Schedule for rating disabilities; hemic and lymphatic systems--VA. Final rule

This document amends the Department of Veterans Affairs' (VA) Schedule for Rating Disabilities of the Hemic and Lymphatic Systems. The effect of this action is to update the hemic and lymphatic portion of the rating schedule to ensure that it uses current medical terminology and unambiguous criteria, and that it reflects medical advances that have occurred since the last review.     

论医疗损害赔偿原则体系

我国《医疗事故处理条例》对医疗损害赔偿实行单一的限额赔偿原则,且赔偿范围规定不全面,使得该条例不能有效和合理地处理所有的医疗损害赔偿,并使得该条例在医疗损害赔偿诉讼中日益边缘化。鉴于此,本文提出一种适应全部医疗损害赔偿的赔偿原则体系,该原则体系由全面赔偿原则、限额赔偿原则、惩罚性赔偿原则和衡平赔偿原则构成。     

Enrollment--provision of hospital and outpatient care to veterans. Department of Veterans Affairs. Final rule

This document amends VA's medical regulations. The Veterans' Health Care Eligibility Reform Act of 1996 mandates that VA implement a national enrollment system to manage the delivery of healthcare services. Accordingly, the medical regulations are amended to establish provisions consistent with this mandate. Starting October 1, 1998, most veterans were required to be enrolled in the VA healthcare system as a condition of receiving VA hospital and outpatient care. Veterans will be allowed to apply to be enrolled at any time. They will be eligible to be enrolled based on funding availability and their priority status. In accordance with statutory provisions, the final rule also states that some categories of veterans are eligible for VA hospital and outpatient care even if not enrolled. This document further establishes a "medical benefits package" setting forth, with certain exceptions, the hospital and outpatient care that will be provided to enrolled veterans and certain other veterans. Moreover, this document announces that VA will enroll all 7 priority categories of veterans for the period October 1, 1999 through September 30, 2000, unless it is necessary to change this determination by a subsequent rulemaking document.     

Schedule for rating disabilities; evaluation of scars. Final rule

This document amends the Department of Veterans Affairs (VA) Schedule for Rating Disabilities by revising that portion of the Schedule that addresses the Skin, so that it more clearly reflects our policies concerning the evaluation of scars.     

The conversion of coroner systems to medical examiner systems in the United States: a lull in the action

Coroner and medical examiner systems in the United States conduct death investigations for most deaths that are sudden and unexplained, or which involve external causes such as injury and poisoning. They play a very important role in the criminal justice, public health, public safety, and medical communities, and they also contribute a substantial portion of autopsy-based mortality data to the state and federal mortality statistics systems. Death investigations often involve complex medical issues and necessarily require the involvement of appropriately trained physicians. Over the years, there has been a trend to replace the elected lay coroner systems with systems run by appointed, physician medical examiners. Presently, about 31% of counties in the United States are served by a medical examiners at the county, district, or state level. Between 1960 and 1989, there was considerable conversion to medical examiner systems, but this trend slowed in the 1990s. Since 2000, only 6 counties in the United States have converted to a medical examiner system, no states have converted since 1996, and 1 county has reverted to a sheriff-coroner system. Possible reasons for this decline are discussed, including legislative, political, geographical, financial, population-based, and physician manpower distribution factors. It is important to ensure that all death investigation systems have appropriate access to medically educated and trained physicians such as forensic pathologists.     

大胆尝试,谨慎操作——论医疗公证中的若干问题

本文从真实性、合法性、可行性三个角度论证了医疗公证可以成为公证业务的新领域 ,医疗公证可以大胆尝试。但同时指出 ,由于相关法律不健全 ,配套条件不完善 ,尤其是监督机制的缺失 ,医疗公证存在被滥用的可能 ,因此 ,医疗公证在实践中必须谨慎操作。最后作者对如何遏制滥用医疗公证提出了自己的建议。     

Schedule for rating disabilities; gynecological conditions and disorders of the breast--VA. Final regulation

This document amends the section of the Department of Veterans Affairs (VA) Schedule for Rating Disabilities on Gynecological Conditions and Disorders of the Breast. This amendment is based on a General Accounting Office (GAO) study noting that there has been no comprehensive review of the rating schedule since 1945, and recommending that such a review be conducted. The intended effect of this action is to update the gynecological and breast disorders section of the rating schedule to ensure that it uses current medical terminology, unambiguous criteria, and that it reflects medical advances which have occurred since the last review.     

医疗技术发展风险抗辩

本文从医疗纠纷处理的难点出发 ,结合医疗损害事件向无过错责任转化的趋势。提出医疗核技术发展风险抗辩 ,作为医方免责理由 ,并分析了此抗辩的构成要件 ,与相关因素。     

The trouble with psychopathy as a general theory of crime

The concept of psychopathy, as defined by Robert Hare, is reviewed with respect to its status as a general theory of crime. A hybrid of the medical pathology model and personality trait approach, the psychopathy concept proposes that a significant portion of serious crime is committed by psychopathic individuals. Hare's version of psychopathy, besides demonstrating weak applicability and a propensity for tautology, is subject to labeling effects, oversimplicity, reductionism, the fundamental attributional error, inattention to context, and disregard for the dynamic nature of human behavior. It is concluded that the psychopathy concept is substantially limited with respect to its ability to describe and clarify general criminal behavior but that it may still have value as a partial explanation for certain types of non-criminal predatory behavior.     

Possession, use, and transfer of select agents and toxins--reconstructed replication competent forms of the 1918 pandemic influenza virus containing any portion of the coding regions of all eight gene segments. Interim final rule

We are adding reconstructed replication competent forms of the 1918 pandemic influenza virus containing any portion of the coding regions of all eight gene segments to the list of HHS select agents and toxins. We are taking this action for several reasons. First the pandemic influenza virus of 1918-19 killed up to 50 million people worldwide, including an estimated 675,000 deaths in the United States. Also, the complete coding sequence for the 1918 pandemic influenza A H1N1 virus was recently identified, which will make it possible for those with knowledge of reverse genetics to reconstruct this virus. In addition, the first published study on a reconstructed 1918 pandemic influenza virus demonstrated the high virulence of this virus in cell culture, embryonated eggs, and in mice relative to other human influenza viruses. Therefore, we have determined that the reconstructed replication competent forms of the 1918 pandemic influenza virus containing any portion of the coding regions of all eight gene segments have the potential to pose a severe threat to public health and safety.     

Forensic pathology and related sciences. A model for teaching medical students

Recently, awareness of the importance of forensic pathology and related sciences in the United States has grown. At our medical center, we developed a concise and systematic program on this subject and offered it as an elective in pathology to level II medical students. The course was very successful and rated highly by the medical students.     

医疗纠纷中篡改病历相关法律责任研究

病历是医院最常见的文书之一。在法律上,病历也充当着重要的证据作用。在医疗纠纷中,病历是一把双刃剑,高质量的病历可以是医务人员的保护伞,反之则会是其最大的敌人。但是在医务人员在医疗纠纷中篡改病历的现象并不少见。关于篡改的病历的证据作用以及对相关人员的处理,国内外学者存在着不同的认识。     

医事法论纲

鉴于医事法律立法的迟滞和理论研究的欠缺 ,应开辟独立的医事法研究领域。医事法具有三个特点 :( 1)缺乏完整的医事法典 ;( 2 )主要内容包括医事主体法、医事行为法 (含医事程序法 )和医事社会法三个方面 ;( 3 )医事法律关系中双方主体权利义务的不完全对等。医事法还具有三条基本原则 ,即先导义务原则 ;最少损害原则 ;生命伦理原则。     

Physical qualification of drivers; medical examination; certificate. Federal Motor Carrier Safety Administration (FMCSA), DOT. Final rule

This document updates and simplifies the medical examination form that is currently used to determine the physical qualification of commercial motor vehicle (CMV) drivers operating in interstate commerce. The FMCSA takes this action in response to numerous requests from medical examiners to update and simplify the medical examination form that is currently used. This action is intended to reduce the incidence of errors on such forms and to provide more uniform medical examinations of CMV drivers engaged in interstate commerce. The current Federal physical qualification standards tested by medical examiners and recorded on the form will not be revised in this rulemaking.     

医疗事故赔偿责任中美立法比较

笔者认为医疗事故的处理中存在4大关键性问题:范围限定、科学鉴定、赔偿依据、责任承担方式。大量的事实说明,在对医疗事故处理的立法上,不仅在中国,而且在世界上许多发达国也没有合理解决这些。为了更科学的处理医疗事故、协调医患双方的利益,本文对这4个方面进行了分析,比较了中美立法上的异同,指出中美立法中各自存在的优缺点,在一些敏感、难点问题上提出了自己的一些建议,对今后中国医疗事故处理的立法、兼顾医患双方利益、妥善处理民事纠纷做出了有益的探索。     

美国医疗差错的概念、定义与特征本

医疗差错已经是一个全世界的问题。越是现代化的国家 ,这一问题就显得越为严重 ,在美国因医疗差错导致患者死亡已占死因的第 8位。在我国 ,一直习惯使用医疗事故的概念 ,而医疗事故又在《刑法》里有明确的罪责。随着中国经济日益与世界接轨 ,法律制度中的一些概念性问题也在逐步朝向国际统一方向发展。因此 ,对于医疗差错的明确统一定义 ,就显得十分很重要。本文主要介绍美国法律方面的相关规定。一、医疗差错是当今的世界性问题1999年 ,美国医学研究所 (ＩＯＭ ,ｔｈｅＩｎｓｔｉｔｕｔｅｏｆＭｅｄｉｃｉｎｅ )估计 ,每年有 980 0 0人死于…     

Measurement of the activity of radiopharmaceutical dosages: Nuclear Regulatory Commission. Proposed rule

The Nuclear Regulatory Commission (NRC) is proposing to amend its regulations on human uses of byproduct material, to require specific medical licensees to (1) Measure the total activity of each radiopharmaceutical dosage, except those containing less than 10 microcuries or a pure beta-emitting radionuclide, before it is administered to a patient; (2) verify that smaller dosages contain less than 10 microcuries; and (3) keep a record of the measurements. The assary of each radiopharmaceutical dosage before it is administered to a patient is currently required as a condition for a specific license. Measurement of the total activity of radiopharmaceutical dosage helps to protect patients from unnecessary radiation resulting from errors in labeling, calculating or dispensing dosages. The purpose of this rulemaking is: (1) To simplify licensing by replacing a condition that appears in all medical licenses with one regulation, and (2) To enhance patient radiation safety by minimizing potential misadministrations caused by not measuring the patient dosage.     

Medical devices; preemption of state product liability claims--FDA. Withdrawal of proposed rule

The Food and Drug Administration (FDA) is announcing that it is withdrawing a proposed rule that published in the Federal Register of December 12, 1997 (62 FR 65384), relating to medical device preemption of State product liability claims. FDA is making this withdrawal because of concerns that have been raised regarding the interplay between the FDA Modernization Act of 1997 (FDAMA) and the proposed rule.     

精神病人强制医疗制度研究

强制医疗是一项重要的社会防卫措施 ,涉及到公民人身自由权和社会安全及治安秩序。我国目前的强制医疗制度存在着政策性、行政性太强而法定化、司法化不足等缺陷。完善强制医疗制度必须使其适用条件明确化、适用程序司法化以及执行过程合理化。     

Medical negligence in the U.K.--directions for research

While the debate concerning compensation for victims of medical injury continues unabated, it is presented that many conclusions and recommendations are based on inadequate data. There is a need to examine, not only the legal requisites of a claim, but the factual circumstances surrounding claims. The direction of future studies must include an examination of: the relative experience of practitioners; frequency of medical specialties; demographic characteristics of patients; and the nature of the complaints.