pacientes foi realizada uma análise do trâmite regulatório, bem como, do processo de obtenção do Termo de Consentimento Livre e Esclarecido de 180 pacientes de 16 instituições. RESULTADOS: Dez dos dezesseis centros submeteram o Protocolo ao Comitê de Ética em Pesquisa local. Em relação ao Termo de Consentimento Livre e Esclarecido, 161 dos 180 pacientes e/ou seus representantes legais consentiram e assinaram o Termo aplicado pelo pesquisador. Destes, 123 assinaram o Termo de Consentimento específico do protocolo e 38 assinaram o Termo de Consentimento institucional. Em relação à data da assinatura do consentimento, 141 dos 161 pacientes assinaram o Termo de Consentimento após receberem as informações referentes ao estudo clínico e antes de iniciar o tratamento. CONCLUSÃO: A maioria das instituições participantes apresenta uma estrutura adaptada ao assistencialismo e não estavam familiarizadas com aspectos éticos, legais e regulatórios que envolvem um projeto desta natureza. / OBJECTIVE: To analyze the frequency of submission of the research protocol to the Institutional Research Board and application of Informed Consent Form related to a clinical trial entitled “Treatment of Patients with Ewing Sarcoma Family of Tumors: A study of the Brazilian Cooperative Group”. METHODS: Retrospective cross-sectional study. Through patient records were performed an analysis of the regulatory proceeding and the signing of the Informed Consent Form by 180 patients from 16 institutions. RESULTS: Ten of the sixteen centers submitted the Protocol to the local Institutional Review Board. Regarding the Informed Consent Form, 161 of 180 patients and/or their legal representatives consented and signed the Form applied by the researcher. Of these, 123 signed the consent form specific to the protocol and 38 signed an institutional form. Regarding the date the consent form was signed, 141 of 161 patients signed it after receiving information about the trial and before starting treatment. CONCLUSION: Most of the participating institutions had a structure adapted to welfare and were not familiar with the ethical, legal and regulatory systems involved in a project like this.

The purpose of this paper is twofold. Firstly, it makes a normative idea analysis concerning organ donation, by comparing the perspectives of utilitarianism and classical liberalism. Secondly, it applies these perspectives on the Swedish legislation, in order to understand it in a political philosophical view. As a theoretical framework, the paper uses the two perspectives´ overarching ethical standpoints, but also try to discern their views on four - for the topic -appropriate concepts, these being the concepts of liberty, consent and self-ownership. These are then bundled together into two so-called ”ideal types”, to use for making normative statements about what the most morally right legislation would be concerning organ donation. In utilitarianism, an agent-neutral overall happiness is at the forefront, which leads it to prioritize an increase in donations over the autonomy of the individual. This makes the case for a conscription of organs or the softer notion of an opt-out system. Classical liberalism focus more on the right to self-ownership and negative liberty, and therefore argue for an opt-in system, which requires the explicit consent of the individual. Lastly, the paper makes the claim that the Swedish legislation falls in a category inbetween the normative judgements of the two perspectives, as it prescribes an opt-out system, but reserves the right of the family to refuse a donation, in case the deceased had not made a choice ante mortem.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study aimed to analyze the relationship between the ties of workers with the organization and the leadership styles of managers in Public and Private Hospitals Nursing team in Rio Grande do Sul (RS). Therefore, we carried out a case study, descriptive and quantitative approach nature. The research sample consisted of 347 nurses, technicians and nursing assistants from a public and a private hospitals, located in the city of Porto Alegre/RS. To collect data, we used a research protocol (questionnaire) with closed items, divided into three parts: personal and occupational data; Ties to the Organization; and Leadership styles. Data analysis was performed using the software "Microsoft Excel" version 2010, SPSS version 18 and SAS version 9.1, by calculating descriptive statistics, groups comparison of techniques and correlation analysis - Pearson correlation coefficient. The data obtained in the analysis revealed that the correlations between the constructs all associations were positive, which indicates there is some form of direct relation between them. Considering the relationship between "Ties with the Organization" and "Leadership Styles" concluded for the study context, the Organizational Commitment correlated more strongly with the Transformational Leadership and its Intellectual Stimulation basis, as Organizational Consent also bound more strongly with this leadership and its base Charisma or Idealized Influence. At the same time, the Organizational Entrenchment was related significantly only with Leadership Absence, showing that, on this link, very little is perceived by employees as of leadership responsibility. From these results, we can say that the ties that workers develop with their organizations are related to leadership styles of their managers, or the absence of these, some with a stronger intensity, other weaker, but all positively associated. / Este estudo teve como objetivo analisar a relação entre os vínculos dos trabalhadores com a organização e os estilos de liderança dos gestores na equipe de Enfermagem de Hospitais Públicos e Privados no Rio Grande do Sul (RS). Para tanto, realizou-se um estudo de caso, de natureza descritiva e abordagem quantitativa. A amostra da pesquisa foi composta por 347 enfermeiros, técnicos e auxiliares de enfermagem de um Hospital público e um Hospital privado, localizados na cidade de Porto Alegre/RS. Para a coleta de dados utilizou-se um protocolo de pesquisa (questionário) composto por itens fechados, divididos em três partes: Dados pessoais e ocupacionais; Vínculos com a Organização; e, Estilos de Liderança. A análise dos dados foi realizada com o auxílio dos softwares Microsoft Excel versão 2010, SPSS versão 18 e SAS versão 9.1, por meio de cálculo de estatísticas descritivas, técnicas de comparação de grupos e análise de correlação - coeficiente de correlação de Pearson. Os dados obtidos nessa análise revelaram que, entre as correlações dos construtos, todas as associações foram positivas, o que indica haver alguma forma de relação direta entre estes. Considerando a relação entre Vínculos com a Organização e Estilos de Liderança concluiu-se, para o contexto de estudo, que o Comprometimento Organizacional se correlacionou mais intensamente com a Liderança Transformacional e sua base Estimulação Intelectual, à medida que o Consentimento Organizacional também se ligou mais fortemente com essa liderança e sua base Carisma ou Influência Idealizada. Ao mesmo tempo, o Entrincheiramento Organizacional relacionou-se significativamente apenas com a Ausência de Liderança, demostrando que, em relação a este vínculo, muito pouco é percebido pelos colaboradores como de responsabilidade da liderança. Diante desses resultados, é possível afirmar que os vínculos que os trabalhadores desenvolvem com suas organizações estão relacionados aos estilos de liderança dos seus gestores, ou a ausência destes, sendo algumas com uma intensidade mais forte, outras mais fracas, mas todos positivamente associados.

The aim of thesis is to create an overview of the holistic concept of domestic palliative care in the context of social work. This overview includes identification of the needs of people in the terminal stage of life and the dilemmas that families face in the final stage of the lives of their loved ones. The individual chapters of this thesis describe the needs of the dying and informal caregivers, and they point out the importance of the family environment for coping with death-related concerns. The qualitative survey carried out via semi-structured interviews includes identification of the needs of the dying and caregivers, the dilemmas of caregivers in making decisions about choosing the form of care for their loved ones, and mapping the awareness of caregivers about the possibilities of social work support.

Informed consent presents interesting legal and ethical challenges that have been widely discussed both in Czech and foreign literature. Significant portion of the literature is concerned with a relationship between doctors and their patients and with the historical development of this relationship or with the principle of autonomy as one of the fundamental principles in the area of healthcare provision. Issues related to informed consent of minors or persons with limited legal capacity are often given only small amount of scholarly attention. It is for this reason that this diploma thesis deals solely with the issues related to the health care provided to minors and persons with limited legal capacity. The aim of this thesis is to create an integrated overview of the law regulating informed consent of these persons, to introduce the most important changes that have been made in recent years by the Act on Health Services and Conditions of Their Provision and by the Civil Code, and finally to add some of my reflections on selected issues which I find particularly problematic. The sixth chapter of the thesis focuses on a comparison between the Czech law and the English common law regulating informed consent of minors and persons with limited legal capacity. The issues of informed consent is an...

The subject of this thesis is "Protection of personality in health care" which is an important and especially current topic. After the recodifications of relevant legislation - particularly the recent Civil Code (which is built on the natural law concept) - is more focused on the protection of personality and it generally changed perception of harm to personal rights. It is newly called "compensation for personal harm to the natural rights of person" and claims for compensation for damages and recompense of non-pecuniary damages is tied to a single court proceedings. The thesis is divided into four parts. The first part introduces the basic concepts related to personal rights and to certain medical terminology including explanation of the term "lege artis". The second part presents the relevant legislation, both national and international. The third and largest section is devoted to the protection of patient's personality which is defined by the individual rights of patient in health care. It refers to the patient's right to be treated "lege artis" during receiving of health services, patients' right to be informed and provide related informed consent (on which the thesis is particularly focused), medical confidentiality of health workers and issues related to handling the patient's medical...

Pour faire face à la stigmatisation et l’exclusion vécues par les personnes atteintes de troubles mentaux, le Ministère de la Santé et des Services Sociaux au Québec (province du Canada) a mis en place un plan d’action en santé mentale 2005-2010, la force des liens, afin d’offrir des services de première ligne en santé mentale accessibles et efficients dans la communauté.. Cette société de droit par son dispositif législatif, veut protéger les personnes vulnérables d’autant plus les personnes présentant un danger pour elles-mêmes ou pour autrui, ceci parfois même au prix de leur liberté, par des mesures de contrôle, ce qui implique ingérence médicale et sociale. La révision des services de santé mentale dans un centre de santé et des services sociaux au Québec permet de préciser ce qu’en disent les acteurs impliqués et les personnes souffrant de troubles mentaux. Cette démarche met en évidence les difficultés des personnes utilisatrices de services pour recevoir le support nécessaire à leur intégration dans la communauté et à l’atteinte de leur pleine citoyenneté. Un des défis de l’avenir est de solliciter leur participation à différents niveaux de décision, les stratégies législatives internationales viennent illustrer et compléter cet alignement. / In order to take on stigmatization and exclusion experienced by people who have mental health problems, the Quebec Minister of Health and Social Services (province of Quebec in Canada) put in place The Mental Health Action Plan 2005 – 2010 The Strength of Links offering first line services in Mental Health that are accessible and of quality to the community. The Legislative assembly of Quebec as a society of rights wants to protect vulnerable persons and even more so those persons who are a danger to others or themselves sometimes at the price of their freedom, by measures of restraint that implicate medical and social intrusion. The revision of Mental Health Services in a Quebec Health and Social Services Centre permits clearer understanding of needs expressed by those implicated who suffer from mental health as well as the users of the services. This method gives a greater overview of the difficulties people have in receiving the necessary care and support so as to integrate fully in society as full citizenship entails. This is a challenge for the future, to seek their participation at different decision levels; international legislative strategies do illustrate and complete this alignment.

Aujourd’hui, il n’est pas rare qu’une personne se trouve en position de faiblesse lorsqu’elle contracte. Une entreprise en situation de dépendance économique, un consommateur face à un professionnel, l’utilisation de plus en plus fréquente de contrats d’adhésion, sont autant de facteurs pouvant conduire à la vulnérabilité d’un contractant. Le risque est alors que la partie dite « forte » abuse de sa position pour pousser l’autre à s’engager dans une convention fortement déséquilibrée, profitant essentiellement à l’auteur de l’abus. Ce type blâmable de comportement se manifestant lors de la formation des contrats, la partie lésée devrait pouvoir trouver une protection à travers la théorie des vices du consentement. Toutefois, cette théorie se révèle aujourd’hui inadaptée pour protéger efficacement les contractants victimes d’abus. Ce constat s’explique principalement par le fait qu’elle est restée inchangée depuis 1804. Basée sur une conception individualiste du contrat, les conditions d’admission propres à chaque vice, que sont l’erreur, la violence et le dol, sont trop restrictives. Or, les inégalités contractuelles étant à ce jour plus prononcées, elles entraînent nécessairement davantage d’abus, c’est pourquoi il convient de restaurer une telle théorie pour protéger comme il se doit les contractants. C’est à travers la notion de dol que nous proposons de le faire. Ce choix n’est pas le fruit du hasard. Il se justifie par le fait que le dol est un délit civil, avant même d’être un vice du consentement. Plus précisément, il est la manifestation de la déloyauté précontractuelle. Le consacrer comme un fait altérant la volonté engendre alors deux effets négatifs. Le premier tient au fait qu’il apparaît, en droit positif, comme une notion complexe, source de contradictions. Le second consiste à ne pouvoir réprimer la malhonnêteté perpétrée lors de la formation des contrats que de manière imparfaite et ce, en raison du champ d’application trop restreint du dol, celui-ci étant cantonné à une erreur provoquée. En lui redonnant sa véritable nature, celle de délit civil viciant le contrat, id est d’atteinte à la bonne foi précontractuelle, on remédierait à ces deux imperfections. / Professional, or the increasing use of adhesion contracts (“take it or leave it agreements”), all are factors that can lead to the contractor’s vulnerability. The risk is, for the so-called “strong” party, to abuse its position in order to force the other party into a strongly unbalanced agreement, mainly in its own benefit. Since such a reprehensible behavior occurs during the contract formation, the weakened party should be able to find protection through the use of the defects of consent theory. However, this theory has proven inadequate to effectively protect abused contractors today. A major explanation is due to the fact that this theory remains unchanged since 1804. Based on an individualistic conception of the contract, conditions of admission of each defects of consent, such as error, abuse and fraud, are too restrictive. However, the more contractual inequalities exist, the more they will turn into abuse. Therefore, this is why such a theory should be restored in order to protect contractors. It is through the notion of “dol” (willful misrepresentation or fraudulent concealment) that we propose to do so. This choice is not a coincidence. It is justified by the fact that “dol” is a tort, even before being a defect of consent. Specifically, it is the manifestation of pre-contractual disloyalty. Its recognition as a fact altering willpower will generate two negative effects. The first is linked to the fact that “dol” appears to be a complex notion and a source of contradiction in substantive law. The second is not permitting to properly penalize the dishonesty perpetrated during the contract formation due to a too narrow scope of the “dol”, the latter being understood as an induced error. Giving it back its real nature of a civil tort defecting the contract and undermining the pre-contractual good faith, our work aims at finding a remedy to these two shortcomings.

Le mutuus dissensus est une locution latine de droit positif français. Elle est utilisée par la doctrine civiliste depuis la fin du XIXème siècle pour désigner une notion fondamentale du droit des conventions. La notion juridique de mutuus dissensus peut être définie comme la convention par laquelle toutes les parties consentent à la révocation de la convention qu’elles ont conclue antérieurement. La notion de mutuus dissensus présente une unité. Elle repose sur la réunion de deux éléments constitutifs essentiels. Le premier est une procédure classique : une convention. La convention de mutuus dissensus est une véritable convention extinctive plutôt qu’un nouveau contrat identique en sens inverse du contrat révoqué. Le second est un effet de droit spécifique : la révocation. La révocation par mutuus dissensus est plutôt une résiliation du contrat opérant uniquement pour l’avenir qu’une prétendue résolution d’un contrat à effet rétroactif. La notion de mutuus dissensus a un domaine très large en droit positif. La révocation par mutuus dissensus est un principe général du droit des conventions fondé sur l’article 1134, alinéa 2, du Code civil, qui a vocation à s’appliquer à toutes les conventions et dans toutes les matières. La notion de mutuus dissensus détermine un régime juridique spécifique. Les parties sont libres de déterminer les effets de la révocation par mutuus dissensus. Le principe de la liberté des parties est limité par l’ordre public. La sécurité des tiers est assurée par une protection générale et des protections spéciales reposant principalement sur le mécanisme de l’inopposabilité. / Mutuus dissensus is a latin expression in the French positive law. It has been used by civil doctrine since the end of the nineteenth century to designate a basic notion of Contract Law. The juridic notion of mutuus dissensus may be defined as an agreement between all the parties to rescind their precedent contract. The notion of mutuus dissensus has an unity. It stands on two essentials constituent elements. The first one is a classical procedure: an agreement. Mutuus dissensus agreement is a real subsequent agreement to end a contract, rather than a new identical contract but opposite to the rescinded contract. The second one is an effect of specific right: the rescission. Rescission by mutuus dissensus is the termination of a contract for the future rather than a supposed discharge of a contract with a retroactive effect. The notion of mutuus dissensus has a very wide field in positive law. Rescission by mutuus dissensus is a general principle of law of contracts based on section 1134, subsection 2, of the French civil code, which is to apply to every contract and in every subject. The notion of mutuus dissensus determines a specific juridical system. Parties are free to decide the effects of the rescission by mutuus dissensus. The principle of freedom of parties is limited by law and order. The protection of third parties is ensured by a general protection and special protections which limit the effects of the rescission of contract by mutuus dissensus.

Les évolutions sociétales témoignent d’une prise en compte grandissante du concept de victime par le droit, et spécifiquement par le droit de la santé. Le droit de la santé est une branche du droit particulièrement riche et complexe dont l’expansion résulte à la fois d’une judiciarisation des professions de santé et d’une succession de scandales sanitaires. La transversalité du droit de la santé et l’appréhension évidente de la victime conduisent à souligner l’existence d’une relation particulière entre ces deux concepts. Néanmoins, il convient de se demander si le caractère épars des règles du droit de la santé permet d’accorder un statut juridique cohérent à la victime dans ce domaine. Si la recherche d’un statut juridique de la victime peut être entreprise, cela se justifie au regard de la spécificité que le droit de la santé semble lui accorder. La présente étude entreprend de démontrer l’existence d’une singularité de la victime dans le domaine de la santé, légitimant dans le même temps la recherche d’un statut juridique. L’assise de la spécificité de la victime réside dans l’attribution de cette qualité indépendamment de la réalisation d’un risque. La survenance d’un évènement constitue donc un critère temporel dont dépend la qualité de « victime avérée » ou celle de « victime potentielle ». La tangibilité du statut juridique de la victime en droit de la santé naît alors de la reconnaissance de sa singularité à travers la présente dichotomie / Evolutions of the society testify a growing awareness of the concept of victims by the law, and especially in Health Law. Health Law is a branch of law which is particularly rich and complex, and whose expansion results both from the judicialization of the health professions and from the succession of health scandals. The transversality of Health Law and its obvious apprehension of the victim lead to highlight the existence of a special relationship between these two concepts. However, the question is whether the scattered character of the Health Law rules assigns a coherent legal status to the victim in this area. If the search for the legal status of the victim can be undertaken, this can be justified by the specific nature of Health Law. The present study tries to demonstrate the existence of the singularity of the victim in the Health Law, while legitimating at the same time the search for the legal status. The foundation of the victim’s specificity lies in the attribution of this quality independently from the realization of a risk. The occurrence of an event constitutes therefore a temporal criterion on which depends the quality of “proved victim” or that of “potential victim”. The tangibility of the victims’ legal status in Health Law arises from the recognition of the singularity through the present dichotomy