Background: Sexual consent is often defined as the voluntary agreement to participate in a sexual act, though the differing definitions across and within countries make legal consensus difficult. In recent years, due to popularization through social media, nonconsensual condom removal, termed stealthing, is becoming common, especially among young adults. Yet, little to no empirical evidence exists on this sexual behavior. Methods: In this exploratory sequential mixed methods approach, we aimed to address the current perception of stealthing among young adults. College students were recruited from general education courses at a medium-sized four- year public university. Focus groups were conducted to understand the current perception of stealthing, including knowledge, perceived influence, and outcome, followed by quantitative assessment of knowledge, attitude, and self-efficacy of sexual consent. Results: Results demonstrated central theme of health-decision making with associated themes of consent, which further included subthemes of privacy, trust, and violation, followed by consideration of stealthing as sexual assault and social norm and acceptance of stealthing. Quantitative assessment showed that knowledge and awareness of stealthing remains low, though sex differences exist on the perception of stealthing being considered sexual assault; with higher rates among males as compared to females. Conclusion: The act of stealthing has been popularized in social media. Our results demonstrate that there is a need for health educators to assess the prevalence of such a behavior among young adults and policy makers to assess the legal implications of nonconsensual condom removal.

This research thesis is a policy assessment of the factors that contribute to the current status in treating autism. The policy assessment begins with a description of the key components that that influence policy outcomes in regard to autism. After developing a policy model that outlines various components of issues and approaches to the policy has on Autism, the paper examines several issues with regard to Autism policy, including the lack of insurance coverage, state legislation, waiting lists, evidence vs. non evidence treatments, and the high price for treatments. The paper also examines current approaches to Autism, and potential solutions. Solution analysis on current policy alternatives is provided and, this suggests that increasing knowledge and awareness of the affects of autism on society needs further attention along with proper funding for early treatment.

The author in his essay lays down pretreal and judicial opportunities of protection of patient‘s rights. For comparison there are analysed Lithuanian and British systems of protection of patient‘s rights. Patients suffer certain dificulties inherent only for this category of cases. Only a small number of patients have opportunity to embrace their rights in international level. Patients migrating wthin European Union have opportunity to apply to the Court of Justice of European Communities.

Submitted by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2018-05-30T17:03:54Z No. of bitstreams: 1 Luciana Mirella Lacerda de Jesus.pdf: 1213904 bytes, checksum: 05376e2d44d2d1faaa84f90715f8aaf7 (MD5) / Approved for entry into archive by Ana Valéria de Jesus Moura (anavaleria_131@hotmail.com) on 2018-05-30T17:12:28Z (GMT) No. of bitstreams: 1 Luciana Mirella Lacerda de Jesus.pdf: 1213904 bytes, checksum: 05376e2d44d2d1faaa84f90715f8aaf7 (MD5) / Made available in DSpace on 2018-05-30T17:12:28Z (GMT). No. of bitstreams: 1 Luciana Mirella Lacerda de Jesus.pdf: 1213904 bytes, checksum: 05376e2d44d2d1faaa84f90715f8aaf7 (MD5) / O presente trabalho versa acerca da concretização do direito fundamental à saúde pelo Estado brasileiro, através do fornecimento de medicamentos excepcionais, que são caracterizados pelo seu alto custo. Objetiva-se realizar uma investigação sobre os critérios que legitimam a concessão judicial de medicamentos não previstos na Política de Dispensação em Caráter Excepcional, elaborada pelo Ministério da Saúde. Assim, a partir da contextualização da assistência farmacêutica como medida relevante das ações de saúde, bem como a partir da análise da força normativa dos preceitos constitucionais e da dimensão do direito ao acesso à justiça, pretende-se demonstrar que o Poder Judiciário está autorizado a apreciar as demandas individuais e, a depender das peculiaridades de cada caso, imputar aos Entes Federativos à obrigação de fornecer medicamento excepcional, se for comprovada a sua imprescindibilidade para assegurar a dignidade da pessoa humana. Para tal, será destacada a inadequação da utilização da teoria da reserva do possível no Brasil, bem como enaltecida a necessidade de serem ultrapassados diversos argumentos teóricos que, na prática, acabam por inviabilizar a concretude dos direitos fundamentais e dificultar o atendimento das necessidades sociais. / The present work circumscribes on the realization of the fundamental right to health by the Brazilian State, through the provision of exceptional medicines, which is characterized by their high costs. The objective is to carry out an investigation into the criteria that legitimize the legal concession of medicines not provided by the Exceptional Dispensation Policy, elaborated by the Ministry of Health. Thus, from the contextualization of pharmaceutical assistance as a relevant measure of health action, as well, based on an analysis of the normative force of the constitutional precepts and the right of access to justice, attempts to demonstrate that the Judiciary is authorized to assess the individual demands and, depending on the peculiarities of each case, to impute to the entities of the Federation the obligation to provide an exceptional remedy if it is proven that it is essential to guarantee the dignity of the human being. For this purpose, it will be highlighted the inadequacy of the use of reserve theory of what is possible in Brazil, as well the need to overcome various theoretical arguments that, in practice, end up making the concreteness of fundamental rights impractical and making it difficult to meet social needs.

Submitted by Jamile Barbosa da Cruz (jamile.cruz@ucsal.br) on 2017-01-13T16:49:49Z No. of bitstreams: 1 MIRANDA FA 2014.pdf: 1149830 bytes, checksum: 17449d0f9f642315be2c1b15306fb5c4 (MD5) / Approved for entry into archive by Rosemary Magalhães (rosemary.magalhaes@ucsal.br) on 2017-01-16T15:57:40Z (GMT) No. of bitstreams: 1 MIRANDA FA 2014.pdf: 1149830 bytes, checksum: 17449d0f9f642315be2c1b15306fb5c4 (MD5) / Made available in DSpace on 2017-01-16T15:57:40Z (GMT). No. of bitstreams: 1 MIRANDA FA 2014.pdf: 1149830 bytes, checksum: 17449d0f9f642315be2c1b15306fb5c4 (MD5) Previous issue date: 2014-08-26 / Esta pesquisa teve como objeto de estudo pesquisa a análise da efetivação do direito à saúde da população em situação de rua no Município de Salvador. O trabalho foi iniciado a partir da caracterização da população em situação de rua do Município de Salvador e sua condição face ao direito humano fundamental à saúde. Para tanto, apresentou o conceito, o perfil, as características das pessoas em situação de rua, realçando a sua heterogeneidade, especificidades e os fatores que levam à situação de rua. O direito à saúde da população em situação de rua foi identificado como direito humano, previsto em declarações de direitos, tratados e protocolos de direito internacional, e direito fundamental. Foi acentuado que a situação de rua viola a dignidade da pessoa humana e que em razão do princípio da igualdade, há a necessidade da realização de ações afirmativas para garantir o acesso dos indivíduos em situação de rua aos serviços de saúde. Foi verificado que um Estado que não garanta os direitos sociais de seus cidadãos não se constitui em Democrático de Direito e que, mesmo em situação de rua, o indivíduo tem o direito fundamental de gozar do melhor estado de saúde possível e os poderes públicos têm a obrigação de implantar medidas sanitárias e sociais adequadas para conseguir esse objetivo. Houve a verificação, ainda, de que o conceito de saúde engloba o contexto social em que o indivíduo está inserido e, que por isso, a situação de rua é determinante para a identificação do estado de saúde de uma pessoa que se encontre nessa condição, como também para a formulação de ações de políticas de saúde afirmativas. Foi constatado que o poder público não pode deixar de implementar ações de saúde adequadas e apropriadas às peculiaridades da população em situação de rua, sob o argumento da discricionariedade administrativa, diante da fundamentalidade do direito à saúde. Algumas ações de políticas de saúde para a população em situação de rua foram normatizadas, através de atos administrativos normativos, e constituem-se em normas de direito sanitário, submetidas aos seus princípios e regime jurídico. Como a Organização Mundial da Saúde conceituou saúde como estado de bem estar, físico, mental e social, para a efetivação do direito à saúde da população em situação de rua, deve-se promover também os outros direitos sociais, como a alimentação, a educação, a assistência social, o trabalho e a identificação. Identificou-se as iniquidades em saúde como desigualdades sociais sistemáticas, relevantes, injustas, evitáveis e desnecessárias que prejudicam o exercício do direito à saúde e que, para enfrenta-las, deve-se efetivar ações de políticas de saúde que superem às dificuldades impostas pelo cotidiano da situação de rua. Foi demonstrado que, com a normatização de ações e estratégias para a promoção da equidade em saúde da população em situação de rua houve um grande avanço para o acesso aos serviços de saúde, mas ainda precisa muito a ser feito para a efetivação do direito à saúde desse grupo populacional. / This research had as object of study research analyzing the realization of the right to health of the homeless in the city of Salvador. The work was started from the characterization of the population of Salvador Municipality of homelessness and its condition against the basic human right to health. Therefore, the presented concept, the profile, the characteristics of people in the streets, highlighting its heterogeneity, circumstances and the factors that lead to homelessness. The right to health of the homeless was identified as a human right provided for in rights declarations, treaties and international law protocols, and fundamental right. It was pointed out that homelessness violates the dignity of the human person and that because of the principle of equality, there is the necessity of affirmative action to ensure access of individuals on the streets to health services. It was found that a state that does not guarantee the social rights of its citizens does not constitute Democratic rights and that even in the streets, the individual has the fundamental right to enjoy the best possible state of health and the public authorities have the obligation to implement health and social measures to achieve that goal. There was a check, too, that the concept of health encompasses the social context in which the individual is inserted, and that therefore the homeless is crucial to identify the health status of a person in this condition, but also for the formulation of health policies affirmative actions. It was found that the government can only implement appropriate health actions and appropriate to people's peculiarities in the streets, on the grounds of administrative discretion, before the fundamentality of the right to health. Some health policy actions for the people on the streets were normalized through normative administrative acts, and are in sanitary law, subject to the principles and legal framework. As the World Health Organization conceptualized health as well-being, physical, mental and social, for the realization of the right to health of the homeless, one should also promote other social rights such as food, education, social welfare, labor and identification. It was identified health inequities as systematic, relevant, unfair, unnecessary and avoidable social inequalities that affect the exercise of the right to health and to confront them, should be effective health policy action that overcome the difficulties imposed by daily life of the streets. It has been shown that with the standardization of actions and strategies to promote equity in health of the homeless was a great advance for access to health services, but it still needs a lot to be done for the realization of the right to health this population group.

A presente tese visa a investigar em que medida a cooperação internacional sanitária pode ser instrumento para a efetivação do direito humano à saúde nos países em desenvolvimento. Busca-se compreender o alcance jurídico da cooperação horizontal em matéria sanitária, a partir da interpretação das normas internacionais, à luz dos direitos humanos e da teoria das relações internacionais, através de um enfoque dialético das contradições que o tema abarca. O estudo documental se delimita nos atos bilaterais celebrados entre o Brasil e cada um dos Países Africanos de Língua Oficial Portuguesa (PALOP) Angola, Cabo Verde, Guiné-Bissau, Moçambique e São Tomé e Príncipe. A análise do conteúdo desses acordos indica que a cooperação internacional sanitária pode ser um instrumento para a efetivação do direito humano à saúde entre países periféricos, na medida em que for horizontalizada e democratizada. Isso implica atender menos a interesses de Estado por poder e influência internacionais e mais a valores comuns à humanidade, traduzidos na forma dos direitos humanos internacionalmente reconhecidos. Então, são apresentados elementos para o aperfeiçoamento da cooperação Sul-Sul, a fim de que ela cumpra com a função de garantir direitos que o poder público estatal, por seus próprios esforços, é incapaz de efetivar. Com isso pretende-se contribuir para a elaboração de um modelo Sul-Sul de cooperação, importante para diminuir a dependência externa dos países periféricos e para promover os direitos humanos. Enfim, propõe-se que a cooperação internacional seja compreendida e reconhecida como instrumento jurídico para a efetivação do direito humano à saúde. / The purpose of the present thesis is to investigate at which extent international health cooperation can be an instrument for the achievement of the human right to health in developing countries. The author seeks to understand the legal scope of horizontal cooperation regarding health, from the interpretation of international rules, in view of human rights and international relations theory, through a dialectical approach of the contradictions encompassed by the theme. The documental study is delimited in the bilateral agreements which have been celebrated between Brazil and each one of the African Countries of Portuguese Official Language (PALOP) Angola, Cape Verde, Guinea-Bissau, Mozambique and São Tomé and Príncipe. The analysis of the agreement content indicates that international cooperation can be an instrument to achieve the right to health among peripheral countries as it is horizontal and democratic. This implies seeking less the State interests for international power and influence and more the values shared by the whole humanity, proclaimed in the internationally recognized human rights. Therefore some elements are presented in view of to perfect South-South cooperation, so it fulfills its function of ensuring rights that the governments, by their own efforts, are not able to fulfill. This work intends to contribute to make a South-South model of cooperation, important to diminish the external dependence of the peripheral countries and to promote human rights. Finally, we propose that international cooperation is understood and acknowledged as a legal instrument for the accomplishment of the human right to health.

Este trabalho tem o propósito de examinar as implicações da estrutura federativa brasileira no processo de regionalização das ações e serviços de saúde do Sistema Único de Saúde (SUS). A ideia nuclear é que, por sua natureza federativa, a regionalização da saúde no Brasil deve realizar-se no contexto das relações intergovernamentais fundadas na configuração institucional do federalismo cooperativo do país e em sua expressão na área da saúde. O método empregado inclui a utilização de material bibliográfico e a incorporação de componentes de investigação empírica. A análise desenvolvida baseia-se numa abordagem diacrônica do federalismo, tomando-o como princípio organizador do Estado que se manifesta em suas diversas dimensões. Desse modo, o fenômeno do federalismo é estudado em função de sua evolução no tempo e, de forma concatenada, partindo de seus aspectos gerais em direção aos específicos que se exprimem no Estado brasileiro e particularmente no âmbito da saúde. O federalismo sanitário brasileiro é abordado a partir de seu ingresso no ordenamento constitucional, identificando dois períodos bem delimitados de formação: a descentralização e a regionalização. Agregam-se elementos empíricos de pesquisa em que a regionalização da saúde é caracterizada a partir de concepções expressas por atores políticos que representam as perspectivas das três esferas de governo. Os condicionantes do processo de regionalização do SUS são então explorados à luz do referencial teórico do federalismo em três dimensões de análise: base normativa, estrutura de financiamento e dinâmica política. Assim, identificam-se pontos facilitadores e entraves para a regionalização e apontam-se possibilidades para a efetivação dessa diretriz organizativa no SUS. Conclui-se que a regionalização da saúde no Brasil está apoiada em arcabouço normativo bem definido, proveniente da assimilação dos princípios do federalismo cooperativo no direito sanitário brasileiro, e que encontra obstáculos derivados do modelo federativo de financiamento e relacionados ao funcionamento das relações intergovernamentais instituídas no SUS. / This study aims to examine the implications of Brazilian federal structure in the regionalization process of healthcare services of the national health system (Sistema Único de Saúde SUS). The core idea is that, by its federal nature, the regional health planning in Brazil must take place in context of intergovernmental relations founded on the institutional configuration of cooperative federalism in the country and on its expression in health. The method includes the use of bibliographic material and incorporation of empirical research components. The analysis is based on a diachronic approach, taking federalism as an organizing principle of State which is manifested in its various dimensions. Therefore, the phenomenon of federalism is studied in terms of its evolution in time and, so concatenated, starting with its general aspects towards specific ones which are expressed in the Brazilian State and particularly in health. The Brazilian health federalism is approached from its entry into the constitutional order, with two clearly defined development periods: decentralization and regionalization. Empirical elements are added from a study in which health regionalization is characterized from ideas expressed by political actors representing the perspectives of three levels of government. The conditioning factors of SUS regional health planning are then explored in light of the federalism theoretical framework taking three dimensions of analysis: normative basis, funding structure and political dynamics. Thus, facilitators and barriers to regional health planning are identified and opportunities for actualizing this organizational guideline in SUS are indicated. It is concluded that health regionalization in Brazil is supported by well-defined regulatory framework, proceeding from assimilation of cooperative federalism principles in Brazilian health law, and that it has obstacles derived from the federal model of financing and related to the operation of intergovernmental relations established in SUS

Institution spécialisée du système des Nations Unies créée à la sortie de la Seconde guerre mondiale, l'Organisation mondiale de la santé (OMS) s'est vu confiée, par l'article premier de sa Constitution, le but « d'amener tous les peuples au niveau de santé le plus élevé possible ». Pour atteindre cet objectif, les États membres lui ont conféré vingt-deux fonctions dont une normative. Cette dernière lui permet, en théorie, d’adopter à la fois des instruments de santé non contraignants et d'autres contraignants. L'étendue du champ d'application de cette fonction permet à l'OMS d'élaborer des normes au contenu très divers et varié dès lors qu'elle agit dans le cadre de son objectif sanitaire. Parallèlement, en raison de difficultés internes, propres à son organisation régionalisée et à une concurrence externe accrue par la multiplication d'acteurs de santé mondiale, l'OMS est à un tournant de son histoire comme en atteste l'envergure de la réforme qui est toujours en cours depuis 2010. Dans ce contexte, il s'agit de comprendre et d'analyser l'influence du rôle normatif de l'OMS dans les systèmes de santé nationaux. D'abord, une évaluation de son autorité normative, qui apparaît affaiblie, est proposée afin de présenter des évolutions pour la renforcer et ainsi améliorer la protection de la santé mondiale au sein d'un droit international de la santé consolidé. Ensuite, l'étude approfondie de son activité normative est envisagée pour délimiter la conception de la norme de l'OMS par le prisme de son efficacité. L'objectif in fine est de proposer une réflexion sur l'avenir du rôle normatif de l'OMS. / The World health organization (WHO), as a specialized agency, was created, after the Second world war with the objective of, according to article 1 of its Constitution, the "attainment by all peoples of the highest possible level of health”. For that purpose, the WHO was granted twenty two functions by the Member States including a normative one. This normative function allows, in theory, the WHO to adopt both binding and non binding health instruments. The extent of the scope of this function offers a wide and diverse content to theses norms with the only limit that it pursues a health purpose. At the same time, the WHO shows internal difficulties, in part, due to its regional structure and overall lack of financing. Further, the increase number and diversity of actors of global health result in potential external competition with the WHO. The reform initiated in 2010 and still ongoing proves that the WHO is a turning point in its history. In this context, this research seeks to understand and analyze the influence of the normative role of the WHO on national health systems. First, we study the normative authority of the WHO which appears weakened. With the objective of increasing health protection based on a reinforced global health law paradigm, our proposals aim at strengthening the normative authority of WHO. Then, our in-depth analysis of the normative activity of the WHO allows to the define the conception of norm by the WHO using effectiveness as our analytical frame. Finally, this research offers an opportunity to reflect on the future of the normative role of the WHO.

Doctors' Right to Withhold Medical Care Abstract Very little attention is being paid to the rights doctors have to refuse to provide medical care, notwithstanding how important this area of interest is. It is not the aim of this thesis to provide a superficial description of fundamental grounds for withholding treatment. Its primary purpose is to present an analysis of the issues that are of most concern. To this end, the key concepts closely examined are conscientious objection and religious beliefs, as these constitute the subject of frequent interpretative, judicial and ethical disputes. A chapter in this thesis is also dedicated to refusal to provide healthcare based on a risk to the life or body of the health professional. All of the other reasons for not providing medical care or for ending it are briefly discussed within the context of the so-called contractual obligation of healthcare providers. Conscientious objection and religious beliefs are most often viewed from the perspective of public law. Nevertheless, in this thesis the two concepts are presented mainly in the light of private and civil law. A short philosophical and ethical analysis of the two concepts is followed by an extensive legal analysis. The theoretical part of the thesis concentrates on related statutory regulation and the...

Informacijos apie asmens sveikatos būklę konfidencialumas yra svarbi įstatymų saugoma vertybė. Tačiau teisės doktrinoje, teisės aktuose ir teismų praktikoje pri¬pažįstama, kad teisė į privataus gyvenimo neliečiamumą nėra absoliuti. Kai ribojama asmens teisė į privatų gyvenimą, toks ribojimas turi būti numatytas įstatymų lygmenyje ir ad hoc analizuojama, ar toks ribojimas yra būtinas demokratinėje visuomenėje, siekiant ap¬saugoti teisėtą tikslą. Darbe yra nagrinėjami ir vertinami informacijos apie asmens sveikatos būklę atskleidimo tretiesiems asmenims atvejai, identifikuojami pažeidimai ir pateikiamos rekomendacijos, kokių teisinių priemonių įgyvendinimas padėtų tinkamai užtikrinti asmens teisę į šią privataus gyvenimo sritį. Darbe pristatoma asmens sveikatos informacijos konfidencialumo samprata, aprašoma, koks yra asmens, kaip paciento, teisės į privataus gyvenimo neliečiamumą reglamentavimas Lietuvoje, pristatoma šalių praktika, identifikuojami sveikatos informacijos konfidencialumo principo ribojimai, pateikiami atvejai, kuomet informacija apie asmens sveikatos būklę yra atskleidžiama pažeidžiant teisės aktus, taip pat vertinami atvejai, kai galimai ultra vires įstatymų leidėjas priima įstatymus, kurie prieštarauja LR Konstitucijai ir tarptautinėms sutartims. Darbe yra išsikeliamos dvi hipotezės: H1 – Lietuvoje be paciento sutikimo atskleidžiant informaciją apie paciento sveikatos būklę draudimo įstaigoms pažeidžiama asmens teisė į privatų gyvenimą; H2 – Lietuvoje... [toliau žr. visą tekstą] / Confidentiality of personal health information is an important value which is protected by The Convention for the Protection of Human Rights and Fundamental Freedoms, Constitution of the Republic of Lithuania and other laws. However, the right to confidentiality is not recognized as absolute in the doctrine of law, legislation and legal cases. When there is the restriction of confidentiality of personal health information, it is necessary to emphasize the principle of necessity to protect a legitimate target which is necessary in a democratic society. It is important to notice that every restriction must be provided at the level of a piece of legislation. In the paper there is analyzed and evaluated the cases of the disclosure of personal health information to third parties, identified violations and made recommendations what legislative measures should be implemented to ensure the patient's right to private life. In the paper there has set the following objectives: to analyze the current situation in Lithuania what there is the regulation of the patient's right to privacy; to present the practice of different countries about patient's right to privacy; to carry out a theoretical analysis by comparing the various scientific researches on the personal health privacy; to determine what is the restrictions for the principle of medical confidentiality; to identify privacy problems while disclosing personal health information; to reveal when information is disclosed in accordance... [to full text]