Statement in Support of Revising the Uniform Determination of Death Act and in Opposition to a Proposed Revision.

Discrepancies between the Uniform Determination of Death Act (UDDA) and the adult and pediatric diagnostic guidelines for brain death (BD) (the "Guidelines") have motivated proposals to revise the UDDA. A revision proposed by Lewis, Bonnie and Pope (the RUDDA), has received particular attention, the three novelties of which would be: (1) to specify the Guidelines as the legally recognized "medical standard," (2) to exclude hypothalamic function from the category of "brain function," and (3) to authorize physicians to conduct an apnea test without consent and even over a proxy's objection. One hundred seven experts in medicine, bioethics, philosophy, and law, spanning a wide variety of perspectives, have come together in agreement that while the UDDA needs revision, the RUDDA is not the way to do it. Specifically, (1) the Guidelines have a non-negligible risk of false-positive error, (2) hypothalamic function is more relevant to the organism as a whole than any brainstem reflex, and (3) the apnea test carries a risk of precipitating BD in a non-BD patient, provides no benefit to the patient, does not reliably accomplish its intended purpose, and is not even absolutely necessary for diagnosing BD according to the internal logic of the Guidelines; it should at the very least require informed consent, as do many procedures that are much more beneficial and less risky. Finally, objections to a neurologic criterion of death are not based only on religious belief or ignorance. People have a right to not have a concept of death that experts vigorously debate imposed upon them against their judgment and conscience; any revision of the UDDA should therefore contain an opt-out clause for those who accept only a circulatory-respiratory criterion.

Independent forensic medical examination as a mean of proving the facts of a torture usage.

OBJECTIVE: Introduction: In most countries detainees are often subjected to physical and mental abuse by law enforcement officials, but very rarely victims of torture can prove the guilt of these offenders due to the poor quality of findings of state forensic medical and forensic psychiatric experts and due to inconsistency of their findings with international guidelines (Istanbul Protocol). The aim: To determine the role of forensic medical examination in the investigation of torture crimes, to provide arguments for necessity to security of the victim's right to collect evidence independently, including through using of special knowledge of independent forensic medical and forensic psychiatric experts in criminal proceedings. PATIENTS AND METHODS: Materials and methods: The authors used the European Court of Human Rights (ECHR) Decisions on the complaints of the victims' torture, international and Ukrainian human rights legal acts, the results of numerous torture investigations conducted by medical and criminalistics scientists. The research is carried out on the basis of a harmonious combination of philosophical approaches, general and special scientific methods. CONCLUSION: Conclusions: In order to exercise the rights of victims of torture in accordance with the Convention on Human Rights and Fundamental Freedoms, the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, and according to other international and Ukrainian legal acts on human rights the arguments given for the need to enable the victim to engage independent forensic medical and forensic psychiatric experts to provide their conclusions in torture-related criminal proceedings.

[Telematics services and telemedicine under ophthalmological legal aspects]. / Telematik und telemedizinische Leistungen unter rechtsophthalmologischen Aspekten.

Telemedical solutions are increasing with respect to diversity, frequency and scope. It should be part of medical practice to remind again and again that telemedicine does not represent a special medical field or even a subspecialty. The concept of telemedicine is more used as a superior term for different medical care concepts, provided across distance and time barriers. Telematic solutions implemented as a new field of service in ophthalmological practice or in hospitals must fulfill the following obligatory requirements in conformity with the law: patients must be informed about the range of telemedical solutions, operators must ensure medical specialist qualifications and all care responsibilities combined with the telemedical services must be guaranteed. The legal assessment standard is always the direct comparison between telemedical measures and the individual patient result of medical treatment in a face to face situation in an ophthalmologists practice as the gold standard. The court makes a targeted examination on whether the individual damage to health of a patient under telemedical care would also have normally occurred under medical treatment within the framework of regular care by a medical specialist in a practice or clinic. If the court has a well-founded doubt, the operator must be able to justify either constraints in individual cases or a better prognosis and success rate (reversal of burden of proof). Especially due to the latter aspect it is important for the operator that the standards for telemedical services of the specific medical fields are predefined by the specialist societies or that corresponding results from healthcare research projects are available.

An empirical study on medical selection of flying cadets regarding genu varum and genu valgum between PLAAF and USAF / 军事医学

Objective To reveal the difference between the standards for genu varum and genu valgum in the medical standard directory PLA Air Force( PLAAF) for recruitment of flying cadets and those adopted in the United States Air Force ( USAF) , and suggest a method for the reform of our flying cadets recruitment.Methods The rejection rate and comprehe nsive assessment qualification rate of genu varum and genu valgum during physical examinations for recruitment of flying cadets between 2012 and 2015 were analyzed.The different standards for genu varum and genu valgum in PLAAF and USAF flying cadets recruitment were compared and subjected to an empirical study.Results During the final physical examination for selection of flying cadets between 2012 and 2015, only 18 candidates were eliminated because of genu varum and genu valgum, accounting 9.1% of the total eliminated candidates because of orthopadics diseases.Four candidates with genu varum and genu valgum passed the comprehensive assessment in 2014 and 31 in 2015, which accounted for 15%of the candidates with orthopaedics diseases approved by comprehensive assessment.The standards for genu varum and genu valgum in PLAAF were based on morphology while those in the USAF based on the function of knees.According to the USAF medical standard directory, 9 of the candidates rejected because of genu varum and genu valgum were qualified and 9 disqualified.Among the candidates with genu varum and genu valgum approved by comprehensive assessment, 32 were qualified and 3 disqualified.Conclusion The standards for genu varum and genu valgum in PLAAF medical standard directory are of lower accuracy.The standards of USAF should be referred to and the function of knees should be considered in selection of flying cadets.Femur-tibia angle should be measured to improve the morphological standards.

Implications of the concept of the standard of care on self-regulation and medical ethics based on medical regulation

Self-regulation has a long tradition in countries such as Germany. In healthcare, a professional level of quality is known as the standard of care, but the concept is not defined by law. In practice, this concept has developed into physician self-regulation. In addition, a normative judgment about the medical standard can be understood as a concept developed by precedent related to medical malpractice cases. The law functions reactively rather than proactively. However, clinical ethics has a wider scope within the legal field than simply the corrective function of medical liability. This study focuses on a legal approach to self-regulation, the normative concept of medical standards in legal criteria, and its requirement. Regarding civil responsibility, the paper reviews an assessment of autonomy in the determination of the medical standard. In comparison to the disciplinary system of Germany's criminal law, the offenses of doctors under Korean law is considerably below the international standards for self-regulation. In fact, discipline for malpractice is effectively regulated by the state. Therefore, when doctors take an ethical approach, it can help protect patients and at the same time raise a sense of professional responsibility. This plays an important role in the complementary relationship between medical ethics as a preventive function and the standard of care or practice standards as a part of self-regulation. In conclusion, self-regulation can have a much more effective and positive impact on relationships between the patient and the doctor and strengthen preventive measures for the patient's safety within medical regulation.

Performance verification for Olympus Au5400 in automatic biochemistry analyzer / 国际检验医学杂志

Objective To verify and confirm the optical performance of the Olympus AU5400 Automatic Analyzer is satisfied for the professional requirements.Methods According to the Medical Standard of the People's Republic of China:Automatic chemistry analyzer(YY/T 0654-2008),the Analyzer Modular Ⅰand Ⅱ optical performance were measured to verify the stray light,the ab-sorption accuracy,linear range,stability and repeatability.Results The stray light absorption of tow modular was 4.789 4-5.158 9;The absorption accuracy of potassium dichromate standard solution (1-1)was (-0.002 1--0.024 7),and solution (1-2)was (-0.008 6--0.067 7);The D-value of stability that the highest absorption of standard solution (1-1)minus the lowest was 0.000 5-0.001 5;The CV% of repeatability for standard solution (1-2)was 0.02%-0.04%;Therof absorption linear was 0.999 6-0.999 9. Conclusion The optical performance of Olympus AU5400 Analyzer conforms to the standard of YY/T 0654-2008.

Standard position of off icially medical literature in Tang-Song dynasty / 中华中医药杂志

It is the most important mission that preserving and developing advancement of TCM theory and practice.We need defi nitive medical standard to standardize the development.Whether there was any standards in the history of traditional Chinese medicine is a hot question.Though the history research,we found that TCM classic literature was the medical standard in ancient China,which was confirmed by Tang-song government though official action.The standard teaching materials promoted the communication and development of TCM.After Song dynastythe standard position and function was strengthened continuouslywhich had a profound effect.