Medical waste: the dark side of healthcare.

Hospitals and other health facilities generate an ever-increasing amount of waste, approximately 15% of which may be infectious, toxic, or radioactive. The World Health Organization has been addressing the issue since the 1980s. After initially focusing on high-income countries, it then focused on low-income countries, with unsafe disposal methods in landfills and inadequate incinerators as major concerns. Gradually, the understanding of the issue has undergone several shifts, including from a focus on the component of medical waste considered "hazardous" to all forms of waste, and from accepting medical waste as a necessary downside of high-quality healthcare to seeing the avoidance of healthcare waste as a component of high quality healthcare.

Medical waste: the dark side of healthcare / Resíduo hospitalar: o lado sombrio da assistência médica

Abstract Hospitals and other health facilities generate an ever-increasing amount of waste, approximately 15% of which may be infectious, toxic, or radioactive. The World Health Organization has been addressing the issue since the 1980s. After initially focusing on high-income countries, it then focused on low-income countries, with unsafe disposal methods in landfills and inadequate incinerators as major concerns. Gradually, the understanding of the issue has undergone several shifts, including from a focus on the component of medical waste considered "hazardous" to all forms of waste, and from accepting medical waste as a necessary downside of high-quality healthcare to seeing the avoidance of healthcare waste as a component of high quality healthcare.

Resumo Hospitais e outros centros de tratamento de saúde geram um volume de resíduos cada vez maior, dos quais cerca de 15% podem ser infecciosos, tóxicos ou radioativos. A Organização Mundial da Saúde começou a enfrentar o problema na década de 1980. Inicialmente, concentrou-se nos países ricos, depois mudou o foco para os países pobres, onde métodos de eliminação inseguros, como aterros sanitários e incineradores inadequados, preocupavam. Aos poucos, a compreensão do problema passou por mudanças, inclusive do enfoque no conteúdo do resíduo hospitalar considerado "perigoso", passando para todas as formas de resíduos, e da aceitação do resíduo médico como um inconveniente inerente aos cuidados de saúde de alta qualidade, até o conceito de que evitar a produção de resíduos hospitalares faz parte dos cuidados de saúde de alta qualidade.

"Properly disposed of": a history of embryo disposal and the changing claims on fetal remains.

This paper explores recent controversies concerning the disposal of embryonic and fetal remains in order to ask how such remains came to be classified as "medical waste." Based on archival research into the social history of human embryo collecting in Baltimore, Maryland, in the early 20th century, I argue that the classification of embryos and fetal remains as medical waste can be traced to a pragmatic alliance between embryologists and state functionaries. Embryologists relied on the state to assist them in acquiring thousands of human embryo remains for scientific study, while state authorities relied on embryologists to provide authoritative knowledge that could be used to facilitate state control over nascent citizens. This alliance contributed to the development of an "embryological worldview," in which human embryos were cast as objective biological "specimens" of use only to embryologists. This exclusive view of the social value of embryos and fetal tissue is now being challenged as other constituencies claim jurisdiction over the remains in order to advance diverse social agendas.