The patient's right to know, in the 1996 Israel law for the rights of the patient: the pains of progress.

The 1996 Israel Law for Patients' Rights, Sections 21 and 22, introduces to the field of health legislation two new entities: internal examination committees and quality-control committees. The former are to be established when there is a need to investigate unusual, irregular or exceptional events related to diagnosis and/or treatment. Furthermore, the 1996 Law directs the internal examination committee to reveal its findings to the patient or to his representatives. This approach has evoked strong controversy up until the present time. On the other hand, the quality-control committees which produce privileged information have been smoothly integrated into psychiatric practice. This paper presents the history of the creation of these two committees based on law, and examines their effect on the daily practice of medicine and the reaction of the physicians' guild to their activation. It also discusses the effect of the implementation of these committees on the level of mutual trust between therapist and patient, and on medical morality and its relationship to the social phenomenon known as defensive medicine. Feasible solutions for controversial issues are presented. These include participation of patients or their representatives in the internal examination committees, privileged peer reviews, increased utilization of quality control committees and of ethics committees.

[Cyclic vomiting syndrome in children].

Cyclic vomiting syndrome in children is a manifestation of various etiologies, including gastroenterological and renal disorders, central and autonomic nervous system abnormalities, as well as metabolic and endocrine dysfunction. Frequently no organic cause is found. Personality profiles of children with cyclic vomiting reveal perfectionism, competitiveness, and aggressive behavior. Vomiting attacks have been induced by anxiety and excitement in patients with cyclic vomiting. We describe an 8-year-old girl with cyclic vomiting, frequently associated with occipital headaches, photophobia or dizziness. Psychiatric evaluation indicated a generalized anxiety disorder.

Psychopathology in dementia.

The purpose of this overview is to describe the psychological and behavioral symptoms of dementia reported in the professional literature in recent years. This subject, a relatively neglected one, is considered in order to focus attention on a number of the symptoms most troublesome to the demented person's surroundings which lead to his/her hospitalization, with all the implications this has on the patients, their families and the community's health budget. To carry out an early and effective intervention, professionals need to define and recognize these symptoms and gain experience in treating them, either by intervention in the environment or by medication. This survey attempts to examine the state of the art in this field, while analyzing the difficulties that emerge in studying it.