Análisis de la legislación estatal y autonómica en materia de instrucciones previas o voluntades anticipadas

[Resumen] Las instrucciones previas o voluntades anticipadas han sido objeto de un amplio desarrollo legislativo en nuestro ordenamiento jurídico en los últimos años. Dado que el art. 148.1.21 de la Constitución Española determina que las Comunidades Autónomas podrán asumir la competencia en sanidad e higiene, actualmente existe una extensa legislación estatal y autonómica sobre esta materia. En el presente trabajo, se aproxima una breve exposición de la normativa en vigor; se debe señalar que las diferencias en la regulación de los distintos aspectos de esta institución son notables, lo que provoca que actualmente exista una heterogeneidad legislativa en relación a esta figura jurídica[Abstract] The previous instructions or early wills have been an object of a wide legislative development in our juridical classification in the last years. Provided that the art. 148.1.21 of the Spanish Constitution determines that the Autonomous Communities will be able to assume the competition in health and hygiene; nowadays there exists an extensive state and autonomous legislation on this matter. In the present work, a brief exhibition of the regulation comes closer in effect; it is necessary indicate that the differences in the regulation of the different aspects of this institution are notable, which provokes that nowadays a legislative heterogeneity exists in relation to this juridical figure

La interpretación jurisprudencial sobre el internamiento no voluntario por razón de trastorno psíquico

En el presente estudio se procede al estudio de la doctrina emanada de los distintos tribuales, fundamentalmente, del Tribunal Constitucional sobre ciertos aspectos del artículo 763 de la Ley de Enjuiciamiento Civil, que regula el internamiento no voluntario por razón de trastorno psíquico. Como se tendrá ocasión de comprobar, son numerosas las demandas presentadas por parte de las personas afectadas, referidas fundamentalmente al incumplimiento de los requisitos contemplados en dicho precepto

La interpretación jurisprudencial sobre el internamiento no voluntario por razón de trastorno psíquico

In this study, it is proceeded to analized the doctrine emanated from the differents courts, fundamentally, from the Constitucional Court about certain aspects of the article 763 of the Civil Procedure Law, wich regulates non-voluntary confienment due to mental disruption. As it will be posible to verify, there are numerous demands presented by the persons affected, mainly referring to non-compliance with the requirements set forth in the aforementioned article.En el presente estudio se procede al estudio de la doctrina emanada de los distintos tribuales, fundamentalmente, del Tribunal Constitucional sobre ciertos aspectos del artículo 763 de la Ley de Enjuiciamiento Civil, que regula el internamiento no voluntario por razón de trastorno psíquico. Como se tendrá ocasión de comprobar, son numerosas las demandas presentadas por parte de las personas afectadas, referidas fundamentalmente al incumplimiento de los requisitos contemplados en dicho precepto

The legal framework for the child protection under spanish regulation

The current article aims to explain the different protective measures for minors immersed in social and familial conflict situations regulated by the Spanish regulation after the legislative reform carried out in 2015. Public administrative organisms assume competencies in this matter by authorising the taking of different measures depending on the specific circumstances of each case. Undoubtedly, it can be confirmed that the current legal framework has achieved the integrated protection of those children and youngsters whose parents or tutors do not meet, or do so faultily, the duties associated with parental custody. However, its application in practice has also shown the problems and deficiencies this normative framework suffers from. In this study, it will be presented the legal system in the protection of children as regulated in the state law as well as a critical opinion on it to be conducted afterwards.El presente artículo pretende la exposición de las diferentes medidas jurídicas de protección para los menores inmersos en situaciones conflictivas familiares y sociales reguladas por el Derecho estatal tras la reforma legislativa efectuada en el 2015. Los organismos administrativos competentes en esta materia deben aplicar las distintas medidas protectoras en función de las específicas circunstancias de cada caso. De forma indudable, se puede afirmar que la actual normativa en vigor ha conseguido, en líneas generales, la protección integral de esos menores cuyos padres o tutores no ejercen, o lo hacen inadecuadamente, sus obligaciones derivadas de la patria potestad. Sin embargo, su aplicación práctica ha puesto de relieve las deficiencias de las que esta legislación adolece. En este estudio, expondremos el sistema jurídico de protección de menor regulado en el ámbito estatal y realizaremos un juicio crítico sobre el mismo

Breves apuntamentos sobre a tutela "ope legis"

O sistema legal de protección ao menor de idade actualmente en vigor regula a tutela ope legis, aquela que por ministerio da lei asumirá automaticamente a entidade pública competente tras a declaración de desamparo do menor. Neste artigo preténdese perfilar o réxime xurídico desta institución como medida de protección aos menores en situación de conflito social ou familiar, sendo considerada pola doutrina maioritaria como unha tutela especial dada a súa propia idiosincrasia, pois, a pesar das similitudes formais que presenta co organismo tutelar regulado nos artigos 222-285 do Código civil (C.c.), require unha regulación específicaEl sistema legal de protección al menor de edad actualmente en vigor regula la tutela ope legis, aquella que por ministerio de la ley asumirá automáticamente la entidad pública competente tras la declaración de desamparo del menor. En el presente artículo se pretende perfilar el régimen jurídico de esta institución como medida de protección a los menores en situación de conflicto social o familiar, siendo considerada por la doctrina mayoritaria como una tutela especial dada su propia idiosincrasia, pues, a pesar de las similitudes formales que presenta con el organismo tutelar regulado en los artículos 222-285del Código Civil (C.C.), requiere una regulación específica

A situación de risco na lexislación estatal e autonómica galega: estudo xurisprudencial e doutrinal

No ordenamento xurídico estatal e autonómico galego regúlase a declaración de risco como medida de protección para os menores que se atopen inmersos nunha situación de conflitividade familiar ou social que non alcanza a gravidade suficiente como para separar o menor do seu contorno. Dada a incompleta regulación legal da figura, os distintos pronunciamentos xudiciais e doutrinais foron perfilando os aspectos básicos desta institución cuxa finalidade é a superación da problemática familiar mediante programas de apoio desenvolvidos polos entes públicos competentes. Non obstante, se os factores de risco non poden ser suprimidos ou atenuados, a entidade pública deberá proceder á declaración de desamparo do menorEn el ordenamiento jurídico estatal y autonómico gallego se regula la declaración de riesgo, como medida de protección para los menores que se encuentren inmersos en una situación de conflictividad familiar o social que no alcanza la gravedad suficiente como para separar al menor de su entorno. Dada la incompleta regulación legal dela figura, los distintos pronunciamientos judiciales y doctrinales han ido perfilando los aspectos básicos de esta institución cuya finalidad es la superación de la problemática familiar mediante programas de apoyo desarrollados por los entes públicos competentes. No obstante, si los factores de riesgo no pueden ser suprimidos o atenuados, la entidad pública deberá proceder ala declaración de desamparo del menor

Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31â127 anaesthetic procedures in 30â874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0â5·5) with an incidence of respiratory critical events of 3·1% (2·9â3·3). Cardiovascular instability occurred in 1·9% (1·7â2·1), with an immediate poor outcome in 5·4% (3·7â7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10â000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86â0·90; p<0·0001), medical history, and physical condition (1·60, 1·40â1·82; p<0·0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0·99, 0·981â0·997; p<0·0048 for respiratory critical events, and 0·98, 0·97â0·99; p=0·0039 for cardiovascular critical events), rather than the type of health institution or providers. Interpretation This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia. Funding European Society of Anaesthesiology

Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6.35 years (SD 4.50) were included. The incidence of perioperative severe critical events was 5.2% (95% CI 5.0-5.5) with an incidence of respiratory critical events of 3.1% (2.9-3.3). Cardiovascular instability occurred in 1.9% (1.7-2.1), with an immediate poor outcome in 5.4% (3.7-7.5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0.88, 95% CI 0.86-0.90; p<0.0001), medical history, and physical condition (1.60, 1.40-1.82; p<0.0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0.99, 0.981-0.997; p<0.0048 for respiratory critical events, and 0.98, 0.97-0.99; p=0.0039 for cardiovascular critical events), rather than the type of health institution or providers. Interpretation This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia