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PubMed1992

Therefore be it resolved: 25 years of Delegate Assembly/Representative Assembly legislation.

In 1965, the power to legislate the affairs of the American Occupational Therapy Association (AOTA) passed from the Board of Management to the newly created Delegate Assembly. AOTA's progress in the 25-year period from 1965 to 1990 can be traced by studying the resolutions deliberated upon by that Assembly and its successor, the Representative Assembly. Of interest historically are not only the resolutions passed, but those defeated as well, because all indicate concern for the issues of the times in which the resolutions originated. This paper discusses certain trends that became evident, such as health care legislation concerns, strategic planning, the position of the certified occupational therapy assistant in AOTA, standards in practice and research, and advanced education. It emphasizes such issues as membership fees, continuing competency and continuing education, recruitment and personnel, and specialization.

Constitution and Bylaws↗
PubMed1985

Changes in tobacco advertising in Western Australian newspapers in response to proposed government legislation.

The number of cigarette and tobacco advertisements in the major Western Australian newspapers was counted for the six-month period June to November in the years 1981 and 1983. The latter period covered the introduction of the Western Australian Government's Tobacco (Promotion and Sales) Bill 1983 and the debate surrounding it. The change in the volume of cigarette advertising in Western Australia in those two years was compared with that which occurred in comparable Queensland papers in the same period. Three major factors emerged: (i) the volume of cigarette advertising was much higher in Western Australia in 1983 compared with 1981; (ii) the volume of advertising increased markedly in Western Australia when legislative action was threatened, and remained at very high levels until the Bill failed; and (iii) the number of cigarette advertisements placed in the Queensland papers surveyed fell between 1981 and 1983. The findings are presented in support of the view that the tobacco industry made a powerful and organized attack to defeat the proposed legislation; the means it adopted to do this are discussed.

Advertising↗
PubMed1978

[The cost of pacemaker therapy from 1970 to 1975 with particular reference to the new hospital legislation (author's transl)].

The changes introduced by the new legislation on hospital allowances are discussed with reference to the costs (1970 to 1975) for inpatient treatment of patients with pacemakers. As a result of the new legislation, centralizing pacemaker therapy must cause a great strain on the regional statutory insurance authorities if the area served by the pacemaker center is greater than that of the health insurance authority.

Age Factors↗
PubMed1990

I.v. therapy: the legislative and regulatory arena.

The inclusion of home IV drug therapy in the Medicare Catastrophic Coverage Act of 1988 brought IV therapy issues to the attention of regulators and providers. Although the legislation was revoked, the issues that were raised in its development must be addressed under the current programs and in any future home IV therapy legislation.

Aged↗
PubMed1991

AIDS legislation.

Significant and varied legislation relating to the AIDS crisis has been passed, and much remains pending for further debate. These measures, in various stages of the legislative process, affect PWAs and those who come into contact with the health care system.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Defining death, natural death legislation and withdrawal of treatment.

This article summarises and comments on a number of legal developments (legislation and judicial precedents) in Australia and England in recent years concerned with definitions of death, and withdrawal of life-preserving treatment. The general thrust of these developments and other proposed legislation is four-fold: (i) to respond to technological advances in clinical medicine; (ii) to strengthen patient rights of autonomy and self-determination in the right to refuse treatment; (iii) to reflect a shift in dominant community attitudes and social morality, and to approximate more closely to common clinical practices, which take account of 'quality-of-life' considerations as well as 'sanctity of life' in decision-making for patients unable to express a view because of youth or impaired mental capacity; (iv) to give a greater certainty and legal guidance to clinicians, and to give legal protection to clinicians who follow certain decision-making procedures.

Adult↗
PubMed1999

Medical records and privacy: empirical effects of legislation.

OBJECTIVE: To determine the effects of state legislation requiring patient informed consent prior to medical record abstraction by external researchers for a specific study. DATA SOURCES/STUDY SETTING: Informed consent responses obtained from November 1997 through April 1998 from members of a Minnesota-based IPA model health plan. STUDY DESIGN: Descriptive case study of consent to gain access to medical records for a pharmaco-epidemiologic study of seizures associated with use of a pain medication that was conducted as part of the FDA's post-marketing safety surveillance program to evaluate adverse events associated with approved drugs. DATA COLLECTION: The informed consent process approved by an institutional review board consisted of three phases: (1) a letter from the health plan's medical director requesting participation, (2) a second mailing to nonrespondents, and (3) a follow-up telephone call to nonrespondents. PRINCIPAL FINDINGS: Of 140 Minnesota health plan members asked to participate in the medical records study, 52 percent (73) responded and 19 percent (26) returned a signed consent form authorizing access to their records for the study. For 132 study subjects enrolled in five other health plans in states where study-specific consent was not required, health care providers granted access to patient medical records for 93 percent (123) of the members. CONCLUSION: Legislation requiring patient informed consent to gain access to medical records for a specific research study was associated with low participation and increased time to complete that observational study. Efforts to protect patient privacy may come into conflict with the ability to produce timely and valid research to safeguard and improve public health.

Cohort Studies↗
PubMed1983

Legislation and respiratory rehabilitation.

The provision of respiratory rehabilitation services has been frustrated by legislative and regulatory omissions and struggles. The original Medicare and Medicaid statutes did not mention respiratory therapy services, a fact that has excluded reimbursement for such services in the home. However, the Health Care Financing Administration (HCFA) has ruled that outpatient rehabilitation is a reimbursable service, a point about which third-party payers sometimes have to be reminded. In 1980 the Medicare program was adjusted to provide for the creation of comprehensive outpatient rehabilitation facilities (CORFs); the statute written then is the first to mention "respiratory therapy" as a reimbursable service. In 1982 regulations were published that included a detailed definition of recognized respiratory therapy services, and more recently HCFA released implementing regulations to fiscal intermediaries. However, the home care aspect of respiratory rehabilitation remains a legislative stepchild, permitting only one home evaluation visit, even though it has been reported in the literature that home respiratory care can be a cost saver. Home care by respiratory therapists probably will come, but experience shows that the Federal regulation maze can be very difficult to negotiate, especially in the face of opposition by the Administration.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

[The occupational risks and pathologies due to the manual lifting of patients in Italian legislation].

Current Italian legislation establishes all necessary details of intervention procedures aimed at elimination or substantial reduction of risk due to manual lifting of patients. Chapter V of Law No 626/94, which was a thoroughly innovative step in the field of safety, hygiene and prevention at the workplace, in 3 articles and one annex incorporated Community Directive 269/90 into Italian legislation. The model to approach manual load handling, whose definition can in all respects be transferred to health facilities where load means patients who are not self-sufficient in movement, sets out a precise strategy of actions. The first action is automation of the "production process", which is inapplicable in the health care sector; the second action is to provide "aids", which is perfectly applicable to the health care sector. A further action foreseen by the regulations that should be taken into consideration in addressing the problem of manual patient handling from the point of view of prevention is found in the Law (Presidential Decree) of 14/1/97 concerning criteria of accreditation of health facilities, which also refers to the regulations contained in Law 626/94. As regards the insurance coverage of acute or chronic impairment due to manual handling of loads/patients, these aspects are still not contemplated in any regulations. This contradiction became even more evident with the introduction of Law No 626/94 where in Chapter V reference is made to "dorsal-lumbar lesions". Although these lesions are recognized legally in the acute form (accidents), there are also degenerative diseases with chronic development, and the latter are not given any protection apart from the theoretical recognition contained in the Constitutional Court Sentence 179/88. It is to be hoped that the review process of the list of compensable occupational diseases will address this problem, too, so that it can be solved as soon as possible.

Humans↗
PubMed1999

[Effects exercised by the new federal German social legislation SGB III on assessing the incapacity to work by the medical experts of German statutory sickness insurance bodies].

The rules laid down in Volume III of German social legislation have a direct bearing on expertising on the incapacity to work. The article explains the new tolerance limits and the unrestricted validity of the relevant paragraphs of the German social laws and points out the differences in respect of other areas of social care legislation.

Germany↗
PubMed1999

[Is it necessary to legislate euthanasia?].

There are no specific articles on the end of life in French law. Thus an act of euthanasia can be qualified as murder, murder with premeditation or non-assistance to a person in danger. Recent events and debates have raised the question of enacting new legislation to deal with this problem. Two contrary positions could be considered: either create a special offence or explicitly authorize acts of euthanasia. There are major objections to both these propositions. The first one would require taking account of various situations, --unbearable suffering, loss of dignity, and precise requests,--that would be impossible to specify in legislative terms. The second proposition would be open to the same objection; it would also derogate from the major principle of respect for the life of persons and thus risk setting a precedent that could be used in other circumstances to evade this principle. Finally, if a law were enacted to this effect, it would constitute a threat for the development of palliative care.

Euthanasia↗
PubMed1999

Genetic information and genetic discrimination how medical records vitiate legal protection. A comparative analysis of international legislation and policies.

This study compares currently enacted and pending legislation and policies concerning genetic information and genetic discrimination in Europe and the USA. The emergence of a multi-disciplinary scientific field comprising genetically-related areas and the discovery of new genetic factors have improved our ability to predict genetic risks associated with illness. Early detection and preventive healthcare thus hold promise for improving public health, but much remains unknown about the actual risks deriving from genetic testing. Positive (not-normal) test results may give little certainty of the actual severity of a disease. Genetic information could thus be used for social stigmatization and genetic discrimination. Western laws have been enacted in a context of unknown potential risks and benefits, and an increased number of regulatory initiatives is to be expected. Yet, there is currently no comprehensive US or European legal approach concerning genetic information and genetic discrimination and, despite legislation thus far enacted, the protection of individuals remains uncertain, and this could have a negative impact on attitudes to genetic testing, with important consequences for public health strategies to prevent disease.

Confidentiality↗
PubMed1999

Federal and state privacy legislation moving ahead.

Federal and state legislators continue moving swiftly to enact legislation regarding the privacy of medical records. In this quick update, find out the latest and how it may affect your disease management efforts.

Disease Management↗
PubMed2000

[Security services: an overview of the French legislation on cryptography].

This paper deals with the main security services of data protection: integrity, authentication, nonrepudiation and confidentiality. It describes the different tools which may be used to achieve these security objectives: encryption, digital signature, access controls, integrity control, audit and certification. The French legislation concerning encryption has been recently updated in order to simplify the use of encryption techniques for personal data security. This legislation describes different authorization or reporting procedures according to the type of the request (application, equipment, import or export of encryption techniques) and the security level required.

Algorithms↗
PubMedDate not supplied

Legislative and regulatory strategies to reduce childhood unintentional injuries.

Laws and regulations are among the most effective mechanisms for getting large segments of the population to adopt safety behaviors. These have been applied at both the state and federal levels for diverse injury issues. Certain legal actions are taken to prevent the occurrence of an otherwise injury-producing event, while other legal actions are designed to prevent injury once an event has occurred. At the federal level, effective laws and regulations have been directed at dangers posed by unsafe manufactured products or motor vehicle design. At the state level, effective safety laws and regulations have been directed at encouraging safety behaviors and regulating the use of motor vehicles or other forms of transportation. In this article, six legislative efforts are described to point out pros and cons of the legislative approach to promoting safety. Three such efforts are aimed at preventing injury-producing events from occurring: mandating child-resistant packaging for prescription drugs and other hazardous substances, regulating tap water temperature by presetting a safe hot-water heater temperature at the factory, and graduated licensing. Three other examples illustrate the value and complexities of laws designed to prevent injuries once an injury-producing event does occur: mandatory bicycle helmet use, sleep-wear standards, and child safety seat use. This article concludes with specific recommendations, which include assessing the value of laws and regulations, preventing the rescission of laws and regulations known to work, refining existing laws to eliminate gaps in coverage, developing regulations to adapt to changing technology, exploring new legal means to encourage safe behavior, and increasing funding for basic and applied research and community programs. Further reductions in childhood injury rates will require that leaders working in the field of injury prevention together provide the creativity to devise new safety devices and programs, incentives to persuade the public to adopt a "culture of safety" as a social norm, training and education to develop new leaders and workers, and the political will to challenge the status quo and engage the public interest.

Adolescent↗
PubMed2000

[The amount of time spent in processing of 40 cases involving involuntary commitment under the legislation of 1989 in a Danish county 1990-1994].

This investigation examines forty cases dealing with compulsory admission or detention which have been presented at the Local Magistrates Court in a Danish county under the Danish Mental Health Legislation of 1989 during a five year period from 1990-1994. The amount of time spent in processing the cases by the psychiatric department, the Forensic Medical Council and the magistrate was registered. The results show a written psychiatric statement from the department is available after seven to ten days. Five weeks pass when the case is presented to the Forensic Medical Council, (four weeks with the Council and one week with the magistrate). The importance of obtaining statements from the Forensic Medical Council and the time spent in considering the cases with reference to the Justice Department's survey of the Danish Mental Health Legislation of 1989 is discussed. The investigation concludes that despite the resulting prolonged case evaluation it is recommended that cases involving detainment are brought before the Forensic Medical Council.

Adult↗