Religion and healthcare in the European Union : policy issues and trends

92 p. ; 24 cm.Libro ElectrónicoThe impact of religious doctrine on the law, policy and practice of healthcare is becoming increasingly significant for a whole range of issues – from euthanasia to fertility treatment; from belief-based exemption from performing abortion for doctors to the medication and dietary needs of religious patients; from organ donation to contraception; from circumcision to suicide. The relationship between religion and healthcare has a long history of evoking tension and debate in Europe. While developments in medical technologies and techniques question the religious beliefs of policy-makers, practitioners and patients across the European Union, research into the legal and policy responses by EU member states on such issues remains underdeveloped. The challenge of health policy, which is common across the European Union, is to balance fundamental human rights such as the right to equality, the right to health and the right to freedom of religion while adhering to secular principles. This report aims to map out the major issues at stake and to initiate a broader discussion on how the religious needs of the community, religious doctrine and religious practices across the European Union affect public health policy.Preface: The ‘Religion and Democracy in Europe’ initiative 7 About the authors 8 Introduction 9 Background 9 Purpose and conceptual framework 10 Terms, scope, methodology and structure 13 Summary of recommended main policy questions for further development 16 1 The legal and policy context in the European Union 17 1.1 European Union law 17 1.2 National law and policy 18 2 The influence of religion on national healthcare policy development 21 2.1 Conflict of duty in health‑service provision 22 2.1.1 Does national healthcare policy permit belief‑based exemption? 23 2.1.2 Scope and limits of belief‑based exemption in healthcare 23 2.1.3 Safeguards 27 2.2 Euthanasia 27 2.2.1 Active euthanasia 29 2.2.2 Passive euthanasia 30 2.2.3 Conflict of duty and safeguards related to euthanasia 32 2.3 Belief‑based patient decisions 34 2.3.1 Organ transplant and donation 34 2.3.2 Refusal of medical treatment 36 2.4 Emerging policy trends and outstanding policy questions 413 Healthcare policy and religious diversity 43 3.1 Healthcare policy and accommodating religious needs in hospitals 45 3.1.1 Religious assistance and faith space 45 3.1.2 Medication and dietary needs 47 3.1.3 The sex of the health practitioner and hospital clothing 48 3.1.4 After‑death issues: post‑mortem and burial 49 3.2 Healthcare policy and accommodating religion outside hospitals 50 3.2.1 Training of healthcare professionals 50 3.2.2 Substance abuse 52 3.3 Emerging policy trends and outstanding policy questions 53 4 Religion and sexual and reproductive healthcare 56 4.1 Contraception, HIV/AIDS and other sexually transmitted diseases 56 4.1.1 The influence of religion on contraception policy 57 4.1.2 The influence of religion on HIV/AIDS education and prevention policies 58 4.1.3 The4.1.3 The influence of religion on other STD policy 60 4.2 Abortion and sterilization 61 4.2.1 Some religious positions on abortion 61 4.2.2 National policy positions 62 4.2.3 Safeguards when abortion is denied 63 4.2.4 Sterilization 65 4.3 Fertility treatment and reproductive techniques 65 4.4 Circumcision 68 4.5 Female genital mutilation 70 4.6 Emerging policy trends and outstanding policy questions 71 5 Religion and mental healthcare 73 5.1 The European policy context and the influence of religious institutions 74 5.2 The influence of religion on mental illness 77 5.2.1 Diagnosis of mental illness 77 5.2.2 Treatment of mental illness 78 5.3 Emerging policy trends and outstanding policy questions 82 Conclusion 84 Appendix A Roundtable participants 86 Appendix B Belief‑based exemption from healthcare provision 87 Appendix C National policy on euthanasia in some EU states 88 Appendix D National policy on abortion in some EU states 8

Strengthening Renal Registries and ESRD Research in Africa

CITATION: Davids, M. R., et al. 2017. Strengthening renal registries and ESRD research in Africa. Seminars in Nephrology, 37(3):211-223, doi:10.1016/j.semnephrol.2017.02.002.The original publication is available at http://www.seminarsinnephrology.orgENGLISH ABSTRACT: In Africa the combination of non-communicable diseases, infectious diseases, exposure to environmental toxins and acute kidney injury related to trauma and childbirth are driving an epidemic of chronic kidney disease (CKD) and end-stage renal disease (ESRD). Good registry data can inform the planning of renal services and can be used to argue for better resource allocation, audit the delivery and quality of care, and monitor the impact of interventions. Few African countries have established renal registries and most have failed due to resource constraints. In this paper we briefly review the burden of CKD and ESRD in Africa then consider the research questions which could be addressed by renal registries. We describe examples of the impact of registry data and summarise the sparse primary literature on country-wide renal replacement therapy (RRT) in African countries over the past 20 years. Finally, we highlight some initiatives and opportunities for strengthening research on ESRD and RRT in Africa. These include the establishment of the African Renal Registry and the availability of new areas for research. We also discuss capacity-building, collaboration, open access publication and the strengthening of local journals, all measures which may improve the quantity, visibility and impact of African research outputs.AFRIKAANSE OPSOMMING: Geen opsomming beskikbaarhttp://www.seminarsinnephrology.org/article/S0270-9295(17)30002-5/fulltextPostprin

Cancer in the Arab World

This is an Open Access book. This book is a must-have for healthcare providers and researchers, public health specialists and policy makers who are interested and involved in cancer care in the Arab world. The Arab world consists of 22 countries, which are members of the Arab League and spanning over 13,132,327 km2 with over 423,000,000 population. Over the past few decades, the Arab world has witnessed a swift evolution in healthcare provision. Nonetheless, Arab countries have considerable variability in economic capabilities, resource allocation, and intellectual talent that inevitably reflect on access to modern cancer care and prevention. This book is authored by experts from the Arab world who provide vital information on cancer statistics and risk factors, available clinical care pathways and infrastructure, and prevention programs in their individual countries. The chapters also address specific challenges in each country and insights into future directions to achieve optimal care with conventional and novel diagnostics and therapies to keep up with the era of precision medicine. Special topics of interest and unique to the Arab world are also discussed, such as out of the country’s medical tourism for cancer care and cancer care during war and conflict. Other special chapters include: Cancer research in the Arab world, Radiation therapy in Arab World and Pediatric Oncology in the Arab World Cancer in the Arab World is the first comprehensive book that addresses cancer care in depth in all Arab countries and it is endorsed by the prestigious Emirates Oncology Society

Cancer in the Arab World

This is an Open Access book. This book is a must-have for healthcare providers and researchers, public health specialists and policy makers who are interested and involved in cancer care in the Arab world. The Arab world consists of 22 countries, which are members of the Arab League and spanning over 13,132,327 km2 with over 423,000,000 population. Over the past few decades, the Arab world has witnessed a swift evolution in healthcare provision. Nonetheless, Arab countries have considerable variability in economic capabilities, resource allocation, and intellectual talent that inevitably reflect on access to modern cancer care and prevention. This book is authored by experts from the Arab world who provide vital information on cancer statistics and risk factors, available clinical care pathways and infrastructure, and prevention programs in their individual countries. The chapters also address specific challenges in each country and insights into future directions to achieve optimal care with conventional and novel diagnostics and therapies to keep up with the era of precision medicine. Special topics of interest and unique to the Arab world are also discussed, such as out of the country’s medical tourism for cancer care and cancer care during war and conflict. Other special chapters include: Cancer research in the Arab world, Radiation therapy in Arab World and Pediatric Oncology in the Arab World Cancer in the Arab World is the first comprehensive book that addresses cancer care in depth in all Arab countries and it is endorsed by the prestigious Emirates Oncology Society

Improving Access and Outcomes in Living Kidney Donor Transplantation

Shortages in deceased organ donation have necessitated widespread acceptance of living donor kidney transplantation, which offers better outcomes in terms of graft survival, life expectancy and quality of life for many patients with end-stage kidney disease, compared with deceased donor kidney transplantation and dialysis. However, there are barriers and challenges that exist in the current practice of living kidney donor transplantation. Overall, the rates of living kidney donor transplantation have decreased or plateaued, with ethic and socio-economic disparities in access to living kidney donation reported in many countries that remain largely unexplained. Living donors must accept risks associated with undergoing nephrectomy, yet the evidence on the long-term risks of living kidney donation remains uncertain. In response, there have been efforts to identify and describe the barriers and disparities in living kidney donor transplantation, improve the pathway for living donors and to assess a range of outcomes for living donors. A comprehensive understanding of the values, beliefs, experiences, priorities and preferences of the key stakeholders, including donors and health professionals involved in their care is needed to ensure that research; clinical practice and policy in living kidney donation address their needs and priorities. This is a thesis by publication containing published and submitted work. The aims of the studies included in this thesis are: 1) To identify and describe the beliefs, attitudes and expectations of patients with CKD regarding living kidney donation. 2) To describe kidney donors’ experiences of the evaluation process, and the motivations and challenges to sustaining commitment prior to donation. 3) To describe nephrologists’ perspectives on barriers to living kidney donation and disparities in access to living kidney donor transplantation. 4) To identify living kidney donors’ priorities for outcomes and describe the reasons for their choices. 5) To determine the characteristics and heterogeneity of outcomes reported in randomised trials and observational studies in adult living kidney donor

Transplanting education: a case study of the production of 'American-style' doctors in a non-American setting

This thesis examines the transfer of an American pedagogical model to the Arabian Gulf against the wider context of the globalisation of higher education. Weill Cornell Medical College in Qatar is used as a case study to examine how American medical knowledge and professional practice are transmitted to and assimilated by an Arabic social setting. It considers the workings of what is presumed to be a universal pedagogical model by examining how the degree is culturally translated and localised in Qatar. It addresses the question of whether or not the Cornell degree of “Doctor of Medicine” is simply an American product transplanted to the Middle East, or rather a malleable artefact: sought out, manipulated and shaped by the Qataris for their own ends. Medical education necessitates a highly challenging process of acculturation that is amplified for Arabic-educated students who enter the American medical curriculum without many of the values derived from a Western educational system. In addition to language, students from Arabic-medium schools cite dress, familial, cultural and ethical dissonance as issues that had to be negotiated while undertaking the degree. Students enrolled at the American-style medical college currently divide their clinical training between the Gulf and America. The structure of the imported curriculum and biomedical practices generated in the metropole demand that students become bilingually competent in both Arab and American health care systems. The “American way” of doing things, however, does not always translate or conform to cultural mores and standard practice within the Gulf setting. This thesis follows Arab students as they move between the coeducational American academic setting and local health care facilities, examining the ways that the physicians-in-training contextualise, appropriate and reconstruct the medical degree according to their own cultural referential framework. The thesis introduces the language of “transplantation” as a heuristic tool through which the globalisation of higher education might be explored conceptually. It is an ethnography of an emergent educational transplant propagated in a globalised era, which explores novel modes of knowledge transfer, institutional and social arrangements across local and transnational boundaries, changing subjectivities and the generation of new life forms. In a setting in the Islamic world, Weill Cornell Medical College in Qatar provides a strategic site for observing the dynamics of a nation and its people grappling with modernity. Through its production of Americanstyle doctors in a non-American setting, Cornell’s transnational medical school serves as a niche through which to explore the tensions that arise in global models of tertiary education

Skin immunity to dermatophytes: From experimental infection models to human disease

Dermatophytoses (ringworms) are among the most frequent skin infections and are a highly prevalent cause of human disease worldwide. Despite the incidence of these superficial mycoses in healthy people and the compelling evidence on chronic and deep infections in immunocompromised individuals, the mechanisms controlling dermatophyte invasion in the skin are scarcely known. In the last years, the association between certain primary immunodeficiencies and the susceptibility to severe dermatophytosis as well as the evidence provided by novel experimental models mimicking human disease have significantly contributed to deciphering the basic immunological mechanisms against dermatophytes. In this review, we outline the current knowledge on fungal virulence factors involved in the pathogenesis of dermatophytoses and recent evidence from human infections and experimental models that shed light on the cells and molecules involved in the antifungal cutaneous immune response. The latest highlights emphasize the contribution of C-type lectin receptors signaling and the cellular immune response mediated by IL-17 and IFN-γ in the anti-dermatophytic defense and skin inflammation control.Fil: Burstein, Verónica Liliana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Beccacece, Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Guasconi, Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Mena, Cristian Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Cervi, Laura Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; ArgentinaFil: Chiapello, Laura Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Córdoba. Centro de Investigaciones en Bioquímica Clínica e Inmunología; Argentin

The New Hampshire, Vol. 79, No. 44 (Apr. 7, 1989)

The student publication of the University of New Hampshire