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PubMed1997

A review of the use of radio-isotopes in medicine and medical research in Australia (1947-73).

Recent reports in the Australian media have claimed that after the Second World War 'hundreds of (Australians) were injected with radioactive materials in medical experiments that continued in Australian hospitals until the 1960s'. These claims prompted a review of archival records of the Australian Radiation Laboratory (ARL) that are held by the Australian Archives pertaining to the medical uses of radio-isotopes during the period 1947-73. The material examined indicates that the procurement, distribution, and therapeutic and diagnostic uses of radio-isotopes were stringently controlled by the Radio-isotopes Standing committee (RSC) until 1973, when the responsibility of regulation of medical uses of radio-isotopes passed to the Therapeutic Goods Administration. On the basis of available information it appears that the claims made by the media that many Australians were subjected to unconscionable medical experiments are unjustified. A full report has been released by the Commonwealth Minister for Human Services and Health. The following is an abridged version of that report, detailing some of the more contentious uses of radio-isotopes for medical purposes in Australia during the period 1947-73.

Advisory Committees↗
PubMedDate not supplied

[Alzheimer's disease and informed consent of incapacitated people: propositions aimed at improving the procedure].

Ethical considerations must be given priority when deciding whether or not to include an Alzheimer's Disease patient in a study leading to direct individual benefits. Although the law applies to ethics, the Huriet-Serusclat law was nevertheless written in the spirit of the major ethical declarations of the last 50 years (Nurenberg, Helsinki, Tokyo...) in order to protect patients from abusive decisions, whether these decisions were for or against the patient receiving treatment. This paper describes an incident during a phase II trial involving patients with Alzheimer's Disease. Four incapacitated patients protected by guardianship had given their informed consent to take part in the study. Their participation required that the informed consent be signed by the guardian as well. By misunderstanding of the law, the guardian transmitted the decision to the guardianship judge. Surprisingly, the guardianship judge refused permission for all patients to take part in this therapeutic trial against the wishes of the patients. Even more surprisingly, it appeared clearly that this judge was not thoroughly informed of each detail of the law. Prevention of this kind of situation might require modifications of the responsibilities of the CCPPRB. It is suggested that before the start of a study the CCPPRB should give a precise definition of the way in which incapacitated persons should be treated.

Aged↗
PubMed1996

Environmental health in Europe. A WHO perspective.

Concern about public health implications of environmental conditions in countries in the European region reached high political levels, demonstrated by European ministers of health and of environment protection at their second European Conference on Environment and Health, Helsinki, 20-22 June 1994. The report "Concern for Europe's Tomorrow", prepared by the WHO European Centre for Environment and Health was a basis for endorsing by the Conference an Environmental Health Action Plan for Europe and adopting a Declaration by which the ministers committed their governments to developing National Environmental Action Plans by the year 1997. Interactions between health and environment, integrated with policies and programmes for sustainable development, provide a unifying framework for a new public health.

Environmental Health↗
PubMed1990

Initiation of resuscitation in patients with prehospital bradyasystolic cardiac arrest in Helsinki.

The factors influencing the decision to initiate resuscitation in prehospital cardiac arrest patients encountered in bradyasystole due to presumed heart disease were studied. For this purpose, the characteristics and circumstances of arrest of the patients encountered in asystole and electromechanical dissociation, seen by a physician-staffed prehospital emergency care unit in a tiered emergency medical system, were reviewed. During the study period, resuscitation was initiated in 83 bradyasytolic patients. The characteristics of these patients were compared with those of 72 patients in asystole or electromechanical dissociation declared dead on the scene without resuscitation. The presence of EMD was the most important factor influencing the decision to resuscitate (P less than 0.001), even if the arrest was unwitnessed, while the patient's age was of less importance. For the patients with a witnessed arrest, the delay before treatment was initiated also affected the decision. Successful resuscitation and survival of the patients was similar to earlier reports. The results provide guidelines in the decision making of initiation of resuscitation when developing our emergency care system into one with non-physicians as advanced life support providers.

Adult↗