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Constitutional challenges to child witness protection legislation: an update.

The Supreme Court's landmark decision in Maryland v. Craig created some uncertainty about the state constitutionality of child witness protection legislation. This article briefly discusses the current status of child witness protection legislation in light of recent litigation, focusing on Illinois. Conclusions are drawn concerning the likely future course of litigation affecting child witness protection legislation in other jurisdictions.

Child↗

The right to die in Canadian legislation, case law and legal doctrine.

This article discusses moral, social, medical and legal problems pertaining to the so-called 'right to die' from the perspective of Canadian criminal legislation (the Criminal Code), constitutional law (the Charter of Rights and Freedoms) and court rulings. Regarding the latter, the opinions delivered in Nancy B v Hôtel-Dieu de Quebec and Rodriguez v British Columbia (Attorney General) are especially significant. In Rodriguez, the Supreme Court of British Columbia unequivocally rejected the petitioner's submission that the Charter of Rights and Freedoms guarantees the right to die. This judgment was upheld on appeal by both the British Columbia Court of Appeal and the Supreme Court of Canada. In addition, the article addresses the complex problem of legislating the right to die in Canada. Several options are examined, such as professional judgment and advance health care directives including living wills and powers of attorney for health care. In this context, the recommendations adopted by both the Law Reform Commission of Canada and provincial commissions are analysed. Finally, the article discusses the legislation proposed recently in Alberta, Manitoba, Newfoundland, Ontario and Saskatchewan. It seems doubtful, however, whether a nation-wide solution will be found in the near future.

Advance Directives↗

A review of state legislation on DNA forensic data banking.

Recent advances in DNA identification technology are making their way into the criminal law. States across the country are enacting legislation to create repositories for the storage both of DNA samples collected from convicted offenders and of the DNA profiles derived from them. These data banks will be used to assist in the resolution of future crimes. This study surveys existing state statues, pending legislation, and administrative regulations that govern these DNA forensic data banks. We critically analyzed these laws with respect to their treatment of the collection, storage, analysis, retrieval, and use of DNA and DNA data. We found much variation among data-banking laws and conclude that, while DNA forensic data banking carries tremendous potential for law enforcement, many states, in their rush to create data banks, have paid little attention to issues of quality control, quality assurance, and privacy. In addition, the sweep of some laws is unnecessarily broad. Legislative modifications are needed in many states to better safeguard civil liberties and individual privacy.

Advisory Committees↗

The development of Israeli legislators' attitudes towards the rights of the mentally ill.

This article gives an overview of the Israeli legislators' handling of the rights of mentally ill persons. The developments and lacunae in the successive legislative provisions since 1955 until 1991 on the subject are critically examined. The role behind the scenes of politicians in shaping mental health legislation is highlighted. The article concludes with some proposals relating to future developments in the protection of the rights of the mentally ill.

Attitude↗

[Maternity protection legislation: a tool for promoting mother-child health].

OBJECTIVE: To describe the legislation existing in Spain on the protection of women in paid work after giving birth. SETTING: Spanish legislation was reviewed and the following aspects examined: time off for childbirth, leave to care for children, hours for breast-feeding, reduction in the working day for the care of small children and time off because of children being ill. MEASUREMENTS AND MAIN RESULTS: Time off for childbirth is 16 weeks, of which 6 must be after the birth. If both parents work, the father can opt for the last 4 weeks. The amount paid is 100% of the regulated basic wage and will be paid directly by the relevant managing body. Both workers under the general regimen and those under special regimens can receive this benefit. Workers in normal employment can have unpaid leave for a period of up to three years. Other measures are the daily period of one hour for breast-feeding a child under 9 months, the reduction in the working day by between a third and a maximum of half its length to care for children under 6 and the possibility of being away from work for two days because of a child's serious illness. CONCLUSIONS: The existence of specific legislation protecting maternity is an important, though insufficient, step towards guaranteeing equal opportunities for men and women in the labour market. Specially noteworthy is the reconciliation of paid work and family responsibilities.

Breast Feeding↗

Revisiting New York State's proposed surrogate decision-making legislation.

More than 2 years have passed since legislation was first proposed in New York to remedy the absence of legal authority for family members who must make important health care decisions for incapacitated loved ones who have left no advance directives. This legislation, the "Family Health Care Decisions Act," included standards for surrogate decision-making and safeguards for surrogate decisions about the use of life-sustaining treatments. This article argues in favor of the legislation and discusses the concerns presented in opposition.

Advance Directives↗

[Research in psychiatry and legislative restrictions].

Over the last few weeks decades research in psychiatry has undergone a considerable efflorescence. Experimental projects in fields as different as neurobiology or psychopathology, neuro-anatomy or epidemiology, or even cognitive psychology are of course subject to precise conditions which may derive from ethical guidelines as well as different legal systems. These legislative contexts therefore represent a parallel set of restrictions in the path of research activities and may in some cases curb their development. Restrictions of an ethical or deontological type are direct heirs of necessity. They emerged on the eve of the second world war when it became apparent that precisely defined conditions in which research could be conducted in humans were required, and derived for the most part from the recommendations of the Nuremberg Code on the one hand, and the Helsinki declaration on the other. The last version of the Code of Medical Deontology applicable to medical practice in France, and published by decree in September 1995, devoted an article to the question of experimentation. Each country has its own specific legislation which, in France, was explicitly formulated with the publication of the Loi Huriet in December 1988. The European Union is currently attempting to produce a homologous version of the various legislative documents and recommendations should soon be forthcoming which will be applicable to all member countries of the Community. Another area of limitation is less clearly formulated and involves the technical and occasionally methodological framework within research projects take place. Technical demands are highly variable depending on the field of investigation and chiefly revolve around a dogged hunt for statistically significant results (statistical significance sometimes seems to dispense with the need to determine the real meaning of results!); in some cases they too may curb inventiveness. This last type restriction is particularly apparent in drug trials where imperatives of industrial development as viewed by the sponsor may not always coincide with the investigators' desire to mark therapeutic progress. The increasing rigidity of strategies for assessing new substances which has become obvious over the last few years may in the end risk penalizing the discovery of innovative treatments. Promoting a return to clinical practice in the setting of these research projects would indisputably provide some novel solutions. Although many of the restrictions which currently stand in the way of psychiatric research are, so to speak, natural limitations and difficult to debate, excessive formalism in some areas should be spoken out against. Much thought has been given to this subject, a trend which is likely to inject some dynamism into psychiatric research at the dawn of the third millennium just around the corner.

Data Interpretation, Statistical↗

Legislation covering the licensing of veterinary medicines in the United Kingdom.

The procedures used in the United Kingdom governing the licensing of veterinary medicines based on an advisory committee procedure are summarised. The article does not purport to cover all aspects of medicines legislation and must not be treated as a complete or authoritative statement of the law on any particular case. Reference should be made to the Medicines Act 1968 and regulations made under the Act. It does not cover EEC legislation.

Legislation, Drug↗

Enabling legislation in diagnosis and prescribing of medicine by nurses/health practitioners.

The South African health system has undergone major changes over the last 5-10 years. These rapid changes have not only significantly increased the visibility of the nurse practitioner in South Africa, but are also posing challenges to the profession and health care services that need to be addressed. In its Health Policies the Government has indicated that the nursing/midwifery profession, as the biggest group of health care professionals, should be the practitioners to provide primary health care services to the communities. But to do this, they require enabling legislation. The "permit system" has been in place for non-pharmacists and institutions other than hospitals and pharmacies to acquire, possess, use and supply medication for a number of years. This system has been fraught with problems mainly due to a lack of clarity on exactly how the system works and the system had been abused. The purpose of this article is to explore the current situation with the aim to analyze the legal framework that exists within which the primary health care services, and specifically the diagnosing and prescribing of medication, could be performed. The conclusion is made that health legislation has not kept up with the rapid changes in service delivery and are not adequate to empower the nurse to deliver health services. Some recommendations are made for the way forward.

Drug Prescriptions↗

Age of retirement legislation, March 1987.

This legislation provides that, under any collective agreement in which the retirement age for female workers is lower than that for male workers, women can choose to retire at any point between the different ages set for men and women. Passage of this legislation followed a decision of the National Labour Court that setting a different retirement age for men and women in a collective agreement did not constitute discrimination.

Asia↗

Overview on community legislation in the field of official control of mycotoxins in feedingstuffs.

The Community legislation currently in force identifies a group of substances whose presence in feedingstuffs is undesirable. For each one of these substances, acceptable maximum levels have been fixed. The compliance with these levels in feedingstuffs must be checked by Community sampling and analysis methods. In the specific case of the aflatoxins, analytical methods, based on thin-layer chromatography (TLC) and high performance liquid chromatography (HPLC), have been adopted by directive. Another directive has established a general sampling method. The practice, however, has shown that it is not applicable to very large batches where the distribution of the contaminants is not homogeneous. A small group of experts of the Commission reached the conclusion that, in the future Community legislation, it will be appropriate: i) to divide the undesirable substances in two groups (substances with homogeneous and non-homogeneous distribution); ii) to adopt two different strategies for the cargoes "at risk" and "not at risk"; iii) to have methods of sampling, preparation, and analysis which are fast, reliable, easy to apply, and recognized at the international level. These experts proposed adaptations in the directive on "Sampling," in the case of large vessels, but suggested at the same time deferring any decision to the near future.

Aflatoxin B1↗

Effect of New York State's do-not-resuscitate legislation on in-hospital cardiopulmonary resuscitation practice.

PURPOSE: On April 1, 1988, New York State enacted legislation governing the withholding of cardiopulmonary resuscitation (CPR). Suggestions that the mandated protocol for withholding CPR is too cumbersome and will result in an increase in CPR attempts led us to study the effect of the new law on in-hospital resuscitation practice. PATIENTS AND METHODS: We retrospectively reviewed the charts of 245 adult in-patients at a county teaching hospital who died during three-month periods before and after the law took effect. RESULTS: There was a statistically nonsignificant decline in the frequency of CPR attempts at the time of death, from 59 (50%) of 119 patients in 1987 to 57 (45%) of 126 patients in 1988. Use of explicit written "do-not-resuscitate" (DNR) orders increased significantly from 13 (22%) of 60 patients who died without CPR in 1987 to 64 (93%) of 69 patients in 1988. Patient and family involvement in decisions to withhold CPR was common before the law and did not change significantly. CONCLUSION: Although changing the way DNR decisions are documented, the legislation resulted in no significant change either in the frequency of CPR or in the degree to which patients are involved in these decisions.

Adult↗

The hospital experience of seat belt legislation in the county of Skaraborg, Sweden.

The effect of legislation for the compulsory wearing of seat belts by car drivers and front seat passengers was prospectively analysed in the county of Skaraborg, Sweden. After legislation fewer vehicle occupants were admitted to the hospitals, depsite a 40 per cent increase in crashes reported to insurance companies in the country. The frequency of seat belt wearing among injured victims was considerably lower than that recorded in regular traffic surveys. Significantly fewer head and neck injuries were suffered by restrained drivers than by unrestrained. Restrained front seat passengers had more thoracic injuries than unrestrained, but the degree of severity was less. The frequency of seat belt wearing by rear seat passengers was low, but they were injured as severely as front seat occupants. It seems important to insist on an increase in seat belt wearing for this category.

Accidents, Traffic↗

Organic contaminants in the aquatic environment. III. Public health aspects, quality standards and legislation.

Literature on the health aspects and possible risks of the presence of organic micropollutants in water and waste waters is reviewed and the quality standards and legislation pertaining to certain organic compounds which have been promulgated by some countries and international organisations are assessed and compared. It is evident from the literature that different standards may be applied to waters which are designated for particular uses and that quality standards for protection of the aquatic environment (aquatic organisms) are generally more stringent than those applied to drinking water. Quality standards developed by different countries and organisations display a broad similarity in most cases, but differ where various approaches have been employed in determining the toxicity of and hazards presented by individual compounds. It is concluded that such legislation will become more comprehensive in the future, with the inclusion of more substances and recommendations for treatment procedures.

Carcinogens, Environmental↗

Legislation and policy for the protection of the drinking water supply in The Netherlands.

The drinking water supply in The Netherlands is particularly influenced by the pollution of surface water with organic micropollutants as the country is located at the delta of the polluted rivers Rhine and Meuse. Also ground water pollution, resulting from intensive industrial and agricultural activities in this densely populated country, is becoming increasingly important. Consequently the Dutch Government has great interest in international research, discussions and agreements concerning the protection of raw water sources. This paper summarizes the drinking water quality regulations together with the present legislation and activities carried out for the protection of both surface water and ground water. Most measures are now taken in the international frameworks of the EC (European Community) or IRC (International Rhine Commission), but in the Dutch legislation and sanitation policy additional activities are being carried out to safeguard the quality of drinking water in The Netherlands. Finally the policy of the Dutch government to continue the safe and durable provision of drinking water in the future is discussed.

Air Pollutants↗

California mandatory seat belt law: the effect of recent legislation on motor vehicle accident related maxillofacial injuries.

This study evaluated the effects of the California mandatory seat belt law on prevention of motor vehicle accident (MVA)-related maxillofacial injuries. The records of 950 MVA-related injury victims treated at San Francisco General Hospital during comparable 3-month periods in 1985 (451) and 1986 (499) were reviewed to assess the effect of seat belt legislation on reduction of maxillofacial trauma. No significant difference was found in the injury severity scores between the two study periods. In addition, this study did not confirm the reported beneficial effect of seat belt legislation on reduction of MVA-related facial injuries in California. This finding was attributed to poor compliance with the law (50.3% compliance rate).

Accidents, Traffic↗

German mental health legislation and alcoholism treatment: results of a retrospective long-term study in a Berlin state mental health hospital.

In 1985 German mental health legislation underwent a transformation. In accordance with an international trend, the State of Berlin, a pacesetter in this field, introduced a Law for Mentally Diseased Patients (Gesetz für psychisch Kranke). In contrast to the former Law for the Committal of the Mentally Ill and Substance Abusers (Gesetz über die Unterbringung von Geisteskranken und Süchtigen) healing and recovery are the main aims which the legislation focuses on with the intention of avoiding committal by excluding patients with mild disorders from involuntary admission. The Karl-Bonhoeffer-Mental-Health Hospital's Department for Dependency Disorders conducted a study on 3014 alcohol-dependent patients who were discharged between 1984-1990. The focus of the study was to determine predictors for involuntarily committal; patients were explored in respect to age, sex, length of stay, psychiatric disorders, their living situation and how they had been admitted. Moreover, attempts were made to discover whether the 1985 law had changed the patient profile or the frequency or length of treatment in comparison to the previously valid law.

Adult↗