The ménage à trois of healthcare: the actors in after-AI era under patient consent

Introduction: Artificial intelligence has become an increasingly powerful technological instrument in recent years, revolutionizing many sectors, including public health. Its use in this field will inevitably change clinical practice, the patient-caregiver relationship and the concept of the diagnosis and treatment pathway, affecting the balance between the patient’s right to self-determination and health, and thus leading to an evolution of the concept of informed consent. The aim was to characterize the guidelines for the use of artificial intelligence, its areas of application and the relevant legislation, to propose guiding principles for the design of optimal informed consent for its use. Materials and methods: A classic review by keywords on the main search engines was conducted. An analysis of the guidelines and regulations issued by scientific authorities and legal bodies on the use of artificial intelligence in public health was carried out. Results: The current areas of application of this technology were highlighted, divided into sectors, its impact on them, as well as a summary of current guidelines and legislation. Discussion: The ethical implications of artificial intelligence in the health care system were assessed, particularly regarding the therapeutic alliance between doctor and patient, and the balance between the right to self-determination and health. Finally, given the evolution of informed consent in relation to the use of this new technology, seven guiding principles were proposed to guarantee the right to the most informed consent or dissent

The Increasing Centrality of Robotic Technology in the Context of Nursing Care: Bioethical Implications Analyzed through a Scoping Review Approach

At the dawn of the fourth industrial revolution, the healthcare industry is experiencing a momentous shift in the direction of increasingly pervasive technologization of care. If, up until the 2000s, imagining healthcare provided by robots was a purely futuristic fantasy, today, such a scenario is in fact a concrete reality, especially in some countries, such as Japan, where nursing care is largely delivered by assistive and social robots in both public and private healthcare settings, as well as in home care. This revolution in the context of care, already underway in many countries and destined to take place soon on a global scale, raises obvious ethical issues, related primarily to the progressive dehumanization of healthcare, a process which, moreover, has undergone an important acceleration following the outbreak of the COVID-19 pandemic, which has made it necessary to devise new systems to deliver healthcare services while minimizing interhuman contact. According to leading industry experts, nurses will be the primary users of healthcare robots in the short term. The aim of this study is to provide a general overview, through a scoping review approach, of the most relevant ethical issues that have emerged in the nursing care field in relation to the increasingly decisive role that service robots play in the provision of care. Specifically, through the adoption of the population-concept-context framework, we formulated this broad question: what are the most relevant ethical issues directly impacting clinical practice that arise in nursing care delivered by assistive and social robots? We conducted the review according to the five-step methodology outlined by Arksey and O’Malley. The first two steps, formulating the main research question and carrying out the literature search, were performed based on the population-context-concept (PCC) framework suggested by the Joanna Briggs Institute. Starting from an initial quota of 2,328 scientific papers, we performed an initial screening through a computer system by eliminating duplicated and non-English language articles. The next step consisted of selection based on a reading of the titles and abstracts, adopting four precise exclusion criteria: articles related to a nonnursing environment, articles dealing with bioethical aspects in a marginal way, articles related to technological devices other than robots, and articles that did not treat the dynamics of human-robot relationships in depth. Of the 2,328 titles and abstracts screened, we included 14. The results of the 14 papers revealed the existence of nonnegligible difficulties in the integration of robotic systems within nursing, leading to a lively search for new theoretical ethical frameworks, in which robots can find a place; concurrent with this exploration are the frantic attempts to identify the best ethical design system applicable to robots who work alongside nurses in hospital wards. In the final part of the paper, we also proposed considerations about the Italian nursing context and the legal implications of nursing care provided by robots in light of the Italian legislative panorama. Regarding future perspectives, this paper offers insights regarding robot engagement strategies within nursing

A global analysis of Y-chromosomal haplotype diversity for 23 STR loci

In a worldwide collaborative effort, 19,630 Y-chromosomes were sampled from 129 different populations in 51 countries. These chromosomes were typed for 23 short-tandem repeat (STR) loci (DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS385ab, DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635, GATAH4, DYS481, DYS533, DYS549, DYS570, DYS576, and DYS643) and using the PowerPlex Y23 System (PPY23, Promega Corporation, Madison, WI). Locus-specific allelic spectra of these markers were determined and a consistently high level of allelic diversity was observed. A considerable number of null, duplicate and off-ladder alleles were revealed. Standard single-locus and haplotype-based parameters were calculated and compared between subsets of Y-STR markers established for forensic casework. The PPY23 marker set provides substantially stronger discriminatory power than other available kits but at the same time reveals the same general patterns of population structure as other marker sets. A strong correlation was observed between the number of Y-STRs included in a marker set and some of the forensic parameters under study. Interestingly a weak but consistent trend toward smaller genetic distances resulting from larger numbers of markers became apparent.Peer reviewe

I delitti sessuali

A seguito di profonde modifiche culturali avvenute nella societ\ue0 del dopoguerra e di un dibattito parlamentare di durata ventennale, l\u2019introduzione della legge n. 66/1996 recante \u201cNorme contro la violenza sessuale\u201d ha determinato una radicale modifica dell\u2019inquadramento giuridico della fattispecie delittuosa nel Codice Penale. In questo capitolo vengono prese in considerazioni le modifiche di legge apportate e le procedure sanitarie adottate in caso di violenza sessuale

Prime riflessioni medico legali sul nuovo ordinamento della RC sanitaria (legge 8 marzo 2017, n. 24, Gelli-Bianco)

La legge Gelli-Bianco pone sicuramente in risalto il contributo della medicina legale nella valutazione e definizione degli eventuali profili di responsabilit\ue0 emergenti nel corso dell\u2019attivit\ue0 sanitaria

Allele frequencies for six STR loci (D5S818, D7S820, D8S1179, D13S317, D16S539, FGA) in a population sample of North Italy

Allele frequencies for six STR loci (D5S818, D7S820, D8S1179, D13S317, D16S539, FGA) in a population sample of North Ital

I delitti sessuali

A seguito di profonde modifiche culturali avvenute nella societ\ue0 del dopoguerra e di un dibattito parlamentare di durata ventennale, l\u2019introduzione della legge n. 66/1996 recante \u201cNorme contro la violenza sessuale\u201d ha determinato una radicale modifica dell\u2019inquadramento giuridico della fattispecie delittuosa nel Codice Penale. In questo capitolo vengono prese in considerazioni le modifiche di legge apportate e le procedure sanitarie adottate in caso di violenza sessuale

Resizing reaction volumes for the ForenSeq\u2122 DNA Signature Prep kit library preparation

The introduction of next generation sequencing (NGS; also known as massively parallel sequencing) technology in the field of forensic genetics has been welcomed by the scientific community, above all because it complements the weaknesses of capillary electrophoresis (CE) in the analysis of genetic markers, such as single nucleotide polymorphism (SNP) typing. However, one of the main obstacles to its adoption does not seem to be the cost of the instrumentation, but rather the cost of the NGS library preparation kits. With the aim of reducing the cost of library preparation without compromising the quality of the results, we tried to scale down reaction volumes for the first two polymerase chain reactions in the amplification and enrichment phases of the targeted loci of library preparation using the ForenSeq DNA Signature Prep kit. We used 1 L templated DNA input to a concentration of 1 ng/L, instead of the 5 L at 0.2ng/L recommended by the manufacturer. Our findings indicate that reduction of the library preparation volume using the ForenSeq DNA Signature Prep kit did not interfere with the quality and reproducibility of the DNA profiles obtained and can help lower the overall cost of NGS

Le indagini di Sopralluogo

Il sopralluogo giudiziario \ue8 il punto di partenza di ogni attivit\ue0 investigativa correlata all\u2019analisi della scena di un crimine. In questo capitolo vengono presentati i vari passaggi attraverso cui si articol

Il Sopralluogo Medico-Legale

Il sopralluogo giudiziario \ue8 il punto di partenza di ogni attivit\ue0 investigativa correlata all\u2019analisi della scena di un crimine. In questo capitolo vengono presentati i vari passaggi attraverso cui si articola