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Recent developments in legislative and administrative measures in countries of the Association of South-East Asian Nations to counter the illicit traffic in drugs.

The member States of the Association of South-East Asian Nations (ASEAN) have adopted various legislative and administrative measures to combat the illicit traffic in drugs. Some of these measures have been adopted as part of a scheme that aims at establishing uniformity among the methods to be used by ASEAN member States to achieve the common goal of suppressing the illicit traffic in drugs. This article describes some of the latest developments in this area.

Asia, Southeastern↗

Legislation to control smoking: leverage for effective policy.

The concern of the 6th International Symposium on Prevention and Detection of Cancer with legislation to curb smoking reflects the growing recognition of the contribution that the law can make to controlling the promotion and use of one of the most serious health hazards of modern times--tobacco. Oncologists, with their intimate knowledge of the link between smoking and disease, are a powerful ally in this world-wide struggle.

Advertising↗

[Further developments in legislation governing guardianship and nursing care laws (author's transl)].

The legal measures covering protection and care in connection with legislation governing guardianship and fosterage involving medical nursing, which have remained unchanged in principle since 1896, increasingly create the risk of obstructing and hampering the treatment and rehabilitation of mental patients. In order to counteract this development, which is hostile to therapy, as can be demonstrated by means of concrete examples, a number of differentiated deliberations to improve the situation have been included in the expertise preparatory to the inquiry on the situation of psychiatry in the Federal Republic of Germany, dated 1975. These suggestions, which are well differentiated and aim at a minimum restriction of the rights of the individual in respect of protection of his personality, seem to be hardly sufficiently known, so that no use is made of them in public, political and expert discussions. Hence it appeared necessary to point once again to these suggestions as impressively as possible.

Child↗

Implications of health and safety legislation.

The UK Health and Safety at Work Act is described; the duties of the employer, including manufacturers, importers and suppliers, and of the employee for health and safety are laid down. This Act provides the necessary legislative framework for the control of carcinogenic, mutagenic and other health hazards at work. Proposed regulations dealing specifically with carcinogenic substances and with the notification of toxic properties will add strength to these general provisions. The implementation of the new regulations will be the responsibility of the Health and Safety Commission, advised by an expert subcommittee. Ad hoc decisions about handling known and suspected carcinogens are made in consultation with employers and employees. For practical purposes, there must be working limits for carcinogens; zero levels and 'lowest levels of detection' are impracticable. The difficulties of defining the criteria by which substances are judged to be carcinogenic to humans are outlined. Science plays only one part in decision-making, and final decisions depend also on social and economic needs.

Carcinogens, Environmental↗

Tobacco--current French legislation.

A recent French campaign to bring about a reduction in tobacco consumption is described. A number of factors were used to convince the public that smoking is dangerous: it was pointed out that, of all cancers, those in which tobacco plays an important role are increasing the most rapidly; another is that smoking reduces life expectancy. A study of the smoking habit in France showed that it is acquired earlier and earlier; another study showed that 60,000 deaths a year can be linked to smoking; the cost of medical services related to smoking was calculated to be 22 thousand million francs. By comparison, the budget of the anti-smoking campaign was 3 million francs, but this was sufficient to reduce the risk by 7%. The second objective of the programme was to give non-smokers the possibility to assert their rights. The main target of the campaign was young people. The social pressure on them to begin smoking could be reduced if the number of smokers were reduced, if non-smokers asserted their rights and if the image of the smoker were debunked. The campaign was supported by anti-smoking legislation which came into effect in July 1976. Smaller campaigns were planned to follow annually. The main targets of the law were advertising and publicity; in addition, smoking was prohibited in public places, public means of transport and educational establishments. The effectiveness of the campaign was measured by sampling changes in behaviour and in sales volume: there was a 5% decrease in the number of smokers and a 15% decrease in consumption of those who continued to smoke.

Adolescent↗

[Hospital legislation in the Federal Republic of Germany and its effects on psychiatric hospitals (author's transl)].

The article discusses the hospital laws of several land governments enacted subsequent to the hospital financing law of the Federal Government, in respect of the influence exercised by these laws on the internal structure of the hospital. The fact that the laws apply to all kinds of hospitals, and hence also to big psychiatric hospitals, is considered a disadvantage for psychiatric care. Such care is obviously hampered, on the one hand, by the legislative demand for departmentalization of the individual fields according to specialist subjects, representing a setup which is opposed to the realization of patient care in accordance with the requirements of the communities and citizens who expect to be cared for on an individual and not on a schematic basis, whereas, on the other hand, the new structures of management stipulated by the law do not provide for the inclusion of representatives of the new groups of professions now engaged in psychiatric activities. The model of regrouping the hospital structure into sectors instead of medical specialist departments, is presented and contrasted with the proposed model. It is recommended to arrange for representation of the non-medical and non-nursing professions in the managing boards, as well as to take into account the sociotherapeutico-rehabilitative interests as forming part of the conceptual approach to care in psychiatric hospitals, via special hospital committees.

Economics, Hospital↗

Legislation and funding for sickle cell services, 1972-1982.

In 1972, Congress passed the National Sickle Cell Disease Control Act which, for the first time, provided authority to establish education, information, screening, testing, counseling, research, and treatment programs. Under the administration of the National Institutes of Health, comprehensive sickle cell research and treatment centers were established and, under the administration of the Health Services Administration, sickle cell screening and education clinics were established. In the following decade (1972-1982), a flurry of activities occurred in all areas relating to sickle cell disease, including research, treatment, development of teaching and educational materials, public awareness campaigns, as well as community participation and community and patient involvement in program development. Major changes took place in legislation, in funding mechanisms for programs, in interaction of the sickle cell disease constituency population with constituency groups devoted to other categorical genetic diseases, and in the emergence of political activism for sickle cell disease programs and patients. The nature of the recent cuts in funding and their effects on sickle cell programs are discussed.

Anemia, Sickle Cell↗

Adoption: pediatric, legislative and social issues.

Physicians may find themselves involved in many phases of the adoption process, ranging from advising infertile couples who wish to adopt a child to caring for adopted children, adolescents or adults. Recent legislation has been aimed at making it possible for children to be adopted who have been receiving foster care and at providing financial assistance to implement the adoption of children with handicaps and with medical problems. The adoption process is becoming more open. Adoptees are searching for and finding their biological parents and all parties in the "adoption triangle" are developing relationships with one another.

Adoption↗

[Legislation on the control and toxicity of chemical products].

Concern about the possible health and environmental hazards that may arise from exposure to an increasingly number of chemicals has resulted recently in new laws and regulations aimed at protecting human and its environment from an unreasonable risk. The Commission of the European Economic Community has recently passed legislation to control chemical substances. The essential prerequisites for safety evaluations of chemicals which are intended to be put on the market include the following background informations - physico-chemical properties - toxicological studies designed to evaluate human health effects - ecological studies designed to evaluate environmental fate - ecotoxicological studies designed to evaluate environmental effects.

Environmental Pollution↗

Major facial trauma--the effect of legislation.

In January 1976, new seat belt legislation was enacted and speed limits in Ontario were reduced from 70 to 60 miles per hour. This has led to a significant decrease in major facial trauma reducing the medical experience of the surgeons handling these problems. Major facial trauma, however, is often complex and may require the services of neurosurgery and ophthalmology. It compels the otolaryngologist to be aware of these complications so that effective and efficient treatment may be instigated. A recent case illustrates these complications.

Accidents, Traffic↗

Broadening of existing medicolegal office legislation.

Governmental retrenching notwithstanding, there is a need to define the legitimate goals and obligations of our public institutions, so that the good ones do not suffer the same fate as the wasteful or unnecessary ones. This article concerns the broadening of existing legislation governing medicolegal officers and the rules and regulations that may be used to define those officers' procedures.

Autopsy↗

[Compulsory admissions to Frederiksberg Hospital after introduction of the new psychiatric legislation compared with the period just before the change of the law].

The new Danish Act on confinement and other means of compulsion in psychiatry came into force October 1st, 1989. To investigate changes connected with the new act all involuntary commitments to the psychiatric department of the hospital of Frederiksberg, with a catchment area of 85,000 inhabitants, were prospectively registered during 23 months before, 25 months after the new legislation. Information about the commitment was obtained from the admission papers and the case records. The patients were asked to participate in an interview. Both before and after the new act there were about 35 commitments per year. There was a trend towards an increasing number of women being committed by reason of threat to the patient's health after the new act. No significant changes were observed regarding age, condition at admission, diagnoses, duration of hospitalization or condition at discharge. A little more than half of the committed patients participated in the interviews. The new act stressed the rights of the patients. In spite of this the patients did not express any increase in their understanding of or satisfaction with their hospitalization.

Commitment of Persons with Psychiatric Disorders↗

State cancer registries: status of authorizing legislation and enabling regulations--United States, October 1993.

Population-based cancer registries have identified cancer incidence rates indicating that the burden of cancer in the United States is substantial and varies widely by geographic location and ethnicity. However, for most existing state cancer registries, resources are inadequate for insuring minimum standards for quality and for completeness of case information. In October 1992, Congress enacted the Cancer Registries Amendment Act* that authorized CDC to establish a national program in support of cancer registries. The goal of this program is to enhance existing state cancer registries and to help establish statewide cancer registries so that all states have population-based cancer registries meeting minimum standards for completeness, timeliness, and quality. To ensure complete and timely reporting of newly diagnosed cases of cancer, the federal statute requires authorization of cancer registries under state-specific laws and promulgation of regulations that ensure case reporting and use of data for research. This report extends efforts by the National Cancer Institute to assess existing state laws and regulations to determine how they compare to state-specific legislation required in the cancer registries act.

Humans↗

[Perspectives on fair legislation for the assurance of animal health in the countries of the European Union].

The paper provides an overview of Community legislation on the safeguarding of animal health and comments on topical amendments that are being discussed. Special attention is given to the amendment of Directive 64/432/EEC the content of which can be summarised as follows: 1. More stringent requirements for intra-Community-and from a date to be fixed-national trade in bovine animals for breeding and production. Approval of farms of origin shall be mandatory. Holdings are approved only if they participate in the epidemiological monitoring system agreed in the council. This means that the farm is regularly controlled by the "responsible veterinary surgeon" (= veterinary practitioner). 2. More stringent requirements for the intra-Community trade in pigs for breeding and production. The approval of farms and thus their participation in the monitoring systems shall be compulsory in the case, too. 3. Inclusion of carcass disposal plants in the system of epidemiological monitoring through the introduction of a mandatory reporting system if larger numbers of dead animals are removed. 4. More stringent hygiene requirements for all cattle and pig transports.

Animal Husbandry↗

Influencing physician response to prenatal substance exposure through state legislation and work-place policies.

Little research attention has focused on ways to encourage physician response to prenatal substance exposure. We report initial results from a study examining the impact of state laws and work-place policies on physician response by combining legal analyses and data from a national physician survey. Our findings indicate that the message that laws and policies exist usually does not reach physicians. However, when the message does come through, some physician behaviors are influenced. In particular, physicians in states with clearer policies and behavioral expectations are significantly more likely to know and understand the law than physicians in other states. Further, believing that a work-place protocol on prenatal substance exposure exists is associated with significantly increased likelihood of an active response in case vignettes portraying prenatal substance exposure. The findings suggest that state legislative behaviors may increase physician response to prenatal substance exposure, but that response depends on the nature of the policy and on efforts to disseminate it.

California↗

[The new norms decreed by the legislative dirrective 91-93 CCE].

The Community law now rules any sector of the economy including the Pharmaceutical Industry, which is controlled with a special attention starting from drugs manufacturing up to marketing. After detailing the Community regulations acknowledged by the Italian legislation since the adoption of the first Pharmaceutical Directive in 1965, the Authors examine the Decree Law of february 1997 by which the EEC Directive 93/39 is acknowledged (as amended Directives EEC 65/65,75/318 and 75/319 relating to medicinal products for human use). A special attention is devoted to the several regulations concerning Pharmacovigilance, whose importance is emphasized.

Drug Industry↗

The impact of liberalized abortion legislation on contraceptive practice in Denmark.

During the fifteen months following the 1973 Danish abortion legislation, the mean annual rate of induced abortion was 23 per 1,000 women aged 15-44 compared with a mean annual rate of 14.5 during the 15 preceding months. Though use of legal abortion has increased, the rate is not of a magnitude to suggest large-scale abandonment of contraception. On the contrary, preconceptive fertility control continues to be widely practiced.

Abortion, Legal↗

State legislation on abortion after Roe v. Wade: selected constitutional issues.

Over the past three years, a great volume of legislation on abortion has been produced by state legislatures in an attempt to fill the vacuum created by the United States Supreme Court's 1973 decision in Roe v. Wade. This Article examines several of the most common types of statutory provisions and assesses their constitutionality in light of Roe v. Wade and other applicable federal and state legal standards.

Aborted Fetus↗