Public trust and privacy in shared electronic health records

The development of information and communication technology in health care, also called eHealth, is expected to improve patient safety and facilitate more efficient use of limited resources. The introduction of electronic health records (EHRs) can make possible immediate, even automatic transfer of patient data, for health care as well as other purposes, across any kind of institutional, regional or national border. Data can thus be shared and used more effectively for quality assurance, disease surveillance, public health monitoring and research. eHealth may also facilitate patient access to health information and medical treatment, and is seen as an effective tool for patient empowerment. At the same time, eHealth solutions may jeopardize both patient safety and patients' rights, unless carefully designed and used with discretion. The success of EHR systems will depend on public trust in their compatibility with fundamental rights, such as privacy and confidentiality. Shared European EHR systems require interoperability not only with regard to technological and semantic standards, but also concerning legal, social and cultural aspects. Since the area of privacy and medical confidentiality is far from harmonized across Europe, we are faced with a diversity that will make fully shared EHR systems a considerable challenge.     

Origin assignment of unidentified corpses by use of stable isotope ratios of light (bio-) and heavy (geo-) elements--a case report

An unknown male body was found near an expressway in Germany. As different criminalistic and forensic methods (e.g. tooth status, fingerprint or DNA-analysis) could not help to identify the person, multielement stable isotope investigations were applied. The combined analysis of stable isotope ratios of light (H, C, N) and heavy elements (Pb, Sr) on the man's body tissues supported to assign him to Romania. The case report demonstrates an application of multielement-isotope analysis in the forensic fields and its potential.     

One step forward,one step back: Quebec's 2003–04 health and social services regionalization policy

Abstract: This article focuses on Quebec's most recent reform in the regionalization of health care to understand why the government chose to transform the regional boards into agencies. This case study used interviews and documentary analysis. Rooted in a political science perspective, the conceptual framework is inspired by the work of John Kingdon (1995) and draws on the four variables that influence the choice of policy: ideas, interests, institutions and events. Results of the case study suggest that Quebec's Commission of Study for Health and Social Services (the Clair Commission) in 2000 and the 2002 pre-electoral environment put the issue on the agenda. In 2003, the newly elected Liberal government passed Bill 25 – An Act Respecting Local Health and Social Services Network Development Agencies, which represented a political compromise: originally slated for eradication, the regional tier survived but in a new form. The element that sparked reform was the change in government following the elections. Different inquiry reports spread the reform's ideas, while interest groups articulated contrasting visions on the transformation. Above all, regional institutions showed great resilience in the face of change. From a historical perspective, this regionalization policy is a step backward: the regional tier is now stronger from a managerial and technocratic point of view, but it is politically and democratically weakened. This suggests a government intention, at that time, to maintain the regional level as a means of retaining centralized control over Quebec's health-care system.     

Nurturing knowledge: the UK Higher Education Links scheme

This article examines the development of academic networks and expertise through the UK Higher Education Links scheme, which is funded by the UK Department for International Development, managed by the British Council and supported by the principals of UK higher education institutions. The links are established between UK and overseas universities primarily to enhance research and/or teaching capacity, with the ultimate aim of alleviating poverty and promoting sustainable development. This article draws on data gathered for a large‐scale, multiple‐method evaluation which endorsed the scheme's continuation. It is argued that a crucial factor helping to make individual links a success was good relationships between respective co‐ordinators, although the nature of these relationships varied. The article discusses the extent to which the formation of fruitful academic networks and partnerships enabling knowledge transfer were encouraged. Copyright © 2003 John Wiley & Sons, Ltd.     

Umweltschutz in den Verfassungen der EU-Mitgliedstaaten

Angesichts der jüngst zu beobachtenden Dynamik im mitgliedstaatlichen Umweltverfassungsrecht enth?lt der folgende Beitrag in Anknüpfung an die Untersuchung von Thym (NuR 2000, 557 ff.) sowohl eine erforderliche Aktualisierung – insbesondere im Hinblick auf die umfassende Inkorporierung des Umweltschutzes in die franz?sische Verfassung im Jahre 2005 sowie die Erweiterung der EU im Jahre 2004 – als auch eine zukunftsorientierte Analyse des Verfassungsvergleichs mit Blick auf die Normierung des Umweltschutzes in der „Charta der Grundrechte der Europ?ischen Union (GRC)“     

Why Freedoms Do Not Exist by Degrees

The overall freedom of an individual or a society is something that exists in differing degrees. By contrast, anyone's particular freedom to engage in this or that mode of conduct is something that exists (or does not exist) in an all-or-nothing manner. Many political philosophers have taken a contrary view, however, and have contended that each particular freedom exists to a greater or lesser extent in proportion to the easiness or difficulty of exercising it. This essay argues that the temptation to view particular freedoms as matters of degree can be overcome when careful attention is paid to three distinctions: overall liberty versus particular liberties, the existence of any particular liberty versus the probability of its emergence, and becoming more free to do something versus becoming free to do something in more ways. By properly marking these distinctions, one can readily apprehend that the existence or inexistence of each particular freedom is characterized by no gradations – an insight that improves one's understanding of the necessary and sufficient conditions for the existence of any such freedom.