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I REGISTRI COMUNALI ITALIANI DELLE DICHIARAZIONI ANTICIPATE DI TRATTAMENTO: CARATTERISTICHE, EFFICACIA E LIMITI (THE ITALIAN MUNICIPAL REGISTRIES OF ADVANCE DIRECTIVES: CHARACTERISTICS, EFFECTIVENESS AND LIMITS)
No full textRIASSUNTO
OBIETTIVI. Per colmare il vuoto legislativo sulle Dichiarazioni Anticipate di Trattamento (DAT), alcuni comuni italiani hanno istituito dei registri per raccogliere le DAT o le certificazioni dell’avvenuta compilazione. L’obiettivo di questo studio era indagare la disponibilità e le caratteristiche di tali registri nei maggiori comuni italiani e determinare quante persone ne hanno usufruito.
MATERIALI E METODI. Sono stati presi in considerazione i 118 capoluoghi di provincia (15.506.964 residenti adulti). Per quelli che avevano un registro delle DAT sono state raccolte informazioni riguardo a: 1. servizi di informazione/assistenza; 2. numero di utilizzatori; 3. caratteristiche del registro (tipologia, requisiti per usare il registro, persone a cui è consentito l’accesso); 4. istruzioni che era possibile includere nelle DAT e possibilità di modificarle o revocarle.
RISULTATI. Nel settembre 2014, 30 capoluoghi di provincia (8.835.097 residenti adulti) avevano un registro delle DAT. In 12 (40%) erano presenti dei servizi di informazione/assistenza. Aveva utilizzato un registro delle DAT lo 0.041% dei residenti adulti (range 0,013-0,078%). Le caratteristiche dei registri e le istruzioni erano molto variabili e solo 3 (10%) erano accessibili a professionisti sanitari. La possibilità di modifica e revoca era prevista in 23 casi (77%).
ABSTRACT
AIM. In recent years, in order to fill the lack of national legislation regarding advance directives (ADs), Italian municipalities have created registries to collect residents’ ADs or certifications for ADs. We aimed to investigate the availability and characteristics of AD registries in the most populated Italian towns, and to determine how many citizens used these registries.
MATERIALS AND METHODS. We surveyed all 118 Italian provincial capitals (15,506,964 adult residents). For towns with an AD registry, we collected information about: 1. AD-related information/assistance services; 2. number of people who used the registry; 3. registry characteristics (i.e., type, requirements to use the registry, people who were allowed access to the information); 4. which instructions it was possible to include in the ADs, and the possibility of modifying or revoking them.
RESULTS. By September 2014, 30 provincial capitals (8,835,097 adult residents) had created AD registries. AD-related services were present in 12 municipalities (40%). The proportion of citizens who used the registries was 0.041% of adult residents (range 0.013-0.078%). The registry rules varied widely and only 3 registries (10%) were directly accessible to healthcare providers. The option to modify or revoke ADs was provided in 23 cases (77%).
DISCUSSION. Limited availability, lack of consistency and inability of healthcare providers to access registries are likely to make this bottom-up attempt to safeguard personal autonomy ineffective, highlighting the urgent need for legislation about ADs in order to guarantee to all Italian citizens to have a voice in decisions about their future care
Case-Law on Informed Consent in Germany: A Model for Albania?
No full textSince the 1990s, Albania has recognized human dignity as one of thr main constitutional principlrs. Germany is one of the countries that has a long tradition of protecting human dignity in patient-physician relations. Thi contribution studies the German Law on informed consent to medical treatment, Gesetz zur Verbesserung der Rechte von Patientinnen und Patienten of February 2013 through the application of a case-law study. This paper investigates the possibility that Albanian judges could apply the legal arguments of theigerman collegues since in the case of case-law study there is an absence of political interference, which can better demonstrate the ethical principle of autonomy and the right to self-determination
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Full text linkThis research analyses refugee flow through a law and economics lens. This study offers a short
historical overview of the creation of the United Nations High Commissioner for Refugees by
examining some of these events utilizing law and economics methods. In addition, a law and
economics model is applied, based on the idea that refugees, as well as national states, might aim to
maximize their net benefits. Some of the most important variables that impact the refugee decisionmaking
process are then explored as well as the most important “push” factors that impact
lawmakers in enacting and modifying refugee laws (e.g. protection of national security and the
safeguarding of the national job market). Afterwards, the 1951 Convention Relating to the Status
of Refugees is discussed, delving into the main factors for its ratification and compliance by
national parliaments. Then brought forth is a study of the economic advantages and disadvantages
of a centralized supernational asylum law (acquis communautaire) that may result in the
elimination of competition between legal orders in refugee law and the removal of negative
externalities caused by “asylum shopping”. To reach the goal established in Article 5 of the Treaty
on European Union, the need for harmonization of asylum standards is examined through the
application of an economic approach. Specifically, the economic methodology is used to investigate
the application of the subsidiarity principle by considering some of the most important economic
criteria for both centralisation and decentralisation and by applying the findings to the asylum law.
To sum up, international refugee law will be critically analysed through an interdisciplinary
approach. The principal goal is to explore the “demand” and “supply” of the “refugee law market”
through the lens of the law and economics approach but with the context of human rights
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