Ethical and deontological aspects of pediatric biobanks: the situation in Italy

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The will of young minors in the terminal stage of sickness: A case report

AbstractIntroductionIn Italy, both parents have parental responsibility, so they have the power to give or withhold consent to medical procedures on their children.MethodsThe present work reports the case of a 5-year-old boy diagnosed with neuroblastoma in the right adrenal loggia, who underwent several chemotherapy treatments that prolonged his life until the age of 10. Informed consent for treatments was requested exclusively of the parents, without taking into consideration the minor's will, not even when he asked for increased pain relief medication instead of other palliative treatments.ResultsThe authors thought it interesting to examine the case in the light of new Italian legislation on informed consent and to verify whether it promotes greater participation of minors in healthcare choices, given that the issue of acquisition of informed consent is becoming increasingly broad and complex.ConclusionThe case examined here indicates that current Italian legislation, even including the modifications introduced, does not allow for concrete and active participation of minors, especially those under the age of 12, in the discussion of choices about their health, not even in choices regarding the end of life, and not even when the minor manifests a mature capacity for discernment

LEGAL AND ETHICAL ISSUES REGARDING MINORS IN THE ITALIAN CORONAVIRUS FLU EMERGENCY

On February 21, 2020, Italy became one of the countries hit by an epidemic of the new coronavirus that causes “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2). Even a month before that, however, the Italian government began issuing a series of decrees and ordinances aimed at the containment of the virus in Italy, the first of them on January 25, 2020. The COVID 19 infection has been faced as an epidemic through measures to enforce a high degree of isolation. These regulations hold for minors, as well, with consequent difficulties for this age group. While at the moment young people appear to be the least vulnerable to the severe complications of COVID 19, the psychological problems that may be brought on by pandemic-related restrictions should be taken into serious consideration

The Coronavirus Flu Emergency in Italy: Legal Issues Regarding Minors

The COVID 19 infection has been faced as an epidemic, through measures to enforce a high degree of isolation. These regulations hold for minors, as well, with consequent difficulties for this age group, wh

LEGAL AND ETHICAL ISSUES AROUND COVID-19 VACCINATION CONSENT IN ITALIAN CHILDREN FROM 12 YEARS OF AGE

In Europe, there are currently two vaccines against COVID-19 recommended by the European Medicines Agency (EMA) for children aged 12 and older: Spikevax (Moderna) and Comirnaty (Pfizer-BioNTech). At the moment, about half of European countries have decided to age 12 as the minimum age for vaccination against COVID-19. In addition to Italy, France, Spain, Austria, Slovenia, Hungary, Czechia, Slovakia, Denmark, Switzerland, Romania, Bulgaria, Lithuania, Latvia and Estonia. Others (Germany, UK, Netherlands, Belgium, Sweden, Finland) recommend vaccination only for children in textual conditions facing COVID-19 or living with frail people. The Italian Medicines Agency (AIFA) has approved the extension of the therapeutic indications for Comirnaty on May 31 and for Spikevax on July 29, 2021. The various scientific societies in Italy (SIPPS, SIP) agreed in favor of vaccinating children from 12 years old. However the problem of informed consent to COVID-19 vaccination in minors is absolutely emerging, in Italy as well as in other countries (Heuerman, 2021). According to national and international conventions, he should be informed, listened to and must participate in the co-decision process regarding medical treatment. Achieving a \u201ctriple\u201d medical-parent-child therapeutic alliance is the main goal at this time of the pandemic, but this is not always possible (Morgan, 2021). The main key legal and ethical issues on the matter are represented below

The COVID-19 Epidemic and the Prison System in Italy

The Italian Ministry of Justice and that of Health have established two strategies to limit the spread of COVID-19 in prisons: progressive isolation from the external world and adoption of practices to identify possible cases and to treat infected subjects. After the announcement of regulations revolts erupted in numerous Italian prisons. The motivations and effects of these strategy are discussed critically into the search for a balance between the right to health and other rights of prisoners in Italian prisons with the problem of an occupancy level of 121.75%

Histopathology of COVID-19 pneumonia in two non-oncological, non-hospitalised cases as a reliable diagnostic benchmark

In lung cancer patients infected with COVID-19, pathological features are not easy to distinguish. This report presents detailed histopathological findings in two non-neoplastic subjects whose out-of-hospital deaths were caused by COVID-19 infection. These \u2018pure\u2019 cases differ in the time of presentation of symptoms, the phase of lung anatomopathological patterns (acute lung injury versus diffuse alveolar damage) and the mechanism of death. The results provide a valid diagnostic benchmark for evaluating the evolution of COVID-19 pneumonia

A Case of Nosocomial Outbreak of Pantoea agglomerans Related to Parenteral Nutrition Procedures

Pantoea agglomerans is a Gram-negative bacterium that infrequently infects humans. Most reports involving it are about infections in soft tissues or bone/joint infections caused by contamina- tion from soil or penetrating trauma by vegetation, such as thorns and splinters. More frequently, it is found as an opportunistic pathogen in immunocompromised patients. It is not rare to find reports of bacteremia and sepsis from contamination of intravenous fluid, parenteral nutrition, blood products and anesthetic agents\u2014that is, through contamination of medical devices and products. We reported a bacterial infection epidemic occurred in 2011 in a hospital in middle Italy which involved different hospital wards; Pantoea agglomerans was isolated from blood cultures of all infected patients and the source of infection was identified in contaminated parenteral nutrition prepared from the local pharmacy

Legal medicine aspects of female sterilization: our experience

IntroductionThe most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. It may be performed via laparoscopy, mini-laparotomy, or hysteroscopy. Safety, efficacy, short-term complications, long-term complications, and non-contraceptive benefits of sterilization are different for each procedure. Female sterilization has become an important professional liability problem in obstetrics and gynecology.Materials and methodsWe analyzed 6 cases of surgical sterilization that have been the subject of civil proceedings. We review indications, contraindications, and complications associated with each sterilization procedure.ResultsIn our small number of cases, women who have undergone sterilization performed negligently are entitled to recover damages for wrongful conception, negligence, and wrongful birth. We also consider the issue of female sterilization of minors.DiscussionTubal sterilization can be performed with different techniques, chosen in light of the various situations involved, with the goal of reducing as many as possible any failures. Thorough and complete communication of information is of primary importance.ConclusionSterilization is the most widely used birth control method around the world. The procedure is generally safe and highly effective. As reported in the literature, the decision concerning method depends on the setting, the surgeon’s experience, the country’s economic development, and the woman’s preference, but we think that some techniques present a greater risk of failure and expose the surgeon to malpractice litigation

THE COVID-19 EMERGENCY AND THE PROFESSIONAL LIABILITY OF HEALTHCARE PROVIDERS: THE SITUATION IN ITALY

The manuscript concerns the problem connecting to how can the current law on the professional liability of healthcare providers be reconciled with the activities that physicians are substantiall yforced to do in the emergency to care for COVID-19 patients. The Italian healthcare system I sworking in catastrophic conditions of urgency. In the face of this dramatic situation, advertisements for \u201clegal studies\u201d have begun appearing in some newspapers and social media outlets, offering free consultations to represent claims for damages against subjects, physicians and healthcare structures involved in caring for COVID-19 patients. Italian healthcare workers, especially those on the front lines assisting COVID-19 patients, have a compelling need for this amendment in order to be able to work serenely without fearing future penal and/or civil suits against them. In this context, LAW no. 76 of May 28, 2021, containing \u201cUrgent measures for the containment of the COVID-19 epidemic, in the field of SARS-CoV-2 vaccinations, justice and public competitions\u201d was issued. The Italian situation on the relationship between medical liability in the coronavirus emergency and malpractice claims and the solution being proposed in Italy to reduce the problem are also of interest to the global medical community