Should a doctor stop rendering medical services? Part II – Analysis of medico-legal conduct in cases of uncertainties regarding informed consent in minors. The Polish perspective

introduction. The doctor’s decision whether to save the life of a minor who has attempted to commit suicide depends on the decision of the person who, under legal regulations, is responsible for the minor. In everyday medical practice doctors are often placed in difficult situations and often cannot make any decision. Such doubts arise when it is impossible to contact the person(s) responsible for the minor. The doctor encounters similar issues when the parents of a minor under 16 years of age express different opinions on the recommended procedures, and are against the doctor’s decision and do not want their child to be hospitalized. materials and methods. The current legislation and doctrine was analyzed and an attempt was made to determine the way of conduct with regard to suicidal minors, and algorithmize the way of conduct towards such suicidal minors. The conduct was discussed on the two examples, based on real clinical cases. results. With regard to minors in a clinical state demanding urgent procedures, who have of the decision made by the guardian, and regardless of the fact there is no contact with the guardian. If the status is stable, the physician’s modus operandi depends on various accompanying circumstances. However, he is still obliged to provide medical help. discussion. A practical algorithm is presented and all the possible legal variations discussed and clarified

New doesn´t always mean better. Prescription rules according to new Drug Reimbursement Act

In practice still produced many doubts concerning the principles for the issue and control medical prescriptions. Changes in this area has introduced the law of the refund of medicinal products, which took effect on 1 January 2012. This article to explain the issues related to the control carried out by NFZ, with particular regard to the control patient medical records. In addition, in the article was addressed to the principles of the prescriptions, in which there are level remuneration and the withdrawal from prescriptions for the product have. In view of the practical nature article, in the text is given examples designs endorsements, which should be in medical records.W praktyce wciąż powstaje wiele wątpliwości dotyczących zasad wystawiania i kontroli recept lekarskich. Zmiany w tym zakresie wprowadziła Ustawa o refundacji produktów leczniczych, która zaczęła obowiązywać 1 stycznia 2012 roku. Niniejszy artykuł wyjaśniania kwestie związane z kontrolą prowadzoną przez NFZ, ze szczególnym uwzględnieniem kontroli dokumentacji medycznej pacjenta. Ponadto, w artykule odniesiono się do zasad realizacji recept, w których nie określono poziomu odpłatności oraz zasad odstąpienia od wypisania recept na produkt refundowany. Ze względu na praktyczny charakter artykułu, w tekście zamieszczono przykładowe wzory adnotacji, które powinny znaleźć się w dokumentacji medycznej

Alcohol-intoxicated patients at admission room -analysis of legal aspects of rendered medical services

Zajdel J, Zajdel R, Dziki A, Wallner G. Alcohol-intoxicated patients at admission room -analysis of legal aspects of rendered medical services. Ann Agric Environ Med. 2012; 19(4): 701-706. Abstract Current legal regulations do not explicitly state whether the doctor should or should not ignore the patient's refusal to be provided with medical services when such refusal is given by the patients who is temporarily unable to take conscious decisions. The fact that there is no clear jurisdiction over the issue makes the relation between doctor and patient legally complicated. The doctor has no doubts whether he/she should or should not initiate the medical procedure when the patient clearly expresses the declaration of will, in which either refusal or consent is given to be provided with medical care. However, the patient remaining under the in uence of alcohol, i.e. a substance which to some or great extent impairs cognitive functions, rational thinking, and the ability to evaluate incoming information. Alcohol makes the patient unable to interpret the information given by the doctor. Thus, the patient's consent or refusal to be provided with medical care is lacking in the needed elements of "informing" and "conscious declaration of will", which are considered by doctors and lawyers to be absolutely necessary to make such will valid. There are no clear, unambiguous regulations explaining how the doctor should behave in such cases. The authors of the presented study state that it is highly important to determine whether the intoxicated patient is able to understand the incoming information, evaluate it, make a conscious decision and nally, express an explicit (and therefore binding) refusal to accept recommended medical services. In the opinion of the authors, while dealing with such patients, the doctor should bear in mind the patient's right to make autonomous decisions, but that it is also the doctor's duty to provide the patient with medical services

Cardiology telemedicine solutions : opinion of the experts of the Committee of Informatics and Telemedicine of Polish Society of Cardiology, Section of Non-invasive Electrocardiology and Telemedicine of Polish Society of Cardiology and Clinical Sciences Committee of the Polish Academy of Sciences

 For several years, we have observed the dynamic development of technologies that allow patients to access medical care from the comfort of their homes, without direct contact with the doctor. Innovative solutions based on telemedicine improve care coordination and communication among clinicians, patients, and their families, as well as increases patients’ security and gives them greater independence, thus eliminating health care inequalities. The rapidly growth of telemedicine and the adoption of new technologies in clinical practice is also observed in Poland. Crucial moment for the telemedicine facilitation process in our country was Baltic Declaration approved by Minister of Health in 2015, as well as the Medical Profession Amendment Act and remote medical care admission. Since then, as part of the work of the Information Technology and Telemedicine Committee of the Polish Cardiac Society and the Telemedical Working Group, important steps have been taken to implement a telemedicine solutions in the Polish healthcare system, resulting in improved quality and efficiency of this system. The presented document reflects the above actions and encompasses following issues: available telemedicine solutions in the world, analysis of their effectiveness based on clinical trials, funding opportunities, legal status and development prospects telecardiology in Poland.For several years, we have observed the dynamic development of technologies that allow patients to access medical care from the comfort of their homes, without direct contact with the doctor. Innovative solutions based on telemedicine improve care coordination and communication among clinicians, patients, and their families, as well as increases patients’ security and gives them greater independence, thus eliminating health care inequalities. The rapidly growth of telemedicine and the adoption of new technologies in clinical practice is also observed in Poland. Crucial moment for the telemedicine facilitation process in our country was Baltic Declaration approved by Minister of Health in 2015, as well as the Medical Profession Amendment Act and remote medical care admission. Since then, as part of the work of the Information Technology and Telemedicine Committee of the Polish Cardiac Society and the Telemedical Working Group, important steps have been taken to implement a telemedicine solutions in the Polish healthcare system, resulting in improved quality and efficiency of this system. The presented document reflects the above actions and encompasses following issues: available telemedicine solutions in the world, analysis of their effectiveness based on clinical trials, funding opportunities, legal status and development prospects telecardiology in Poland

Prawo medyczne w onkologii — czyli nie wycofuj się rakiem z edukacji prawnej

Hipokratesowską zasadę, zgodnie z którą „lekarz ma za zadanie wyleczyć chorego— jaką drogą to zrobi, jest rzeczą obojętną”, należy zmodyfikować, mając na uwadzeaktualne regulacje prawne, które kształtują zasady udzielania świadczeń zdrowotnych

Knowledge of medical law amongst doctors of internal diseases

Objectives: In Poland, 95% of medical personnel had not received legal education before they completed their studies. Having been given these facts, we have started questioning legal awareness of people providing medical services. Aim of the study: The study aimed at evaluating the knowledge of allergists and pulmonologists. Material and Methods: The group consisting of 328 allergists and/or pulmonologist completed the questionnaire. Results: The participants possess the best knowledge in providing information to patients about their health status (CV1). Sixty nine % of responders replied correctly, and the difference was significant (p < 0.001) in comparison with next aspect referring to the principles of providing medical services following guidelines created by think-tanks and also possibilities to take autonomous decisions by physicians (CV2). The correct answers in relation to CV2 were given by 57% of responders. The third compared aspect was physicians' awareness of patients' right to giving a consent or refusal before undertaking the medical procedure CV3. Only 55% of physicians gave correct answers and the difference was significant compared to CV1 (p < 0.001) as well as CV2 (p < 0.05). Younger doctors showed to have better knowledge than their older colleagues (p < 0.05). Working in urban workplaces proved to be more associated with better knowledge than in rural ones (p < 0.05). Discussion: Insufficient knowledge results in a low quality of provided services and puts the doctors at risk of being liable. The rates indicate that doctors are not aware of the fact that only legal regulations are binding, while standards not published by the Minister of Health are not legally valid. Half of the respondents have the wrong belief that the opinions expressed by experts make the doctor feel exempt from liability. Probably there are specialities, like occupational medicine which are specially linked with awareness of valid legal rules

Summer music festivals as a new form of spending free time by the Poles

Praca ta dotyczy zagadnienia letnich festiwali muzycznych organizowanych w Polsce. Jej celem jest zaprezentowanie ich jako nowej formy spędzania czasu wolnego Polaków. Pojęciem kluczowym dla mojej analizy będzie słowo „festiwal”, pochodzące od łacińskiego słowa festivus i oznaczające radowanie, świętowanie. Zagadnienie to odniosłam do szeregu koncepcji socjologicznych: zabawy i recepcji sztuki B. Sułkowskiego, koncepcji na temat homo ludens autorstwa J. Huizinga, analizy M. Z. Muszyńskiej dotyczącej czasu wolnego, problematyki dotyczącej kultury czasu wolnego, poruszanej przez E. Morina, zagadnienia rytualności poruszanego przez J. Maisonnueve, a także koncepcji odnoszącej się kontrkultury, subkultury i kultury alterantywnej autorstwa M. Filipiaka oraz rozważań M. Golki i D. Strinatiego na temat kultury masowej. W pracy przywołuję także genezę letnich festiwali muzycznych. Pierwsze wydarzenia tego typu miały już miejsce w starożytnej Grecji, za pierwszą współczesną tego typu imprezę uznaje się natomiast Newport Folk Festival, który odbył się w roku 1959. Istotną częścią mojej pracy stanowią także wyniki dotychczasowych badań. Przywołane zostały zarówno dzieła autorów zagranicznych (jak chociażby R. A. Peterson), jak i badania polskie (np. Gemius dla Newsweek.pl). Pytania badawcze stawiane w pracy odnoszą się do opisanych powyżej koncepcji. Hipoteza główna dotyczy letnich festiwali muzycznych w kontekście nowej formy spędzania czasu wolnego Polaków. W badaniach zastosowałam dwie metody badawcze: wywiady pogłębione oraz obserwację uczestniczącą ukrytą. Wszystkie postawione przeze mnie hipotezy potwierdziły się.This thesis concerns the subject of summer music festivals organised in Poland. Its aim is to present them as a new form of spending free time by the Poles. The concept which is very important for my analysis is word „festival” which comes from the Latin word festivus which means rejoicing, celebration. Described issue refers to different sociological theories: fun and reception of art by B. Sułkowski, theory about homo ludens by J. Huizinga, M. Z. Muszyńska analysis connected with issue of free time, theory about culture of free time by E. Morin, the issue of rituals by J. Maisonnueve, the theories related to counter - culture, subculture and alternative culture by M. Filipiak and analysis by M. Golka and D. Strinati about mass culture. In this thesis I also refer to the genesis of summer festiwals. The first events of this kind took place in ancient Greece and the first modern music festival is said to be Newport Folk Festival which took place in 1959. The important part of this thesis are the results of previous studies. I refer there to foreign authors (like R.A. Peterson) and the polish studies (like Gemius for Newsweek.pl). Research questions refer to the theories described above. The main hypothesis is connected with the idea of understanding summer music festivals as a new form of spending free time in Poland. In this thesis I used two research methods: in - depth interview and participant observation. All of the hypothesises which I posed were confirmed

Traces of biography in creations of the lyrical subject in poetry of Józef Bohdan Zaleski

This work is an attempt to read the poetry of Józef Bohdan Zaleski in context of contemporary autobiographical issues. It is divided into three parts. The first part is a theoretical introduction to contemporary issues concerning autobiography and self-creation of the piece, presented in relation to the romantic theory about the concept of poetry and lyrical structure of the lyrical subject. The second part is a biographical feature of Józef Bohdan Zaleski, presented in summary form. It includes only those events in the life of the poet, which, according to the author, could have affected the original form of his creative personality. The most extensive part of the work is the third chapter, in which, the interpretation of Zaleski’s poetry is made, using the previously presented autobiographical theory, based on the biography of the author's poetic texts. Analytical consecutive reading of texts is routed in according to the development path of Zaleski’s poetic. It presents creations of the lyrical subject, constructed by the poet, with special emphasis on ways to implement his own ideas of self-creation in poetry.Praca jest próbą odczytania poezji Józefa Bohdana Zaleskiego w kontekście współczesnych zagadnień autobiograficznych. Została podzielona na trzy części. Pierwsza z nich stanowi teoretyczne wprowadzenie do problematyki, dotyczącej autobiografii i autokreacji dzieła, prezentowanej w relacji do romantycznych teorii na temat koncepcji poezji i konstrukcji lirycznego „ja”. Część druga jest rysem biograficznym Józefa Bohdana Zaleskiego, przedstawionym w formie skrótowej. Obejmuje jedynie te zdarzenia z życia poety, które, według autorki, mogły mieć wpływ na ukształtowanie się jego oryginalnej osobowości twórczej. Najobszerniejszą część pracy stanowi rozdział trzeci, w którym dokonywana jest interpretacja poezji Zaleskiego, z wykorzystaniem wcześniej prezentowanych teorii autobiograficznych i autokreacyjnych, jak również w oparciu o biografię autora tekstów poetyckich. Analityczna lektura kolejnych liryków poprowadzona jest według rozwoju drogi poetyckiej Zaleskiego. Przedstawia stworzone przez poetę kreacje podmiotu lirycznego, ze szczególnym zwróceniem uwagi na sposoby realizacji jego własnej koncepcji autodefiniowania się „ja” w poezji

The level of effectiveness of Polish legislation relating to health protection against the consequences of tobacco use

The purpose of this work is to analyze the regulatory environment for tobacco use, with particular reference to changes made in the last 10 years. An attempt was made to answer the question of the extent to which the regulatory environment has a real impact on the achievement of the objective set out in the existing legal provisions, which is to protect the health and rights of the persons concerned. An analytical method was used in the work to assess the application of legal principles. A method of analyzing the current line of jurisprudence was also used. In the process of final evaluation of public utilities, certain functional methods were used. The assessment was subjected to Polish law, within the scope of the currently binding Act on Health Protection Against the Consequences of Using Tobacco and Tobacco Products of 1995. The study states that the provisions of this Act are only a formal guarantee of protection. The liability arising from the application of its standard is illusory because the procedure for imposing penalties is ineffective. The pursuit of any property claims related to violation of the rights of related entities, as envisaged in this Act, is complicated. This does not apply to a case which is not affected by the decision