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Herman Nys

Publications and source records attributed to Herman Nys.

15 recordsLinked to original sources
PubMed2006

Legal thoughts on the implications of cost-reducing guidelines for the quality of health care.

Health care expenditures in European countries are increasing. Many cost containment mechanisms have been developed, one of which is the introduction of clinical practice guidelines in binding legislation. In developing recent patients' rights laws, many legislators refer to practice guidelines when specifying the right to quality in health care. The courts often follow this example. Initially, practice guidelines were used to improve the quality of care. Recently, their potential to reduce costs is being discovered by policy makers and compliance with the cost-controlling guidelines is mandatory and subject to financial sanctions. This article will question the impact of the 'new generation' guidelines aimed at reducing health care costs and their impact on the quality of care, in particular. The authors will analyse whether a physician, in case of a conflict with a patient, who claims that his right to quality care has been violated, can defend himself in court by stating that he complied with 'financially' inspired guidelines, especially now that non-compliance with these guidelines is sanctioned.

Belgium↗
PubMed2006

Recent developments in health law in Belgium.

After the turbulent years 2002, 2003 and 2004 the Belgian health law seems to have reached calmer water. Indeed, after a quiet 2005, 2006 does not seem to have much to offer either. However, as will be shown in this article, this may be a wrong impression. There is a growing uneasiness with two important pieces of legislation that have been approved by Parliament in 2002: the act on euthanasia and the act on the rights of patients. This has resulted in debates and discussions that may finally lead to new legislation in the coming years.

Belgium↗
PubMed2004

Patient incompetence and substitute decision-making: an analysis of the role of the health care professional in Dutch law.

In any jurisdiction that takes patient autonomy and patient rights seriously, patient competence is a pivotal concept. Competence, which should be distinguished from criminal responsibility and legal capacity, can be defined as the ability to exercise rights, more in particular the ability to exercise one's right to give or refuse informed consent. It depends upon a patient's competence whether or not this patient has the final say in a health care decision and whether or not the patient can legitimately be subjected to compulsory interventions in that context. These possibly far reaching consequences explain why competence is the topic of a growing amount of legal regulation and why policy attempts are made at operationalising the concept in workable criteria. Although agreed upon criteria for competence do not exist, there is consensus about some preconditions of competence assessment. Two kinds of models of substitute decision-making for incompetent patients are available, i.e. best interests models and representational models. The Dutch Contract of medical treatment Act is treated as an example of the latter. It is shown that in the Dutch model, health care professionals are not at the mercy of patient representatives. On the contrary, health care professionals are supposed to judge their patients' subjective interests and may eventually overrule the representatives. A public debate ought to take place about the basis for this authority.

Consensus↗
PubMed2004

Patient capacity in mental health care: legal overview.

The discriminatory effects of categorizing psychiatric patients into competent and incompetent, have urged lawyers, philosophers and health care professionals to seek a functional approach to capacity assessment. Dutch and English law have produced some guidelines concerning this issue. So far, most legal systems under investigation have concentrated on alternatives for informed consent by the patient in case of mental incapacity, notably substitute decision-making, intervention of a judge and advance directives. It is hard to judge the way in which the law may further adapt to a more functional assessment of capacity, because the nature of law shows that legal reforms usually take place only when new methods have been accepted by the field. This is not yet the case today.

Decision Making↗
PubMed2004

The control of medical doctors in Belgium.

First the structure and purpose of three institutions of medical control in Belgium are presented (the Order of Physicians, the provincial medical committees, the medical control service). Secondly, data with respect to their actual functioning are discussed. Finally the present obstacles to effective and efficient self-regulation and control of medical doctors are treated on the basis of our research findings.

Belgium↗
PubMed1994

Legislative developments in patients' rights in Belgium.

The legislative developments regarding the rights of patients in Belgium are described, analysed and discussed. Legislative developments in this field are rather recent and scarce. Up to now overall interest of the legislator has been disappointing. This may be explained by an exaggerated and out-dated confidence in medical professional ethics as an alternative source of regulation.

Adolescent↗