Twelve years after abortion decriminalization in Mexico City: Can we still remain an island of liberties?

Latin America hosts the most restrictive abortion legislation globally. In 2007, Mexico, the second largest Catholic country in the world, decriminalized elective abortion within the first twelve weeks of pregnancy in the capital: Mexico City (also known as Federal District of Mexico). Following the reform, the Mexico City Ministry of Health (MX-MOH) implemented safe and legal services. Free services are provided to Mexico City residents and a sliding fee of up to $100 is applied to women from other Mexican states. Conscientious objection (CO) was addressed and included in service provision guidelines. Since 2007, 18 of 32 states amended their penal codes to restrict abortion. The road toward increasing access to abortion services at the MX-MOH included a shift from dilation and curettage (D&C) to medical abortion (MA), first with the misoprostol-alone regimen, followed by the combined mifepristone-misoprostol regimen. Manual vacuum aspiration is offered to out-of-state-women or to those beyond the gestational age where MA is less effective. Contraceptive uptake among abortion seekers is high (up to 95% of them prefer a free method of their choice). The Legal Interruption of Pregnancy program at the MX-MOH continues to provide effective, safe, reliable, and free services. However, women from indigenous groups residing in rural areas, those with low schooling, and adolescents with an unintended pregnancy who live in rural, urban, peri-urban districts, and at the state level are underserved despite being legally eligible to receive abortion services. Therefore, information and services for the disadvantaged groups need to be strengthened.     

Ethical,legal and professional accountability in emergency nursing practice: An ethnographic observational study

IntroductionAccountability in nursing practice is a concept that influences quality care, decision-making, safety standards and staff values. Therefore, understanding accountability and how it affects nursing practice could improve patient care and nurses’ working conditions.AimThe aim of this study was to find factors that influenced ethical, legal and professional accountability in emergency nursing practice.MethodsA qualitative ethnographic approach using participant observation through convenience sampling was employed as the data collection method, while ethnographic content analysis was used for data analysis.ResultsThe factors linked to nursing accountability found were classified into four main themes: daily dynamics, work environment evolution, customs and routines and bioethics principles’ application.DiscussionThe long-term effect of chronic high workload and crowding, which affects nursing accountability, could promote burnout in a junior ED workforce. Changes in the nurses’ working conditions need to be implemented to limit the workload to which an ED nurse is subjected to.ConclusionED nurses have to manage their accountability in difficult situations regularly, which followed patterns of four main themes across the majority of situations. Nonetheless, all those factors were influenced by nursing workload, an ever-present factor that was always considered by ED nurses during decision-making.     

防御性医疗的法律规制探讨

医疗行为的结果存在许多不确定性,随着患者维权意识的增强以及日益紧张的医患关系,医师在临床决策中不得不采取更多的防御性医疗行为。防御性医疗行为的危害主要包括患者医疗成本增加、医疗资源浪费、妨碍医学科技发展、医患互信进一步降低等。目前我国尚无立法明确对其进行规制。本文从现行医疗法律制度与防御性医疗行为的关系、医疗行为的“可容性危险”原则适用等角度出发,重点分析了防御性医疗行为的法律属性及构成,分析比较了防御性医疗和过度性医疗、保护性医疗的异同;为防御性医疗的法律判定与认定、侵权责任的法律构成与归责原则提供建议,同时为法律制度层面规制防御性医疗提供思路。     

论防控SARS的法律挑战

目的 SARS的爆发流行引发了许多社会问题,法律挑战首当其冲。本旨在讨论引发法律挑战的原因——法律缺位与冲突,并提山解决建议。方法秉承“依法治国”的观点,以分析比较的方法,分别从现有能收集到的行政法、民商法及刑法等涉及的相关规定条款着重论述预防控制SARS存在的法律问题,特别是相关的权利与义务。结果作为一新的病死率高的烈性传染病,SARS的法律地位定位不清,直接影响在非典防治过程中涉及的法律主体的权利(权力)义务关系如何,成为最严重的法律挑战难题之一,《传染病防治法》、《国境卫生检疫法》及相关民事刑事等法律修订工作迫在眉捷。结论在《传染病防治法》中增加并定性SARS为甲类传染病种类,并由国务院宣布将SARS列为检疫传染病。另,建立或完善行政应急体系与救助程序,保障个体法律权利与利益。     

Psychopathie et risque de récidive sexuelle : analyse critique de la littérature scientifique

Objectives

For the past twenty years, sexual violence is a major subject in the legal and criminological fields. Moreover, this phenomenon is becoming a major public health issue and becomes an important topic in termes of prevention. The main objective of this article is to clarify the current state of the litterature about the relationship between the psychopathy and the risk of sexual recidivism. Indeed, the relationship between both of them are debated among the studies right now. So, it's in this context that we wanted to expose the international studies on this topic and to discuss it.

法律视角下家庭医生签约服务双方的权责研究

目的　了解我国家庭医生签约服务相关法律法规,探讨在实施家庭医生签约服务过程中服务双方的法律权责。方法　于2017年7—8月,在浙江省、安徽省、北京市、上海市4个地区的12家社区卫生服务中心,抽取符合本研究目的的医务人员（家庭医生签约服务团队成员、行政管理人员）389例、社区居民360例进行问卷调查,内容包括受试者基本情况、对家庭医生签约服务权利义务的认知情况。结合问卷调查结果开展德尔菲法,邀请20名专家对家庭医生签约服务双方的权利义务及履行的责任进行评价、修改。结果　回收医务人员有效问卷320份,在列出的20项权利和14项义务中：重要程度排在前3位的权利为“人身安全不受侵犯的权利”（89.7%,287/320）、“获得健康安全工作环境的权利”（87.5%,280/320）、“要求签约患者提供自己真实的信息”（87.5%,280/320）;重要程度排在前2位的义务为“关心、爱护、尊重患者”（90.3%,289/320）、“保守患者的病情及个人隐私,未经允许不得向其他人透露”（90.0%,288/320）。回收社区居民有效问卷342份,在列出的7项权利和10项义务中：重要程度排在前2位的权利为“受到关心、爱护、尊重的权利”（91.5%,313/342）、“获得符合合同规定的诊疗服务的权利”（90.0%,308/342）;重要程度排在前4位的义务为“将自己的身体状况如实告知自己家庭医生团队”（96.5%,330/342）、“将自己身体的变化情况及时告知自己的家庭医生团队”（95.3%,326/342）、“尊重家庭医生团队”（91.8%,314/342）、“与自己的家庭医生团队保持有效沟通”（90.0%,308/342）。根据专家咨询结果,最终确定家庭医生签约服务提供方享有权利16项、履行义务15项;确定家庭医生签约服务接受方享有权利8项、履行义务11项;确定双方在签约服务过程中履行的责任有7项。结论　家庭医生签约服务双方对签约过程中权责的认知存在一定差异,应当理顺并明确家庭医生签约服务双方当事人的权责利关系。     

Étude exploratoire sur le rôle des antécédents de tentatives de suicide et de l’agressivité pro et réactive dans le risque de récidive violente auprès d’une population d’hommes incarcérés

The objective of this exploratory study was to understand the risk factors for violent recidivism in a population of incarcerated men (n = 21), through an investigation of the role of psychopathic traits, proactive and reactive hetero-aggressiveness, self-aggressiveness and suicide attempts. The analysis of our results highlights various vulnerability factors associated with an increased probability of recidivism. Factors among which we find: (1) a predominance of the behavioural sphere of psychopathy (Factor 2); (2) the presence of hetero-aggressive behaviours, and more particularly (3) reactive types; and finally, (4) the presence of a history of suicide attempt(s). This study fulfills its main objective by identifying certain psychopathological modalities that play a key role in the process of violent recidivism. In this sense, a focus on the different expressions of aggressiveness and on psychopathic traits is an interesting prism for understanding the problem of violent recidivism. A clinical reading of our data leads us to formulate the hypothesis: deficiencies in representations and mental elaboration processes are crucial elements in understanding the repetition of violent action.