As informações sobre os direitos sociais estão acessíveis aos pacientes oncológicos? / Is information on social rights accessible to cancer patients? / ¿Es accesible la información de los derechos sociales para los pacientes con cáncer?

A legislação brasileira assegura aos pacientes com câncer direitos que auxiliam no tratamento e atenuam os gastos despendidos na jornada de adoecimento. O objetivo do estudo foi calcular a proporção de indivíduos em tratamento oncológico de um centro de referência do Sistema Único de Saúde (SUS) que referiram conhecer 15 direitos específicos previstos em lei, segundo o subgrupo populacional elegível para solicitar cada direito. Foram entrevistados todos os pacientes oncológicos adultos em início de tratamento no Hospital Associação Feminina de Prevenção e Combate ao Câncer de Juiz de Fora (ASCOMCER), Minas Gerais, entre março e julho de 2022 (n = 62). Cerca de 60% desses pacientes eram analfabetos ou não tinham completado o ensino fundamental, aproximadamente 75% viviam em domicílios em que a renda per capita era de no máximo um salário mínimo e 91,9% eram atendidos pelo SUS. Para nove dos 15 direitos selecionados, a proporção de pacientes elegíveis foi superior a 10%, variando de 17,7% para "saque do Fundo de Garantia por Tempo de Serviço (FGTS)" a 100% para "prioridade na tramitação de processos". No entanto, o único desses direitos conhecido por pelo menos 50% dos pacientes elegíveis foi o "auxílio-doença" (70,6%), sendo que para três direitos as respectivas proporções não chegaram a 5% (isenção de imposto sobre propriedade predial e territorial urbana, isenção do imposto de renda na aposentadoria, pensão e reforma e prioridade na tramitação de processos). Os pacientes oncológicos necessitam ter seus cuidados integrais fortalecidos. Dessa forma, é fundamental aumentar o acesso à informação sobre os benefícios que eles podem obter de um Estado democrático de direito.

Brazilian legislation provides for rights for cancer patients in order to assist with their treatment and mitigate the expenses they face during their illness. This study aimed to calculate the proportion of individuals undergoing cancer treatment at a Brazilian Unified National Health System (SUS) referral center who reported being aware of 15 specific legal rights, according to the population subgroup eligible to request each right. All adult cancer patients starting treatment at the Juiz de Fora Women's Association for Preventing and Fighting Cancer Hospital (ASCOMCER), Minas Gerais State, from March to July 2022, were interviewed (n = 62). About 60% of these patients had incomplete primary education or were illiterate, around 75% lived in households with a per capita income below one minimum wage, and 91.9% received treatment from the SUS. For nine of the 15 selected rights, the proportion of eligible patients was higher than 10%, ranging from 17.7% for "Withdrawal from the Severance Pay Fund (FGTS)" to 100% for "priority in the processing of procedures". However, the only one of these rights known to at least 50% of eligible patients was "sickness benefit" (70.6%). The respective proportions were below 5% in three rights, including "exemption from property tax", "exemption from income tax on retirement, pension, and retirement", and "priority in the processing of cases". Cancer patients need to have their comprehensive care strengthened. Therefore, it is crucial to enhance the availability of information regarding the benefits cancer patients may receive from a democratic state that respects the rule of law.

La legislación brasileña garantiza a los pacientes con cáncer derechos que les ayudan en el tratamiento y mitigan los gastos que tienen a lo largo de la enfermedad. El objetivo de este estudio fue calcular la proporción de individuos sometidos al tratamiento oncológico en un centro de referencia del Sistema Único de Salud (SUS) brasileño que informaron conocer 15 derechos específicos previstos por la ley, según el subgrupo de población elegible para solicitar cada derecho. Se entrevistó a todos los pacientes adultos con cáncer que comenzaron el tratamiento en el Hospital Asociación de Mujeres para la Prevención y Lucha contra el Cáncer de Juiz de Fora (ASCOMCER), Minas Gerais, entre marzo y julio de 2022 (n = 62). Cerca del 60% de estos pacientes eran analfabetos o no habían completado la escuela primaria, aproximadamente el 75% vivía en hogares con ingreso per cápita de un salario mínimo y el 91,9% eran tratados por el SUS. Para 9 de los 15 derechos seleccionados, la proporción de pacientes elegibles para ellos fue superior al 10%, oscilando del 17,7% para el "retirada del Fondo de Garantía por Duración del Servicio" al 100% para "prioridad en la tramitación de procedimientos". Sin embargo, de estos derechos el único conociodo por al menos el 50% de los pacientes elegibles conocía fue el "beneficio por enfermedad" (70,6%), y en 3 derechos las proporciones respectivas no alcanzaron ni siquiera el 5% ("exención del impuesto sobre bienes inmuebles y territorial urbano", "exención del impuesto sobre la renta por jubilación, pensión y retiro" y "prioridad en la tramitación de procedimientos"). Los pacientes con cáncer requieren el fortalecimiento de una atención integral. Por lo tanto, es esencial incrementar el acceso a la información sobre los beneficios que los pacientes con cáncer pueden obtener de un Estado de derecho democrático.

Use of smartphone-based instant messaging services in medical practice: a cross-sectional study

ABSTRACT BACKGROUND: Instant messaging services (IMS) are widely used in medical practice. OBJECTIVE: To evaluate perceptions regarding use and usability of IMS within clinical practice and assess users' knowledge of the ethical and legal context involved in using IMS within medical practice. DESIGN AND SETTING: Cross-sectional study conducted in different hospitals and medical institutions in Minas Gerais, Brazil. METHODS: Medical students, medical residents, primary care physicians and specialist doctors answered an online questionnaire regarding epidemiological data, graduation level and use of IMS for medical communication. Responses were collected over a five-month period and data were assessed using the IBM-SPSS software. RESULTS: 484 people answered the questionnaire: 97.0% declared that they were using IMS for medical-related purposes; 42.0%, to elucidate medical concerns every week; 75.0%, to share imaging or laboratory tests and patients' medical records; and 90.5%, to participate in clinical case-study private groups. Moreover, only 37.0% declared that they had knowledge of the legislative aspects of use of smartphones within clinical practice. Differences in the frequency of discussion of medical concerns within the daily routine between student/residents and general practitioners/specialists, and in the frequency of image-sharing and patient-guiding/assistance between students and medical doctors, were observed. CONCLUSIONS: Our results provide reliable proof that medical doctors and students use IMS, as a tool for clinical case discussions, interactions between healthcare providers and patients, or dissemination of knowledge and information. Nonetheless, because of limitations to the ethical and legal regulations, evidence-based discussions between authorities, academics and medical institutions are needed in order to fully achieve positive outcomes from such platforms.

Mujeres argentinas y usos de drogas: análisis sociohistórico del uso femenino de sustancias psicoactivas en Argentina (1860-1930) / Argentinian women and the uses of drugs: A sociohistorical analysis of female drug use in Argentina (1860-1930)

RESUMEN Este trabajo describe casos expuestos por expertos de los ámbitos legislativo y médico-legal periodístico, en los que se reporta el consumo de sustancias psicoactivas por parte de mujeres de Argentina, entre 1878 y 1930. Se presentan antecedentes sobre mujeres y usos de distintos fármacos, se analizan las intervenciones médicas que utilizan sustancias psicoactivas sobre el cuerpo femenino, y se detallan los casos de mujeres consumidoras desde las miradas expertas. En este periodo, los discursos expertos no buscaron comprender la especificidad femenina del consumo, sino promover el tema drogas como un problema. Esto se produce utilizando tres prototipos: la víctima de un marido enfermo, la prostituta que envicia a los débiles de espíritu (criminal nata), y la joven virtuosa que contraviene la ley del padre y sucumbe en la toxicomanía. Cada figura refuerza la necesidad de intervención estatal y control social.

ABSTRACT This article describes cases presented by experts from the legislative and medical-legal fields regarding the use of psychoactive substances among Argentinian women from 1878 to 1930. Background information is presented regarding the relationship between women and the use of different drugs, medical interventions on the female body where psychoactive substances were used are analyzed, and experts' descriptions of cases of female drug users are detailed. Experts' discourses during this period did not attempt to comprehend the specificities of female consumption but were rather used to position the issue of drug use as a social problem. This was done using three prototypes: the victim of a sick husband; the prostitute who encourages drug use among the weak in spirit (natural-born criminals); and the virtuous young woman who succumbs to drug addiction in spite of her father's rule. Each figure reinforces the need for state intervention and increased social control.

Practice of ＂Management Regulation of Medical Institutions＂ based on the questionnaire / 中华医院管理杂志

Objective To learn the comments on the practice of "Management Regulations of Medical Institutions(Regulations below)" by those related to such Regulations. And to identify problems found in the application. Methods A questionnaire was designed by means of literature review and expert brainstorming, to learn the awareness of the respondents on the Regulations, and their comments on regional planning of medical institutions, setup approval authority, classification of medical institutions, and regulators of these institutions. A total of 1 000 questionnaires were delivered to medical institutions, health administrative authorities and patients at large 854 valid questionnaires were recovered, with the data analyzed in descriptive statistics. Results 90.7% of the respondents supported the revision of the main contents of the Regulations. 54.3% of them held that not all types of medical institutions need to be limited by regional planning; 69.1% of them held that the regulatory powers of different rankings on the business approval need to be revised; 56.9% of them held that the Regulations should clarify the legal status of other regulatory authorizes over medical institutions. The respondents also named 11 articles of the Regulations to be added. Conclusions A number of articles of the Regulations need to be revised, such as those on setup approval and classified administration, to meet administrative needs and medical institutions' development needs. In the meantime, interest relationship of health administrators, medical institutions and patients should be taken care of as well.

Procedimento de bichectomia: uma discussão sobre os aspectos éticos e legais em odontologia / Bichectomy procedure: a discussion on the ethical and legal aspects in odontology

Introdução: O procedimento denominado de bichectomia consiste na remoção parcial de uma estrutura adiposa na região das bochechas e ganhou recente popularidade entre a classe odontológica, que passou a executá-lo amplamente, com demandas predominantemente estéticas e, com isso, dúvidas e incertezas surgiram a respeito dos seus aspectos éticos e legais. Objetivo: O objetivo deste trabalho foi buscar legislações nacionais, bem como normativas e resoluções emitidas por conselhos profissionais, visando abordar tais controvérsias, alumiando os profissionais quanto à legitimidade do procedimento. Resultados: Verificou-se que desde 1978, os Conselhos Federais de Medicina e de Odontologia vêm emitindo resoluções para determinar limiares de atuação profissional, em especial, com enfoque na especialidade Cirurgia e Traumatologia Bucomaxilofacial, visto que é a especialidade odontológica clínica que mais se aproxima de campos de atuação médica. Com o tempo, estes Conselhos foram atualizando estas Resoluções, tendo em vista os avanços técnicos e científicos da área, porém todas as resoluções analisadas são unânimes em afirmar que a realização de bichectomia com finalidade estritamente estética é atribuição médica. Conclusão: Desta forma, com base nos documentos atualmente vigentes, verifica-se que o cirurgião-dentista que estiver disposto a realizar a cirurgia de bichectomia com finalidade exclusivamente estética estará incorrendo em transgressões administrativas e, consequentemente, tais interpretações podem ser vislumbradas em outras esferas (cíveis e criminais).

Introduction: Bichectomy consists of removing part of a fat structure in the region of the cheeks, and it recently gained popularity in the field of odontology, which began to widely perform the procedure, with predominantly aesthetic demands and, with that, doubts and uncertainties arose with respect to its ethical and legal aspects. Objective: The objective of this work was to seek national laws, as well as normative and resolutions issued by professional councils, aiming to address such controversies, enlightening professionals to the legitimacy of the procedure. Results: Since 1978, the Federal Councils of Medicine and Dentistry have issued resolutions to determine thresholds for professional performance, which particularly focused on Oral and Maxillofacial Surgery and Traumatology because it is the closest clinical dental specialty of medical practice. Over time, these Councils have been updating these resolutions, considering the technical and scientific advances of the area, but all the resolutions analyzed were unanimous in affirming that the accomplishment of bichectomy with a strictly aesthetic purpose is a medical attribution. Conclusion: Subsequently, based on the documents currently in force, it is verified that the dental surgeon who is willing to perform bichectomy surgery for aesthetic purposes will be incur administrative infractions and, consequently, such interpretations can be seen in other legal areas (civil and criminal).

Prevalence of Sharing Access Credentials in Electronic Medical Records / 대한의료정보학회지

OBJECTIVES: Confidentiality of health information is an important aspect of the physician patient relationship. The use of digital medical records has made data much more accessible. To prevent data leakage, many countries have created regulations regarding medical data accessibility. These regulations require a unique user ID for each medical staff member, and this must be protected by a password, which should be kept undisclosed by all means. METHODS: We performed a four-question Google Forms-based survey of medical staff. In the survey, each participant was asked if he/she ever obtained the password of another medical staff member. Then, we asked how many times such an episode occurred and the reason for it. RESULTS: A total of 299 surveys were gathered. The responses showed that 220 (73.6%) participants reported that they had obtained the password of another medical staff member. Only 171 (57.2%) estimated how many time it happened, with an average estimation of 4.75 episodes. All the residents that took part in the study (45, 15%) had obtained the password of another medical staff member, while only 57.5% (38/66) of the nurses reported this. CONCLUSIONS: The use of unique user IDs and passwords to defend the privacy of medical data is a common requirement in medical organizations. Unfortunately, the use of passwords is doomed because medical staff members share their passwords with one another. Strict regulations requiring each staff member to have it's a unique user ID might lead to password sharing and to a decrease in data safety.

Analysis of medical disputes regarding chronic pain management in the 2009–2016 period using the Korean Society of Anesthesiologists database / 대한마취과학회지

BACKGROUND: The active involvement of anesthesiologists in chronic pain management has been associated with an increase in the number of related medical dispute cases. METHODS: Using the Korean Society of Anesthesiologists Legislation Committee database covering case files from July 2009 to June 2016, we explored injuries and liability characteristics in a subset of cases involving chronic pain management. RESULTS: During the study period, 58 cases were eligible for final analysis. There were 27 cases related to complex regional pain syndrome (CRPS), many of them involving problems with financial compensation (24/27, 88.9%). The CRPS cases showed male dominance (22 males, 5 females). In a disproportionately large number of these cases, the causative injury occurred during military training (n = 5). Two cases were associated with noninvasive pain managements, and 29 cases with invasive procedures. Of the latter group, procedures involving the spine (both neuraxial and non-neuraxial procedures) resulted in more severe complications than other procedures (P = 0.007). Seven of the patients who underwent invasive procedures died. The most common type of invasive procedures were lumbosacral procedures (16/29, 55.2%). More specifically, the most common damaging events were inadvertent intravascular or intrathecal injection of local anesthetics (n = 6). CONCLUSIONS: Several characteristics of medical disputes related to chronic pain management were identified: the prevalence of injury benefit claims in CRPS patients, higher severity of complications in procedures performed at the spine or cervical region, and the preventability of inadvertent intravascular or intrathecal injection of local anesthetics.

El determinismo de Newton-Laplace en el derecho positivo de la legislación colombiana frente a la incertidumbre de Heisenberg en el ejercicio médico / Newton's and Laplace's determinism in the positive law of colombian legislation vs. Heinsenberg's uncertainty in medical practice

Objetivo: hacer una reflexión sobre la tendencia de la legislación colombiana que regula el ejercicio médico, cada vez más impregnada del positivismo de Lombroso, Ferri y Garofalo, seguidores de la corriente determinista de Newton-Laplace, según la cual todo es pronosticable.Tesis: la medicina es una de las disciplinas humanas con más alta probabilidad de producir beneficios o desenlaces aleatorios.Conclusiones: la normatividad debe estar embebida de la prudencia que le es propia, para no sitiar a los profesionales de la medicina.

Objective: To reflect on Colombian legislation regulating medical practice, increasingly permeated by the positivism of Lombroso, Ferri and Garofalo, followers of Newton's and La Place's deterministic think ing according to which every thing is predictable.Thesis: Among human sciences, some of the highest odds of producing random benefits or outcomes are found in medicine.Conclusions: Regulations must be imbued with the wisdom inherent to them in order to avoid placing medical practitioners under siege.

O placebo e a Declaração de Pachuca: letras mortas? / The placebo and the Declaration of Pachuca: dead letters?

A Confederação Médica Latino-Americana e do Caribe, organização que congrega as entidades congêneres dos países da região, atua em defesa da profissão médica e da saúde da população, guiando-se por documentos internacionais. Em sua Assembleia Geral (Pachuca, México; 2013) foi aprovada a Declaração de Pachuca, com severas críticas à revisão da Declaração de Helsinki ocorrida no Brasil e aos ensaios clínicos que usam placebo em doenças com tratamento definido. O tom duro e enérgico dessa Declaração propõe que entidades-membro denunciem os abusos éticos em todos os foros e aos governantes, e que atuem impedindo o uso do placebo nessas condições. Tais recomendações encontram respaldo no movimento mundial sobre integridade e ética na pesquisa. Conclui-se pela importância do papel educativo dos órgãos de fiscalização ética da medicina, alertando-se os médicos que infringirem essa orientação, a qual também integra o Código de Ética Médica, de que estarão sujeitos a processo ético-profissional...

The Latin American and Caribbean Medical Confederation (CONFEMEL), an organization that brings together related organizations from countries of the region, works on behalf of the medical profession and the population's health guided by international documents. During its General Assembly (Pachuca, Mexico; 2013) the Declaration of Pachuca was approved with strong critics regarding the review of the Declaration of Helsinki that occurred in Brazil and the issue of clinical trials that use placebo in diseases with known treatment. The strong and energetic tone of this Declaration proposes that member entities condemn ethical abuses in all forums and also to administrations so that they engage against the use of placebo in these conditions. These recommendations are supported in the global movement on Integrity and Ethics in Research. The conclusion addresses the importance of the educative role of ethical supervision of Medicine warning physicians who violate these guidelines, which are also incorporated in the Code of Medical Ethics, that they will be subjected to ethical-professional process...

La Confederación Médica Latinoamericana y del Caribe (CONFEMEL), una organización que reúne a instituciones similares de los países de la región, actúa en defensa de la profesión médica y salud de la población, guiándose por los documentos internacionales. En su Asamblea General (Pachuca, México; 2013) se aprobó la Declaración de Pachuca con duras críticas a la revisión de la Declaración de Helsinki que tuvo lugar en Brasil y a los ensayos clínicos que utilizan placebo en enfermedades con tratamiento conocido. El tono duro y enérgico de tal Declaración propone que las entidades-miembros a denunciar los abusos éticos en todos los foros y a los gobernantes, y que actúen impidiendo el uso del placebo en estas circunstancias. Estas recomendaciones se apoyan en el movimiento mundial sobre Integridad y ética en la investigación. Se concluye sobre la importancia del papel educativo de los órganos de supervisión ética da medicina, alertando a los médicos que violen esta norma, que también está contemplada en el Código de Ética Médica, que estarán sujetos a proceso ético-profesional...

Analysis of expert consultation referrals for anesthesia-related issues (December 2008-July 2010): KSA legislation committee report / 대한마취과학회지

BACKGROUND: Since 2009, database construction of anesthesia-related adverse events has been initiated through the legislation committee of the Korean Society of Anesthesiologists (KSA), based on expert consultation referrals provided by police departments, civil courts, and criminal courts. METHODS: This study was a retrospective descriptive analysis of expert consultation referrals on surgical anesthesia-related cases between December 2008 and July 2010. RESULTS: During the given period, 46 surgical anesthesia-related cases were referred to the KSA legislation committee for expert consultation. Because six cases were excluded due to insufficient data, 40 cases were included in the final analysis. Of 40 cases, 29 (72.5%) resulted in death. Respiratory events were most common in both surviving/disabled and dead patients (36.4 vs. 51.7%, respectively; P > 0.05). Overall, respiratory depression due to the drugs used for monitored anesthesia care (MAC) was the most common specific mechanism (25%), in which all but one case (profound brain damage) resulted in death. In all of these cases, surgeons or physicians provided MAC without the help of anesthesiologists. CONCLUSIONS: Overall, the most common damaging mechanism was related to respiratory depression due to sedatives or anesthetics used for MAC. Almost all MAC injury cases are believed to be preventable with the use of additional or better monitoring and an effective response to initial physiological derangement. Thus, it is essential to establish practical MAC guidelines and adhere to these guidelines strictly to reduce the occurrence of severe anesthesia-related adverse outcomes.

Conselhos de medicina: criação, trajetória e consolidação / Councils of medicine: establishment, consolidation and trajectory

A criação dos conselhos de medicina no Brasil foi um movimento de grande importância por suas peculiaridades. Para a elaboração deste trabalho, foi realizada uma pesquisa nas bibliotecas dos conselhos de medicina e, com base no material analisado, organizou-se este trabalho com o objetivo de manter viva a memória dos conselhos médicos e contribuir como fonte de futuras indagações. Na primeira metade do século XX, a profissão médica brasileira sofreu um intenso processo de transformação, passando do modelo liberal para o assalariamento, o que provocou conflitos na classe médica. O Movimento Sanitarista teve importância no desenrolar das ações que precederam o movimento pela criação dos conselhos. Em 1930, o sistema de saúde foi organizado com a criação dos institutos de aposentadoria e pensão. A primeira entidade médica criada no Brasil foi o Sindicato Médico Brasileiro, que fiscalizou o exercício da medicina e defendeu o bom nível dos salários médicos. Em 30 de setembro de 1957, foi promulgada a Lei nº 3.268, que determinou a reestruturação dos conselhos de medicina. Assim, esses conselhos passaram a registrar os médicos em seus Estados e fiscalizar o exercício profissional. Em 1964, com a instituição do regime militar, deu-se início ao período de repressão política e, na área da saúde, foi criado o Instituto Nacional de Previdência Social, o INPS, com o objetivo de organizar a previdência e a assistência médica. Nessa época, deu-se o início do sucateamento da saúde pública com o crescimento dos planos de assistência médica privada, os chamados planos de saúde, e da abertura de numerosas escolas médicas. Com a redemocratização do País, foi criado o Sistema Único de Saúde, o SUS, e os Conselhos de Medicina engajaram-se no movimento pelo exercício digno da atividade médica.

The creation of the councils of medicine in Brazil was a movement of great importance for its peculiarities. For the preparation of this work, a literature search on the libraries of the councils of medicine was performed and from the researched material this work was organized with the objective of keeping the memory alive and supply as a source for future research. In the first half of the twentieth century, the Brazilian medical profession suffered an intense process of transformation, going from liberal model for the salaried class, raising conflicts. The Movimento Sanitário had importance in the conduct of actions that preceded the movement for the creation of the councils. In 1930, the health system was organized with the creation of the retirement and pension institutes. The first medical entity created in Brazil was the Sindicato Médico Brasileiro (Brazilian Medical Union), to monitor the medical practice and to protect wages and salaries. On September 30, 1957, the Act 3.268 was promulgated establishing the restructuring of the councils of medicine. Thus, the councils started to register the doctors in their states and to monitor the professional practice. In 1964, with the institution of the military regime has begun a crackdown on health area and the Instituto Nacional de Previdência Social (INPS) was created, with the objective to organize the health and medical assistance. At that time, the fragmentation of public health took place with the growth of the private health coverage plans and the opening of many private medical schools. After the democratization of the country the Sistema Único de Saúde – SUS (Health Single System) was created and the councils of medicine joined the movement for enforcement of respectable medical activity.

Eutanasia y legislación / Euthanasia and Legislation

Se hace una revisión de los conceptos relacionados con la eutanasia, como son Distanasia y Ortotanasia y de los diferentes tipos de Eutanasia, como la Voluntaria, la no voluntaria y la Involuntaria, la Eutanasia Eugenésica. Se valoran las distintas posibilidades desde el punto de vista jurídico, donde puede estar regulada o no; la regulada puede serlo por norma penal, en ese caso la regulación puede ser como figura delictiva típica o dentro de otro tipo legal, y de la regulación no penal puede serlo por normas administrativas y puede tratarse de regulaciones permisivas o no permisivas. Se valoran estas posibilidades, exponiendo como tipifica en el Código Penal Cubano y cual es el criterio de los autores. A continuación se exponen algunos ejemplos de países donde se ha tratado o logrado tipificar la Eutanasia de forma diferente, exponiendo los resultados de un estudio hecho en Holanda antes de la despenalización de la Eutanasia y como se comportó la atención a pacientes terminales en ese año. Finalmente se expone el criterio de los autores en torno a la regulación legal de la Eutanasia.

Concepts related to Euthanasia as Disthanasia and Ortothanasia are reviewed as well as the different types of Euthanasia, such as the Voluntary Euthanasia, the non Voluntary Euthanasia and the Involuntary Euthanasia, the Eugenesic Euthanasia. The different possibilities from the legal point of view are assessed; the Euthanasia may be regulated or not, the first type of Euthanasia may be regulated by penal rules. i.e., the regulation may be a typical delictive figure or to be within another legal type and in case of not penal regulation, it may be by administrative rules and in such case it may be treated of permissive regulations or not. These possibilities are valuated exposing how they are classified in the Cuban Penal Code and which is the authors´s criterion. The countries where the classification of Euthanasia has been treated or attained from different ways are exposed as well as the results of Holland's study before the decriminalization of Euthanasia and the behaviour in terminal patients in this year. Finally, the authors´s criterion about the legal regulation of Euthanasia is exposed.