Is the medicine right?

Is asking the Better Regulation Agenda (BRA) to answer the same preconditions it requires for any regulatory action a proper treatment? Does any assessment of the agenda necessarily imply a thorough definition of the costs and the benefits deriving from its application or is it enough to provide a few key insights to perform it? Is the BRA really so ideological, deriving from “a liberal analytical framework that considers no regulation/state intervention” as the preferred option? Is regulatory quality an issue that “cannot realistically be solved”? Does the principle of subsidiarity as a policy objective need some revision? Several questions come to mind when reading a very thought‐provoking article that is very critical of the BRA but that in the end recognises some of its main qualities.     

Bioterrorism--also a challenge for forensic medicine?

In view of current events the question is discussed to what extent the risk of bioterrorism may be an issue relevant for forensic medicine also in Germany, although at present there seems to be no concrete threat. The cases which became known so far were either false alarms or foolish pranks (copycats), which have to be, and are indeed, prosecuted by the state (section 126 German Criminal Code). Reference is also made to the measures of disinfection recommended by the Robert Koch Institute.     

Can criminals create opportunities for crime? Malvertising and illegal online medicine trade

Opportunity theories suggest that the occurrence of an offence depends on the presence of a motivated offender and a specific condition in the environment that presents an opportunity for crime. While offenders may be able to choose among crime opportunities, the question is whether they can create new crime opportunities. Based on a qualitative analysis of court cases, investigative reports and the news media, this article examines the genesis of crime opportunities by looking into the malicious online advertising (malvertising) of substandard, spurious, falsely labelled, falsified and counterfeit (SSFFC) medical products. While further research on this topic is needed, the findings of the article help to understand the importance of unsavoury advertising as a tool that perpetrators use to manipulate consumer demand and proactively create (or expand) criminal markets.     

Is the doctor in? The evolving role of organized medicine in health policy

Until recently, physicians were viewed as the dominant player in health policy. Now, however, they compete with many other effective interest groups. This article analyzes this changing role, and specifically how organized medicine has changed its approach to influencing health policy. The essay begins with a review of the reasons for the growth and subsequent decline of physicians' influence. This is followed by a case study of physician payment reform under Medicare, which illustrates the ways in which organized medicine chooses when and when not to cooperate with government. The article concludes with a discussion of where physicians are likely to continue to be influential in future health policy reform. Three such areas are noted: payment policy, quality and clinical innovation, and medical education and training.     

Chinese dragon or toothless tiger? Regulating the professional competence of traditional Chinese medicine practitioners

The escalation in popularity of complementary and alternative medicine (CAM) has begun to stimulate regulatory responses to ensure the safety and efficacy of different modalities. The Therapeutic Goods Authority in Australia oversees a scheme of listing and registration, said to lead the world. Established CAM courses now confer recognised bachelor degrees. Victoria has recently regulated Traditional Chinese Medicine (TCM) practitioners, through the Chinese Medicine Registration Act 2000 (Vic), modelled on legislation regulating medical practitioners. CAM is being integrated into conventional medical (especially general) practice, and calls for the "mainstreaming" of CAM are increasing. Integrating CAM, however, involves a critical incoherence, well illustrated by the Victorian legislation. Clinical competence can only be properly assessed against standards established through scientific validation. If CAM systems, which purport to offer alternatives to science-based medicine, are regulated through conventional instruments, they may well be relinquishing the very identities which set them apart.     

Does a doctor have a duty to provide information and advice about complementary and alternative medicine?

It is argued that a doctor has a duty to provide information about reasonably available complementary and alternative medicine treatments where that information would be material to the particular patient or the hypothetical prudent patient. Given the vast array of such treatments available, doctors will want to rely on evidence-based medicine problem-solving skills to ascertain those treatments that are safe and efficacious. While the risk of litigation for failure to provide such information is probably low at this time, given the high rate of patient self-prescribing, it is necessary for a doctor to open a dialogue with a patient about complementary and alternative medicine to address safety concerns. In addition, it is important to facilitate access to the best of conventional and complementary treatments to ensure better health outcomes for the patient.     

面对,接受,处理,放下

"面对,接受,处理,放下。这是任何人面对一起不幸事件时都应有的态度。"李双江之子李天一涉嫌强奸案被炒作得沸沸扬扬。这起事件引发"网民的狂欢",除了对被害人的怜悯与同情外,更多的是对李天一的痛责,恨不得要司法机关立即从肉体上消灭之,还有就是对李双江夫妇教子无方的嘲讽与抨击,等等。面对这种巨大的喧嚣,我援引一个故事来谈"接纳"的观点:国际著名教育专家麦道卫博士的女儿上中学时有一天问他:"爸爸,要是我这会儿怀孕了,你怎么处理?"他回答说:"我是一名布道家,教了一辈子的亲子教育,要是你     

Unwarranted variations in the quality of health care: can the law help medicine provide a remedy/remedies?

This Article reviews the essential findings of studies of variations in quality of care according to three categories of care: effective care, preference-sensitive care, and supply-sensitive care. It argues that malpractice liability and informed consent laws should be based on standards of practice that are appropriate to each category of care. In the case of effective care, the legal standard should be that virtually all of those in need should receive the treatment, whether or not it is currently customary to provide it. In the case of preference-sensitive care, the law should recognize the failure of the doctrine of informed consent to assure that patient preferences are respected in choice of treatment; we suggest that the law adopt a standard of informed patient choice in which patients are invited, not merely to consent to a recommended treatment, but to choose the treatment that best advances their preferences. In the case of supply-sensitive care, we suggest that physicians who seek to adopt more conservative patterns of practice be protected under the "respectable minority" or "two schools of thought" doctrine.