scholarly journals O direito fundamental a serviços de saúde no Brasil

2018 ◽  
Vol 277 (2) ◽  
pp. 75
Author(s):  
Gabriel Ducatti Lino Machado
Keyword(s):  
Health Services ◽  
Health System ◽  
Scientific Evidence ◽  
General Rule ◽  
Individual Case ◽  
Right To Health ◽  
Health And Illness ◽  
Para Determinar ◽  
Therapeutic Assistance ◽  
The Individual

<p>The fundamental right to health services in Brazil</p><p> </p><p>O ramo público do sistema de saúde brasileiro é marcado por uma tensão entre um auspicioso direito fundamental à saúde, que até mesmo garantiria a qualquer pessoa o acesso gratuito a serviços de assistência terapêutica, e uma política que se esforça para restringir os serviços disponíveis. Se, por força dos arts. 6º e 196 CF, existe um direito fundamental a serviços de saúde (serviços de assistência terapêutica), então a quais serviços? Essa é a questão central que aqui se analisa, de uma perspectiva jurídico-dogmática. Em outras palavras: objeto de investigação é a dimensão material do direito fundamental a serviços de saúde. Para a definição de seus limites, ressaltam como determinantes os conceitos de saúde e de doença em sentido amplo; a segurança e eficácia do serviço, servindo a exigência de evidência científica verificada em processo próprio de aprovação como regra geral, mas se admitindo uma regra de exceção que responda às peculiaridades do caso concreto; e a eficácia marginal ou relevante do serviço. Finalmente, se Legislativo e Executivo têm pouco espaço para determinar os serviços disponíveis, eles têm uma ampla margem de discricionariedade para a organização do sistema de saúde.</p><p> </p><p>The public branch of the Brazilian health system is characterised by a tension between an auspicious fundamental right to health, which should even guarantee to anyone gratuitous access to the therapeutic assistance services, and a politics which strives to restrict the available services. If, by virtue of Articles 6 and 196 of the Brazilian Constitution, there is a fundamental right to health services (therapeutic assistance services), then to which services? This is the central question to be analysed here, from the perspective of legal dogmatics. In other words: object of inquiry is the material dimension of the fundamental right to health services. Determinant for the definition of its limits are the concepts of health and illness in a broader sense; the safety and effectiveness of the service, whereby the requirement of scientific evidence verified in a particular process of approval should serve as a general rule, supplemented by an exception rule which takes account of the peculiarities of the individual case; and the marginal or relevant effectiveness of the service. Finally, if Legislative and Executive do not have much freedom to determine the available services, they have a wide margin of discretion in the organization of the health system.</p>

Evidence of prophylaxis treatment in adult haemophiliacs

2011 ◽  
Vol 31 (S 01) ◽  
pp. S34-S37
Author(s):  
J. Holzschuh ◽  
K.-H. Beck
Keyword(s):  
Health Care Providers ◽  
Task Force ◽  
Scientific Evidence ◽  
Individual Case ◽  
Opinion Leaders ◽  
Care Providers ◽  
Federal Joint Committee ◽  
Randomized Controlled ◽  
Set Up ◽  
The Individual

SummaryIn contrast to children with haemophilia the scientific evidence of prophylaxis treatment in adults is not yet proven. Existing studies are of observational character and mostly retrospectively designed. Therefore, opinion leaders in this field postulate prospectively designed, randomized, controlled and multicentric studies to set up urgently needed guidelines. Evidence according to the Canadian task force ranking is assessed as level III with a re- commendation grade C by the authors.The recognition of benefits of health care providers in accordance with the German Federal Joint Committee generally demands a Grade- Ia to Ib evidence. As long as the actual evidence of prophylaxis in adult haemophiliacs does not meet the postulated criteria of the German Federal Joint Committee, prophylactic replacement therapy of the individual case has to be well documented and reasonably explained.

Hormesis and toxic torts

2008 ◽  
Vol 27 (2) ◽  
pp. 97-107
Author(s):  
Gary E Marchant
Keyword(s):  
Scientific Evidence ◽  
Critical Factor ◽  
Individual Case ◽  
Toxic Substances ◽  
New Concepts ◽  
Close Call ◽  
Tort Litigation ◽  
The Individual ◽  
Regulatory Decisions ◽  
To Receive

Policy implementation of hormesis has to date focused on regulatory applications. Toxic-tort litigation may provide an alternative policy venue for real-world applications of hormesis. Businesses and government entities, who are sued by individuals claiming to have been injured by exposure to very low levels of toxic substances may defend those cases by deploying hormesis to argue that such exposures were unlikely to be harmful. The threshold issue in using hormesis in toxic-tort defense is whether such evidence will be admissible under applicable standards for scientific evidence, which will likely turn on whether hormesis is deemed to be `generally accepted' in the relevant scientific community. Given the relatively novel status of hormesis, its admissibility will likely be a close call, but is likely to be held admissible in favorable circumstances. If admissible, hormesis is likely to receive a fairer and more even-handed consideration than in regulatory decisions, where regulatory agencies are bound by policy-based default assumptions that limit their receptivity to new concepts such as hormesis. The perception of hormesis by juries will likely be the critical factor for determining the utility of hormesis in toxic-tort litigation, and this perception is likely to be affected by the presentation and circumstances in the individual case.

If these requirements are met, the seller is bound to take such steps as are reasonable to preserve the goods. The measures that ought to be taken will depend on the circumstances of the individual case. Usually, the seller will have to store the goods and protect them against damage. Under certain circumstances, it will be obliged to resell them (Art. 88(2) CISG). Art. 85, sentence 1 CISG adopts a lower standard than that of Art. 79 CISG, in that the seller may refrain from taking steps, even if they are within its control, if such steps would cause unreasonable costs or are otherwise disproportionate. The duty to preserve the goods ends at the time at which the buyer takes delivery or declares the contract avoided, or where the seller undertakes a resale (Art. 88). The seller is entitled to withhold the goods until the buyer reimburses it for the costs of storage and preservation (Art. 85, sentence 2). Questions Q 85-1 a) What is the function of Arts 85 to 88 CISG? b) Which party do they address? c) Which general rule is reflected in Art. 85 CISG? Q 85-2 What are the consequences if the party who is bound to preserve the goods does not comply with its duty? Q 85-3 Who bears the preservation costs under Art. 85 CISG if the buyer’s refusal to take delivery is justified? Q 85-4 Does Art. 85 CISG apply in the following situations where the seller pre-serves the goods after a) having tendered conforming goods of which the buyer does not take delivery, b) having tendered goods that are evidently non-conforming (= funda-mental breach) of which the buyer does not take delivery, c) having tendered too late (but non-delivery does not amount to fundamental breach) and the buyer does not take delivery, d) having tendered properly and the buyer is willing to take delivery of the goods but unjustifiably refuses to pay the purchase price, e) having tendered and the buyer is willing to take delivery of the goods and to pay the purchase price, but declares that it does not feel bound to the sales distribution agreement concluded between the parties. Without sticking to the distribution agreement, the seller will be deprived of what it was entitled to expect under the contract and will no longer be interested in upholding the contract, f) having tendered and the buyer takes delivery of only part of the goods, because there is allegedly no larger storage room available. Q 85-5 In view of Q 85-4, in which situations alone will the seller not be bound to

2007 ◽  
pp. 640-640
Keyword(s):  
General Rule ◽  
Individual Case ◽  
Purchase Price ◽  
Storage Room ◽  
Lower Standard ◽  
The Individual

scholarly journals Existence of a Neutral-Impact Maxillo-Mandibular Displacement on Upper Airways Morphology

2021 ◽  
Vol 11 (3) ◽  
pp. 177
Author(s):  
Giovanni Badiali ◽  
Ottavia Lunari ◽  
Mirko Bevini ◽  
Barbara Bortolani ◽  
Laura Cercenelli ◽  
...  
Keyword(s):  
Scientific Evidence ◽  
Three Dimensional ◽  
3D Models ◽  
Individual Case ◽  
Mandibular Advancement ◽  
Upper Airways ◽  
Displacement Threshold ◽  
Significant Difference ◽  
The Individual ◽  
Area And Volume

Current scientific evidence on how orthognathic surgery affects the airways morphology remains contradictory. The aim of this study is to investigate the existence and extension of a neutral-impact interval of bony segments displacement on the upper airways morphology. Its upper boundary would behave as a skeletal displacement threshold differentiating minor and major jaw repositioning, with impact on the planning of the individual case. Pre- and post-operative cone beam computed tomographies (CBCTs) of 45 patients who underwent maxillo-mandibular advancement or maxillary advancement/mandibular setback were analysed by means of a semi-automated three-dimensional (3D) method; 3D models of skull and airways were produced, the latter divided into the three pharyngeal subregions. The correlation between skeletal displacement, stacked surface area and volume was investigated. The displacement threshold was identified by setting three ∆Area percentage variations. No significant difference in area and volume emerged from the comparison of the two surgical procedures with bone repositioning below the threshold (approximated to +5 mm). A threshold ranging from +4.8 to +7 mm was identified, varying in relation to the three ∆Area percentages considered. The ∆Area increased linearly above the threshold, while showing no consistency in the interval ranging from −5 mm to +5 mm.

scholarly journals Acción social colectiva por el derecho a la salud, Bogotá, 1994-2010

2011 ◽  
pp. 232-269
Author(s):  
Mauricio Torres Tovar
Keyword(s):  
Health System ◽  
Social Action ◽  
Collective Identity ◽  
Right To Health ◽  
Political Struggle ◽  
Human Right ◽  
Social Actions ◽  
Negative Impacts ◽  
The Individual ◽  
The Right

A finales del año 1993 Colombia estableció a través de la Ley 100 una política de Estado en salud que tiene como base el aseguramiento individual a un mercado de servicios de atención a la enfermedad. El desarrollo de este sistema de salud ha generado impactos negativos sobre la garantía del derecho a la salud de la población, razón por lo cual se fue estableciendo un campo de contienda política por el control de la salud en el país. L articulo describe y analiza las acciones sociales colectivas por el derecho a la salud realizadas después de la expedición de la Ley 100 y hasta el 2010, teniendo como estudio de caso la ciudad de Bogotá. Se hace una caracterización de lo que fueron estas acciones sociales colectivas tanto contenciosas como no contenciosas, permitiendo evidenciar que, producto de la realización de estas acciones colectivas se pudo avanzar en la construcción de una identidad colectiva alrededor de la comprensión de la salud como derecho humano y se configuro un movimiento social capaz de ganar la contienda política y establecer las decisiones necesarias para transformación el campo de la salud a favor de los sectores sociales que demandan la garantía del derecho a la salud. Collective Social Action for the Right to Health, Bogotá, 1994-2010 Through the law 100 Colombia established at the end of 1993 a health policy that is based on the individual access of services market of the care disease. The development of this health system has resulted in negative impacts on the guaranteed right to health for the population, and it was establishing a field of political struggle for control of health in the country. The article describes and analyzes the collective social actions for the right to health made after the expedition of law 100 until 2010, taking Bogota as a case study. A characterization of these collective social actions, both contentious and non-contentious, shows how it has advanced in the construction of a collective identity around the understanding of health as a human right. The article also pinpoints how social movement for the right to health was configured, but without producing a political subject capabla of winning in the political contest, and establishing the necessary decisions for transforming the health field for the social sectors that demand the guarantee of the right to health. Keywords: Colombia, Right to Health, Collective Action, Political Struggle, Health System. 

Compensability of Common Upper Extremity Conditions When Work Activities Are Repetitive

2016 ◽  
Vol 21 (6) ◽  
pp. 3-4
Author(s):  
J. Mark Melhorn ◽  
LuAnn Haley ◽  
Charles N. Brooks
Keyword(s):  
Occupational Safety ◽  
Occupational Injury ◽  
Scientific Evidence ◽  
Individual Case ◽  
Cumulative Trauma ◽  
Work Related ◽  
Safety And Health ◽  
Repetitive Injury ◽  
The Individual ◽  
Injury Causation

Abstract Repetitive illness sometimes is wrongly called repetitive injury or cumulative trauma, but the latter are misnomers because the employee cannot identify a specific injury as a cause of the symptoms. In workers’ compensation, such gradual illness claims may be compensable if the condition arises during the course of employment, which requires that it be caused by occupational duties, exposures, or equipment used on the employer's premises. Expert impairment evaluators face three requirements: they must know the best scientific evidence currently available regarding causation of the condition(s) in question, ie, generic causation; the facts of the individual case, ie, specific causation; and the legal threshold in the applicable jurisdiction for acceptance of a condition as work related. The AMA Guides to the Evaluation of Disease and Injury Causation, Second Edition, is an excellent resource and provides the physician a blueprint for the assessment of causation in occupational injury and illness claims. The book adopts the methodology developed by the National Institute for Occupational Safety and Health and the American College of Occupational and Environmental Medicine. When asked to render opinions regarding causation, a physician is wise to consider this methodology in determining the work relatedness of the condition. Medical opinions based on an accepted methodology and the best scientific evidence will result in better patient outcomes.

Preventative Healthcare

2011 ◽  
pp. 220-229
Author(s):  
James Barrientos ◽  
Michele Barry
Keyword(s):  
Health Services ◽  
Health System ◽  
Cost Effective ◽  
Ageing Population ◽  
Future Health ◽  
Current Health ◽  
Healthcare Model ◽  
The Individual ◽  
Inappropriate Admission ◽  
Preventative Healthcare

Australia’s ageing population has escalated the demand for current health services and the trend could compound to unsustainable levels under the current health system. This chapter proposes a preventative healthcare model based on assistive technology to strengthen wellbeing at the individual and community level. The proposed model could minimise premature and inappropriate admission of Australians to care facilities while enhancing their independence and self care. It could also present a cost effective approach for policy makers by helping to alleviate the escalating costs of the health system. Importantly, this program offers an effective and sustainable alternative for delivering future health services.

scholarly journals EL DERECHO A LA SALUD Y SU VULNERACIÓN EN LOS CASOS DE VIOLENCIA OBSTETRICA EN TABASCO

2020 ◽  
Vol 9 (01) ◽  
Author(s):  
León Felipe Morales Ariza ◽  
José Antonio Morales Notario
Keyword(s):  
Human Rights ◽  
Health Services ◽  
Social Economic ◽  
Right To Health ◽  
The State ◽  
Access To Health Services ◽  
Access To Health ◽  
The Social ◽  
The Individual ◽  
The Right

The Mexican Constitution establishes that everyone has the right to health protection and therefore, the law itself will define the bases and modalities for all to have access to health services. However, not everyone has access to quality medical services despite being in the supreme regulation. The State must understand that any alteration to health generates social security problems, mainly due to its consequences. The right to health is inalienable and does not distinguish between the social, economic, cultural or racial status of the individual. And, by stablishing it as a constitutional regulation, it amounted to an obligation of the State, which must provide quality services for all the society.  There are cases in which the right to health is violated, such as obstetrics, where pregnant women suffer the consequences of bad practices, or where minors are involved and their human rights are violated. We must focus our attention in the fact that their neglect has serious consequences and their impact generates human conditions that affect the dignity of the human being.

The Zimbabwe Crisis and the Provision of Social Services

2010 ◽  
Vol 26 (2) ◽  
pp. 233-261 ◽  
Author(s):  
Norman Z. Nyazema
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health Services ◽  
Health System ◽  
Rural Areas ◽  
Right To Health ◽  
Life Expectancy At Birth ◽  
The Government ◽  
The Right ◽  
The Impact

Historically, health care in Zimbabwe was provided primarily to cater to colonial administrators and the expatriate, with separate care or second-provision made for Africans. There was no need for legislation to guarantee its provision to the settler community. To address the inequities in health that had existed prior to 1980, at independence, Zimbabwe adopted the concept of Equity in Health and Primary Health Care. Initially, this resulted in the narrowing of the gap between health provision in rural areas and urban areas. Over the years, however, there have been clear indications of growing inequities in health provision and health care as a result of mainly Economic Structural Adjustment Policies (ESAP), 1991–1995, and health policy changes. Infant and child mortality have been worsened by the impact of HIV/AIDS and reduced access to affordable essential health care. For example, life expectancy at birth was 56 in the 1980s, increased to 60 in 1990 and is now about 43. Morbidity (diseases) and mortality (death rates) trends in Zimbabwe show that the population is still affected by the traditional preventable diseases and conditions that include nutritional deficiencies, communicable diseases, pregnancy and childbirth conditions and the conditions of the new born. The deterioration of the Zimbabwean health services sector has also partially been due to increasing shortages of qualified personnel. The public sector has been operating with only 19 per cent staff since 2000. Many qualified and competent health workers left the country because of the unfavourable political environment. The health system in Zimbabwe has been operating under a legal and policy framework that in essence does not recognize the right to health. Neither the pre-independence constitution nor the Lancaster House constitution, which is the current Constitution of Zimbabwe, made specific provisions for the right to health. Progress made in the 1980s characterized by adequate financing of the health system and decentralized health management and equity of health services between urban and rural areas, which saw dramatic increases in child survival rates and life expectancy, was, unfortunately, not consolidated. As of 2000 per capita health financing stood at USD 8.55 as compared to USD 23.6, which had been recommended by the Commission of Review into the Health Sector in 1997. At the beginning of 2008 it had been dramatically further eroded and stood at only USD 0.19 leading to the collapse of the health system. Similarly, education in Zimbabwe, in addition to the changes it has undergone during the different periods since attainment of independence, also went through many phases during the colonial period. From 1962 up until 1980, the Rhodesia Front government catered more for the European child. Luckily, some mission schools that had been established earlier kept on expanding taking in African children who could proceed with secondary education (high school education). Inequity in education existed when the ZANU-PF government came into power in 1980. It took aggressive and positive steps to redress the inequalities that existed in the past. Unfortunately, the government did not come up with an education policy or philosophy in spite of massive expansion and investment. The government had cut its expenditure on education because of economic and political instability. This has happened particularly in rural areas, where teachers have left the teaching profession.

Right to health, autonomy, and access to prenatal services

2021 ◽  
pp. 096973302199604
Author(s):  
Tatianne dos Santos Perez Both ◽  
Laís Alves de Souza ◽  
Elen Ferraz Teston ◽  
Antonio Rodrigues Ferreira Júnior ◽  
Maria Elizabeth Araújo Ajalla ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Right To Health ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Mato Grosso ◽  
Unified Health System ◽  
Informed Consent Form ◽  
Access To Health ◽  
The Right

Background: The concept of the right to health includes decent conditions of work, housing, and leisure. It can be assessed through the evaluation of access to health services and programs. The creation of the Brazilian Unified Health System expanded access to healthcare for the entire Brazilian population. Aim: This study aimed to understand the use of the Brazilian Unified Health System by pregnant women who live on the Brazil–Paraguay border, whose residents are known as Braziguayans. Methods: We conducted 16 semi-structured interviews with users of prenatal services at Unified Health System units located at the border of the municipalities of Ponta Porã and Pedro Juan Caballero. Ethical considerations: The Research Ethics Committee of the Federal University of Mato Grosso do Sul approved of this research. All participants were provided with project information and signed an informed consent form. Findings: Through content analysis of the interviews, “right to health” and “autonomy, pathways, and access” were two recurrent themes that have arisen. These suggested that Braziguayan women live in conditions of social vulnerability. They do not fully experience the right to healthcare, despite sufficient knowledge about the Brazilian and Paraguayan healthcare systems from which to choose prenatal care. The interviewees acknowledged that Unified Health System use is a right of Brazilian citizens and considered its units to be safe environments. These women also understand the structuring of Unified Health System and the mechanisms of accessing healthcare programs. Conclusion: We can conclude that, despite widely known difficulties, Unified Health System represents, for Braziguayan women, potential access to reliable health services for adequate prenatal and childbirth assistance.

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