SUPER-SIZED KIDS:

Morbid obesity is an unfortunate problem that is only becoming worse everyday. The alarming aspect of it is that it is affecting people at a much earlier age; thus, young children are becoming morbidly obese and are experiencing the same health problems as middle-aged adults. The first section of this note defines morbid obesity and its causes and trends. Section two describes child neglect in general and then distinguishes medical neglect. Section three discusses education and prevention, which are both crucial steps in the struggle with weight-loss and weight-gain. Section four summarizes the beneficial aspects of removing a morbidly obese child who is in a life-threatening position from his or her parents. Section five highlights case-studies from California, Iowa, Indiana, New Mexico, and Texas, where children have either died or were removed from their families because of morbid obesity. Section six briefly touches upon similar child neglect scenarios where removal is permissible and compares those situations with those of morbidly obese children. The seventh section considers some credible counterarguments to government intervention, and the final section suggests some recommendations on how to prevent the morbid obesity crisis from becoming worse than it already is. Too many people are dying from weight-related problems already, yet morbid obesity is preventable! This severe state of obesity is something that can be controlled and prevented, but only if parents take an active role in their child's diet and exercise.     

当前医疗纠纷案件审理中有关问题初探

审理医疗纠纷案件涉及诸多法律、法规和司法解释,但如何将这些规范运用到医疗纠纷案件审理中,比如适用范围、法律适用、举证责任、医疗事故鉴定与司法鉴定等问题都存在值得探讨的问题。而这些问题的弥补途径只能在司法实践中找到。     

眼外伤分度及其法医学鉴定

在现行的人体损伤程度鉴定标准和道路交通事故伤残评定标准中都有许多涉及眼损伤分度的问题。但由于标准本身缺乏相应的评定细则,给鉴定工作带来诸多困难。同样的损伤可能因鉴定人对标准的理解和掌握存在分歧而导致同一损伤会出现不同的鉴定结果。本文借鉴临床医学分度原则,对眼外伤损伤程度和伤残鉴定中所存在的问题提出具体的适用原则,旨在使鉴定工作更加标准化和规范化。     

我国医疗事故罪的医疗过失问题探讨

目前学界对医疗过失的认定见解不一。本文从医务人员的注意能力和注意义务阐述医疗事故罪的主观方面问题,注意义务包括预见义务和结果避免义务,注意能力的认定采用的是主客观相统一,以客观标准为主兼顾主观标准。同时,对医疗实践中争议很大的尖端医疗中的医疗过失应当具体问题具体分析。     

Forensic Autopsies can Determine Latent Prostate Cancer Prevalence

To evaluate the usefulness of forensic autopsies in determining latent prostate cancer (PC) prevalence, we examined latent PC prevalence from autopsies and compared our findings between decedents with and without cancer. Data from forensic autopsies performed in Japan from 2004 to 2014 were obtained. For each prostate, histopathological examinations were performed in both the base and the apex sections. Three hundred and seventeen Japanese decedents were selected for analysis. The mean age of decedents was 56.4 ± 17.8 years (range, 14–94 years). Among this population, 39.4% died suddenly of disease and 60.6% died of external causes. Latent PC was identified in 45 (14.2%) decedents, who ranged from 27 to 93 years old (mean, 71.1 ± 12.9 years). The prevalence of clinically significant PC with a Gleason score of 7 or more was 8.8%, and the rate increased with age. Fifteen males had cancers other than PC. The prevalence of overall latent PC was significantly higher for those with cancer compared with those without (40.0% vs. 12.9%; P = 0.003). In this study, the use of forensic autopsy materials provided the opportunity to obtain a more accurate natural history of PC, as the decedents in this situation would have been more likely to have died suddenly while behaving as normal prior to death, and less likely to have been impacted by long-term medical interventions.     

Stakeholder governance of organ transplantation: A desirable model for inducing evidence-based medicine?

Medical governance should secure and apply appropriate expertise, accommodate stakeholder interests, and promote social values. The most common form of governance, public (agency) rulemaking by government agencies, usually involves supplementing in-house expertise through advisory committees. An alternative, private (stakeholder) rulemaking, involves delegating the authority for developing rules directly to stakeholders, who often command relevant expertise, including that arising out of tacit knowledge. The possible advantages and disadvantages of agency and stakeholder rulemaking in medical governance can be assessed both from what we know about these forms in general and from experience with a prominent example of stakeholder rulemaking; that is, governance of the US organ transplantation system. It appears that this governance has been exceptionally successful in promoting evidence-based medicine. The stakeholder role in the governance of transplantation could be replicated in other areas by creating meaningful stakes to engage stakeholders and by increasing isolation from legislative politics through an independent funding source and circumscribed oversight.     

医疗纠纷中病历存在瑕疵问题之研究

医患双方因医疗行为发生纠纷诉至人民法院后,对病历中存在改动、添加的痕迹,医方和患方会持截然相反的观点。医院认为这是正常的修改,对医疗行为的正确性没有影响。而患方会认为,这是医疗行为错误或违反卫生法律法规给患者带来损害后,医方为逃避承担责任,而采取的补救措施,是篡改病历,掩饰自己的过错。这样的证据摆在法官面前,无论法官作出怎样的内心确认,法院作出怎样的裁判,都可能使一方甚至双方内心永远留着痛。     

论医疗侵权纠纷案件的举证责任

举证责任分配是证据制度的核心,其基础理论为“法律要件说”,由此而推导出“谁主张,谁举证”的一般举证责任分配规则。举证责任倒置是对“谁主张,谁举证”规则的修正,与侵权行为法相伴而生,其适用条件是由法律严格限制的。《关于民事诉讼证据的若干规定》规定医疗侵权诉讼实行举证责任倒置,这样规定并不妥当,理由也不充分,缺少法律基础,对医学发展不利。要完善我国医疗侵权诉讼举证责任,应当从明确医疗侵权行为的专家责任性质入手,建立专家举证制度,实行举证责任轮换,构建分散医疗风险制度。     

基层医疗机构假药劣药销售监管制度的法律剖析

本文从一起医疗机构销售假、劣药的案件谈起，通过焦点案情分析，引发对基层医疗机构假、劣药销售监管制度的深层次的法律剖析。文章首先采用现代法学理论的成因分析方法对基层医疗机构销售假、劣药品行为进行分析，研究其违法动机、违法方式和违法目的。而后在成因分析的基础上，运用比较法的方法，对中美相关制度进行比较。最后对基层医疗机构销售假、劣药的监管制度提出了一些合理化的建议。