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S Gevers

Publications and source records attributed to S Gevers.

6 recordsLinked to original sources
PubMed2001

Legal issues in the development and use of clinical practice guidelines.

Over the last ten years, the development and dissemination of practice guidelines has increased at a rapid pace. From a legal point of view, it should always be made clear whether a guideline has been developed to improve the quality of care and is based on medical evidence and professional experience, or whether other concerns and considerations (organisational, financial) did prevail. Guidelines should not simply be imposed on health professionals; that would result in a standardisation of care that does no justice to individual patient needs and preferences. Patients have the right to be informed about reasonable and realistic treatment alternatives, even if they are not included in the guideline. Using cost effectiveness analysis in guideline development can help to reduce care of dubious effectiveness. But if cost considerations are used as a reason to limit effective medical care, the guidelines in question need political legitimation.

Cost Control↗
PubMed1998

Late termination of pregnancy in cases of severe abnormalities in the fetus.

Developments in medical technology have increased the possibility of diagnosing severe structural abnormalities in the fetus. In such circumstances, the woman may request termination of her pregnancy. This raises serious ethical and legal questions, in particular if the abnormalities are discovered after 24 weeks of gestation, when the fetus is considered viable. This article discusses the legal aspects of this problem, with particular reference to the Netherlands. If one accepts that, in exceptional circumstances, third trimester abortion may be justified on medical grounds, the law should make provision for it. However, the general protection provided by the law to fetal life-especially in the third trimester--should remain firmly in place.

Abortion, Eugenic↗
PubMed1996

Euthanasia: law and practice in The Netherlands.

In The Netherlands, euthanasia is defined as the deliberate termination of the life of a person on his request by another person. Although, in this limited sense, euthanasia is only one of the issues raised by medical decision-making at the end of life, it is, in particular, the acceptance of euthanasia in this country that has attracted attention from abroad. Also, in The Netherlands itself, the toleration of the courts of euthanasia (if carried out by a physician under strict conditions) has given rise to much debate. This contribution surveys the developments in the law (including recent legislation), and in medical practice, and explores the relation between the two, with particular attention to the position of the physician.

Aged↗
PubMed1996

Clinical practice guidelines; legal aspects.

The number of clinical guidelines is rapidly increasing. The proliferation of guidelines and their growing use in medical practice make them also more conspicuous from a legal point of view. Legal questions relate first of all to guideline development: what are the responsibilities of the makers? when are they liable for 'defects' in their 'products'? Other questions concern the position of doctor and patient: to what extent do guidelines allow for clinical discretion or for patient preferences? How are they to be applied by the courts? The paper briefly discusses these issues, in particular the question to what extent cost-benefit considerations may be taken into account in developing clinical guidelines.

Cost-Benefit Analysis↗
PubMed1996

Clinical practice guidelines; legal aspects.

In many countries, practice guidelines are considered an important means to make medical decisions more effective and rational. The growing use of such standards raises a number of legal questions: What is the legal status of practice guidelines? What are the responsibilities of the makers? To what extent do guidelines allow for clinical discretion or for patient preferences? How are they applied by the courts? This paper briefly discusses these questions in the context of Dutch law and medicine. It also addresses the issue, to what extent cost-benefit considerations may be taken into account in developing clinical guidelines.

Cost-Benefit Analysis↗