In the interplay of critical and self-conscious patients and an ever-aging society the question arises how far patient autonomy sensibly should go and which parameters are deemed to be relevant for end-of-life-decisions. The progress in medicine over the last decades has led on one hand to the possibility of saving lives and maintaining them in situations where before it seemed to be impossible. Nowadays Therefore more and more people are afraid that this boom can be to their detriment when it prolongs instead of shortens their suffering. The fear of unbearable pain and of loss of control fuels the discussion about whether or not euthanasia is morally permissible and should be legalized. This thesis deals with the questions: What speaks in favor of and against the legalization of euthanasia? What forms of treatment are subsumed under the term "euthanasia"? What is the current legal situation in Austria? How far should patient autonomy go? In order to answer these questions a literature research was done which revealed that active euthanasia is not allowed in Austria but in the Netherlands, Belgium, Luxemburg and partly allowed in Switzerland. Interviews conducted among medical staff showed that medical personnel in Austria mostly are in favor of active euthanasia because they are not satisfied with the end of life care that is provided at the moment. They also embrace the trend of patient autonomy and think that patients can have the autonomous wish to end their lives but that it is difficult to determine a patient's autonomy. The reason for this is that autonomy is a gradual value that comprises patients' capacity as well as patients' long-standing goals, values, and preferences that were developed during their life. Therefore it can be concluded that increasing the availability of appropriate end-of-life care could be a solution that prevents medical staff from taking uncomfortable decisions and still enables patients to die in a dignified way.

Although the health care in the Czech Republic is widely available and it is provided often on a high level, there is still a problem in medical facilities to keep a dignity of hospitalized people or their relatives. Particularly patients´ personal rights are often violated. Also, psychological dimensions of a treatment are often underestimated, which is most evident at the most vulnerable groups of hospitalized patients, such as minors, women in labour or dying people. If doctors violate their duties, only a small number of patients are seeking a justice in the court, either from a fear from financial costs of the litigation or a public stigmatization. At present, there might be a turning point in this situation. As of 1st April 2012 Act No. 372/2011 Coll., on the provision of health services, was adopted, that highly emphasises the patients´ right. The aim of the thesis was to summarize a current legislation to the given issue, to map knowledge of patients´ rights in the general public and to find out whether the rights are respected by the medical staff. The chosen method was a method of the quantitative research, a technique of a questionnaire survey. There was designed a questionnaire that ascertained a public awareness of patients´ rights, a process of instructions for patients and a provision of an agreement with the provided care. Respondents were inhabitants of the South Bohemian region older than 18 years. The research shows that respondents know their rights related to the provision of the health care especially in relation to the informed consent. However they consider the medical staff´s instructions to be insufficient. The research results proved that it is still necessary to put an emphasis on the education of the medical staff in the area of instructions for the patients on their health conditions and the care provided, on requirements of the informed consent, the way how to give instructions etc. It is necessary to encourage patients not to be afraid to say their doctor that they do not understand his/her way of the instructions on the intervention, to find a common consensus between patients´ and medical professionals´ demands.

Patient's damage The goal of this presented diploma thesis is to discuss the problem of patient harm due to health care. To achieve the stated goal, the thesis is divided into five main chapters, in which the first chapter discusses the relationship between the patient. The first chapter also introduces the rights and obligations of both the patient and the physician. This chapter also deals with the issue of informed consent. The second chapter focuses on the issue of legal liability, addressing both civil liability in general and its individual types, as well as criminal liability. The next chapter is about the procedure lege artis and the related health ethics concept. Part of this chapter is also the issue of expert opinions. The fourth chapter is crucial for the thesis, because it deals with the patient's own damage. This chapter deals not only with undesirable events that could result in patient harm, but also about the subsequent compensation of the patient in the form of painful and compensation for the burden of social application. Within the subchapter on patient harm in practice are mentioned the decisions of the Supreme Court of the Czech Republic issued in specific cases of patients' injuries. And for completeness, one European Court of Human Rights decision. The last chapter mentions...

Situation of families in which a child with spinal muscular atrophy was born, is the topic of this thesis. This rare genetic disease affects neuromuscular system of children and shortens their lives. In most severe cases the failure of respiratory functions comes in the first year of child's life. This thesis is focused on support that Czech system of social and medical services provides to families with this disease. Next, it looks into needs of these families and examine the extent to which the system is able to saturate them. Very important point in this research is also families' perception of quality of care. The research was implemented with use of qualitative methods, mostly by semi-structured interviews which followed families' journey through the system of social and medical services. Then there is a comparison of experience of families with theories, policy and other normative framework and suggestion of steps that should be taken to improve families' satisfaction with services they receive concerning the child's disease. Key words: spinal muscular atrophy, rare diseases, patient's autonomy, patient- centered care, patient journey, quality of care.

This thesis is focused on the complex nursing care of patients colonized with the resistant microbial strains. In the theoretical section I describe the major events of the history, the current issue of the antibiotic treatment and the species of occurring resistant strains of microbes. It also deals with recommended procedures in the care for these patients, such as patient isolation, use of the protective equipment, handling of the biological material , individualization of the aids, handling of the linen and the principles of health care. It also includes preventing the spread of disease resistant strains of the microorganisms and patient recolonization. The empirical part consists of the quantitative research conducted at the University Hospital in Pilsen with the help of a questionnaire survey. The questionnaires will be distributed to the nurses in intensive care units without the single - patient box system. The aim of the research is to determine nurses' knowledge of the disease resistant microbial strains and the ways they create patient isolation. Evaluation questionnaires will provide the pieces of information to compare the individual practices and knowledge of nurses in intensive care units. Results of this work can be used as a source of information or the study material. The benefit...

The aim of this thesis is a detailed description and analysis of the institute advance directives/previously expressed wishes in the Czech Republic in comparison with the Australian legislation. This thesis deals with the Queenland's legislation and the legislation of the Northern Territory. The methods used in this thesis are analyzes of legal norms and comparison of specific law regulations. Introductory chapters are focused on the principle of patient's autonomy in the Czech Republic legislation and on the protection of the person's integrity. The thesis covers not only the rules contained in the Act. No. 89/2012 Coll., the Civil Code, but also mentions rules in the Act. No. 40/1964 Coll., the Civil Code. The next chapter is focused on different patient's rights, such as the right to life and be healthy, the right to self-determination and the right to dignity. In the second part, the author focuses on the institute of advance directives/previously expressed wishes. First within the international legal framework. This chapter also underlines negative opinions about advance directives/previously expressed wishes and points out the benefits of their use in practice. Next the author focuses on the Czech legal regulations. The author does not mention only the Health Services Act, but also not...

Rights of the Patients (resume) The thesis Rights of the Patients does not provide a comprehensive survey of all rights the patients have under applicable legislation, thus, for reasons of complexity of the theme, the author focused only on the most important of them. Separate chapters are dedicated to individual rights, in order basically corresponding to importance the author attaches to particular ones. Each chapter comprises general lecture on the respective right, its regulation in international legal documents binding on the Czech Republic and in domestic legal documents. In footnotes, the author provides, for the purposes of comparison, regulation of particular institutes in foreign legislation. In the opening, the author defines the terms "health law" and "medical law" and provides overview of the most important international and domestic health-law regulations, supplemented with enumeration of their principles related to the area of providing medical care. With regard to currently discussed legislative proposals, which mean the long-awaited amendment to domestic medical law and, if approved, will bring many significant changes compared to the present state, the author included a separate section dedicated to these legislative proposals at the end of the first chapter. The second chapter discusses...

Civil disputes between doctor and patient in medical healthcare The issue of civil disputes between doctor and patient in medical healthcare is characterized by a high degree of interdependence of substantive and procedural questions. The main issue here is inequality between doctor and patient in their relationship, which is based more on factual inequality than inequality in rights. The patient as consumer and therefore the weaker party has limited access to relevant information concerning the subject of the relationship between doctor and patient. On the other hand, a doctor is a subject which has in its power almost all the relevant information. As can be seen, for a given relationship is characteristic a high degree of inequality of information. This inequality, which arises in the relationship always, is not sufficiently addressed by the substantive regulation and its effects are present in subsequent court proceedings in the form of an information deficit. Intention of this paper is to present the fundamentals of the relationship between physician and patient, the reasons for the information deficit and its consequences in legal proceedings and ways of its compensation. The aim is to assess whether the current regulation is to ensure equality between doctor and patient with emphasis on the...

The process of acquiring informed consents from patients belongs to one of the everyday activities of hospital personnel. The duty of submitting informed consent forms to patients is mostly in competence of the doctors. Nurses, however, are present during the entirety of patients' medical care and should be acquainted with all aspects of the informed consent. The process of acquiring the informed consents from patients admitted to intensive care unit (hereinafter ICU) is connected with a multitude of difficulties. The method of statistical analysis of data acquired by the questionnaire construction method was used for this quantitative research. 99 respondents participated in the questionnaire construction. The research took place within one hospital at chosen ICUs. The main goal of this thesis is to evaluate the process of acquiring informed consents from patients from the point of view of nurses and to identify the main issues connected with signing of informed consents. The results of the research show that patients are adequately informed by their physicians before signing the informed consents. Poor medical condition of patients admitted to ICUs may be seen as one of the main issues during the signing of informed consents. The research further shows that 50% of patients don't read the text of...

Even though the health care services in the Czech Republic are of high international standards and accessible to majority of the population, some drawbacks may be noticed in terms of the approach of health care providers to patients and patient rights. Until 2011, the Act No. 20/1966 Coll., on Public Health Care, had regulated the health care provision and patient rights in a complex way. Gradually, it became clear that the main part of regulations did not consider the patient-specific needs adequately. Legislators' efforts to bring the patient rights in conformity with the principles of the Constitution, Charter of Fundamental Rights and Freedoms, and the Convention of Human Rights and Biomedicine have led to the Act No. 372/2011 Coll., on Healthcare Services, which has replaced the Act on Public Health. The new foundation of patient rights guarantees that the failure to fulfil may be rectified as only the rights defined by law can be effectively enforced. The prerequisite for a patient to exercise and demand his/her rights to be fulfilled is their knowledge. This dissertation aims to provide a concise overview of the progression of patient rights and their origins within the international and national context, to outline some rights of an insured person and a health care user more in-depth, to introduce the protection of patient rights, and to verify the knowledge of selected rights among the patients in the South Bohemian region. Based on my own research which took place in outpatient and inpatient facilities in the South Bohemian region by the questionnaire form I wanted to find how are patiens informed about theirs rights and whether they are actively interested in them. I chose two hypothesis. The first hypothesis was verified claims than the patiens over the age of 50 have more knowlidges about their rights than the patiens to the age of 50. From the results of statistical data exploration it shows implies that the patiens over the age of 50 have really more knowlidges than the patiens of the second age category, therefore the hypothesis was confirmed. The second hypothesis should confirm whether the patiens are passive at getting informations about the patiens rights. The survey shows that the patiens are active and they are interested in finding out informations. The second hypothesis didn´t confirmed. My purpose wasn´t describe in detail all patient rights. I wanted compile basic patient rights and rights of an insured person and a health care user which can be used to more patient know-how, for use of health professionals utilization or to teaching students of the Social and health faculty of South Bohemian University.