The deadliest delusion: unproven methods in the management of cancer

In spite of major advances in cancer treatment over the past decades, unproven or ineffective methods of treatment continue to be offered to the public by unqualified or unscrupulous practitioners. These methods fall into five categories: devices, tests, drugs, diets, and psychological methods, as well as combinations of these. The emotional, physical, and financial burdens of cancer treatment make cancer patients and their families especially vulnerable to the pitch of these operators. Participation in worthless treatments can lead to loss of life or prolongation of illness which might otherwise have been avoided through orthodox cancer treatment. Ineffective treatments can generally be recognized by application of some simple guidelines. Lack of faith in the medical care system is an important motivation in the choice of alternative therapies. Health practitioners have an obligation to be sensitive to patients' needs, and to provide emotional as well as medical support, to communicate openly with patients and families, and to nurture the trust that will prevent abandonment of traditional medical care in favor of quackery.     

State-sponsored primary health care in Africa: the recurrent cost of performing miracles

In this paper the author suggests that the design and execution of ongoing and future primary health care (PHC) interventions in Africa could be improved by more comprehensive and realistic assessments of the recurrent costs of alternative approaches to providing given levels of health care benefits. He develops the distinction between development and recurrent cost elements; distinguishes between marginal and average costs of interventions; identifies elements of social opportunity cost that are frequently overlooked in assessing project costs and shows how their inclusion magnifies the aggregate social cost of interventions featuring recurrent involvement of state agents; suggests that the perception of benefits conveyed by state-sponsored PHC programs to rural populations is limited, especially in relation to the true social costs; and discusses the implications of the above analysis for future PHC strategy.     

The medical passport

A Working Group on Medical Passports was established in 2002 by the International Association of Medical Regulatory Authorities. The goal of this group was to develop a fast-track registration process for highly qualified medical practitioners wishing to move from one jurisdiction to another. A "medical passport" would be available only to practitioners who meet or exceed certain well-defined gold-standard educational, examination, and practice requirements. These standards are the core elements of the international medical passport. Each physician would need to satisfy a series of comprehensive requirements to be eligible for this fast-track, expedited treatment. A medical passport system would ease the movement of highly qualified physicians between countries while contributing to the broader dissemination of scientific knowledge and education. Significant progress has been made, but many issues need further study before the medical passport is ready for piloting.     

The principles of medical ethics and medical research

In this paper I discuss the application of the principles of medical ethics and of medical research to the case of children and others whose consent to treatment and to research is problematic. Public health depends substantially on the possibility of ongoing research into all conditions which affect the health of the people. Constraints on this research are therefore a public health issue. Moreover and more importantly the possibility of predictive testing and indeed of screening for health-relevant conditions is an important public health tool, and limitations on the use of this tool are of great significance to public health medicine. Having considered the particular problems created by research and predictive testing on children for late-onset conditions I go on to discuss research on those whose consent is problematic more generally. I conclude with radical recommendations for the reform of The Declaration of Helsinki and of the International Ethics Guidelines for Biomedical Research Involving Human Subjects, prepared by the Council for International Organizations of Medical Sciences (CIOMS).     

医疗设备档案与医疗设备管理

文章结合实际工作经验。从四个方面详细阐述了做好医疗设备档案管理的重要意义。