Five brains of alienated criminals. Neurological investigations of early twentieth century criminal anthropology.

BACKGROUND: For the followers of criminal anthropology, during the second half of the 19th and the beginning of the 20th century, the association "anatomical anomaly - psyche anomaly" represented an immediate diagnostic tool to identify mental illness and consequently the tendency to become a criminal. In this article, we analyse a clinical report published in 1900 in which the author, Dr. Saporito, described five brains of alienated criminals from the Aversa asylum. METHODS: Through the observations of Dr. Saporito's autoptic evaluations and the literature of the times, the beliefs of the positivist science of that time are highlighted. RESULTS: The identification of multiple physical anomalies focused on the brains, with particular attention to the alteration at the level of some fissures, could lead to identify psychiatric disorders and criminal tendency. CONCLUSIONS: From the observations presented here, the author reiterated that several anomalies recorded in these five brains reproduced atavistic characteristics, which disappeared in the ontogenetic and phylogenetic evolution of the human brain.

Physician assisted suicide and clinical vulnerability: a slippery slope.

AIMS: The Belgian case of a 24 years' woman affected by resistant depression, who obtained the legal right to assisted suicide rehearsed ethical issues. From the famous Chabot case of the Dutch court in 1994, accumulating legal evidence indicates that the unbearable psychiatric suffering may be equate to the physical struggle of end of life patients. The Belgian law has addressed assisted suicide as an option in case of unbearable psychic suffering with no future prospective. DESIGN: It is unlikely that the practice of euthanasia may be mechanistically reduced to the provision of a suicide as alleviating the burden of suffering in depression is a long life commitment; moreover, the principle of patient's self determination and autonomy is highly debatable: the closure to the future, the hopelessness and the suicidal ideation represent per se core features of depression. Might they be discriminated as non pathological in assessing patients' competence and how? DISCUSSION: The slippery slopes is even more upsetting when dealing with elderly affected by chronic disability. Some body of evidence justified suicide in elderly as the final auto determination to preserve the person's dignity, and quality of life. The growing scenario of economic shortages in heath care system seems to further legalize the social prejudice and the ageistic discrimination towards elderly with disability. The silver tsunami will face the challenge of true self determination; will it be acted through assisted suicide or through a rebuilding of western heath care policies to fulfill the emergent needs of an aging population?

Regulating the communication of genetic risk information: the Italian legal approach to questions of confidentiality and disclosure.

Communication of genetic risk is a complex process in which the rights of the individual and those of relatives may conflict with regard to the information revealed by DNA testing. If patients who participate in clinical genetic testing refuse to share their genetic information with at-risk relatives, healthcare professionals need to reach a proper ethical balance between the right of individual patients regarding the confidentiality of their genetic test result and the right of families to be informed about their genetic risk. Rules and legislation in most countries generally protect the confidentiality of medical information but allow limited disclosure of genetic test results without the patient's consent in specific cases when certain conditions are met. The aim of this article is to draw attention to how Italian policymakers have attempted to balance protection of autonomy and confidentiality, and protection of health by means of a hybrid instrument. Furthermore, we show that some of the requirements of that instrument depart from the most widely recognized standards for non-consensual disclosure of genetic risk information, while at the same time allowing an unusually high level of discretion to healthcare professionals involved in genetic counseling and testing.

Medical treatment and patient decisional power: the Italian state of the art.

Therapy dissent and refusal are the situations most debated in the medical profession, that lead to various interpretations with regards to life and health, and even more in case of death risk. In the last decades, the medical treatment consent matter has become such an interesting and central issue that it has considerably modified the doctor-patient relationship. In particular, thanks to a fecund discussion on doctrine and case law, the informed consent became an autonomy act through which the patient exercises his/her personal health right. There are two international provisions that deserve to be mentioned for the matter: article no. 3 of the Charter of Fundamental Rights of the European Union, adopted in Nice on December 7, 2000, and the Oviedo Convention of April 4, 1997, which Italy passed under article no. 145, March 28, 2001. Both laws are symptomatic for the growing attention toward the person's self-determination, and for the impossibility to perform treatment in absence of personal, informed, recent and at any time revocable consent of the person concerned. Actually, these different and opposite ways of thinking correspond to a variable attitude of the case law that, in absence of a clear legislation regarding this matter, induces a deep insecurity in the physician's act on the one hand, and, does not allow the patient to totally avail him/herself of the self-determination principle on the other hand, particularly regarding the will and choices on health care.

Towards an GMO discipline: ethical remarks.

The present technological transformation calls for a new kind of vet: he has to accomplish his own institutional tasks bearing in mind the definition of a "good practice" code and also performing educational and informative tasks in zootechnology in order to ensure the animal well-being. Therefore, his contribution can be relevant in developing and interpreting laws related to the protection of animal welfare and further considerations on the ethical and deontological thought, concerning the technological use of animals. The vet's role is also fundamental in the following areas: further study of bioethical issues related to zootechnology and the professional growth of whoever is engaged, in different ways, in productive activities and research on animals.

[Patient's consent to central venous catheterization]. / Consenso informato al posizionamento dei cateteri venosi centrali: una proposta operativa.

The need to obtain a patient's consent for his health care is a principle set out in the Italian Constitution, which safeguards a person's right to health. Articles 13 and 32.2 confirm a person's freedom and the right to make free decisions about one's medical treatment. Nobody must be obliged to any medical procedure, unless as by law enacted. The obligation to inform patients is important during the contractual phase: consent is an essential element in the professional contract governing the relationship between a physician and a patient. The former is obligated to inform the latter about his medical intervention clearly and precisely, to enable the patient to decide freely whether to undergo a medical procedure. At this point, it is also essential to obtain a patient's consent for those treatments that although they are carried out in a correct and careful way, could damage a person's physical integrity. The failure to obtain consent could give rise to a burden of responsibility on behalf of the clinician. A central venous catheterization in hemodialysis (HD) is a common procedure performed during routine nephrological treatments. Our signed informed consent form prior to introducing a central venous catheter is thought to satisfy requirements provided for in current regulations to give correct information.

Biotechnological patents and ethical aspects.

Developments in the biotechnological fields have stimulated public research institutes to adopt a more enterprising policy that encourages the use of the patent and the commercialization of research results and products. The National Institute for Cancer Research of Genoa (IST) has dealt with a number of the principles and ethically related matters that arise from the acceptance of the patent system and policy. The problem of the patent in the biotechnological fields is particularly complicated given the subject--living matter--and the social alarm that it provokes in the general public. Careful consideration of ethical aspects demands the further evaluation of whether or not the patent is an adequate tool for regulating these matters.