Recommendations of the Group of Experts of the Polish Society of Gynecologists and Obstetricians regarding gynecological examination and treatment of a minor person (01.01.2020).

The recommendations present the current knowledge and procedures, which can be modified and changed in some cases, after careful analysis of a given clinical situation, which in the future may become the basis for their modification and updating.

Knowledge of Law Students on the Problems of Modern Transplantology Is Good but It Can Always Be Better.

The progress of transplantation in Poland is influenced not only by medical staff, but also by the legislative organ, which approves amendments to the Act of the Collection, Storage and Transplantation of Cells, Tissues and Organs. This is why young lawyers should be aware of the scale of the problem and have current statistics on transplant issues. AIM: To assess the awareness of existing problems in the field of transplantation in Poland among law students. MATERIALS AND METHODS: A survey (with 11 questions) of 209 law students at the University of Bialystok (64% women and 36% men). RESULTS: Of respondents, 32% do not see the difference between dialysis treatment and transplantation, and 47% are convinced that the 5-year survival of dialysis patients is as much as 70% (in fact this number is twice as low). Still, 13% of people consider the stereotype of family consent for organ procurement is necessary. Of law students, 5% indicated that organ trafficking is allowed in Poland, and 41% believe that as many as 5% of people in Poland stated in writing opposition to removal of their organs after death. Fortunately, this number is much smaller (2%). The respondents have current knowledge about the place of Poland in the world in terms of the number of donors. Relatively good results were recorded in questions about medical knowledge. CONCLUSIONS: In most questions, the correct answer obtained the highest score, but it was not an absolute majority. There is a trend among law students for an optimistic approach to statistics and the real problems in transplantology.

A Comparative Analysis of the Treatment of Decision-Making by or for Patients with Neurodegenerative Diseases in Four Legal Jurisdictions.

Dementia is associated with the gradual impairment of mental ability. The population of people suffering from dementia is as large as 50 million. Most dementia cases result from various neurodegenerative diseases (NDs) linked by a progressive degeneration of neurons. Among NDs, Alzheimer's disease (AD) is the most frequent cause of dementia and accounts for 60- 80% of cases. Certain pathological changes on the cellular and subcellular level occur even 15 years before the manifestation of clinical symptoms of AD. This first asymptomatic phase of AD is considered a preclinical stage, whereas mild cognitive impairment (MCI) is the symptomatic pre-dementia stage. The third, fully symptomatic phase of AD is dementia due to AD. The presence of specific proteins in the cerebrospinal fluid (CSF) may be considered as a characteristic feature of some NDs. The measurement of their CSF concentrations, together with neuropsychological examination and neuroimaging, may be useful for diagnosing AD. The collection of CSF samples is performed by lumbar puncture, which is a medical procedure that requires obtaining informed consent from patients. While asymptomatic AD patients have full legal capacity, those with dementia require a legal guardian who will represent them. Thus, the objective of this study is to compare the legal systems regulating the legal capacity issue in the USA, U.K. (England and Wales), Germany, and Poland. These countries have been chosen as examples of three different types of legal orders, according to the sources of law, i.e., civil law, common law, and case law.

Selected Legal Aspects of Donation After Circulatory Death in Poland.

Organ transplantation is one of the most critical ethical topics in law and medicine and a matter of debate in various countries. Lack of organs for engraftment to meet the existing demand has resulted in a substantial crisis due to organ shortage and a rise in the critical conditions of certain waitlisted patients, as well as increased mortality of patients while waiting. Organ shortages for transplantation raised the issue of procurement of organs not only from living donors and cadaveric donors after brain death, but also after circulatory death. Renewed interest in donation after circulatory death started in the 1990s, and has been on the rise in recent years, reaching up 40% of donation in some countries. Both legislation on and practice of donation after circulatory death differ significantly throughout the world. Lack of unified guidelines and regulations have challenged the medical, ethical, legal, and transplant communities. Moreover, studies on legal aspects of donation after circulatory death are still lacking. In this review, we present selected legal issues in regulation of donation after circulatory death, and we address the most important legal challenges in this regard with particular attention to category III of donors after circulatory death.

Consent to Medical Procedures of Patients with Neurodegenerative Diseases: A Comparative Study of Legal Regulations in Selected European Countries and in the United States.

According to the projections of the statistical office of the European Union, Eurostat, nearly one third of EU citizens will be at least 65 in 2060. The U.S. population age 65 and older continues to increase and is projected to nearly double from 48 million to 88 million by 2050. Elderly people are especially exposed to neurodegenerative diseases (NDs). The most common ND is Alzheimer's disease (AD), a chronic and progressive disorder with a variety of pathological changes within neuronal tissue, which begin even 10-15 years before the onset of cognitive impairment symptoms. AD is perceived as a disease continuum and considered to include three basic phases: preclinical (asymptomatic) stage, mild cognitive impairment (MCI), and dementia due to AD. A very important issue, from medical and legal perspectives, is the NDs patient's consent to medical procedures, including diagnostic procedures, such as lumber puncture. NDs patients are not always able to express their consent and do not always understand the information provided by a physician. This applies to a group of patients in the final stages of NDs. This paper presents legal regulations of selected European countries and signalizes the U.S. legal solutions on the issue of NDs patients' informed consent to medical procedures.