透视医疗纠纷——辨析医患双方的权利和义务

发生医疗纠纷的一个重要原因是医患双方各自站在自己的立场上,维护自己的权利而产生的争端。由于我国卫生法制的滞后,患者被作为消费者伸张权利逐步成为趋势。但我国的医疗卫生事业的性质决定患者不能与消费者等同。医患双方应在更好的游戏规则下协调关系,减少纠纷。     

医疗事故纠纷的本质及法律责任

医疗事故纠纷及处理的道德本质和司法原则在于对病人权利的维护。强化医务人员对病人生命与健康的医德责任感和病人权利意识,并使之成为自律、自觉的行为是预防和减少医疗事故纠纷发生的第一要素;而提高医务人员的法律意识,完善法律的制约机制,对医疗事故的防范是同样重要的。     

医疗事故处理法律亟待统一规范

目前在我国医疗工作的实践中,医疗纠纷呈上升趋势。然而,解决和处理医疗纠纷与医疗事故的法律、法规尚不移规范统一。随着我国法制的逐步健全,法律,法规的不断完善,医疗事故处理的法律亟待统一规范,以利于全社会遵法,守法,执法的实现。     

卫生资源优化配置的伦理要求

卫生资源是稀缺资源,卫生资源只有优化配置,才能达到我们的医学目的。卫生资源的优化配置的以公平为优先,坚持公平和效率相结合的原则。就目前所存在的和我们的医学目的不相适应的卫生资源配置方式的现状和主要问题进行分析,并提出了相应的改进方法。     

From Copenhagen to the consulting room: Pauli and Jung in Copenhagen

In this paper the city of Copenhagen is used as a starting point to highlight some critical historical events, both concerning the exchange of ideas between the physicist Wolfgang Pauli and C.G. Jung and the history of psychotherapy in Scandinavia. Pauli's years in Copenhagen under the influence of Niels Bohr and his philosophy prepared him mentally to receiveC.G. Jung's ideas. The paper also recounts the one occasion that Jung was in Scandinavia, attending the 9th conference of the General Medical Society for Psychotherapy in Copenhagen, just before going to New York in 1937 to give his final seminars on Pauli's dreams. The reason for focusing on these particular events is that they also constitute part of the history of the reception of psychodynamic psychology in Sweden and Scandinavia.     

新农合制度调整前后豫北地区腹膜透析患者透析质量的比较

腹膜透析是终末期肾脏病的有效替代治疗方法之一。2012年4月,河南省对包括慢性肾衰竭在内的六种疾病的新农合报销比例做出重大调整,腹透患者主要经济花费的透析液报销比例由原来的40％提高至80％。通过研究新农合制度调整前后豫北地区腹膜透析患者的临床资料,报告了制度调整后的患者透析充分性提高,贫血、营养状况较前好转,心血管疾病发生率下降,生存质量改善的现况,论证了老龄、糖尿病、营养不良、心血管疾病、透析不充分、较低的医疗保险支付比例是影响腹膜透析患者预后的重要因素,为腹膜透析患者的预后分析提供了理论依据。     

L’expertise en ingénierie biomédicale ou du bon usage des dispositifs médicaux

How to limit the risks in the use of medical devices increasingly present in medicine an increasingly technologically complex? Simple and regulatory rules apply such as the CE marking. This becomes more complex when it is necessary to prove the compatibility of an assembly of several medical devices. The Vigilance on Medical Devices allows to alert after placing on the market when there has been an incident or a risk of incident on a failing medical device. Users training is one of the key point to control risks. Risk Training in specific fields such as the Electricity hazards associated with the use of electrical scalpels, laser-related hazards, electromagnetic fields, … is not sufficiently developed and renewed for good risk control. Finally, maintenance is a regulatory obligation and must be arranged for proper use of medical devices.     

Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.     

A medical records managing and securing blockchain based system supported by a Genetic Algorithm and Discrete Wavelet Transform

The privacy of patients is jeopardised when medical records and data are spread or shared beyond the protected cloud of institutions. This is because breaches force them to the brink that they start abstaining from full disclosure of their condition. This type of condition has a negative effect on scientific research, patients and all stakeholders. A blockchain-based data sharing system is proposed to tackle this issue, which employs immutability and autonomy properties of the blockchain to sufficiently resolve challenges associated with access control and handle sensitive data. Our proposed system is supported by a Discrete Wavelet Transform to enhance the overall security, and a Genetic Algorithm technique to optimise the queuing optimization technique as well. Introducing this cryptographic key generator enhances the immunity and system access control, which allows verifying users securely in a fast way. This design allows further accountability since all users involved are already known and the blockchain records a log of their actions. Only when the users’ cryptographic keys and identities are confirmed, the system allows requesting data from the shared queuing requests. The achieved execution time per node, confirmation time per node and robust index for block number of 0.19 s, 0.17 s and 20 respectively that based on system evaluation illustrates that our system is robust, efficient, immune and scalable.