[Differences in sexual development-S2k guideline update]. / Varianten der Geschlechtsentwicklung ­ Aktualisierung der S2k-Leitlinie.

BACKGROUND: Human beings with a difference in sexual development (DSD) often underwent gender reassignment surgery during early childhood. However, the medical decision was often not congruent with the gender identity that affected persons developed later on. OBJECTIVES: To represent the interests of affected persons, an interdisciplinary guideline in cooperation with support groups was written. MATERIALS AND METHODS: The revision of the first version of the guideline, published in 2016, was edited by 18 professional societies and working groups as well as 3 support groups. A literature search was performed for each of the 12 chapters. Recommendations and statements created by the working groups were voted on during four consensus conferences. RESULTS: The guideline highlights the right of self-determination of affected persons. In this context, new legal requirements are reported. Other than necessary primary diagnostics, medical procedures should be postponed. Most important is the psychological support of parents and patients. Tumor risk of the gonads and protection of fertility are analyzed and discussed in detail. CONCLUSION: The content of the guideline represents a paradigm shift in dealing with human beings with a difference of sexual development. Projects as DSD Care and Empower-DSD help to promote the practical implementation of the guideline's recommendations.

The Role of Male Consent in Assisted Reproductive Technology Procedures: an Examination of Japanese Court Cases.

With the development of assisted reproductive technologies, medical, ethical, legal, and social issues have arisen that did not exist when natural conception was the only means of childbirth. In Japan, men tend to believe that assisted reproductive technologies are not directly related to them, with the literature showing that men are often reluctant to be involved in fertility treatment processes. To better understand this situation, this study analyzes the role of male consent during assisted reproductive technology procedures in Japan. First, we examined Japanese court cases that dealt with issues related to male consent during assisted reproductive technology procedures and identified three situations in which problems related to male consent during such procedures may arise. Next, we analyzed the background of such issues and the implications of the lack of consent regarding men's reproductive rights. Finally, we explored the need for legislation on assisted reproductive technologies. The study concludes that discussions on the scope of male partner rights in assisted reproductive technology procedures are key for minimizing unnecessary conflict between partners, thus ensuring both the rights of women who wish to have children and the welfare of their children. Supplementary Information: The online version contains supplementary material available at 10.1007/s41649-023-00274-1.

The dilemma，conflict，and solution of patients’ right of self-determination in medical decision-making / 中国医学伦理学

Currently，there are still obstacles for patients’ right of self-determination in medical decision-making. By sorting out its historical origins，this paper found that the reasons for the current situation mainly include the influence of familial culture and medical paternalism，as well as the constraints of the behavioral capacity system and the guardianship systems. In this context，this paper criticized the view that “the key to enjoying decision-making power is rationality”，and called for a return to the concept of patient autonomy，so as to achieve a balance between agency decision-making power of others and the special intervention rights of doctors. The legal system for resolving conflicts can be constructed by replacing behavioral capacity with medical decision-making ability，requiring the evaluation of medical decision-making ability based on actual conditions，establishing a pre-medical instruction system，and clarifying the boundaries of medical special intervention rights.

Biopiracy and the right to self-determination of indigenous peoples.

BACKGROUND: Since over thirty years, I work on the unclear legal situation of in which indigenous peoples find themselves today in the beginning mainly in the USA and later also in Canada, Australia and New Zealand. The status of indigenous people and native nations is characterized as a mixture of national and international law. Hypothesis/Purpose: To clarify the status of indigenous people it is necessary to analyze and interpret carefully hundreds of old treaties, international declarations and covenants, national statutes and jurisprudence, especially the old leading decisions of the US-Supreme Court. Such an analysis and interpretation should prove that indigenous people have the defensive right of self determination. RESULTS: The study outlines the old decisions of the US-Supreme Court with its inherent contradictions which highly influenced the status of indigenous people in all other countries until now. It clarifies the important new developments in international law especially the non binding Declaration on the Rights of Indigenous Peoples and its effects on the interpretation of international and national law in regard to biopiracy. For this purpose it is necessary to use the methods of judgmental comparative law, historical and teleological interpretation. CONCLUSION: By expressly stating that indigenous peoples have a right to self-determination, the Declaration on the Rights of Indigenous Peoples of 2007 complements the protection stipulated in the Charter and the Covenants of 1966. Although the declaration itself is not legally binding as it is a resolution of the UN General Assembly, it can serve as a blueprint to show the rights that indigenous peoples can derive from international law as well as rights which should ideally be granted to them by the states even though they are not yet binding customary or treaty law. Self-determination means exactly that, it is up to the bearers of the right to decide how they want to utilize this right and then work together with the state in which they live in defining a joint framework.

Medical record and privacy of patients / 대한산부인과학회지

Making out medical record is one of the fundamental obligations of doctors in medical service. Primarily, the meaning of medical record is the logical basis to guarantee consistent medical practice by writing out the detailed process, which could make the doctors remember the items of what they have done for their patients. But, nowadays when the medical service is highly specialized and differentiated, it also means not only the important method of communication amongst specialized medical divisions but also legal basis for adjudicating the appropriateness of medical practice at the court. In the process of medical practice, it would be inevitable for personal information, health information and genetic information to be disclosed. On the one hand, doctors meet the legal and ethical obligation to protect the right of privacy of their patients, on the other hand, they bear the legal obligation to observe the rule for the patients' right to know and right of self determination for private information. So, therefore, even if doctors are to provide medical record by the legal provisions, they should inform the patient of the reality and maximum careful attention should be paid in order to minimize the extent of exposure of patients' personal information, health information and genetic information.

Privacy Act in Korea and Electronic Medical Record Protection / 대한의료정보학회지

With the emergence of networked computing and the Internet, this paper addresses the changed medical privacy environment, in which medical data protection now has to be reassessed. It is mainly based on the Korea situation as a country without an omnibus medical data protection law. It touches also on data security, as medical data privacy cannot be effectively protected without strict regimes for data security. The contemporary state of the medical records in Korea stood to gain from the growth of informatics and the spread of trans-institutions data flows. It is in this context that there appears to be a need to review the recent medical records protection acts which are already showing signs of this age both the public sector and private sector. Some recommendations will be adopted to establish baseline principles and goals and to provide guidance on the future work of the medical data privacy act. One of these, the protection of privacy on electronic medical records, recognizes the ubiquitous nature of digital computer and network technologies today. Medical information should be acquired, disclosed and used only in ways that respect an individual's privacy. It should not be improperly altered or destroyed. And medical information should be accurate, timely, complete and relevant to the purpose for which it is provided and used. And it upholds and protects medical data security. For example a right to encrypt personal information effectively, a right to fair treatment in key public infrastructures so that no person is unfairly excluded in a way that would prejudice that person's ability to protect their privacy, a right to human checking of adverse automated decisions and a right to understand such decisions, a right, going beyond the aspiration of the 'openness principle', of disclosure of the collections to which others will have access and which might affect the projection of the profile of the individual concerned.

Discuss on the Right of Enthanasia / 中国医学伦理学

As a cross-disciplinary theory,euthanansia concerns the right of life and the dignity of death. In terms of law principles, according to the independent principle of life, the patient who is in extreme pain with an incurable disease should have the right of self-determination of euthanasia in order to safeguard his legitimate rights and dignity of death.