Medicine and law
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Although several international and regional human rights instruments, including the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights, give explicit recognition to a broad right to health, this right, at present, offers little real protection to interests in individual and community health, including reproductive and sexual health. This is so, the author argues, because the mechanisms now in place for supervision and enforcement of this and other "social human rights" are extremely weak. In these circumstances, better protection is available indirectly, through enforcement of certain "classical human rights," such as the right to life, the right to be free from inhuman and degrading treatment, and the right to found a family, that contribute to--and depend upon--realisation of a right to health.
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Market forces have been introduced in the health care systems of many European countries. Fundamental to the introduction of the market was the need to distinguish between the roles of purchaser and provider. In this article the authors have analyzed the consequences of contracting and the purchaser-provider split from both a legal and organizational perspective. ⋯ Including the legal and organizational dimension into these economically oriented models, these models can also be used for analyzing recent trends and developments. A four-country analysis indicates trends towards convergence of health care systems and both decentralization and integration in the systems. The future roles of both managers and lawyers working in health care need to be further defined.
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National and international variations in clinical practice, study methodologies, and data collection make the estimation of patient deaths attributable in some measure to anaesthesia a difficult task. Such rates have undoubtedly significantly declined, a tribute, in large part, to the work of groups such as the International Committee for the Prevention of Anaesthetic Mortality and Morbidity, the Anesthesia Patient Safety Foundation and the Australian Patient Safety Foundation. There is, however, internationally, still a significant risk of mortality associated with anaesthesia which is distinct from that related to any relevant surgery or intercurrent disease. ⋯ In an age where the global provision of health services and equipment may be increasingly dominated, under trade-promoting international agreements, by a few trans-national corporations, and where technology facilitates dissemination of medical data, a unified, worldwide approach to the investigation and prevention of anaesthetic mortality appears both rational and urgent. The benefits of an investigatory system, focused on subsequent safety rather than present liability and standardized through International Conventions, are well established in the air transport industry. We urge the involvement of persons with political and legal expertise in the development of an International Convention for the Investigation and Prevention of Anaesthetic Mortality.