Hormone Therapy, Dilemmas, Medical Decisions

The decision for women to go on hormone therapy (HT) remains controversial. An historical oscillation of beliefs exists related in part to expectations of the medicinal value of HT over longer-term use beyond the initial peri-menonpausal period. Studies thought to resolve issues surrounding the efficacy of HT were perhaps overstated as confusion still permeates the decision making with regard to HT. Overzealous advertising and exaggerated understanding of the results (negative or positive) undermine patient and physician decision making. There remains no magic bullet with regard to HT. What remains is still the possibility of HT longer-term efficacy on diverse end organ systems with pockets of clinical and scientific ambiguity while working to engender reasonable expectations.     

Deportation, Detention and Medical Intervention

In the UK the foreign national prisoners who have breached immigration rules suffer deprivations from which the ordinary citizens are exempt. Their subjection to prison regimes often on pain of deportation leads to psychological illnesses that cause them long term damage. The deportation regime that arises by default under the Border and Immigration Act 2007 has made it difficult to avoid prison for the breach of immigration rules. The research published by NACRO shows that it can lead to trauma because there is duress accompanied by an uncertainty of fate. The decision by the Court of Appeal in R (Medical Justice) v Secretary of State for the Home Office (2011) has brought this issue of deporting ill patients into the limelight. There are expert reports that reveal that those foreign nationals who are refused permission to stay are at risk from psychiatric illnesses when they are detained. The findings are that the mental illnesses are particularly severe in the most vulnerable prisoners who develop symptoms of long term mental disease. It is critical for the medical professionals to consider their involvement at an early stage when they will be able to supervise and diagnose illness before there is damage. This is particularly the case as the NHS treatment is denied to prisoners who are foreign nationals which is makes it necessary to implement a strategy with local agencies to prevent the onset of debilitating illnesses.     

公共政策、医疗行为与责任配置——关于医疗损害责任制度绩效的观察和评论

从法政策学的角度对侵权责任的制度绩效进行观察和验证,是后侵权责任立法时期中国民法学的重要学术使命之一。本文以医疗损害责任为分析对象,竭力展示公共政策与责任配置之间的微妙关系。研究表明,现阶段公共卫生政策的实质是通过加强管制约束来提高医疗服务的质与量。在此背景下,医疗损害责任的功能定位只能是激励而非补偿;且由于医疗服务自身的特性,相关责任配置的隐性激励作用更加突出。我国现行医疗损害责任在归责原则、责任形态和损失分摊方面分别存在激励不足、不当管制和风险无关的缺陷,极有可能导致制度失灵、立法目的落空,亟需加以改进。     

Radiographic Identification Using Midline Medical Sternotomy Wires,

Forensic anthropologists are regularly asked to assist with the identification of unknown individuals using comparative medical radiography. This study addressed the use of midline medical sternotomy wires as a means for personal identification. Antemortem and postmortem radiographic comparisons were completed by 46 professional forensic anthropologists and anthropology graduate students familiar with comparative medical radiography as a technique for assessing identification. Participants were asked to make five radiographic matches from a pool of 20 radiographs. Participants also completed an anonymous survey detailing their education level and experience making radiographic comparisons. Participants were 99.5% accurate in matching the radiographs. Sensitivity was 98.7%, and specificity was 99.7%. Logistic regression analysis found no statistically significant differences in the participants' ability to make a correct match. As the high accuracy rates indicate, the shape, size, and various characteristics of the sternotomy wires are individualizing and can confidently be used when assisting with personal identification cases.     

Medical,ethical and legal aspects of somatic gene therapy

Somatic gene therapy is one of the most fascinating and important medical developments as well as a field bearing unknown risks in human medicine of the nineties. This article tries to give a short survey on the medical applications of this new technique on the one hand and reflects possible ethical and legal implications on the other hand. We conclude that only an international agreement on risk assessment and ethical principles will lead to a adequate approach to somatic gene therapy.     

看守所收押罪犯保外就医医学鉴定探索

目前有关看守所收押罪犯保外就医医学鉴定的法律规定尚不够规范，看守所收押罪犯保外就医的医学鉴定存在很多问题。要规范看守所收押罪犯保外就医的医学鉴定，就应加快刑罚执行方面的立法完善，规范保外就医等执法行为；建立统一的保外就医鉴定机构准入制度，改变当前鉴定机构的乱、杂局面；针对保外就医出现的新情况，建议尽快构建《看守所收押罪犯保外就医执行办法》及其实施细则和标准.