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[Computerized medical record: deontology and legislation].

Computerization of medical records is making headway for patients' follow-up, scientific research, and health expenses control, but it must not alter the guarantees provided to the patients by the medical code of ethics and the law of January 6, 1978. This law, modified on July 1, 1994, requires to register all computerized records of personal data and establishes rights to protect privacy against computer misdemeanor. All medical practitioners using computerized medical records must be aware that the infringement of this law may provoke suing in professional, civil or criminal court.

Ethics, Medical↗

Does legislation reduce harm to doctors who prescribe for themselves?

OBJECTIVE: To consider the issue of legislation restricting self prescribing by doctors. METHOD: Searches of the medical literature in Medline, Australian Medical Index and CINAHL using the terms 'medical', 'legislation' and 'physician impairment' from 1966-2003 supplemented by checking citations of review papers. RESULTS: We found 144 articles, although no trials of legislation. The remaining research was inadequate to answer the question of whether restricting self prescribing reduces doctor impairment. However, descriptive studies suggest that impairment attributed to self prescribing is most often from self administration, which is not altered by legislation to restrict self prescribing. DISCUSSION: There are important theoretical adverse consequences of legislation that restrict self prescribing. Apparently self evident legislation may be counter productive. The need for doctors to have an independent general practitioner is reinforced.

Drug Prescriptions↗

Teaching medical informatics to medical students in the Federal Republic of Germany.

The medical curriculum in the Federal Republic of Germany (FRG) is regulated by federal legislation. Medical informatics is part of this curriculum and is therefore taught by all 27 medical faculties in the FRG, 24 of which have related departments. The teaching situation in general and the specific approach at the author's department are described.

Attitude to Computers↗

Comprehensive waste regulation dumped. A limited demonstration project is all that remains.

When medical wastes started washing up along the Eastern Seaboard and the shores of the Great Lakes in 1988, healthcare providers became subject to close public scrutiny. Not only was the situation deplorable; the solution, they feared, would keep them entangled in red tape for years. Public outcry sent members of Congress scurrying to legislate medical waste regulation. But what many had predicted would be a comprehensive, nationwide regulation that tracked medical waste from cradle to grave turned out to be a demonstration project limited to Puerto Rico and four states in the Northeast. The Medical Waste Tracking Act of 1988 went into effect in June 1989. When it expires in June 1991, the Environmental Protection Agency (EPA) will report to Congress on the program's impact, presumably with an eye toward whether further legislation and continuing regulations are necessary. In the meantime, participating states must establish a system of tracking medical waste from its point of generation to its disposal by either incineration or burial in a landfill. Medical waste generators must separate it from other kinds of waste and place it in special labeled containers. They must also prepare a tracking form that accompanies the cargo and requires sign-off by generator, transporter, and disposal facility operator. The EPA has legal access to medical waste tracking forms and can inspect any site where medical wastes are located. Violators are subject to stiff civil and criminal penalties.

Facility Regulation and Control↗

[Johann Georg Heine--treatment leeway for technical specialists after Bavarian medical reform in the early 19th century].

Various technical professions such as orthopedics and dentistry were introduced into the universities of Bavaria in the early 19th Century. The representatives of these professions were craftsmen who first had to legally become "doctors" before they could regularly take part in specialized treatment technology and firmly establish their originally technical discipline in an academic setting. A case study is used to paradigmatically illustrate how this course of developments subsequent to the Bavarian Medical Reform of 1808, which was intended to bridge all gaps for these marginal professions, ever became possible and to describe the role of the State in the establishment of technical specialties. It turned out that some of the newly formed fields that were formerly specialized technical trades did not fit into the rigid medical legislative system. This led to great uncertainty about various legal positions in the sector where medical and police regulations did not apply. In this "unlegislated sector", government jurists--not medical boards--made decisions regarding the further development of the new specialty. Economics and public health policies became important factors in view of the demand for services in the new specialty field. This created more freedom of action for "technical" medical specialties that were in great demand.

Education, Medical↗

OSMA and Oklahoma medicine: 1916-1925.

Despite uncertain economic times, the Oklahoma State Association grew steadily in the decade from 1916-1925, passing the 1500 membership mark for the first time and establishing itself as the premier medical organization in the state. While the world fought its first great war and suffered an influenza pandemic, Oklahoma physicians battled diseases for which there were no immunizations or cures, and OSMA struggled to establish its identity in the arena of medical legislation.

History, 20th Century↗