Bringing Climate Change to Strasbourg. The Convention and Healthy Environment Claims.

Climate change profoundly impacts all aspects of human life, including health. International fora and nation States recognise the importance of urgently cutting greenhouse gas emissions as a primary cause of global warming. States' commitment to alter climate change has resulted in several treaty documents referring explicitly to human rights obligations. But what exactly are States' obligations under climate change treaty law and other human rights treaties? And what is the judiciary's role when confronted with the right to health violations and systemic deficiencies relating to climate change? Can climate change litigation give individual citizens a remedy to right to health violations and reduce the impact of climate change?

Obstetric Violence: Sterilisation without Consent. The Case of Y.P. v. Russian Federation.

On 20 September 2022, the European Court of Human Rights (ECtHR) delivered its judgment in a remarkable case on sterilisation without the patient's consent, Y.P. v Russian Federation (ECtHR, application no. 43399/13, 20 September 2022). According to the Court, there is no inhuman and degrading treatment, but it was a justified medical procedure. However, the Court did conclude a violation of the right to private life, under Article 8 ECHR. This outcome is at odds with an earlier sterilisation case without consent, V.C. v Slovakia (V.C. v. Slovakia, ECtHR application no. 18968/07, 8 November 2011). The question is how both rulings can be understood, especially the legal consideration regarding the prohibition of torture. After all, both cases lacked the patient's consent.

View. The Dutch Critical Care Triage Guideline on Covid-19: Not Necessarily Discriminatory.

Recently, the Dutch Medical Doctors Association (Federatie Medisch Specialisten en de Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst) drafted the 'Covid-19 triage guideline ICU admission' that has age cut-offs that deprioritise or exclude the elderly. Such an age limit for intensive care unit (ICU) admission in case of a national emergency seems discriminatory, and thus, is it inappropriate to use, or not? The question is whether age in itself can be considered as an acceptable selection criterion.

Fighting Excessive Pharmaceutical Prices: Evaluating the Options.

New treatment options for various cancer therapies appear to be extremely expensive and prices may increase further. The affordability and availability of life-saving medicines is therefore a key issue in the national health policies of all countries. International and European law grant several price-reducing options, including compulsory licensing. Still, countries are reluctant to apply for compulsory licensing and/or other regulatory options to curtail pharmaceutical prices. Why is that? Evaluating the options will support health policy decision-making on safeguarding access to affordable innovative medicines.

Strasbourg Medical Expulsion Rulings: Beyond the Deathbed Requirement.

For decades, the European Court of Human Rights (ECtHR) has applied a restrictive interpretation on the Article 3 threshold in extradition cases. The removal of aliens from the contracting state is lawful unless the applicant faces an imminent risk of death (D v. the United Kingdom (St Kitts)). However, with the Paposhvili ruling the Court has lowered the deathbed requirement to a more favourable standard as confirmed in the latest Savran case. But will those facing medical expulsion really benefit from this new standard at national level?

Impact of the Directive 2011/24/EU in The Netherlands National Legal System

Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients' rights in cross-border healthcare is aimed at ensuring patient mobility, establishing some rules for facilitating access to safe and high-quality healthcare and promoting cooperation on healthcare between Member States, whilst fully respecting their responsibilities in the organisation and delivery of such healthcare. In this report the impact of the aforementioned Directive in The Netherlands National Legal System is analyzed

La Directiva 2011/24/UE del Parlamento Europeo y del Consejo, de 9 de marzo de 2011, relativa a la aplicación de los derechos de los pacientes en la asistencia sanitaria transfronteriza, tiene como objetivos garantizar la movilidad de los pacientes, establecer unas reglas para facilitar su acceso a una asistencia sanitaria segura y de alta calidad en la Unión Europea, y promover la cooperación en materia de asistencia sanitaria entre los Estados miembros, respetando plenamente las responsabilidades de éstos en la organización y prestación de dicha asistencia. En este informe se analiza el impacto de dicha Directiva en el sistema jurídico de los Países Bajos

Market competition in health care markets in the Netherlands: some lessons for England?

This article seeks to establish what lessons might be available to the English health care sector following enactment of the Health and Social Care Act 2012 from the Dutch experience of introducing market competition into health care via a mandatory health insurance scheme implemented by for-profit insurance companies. The existence of the Beveridge NHS model in England, and a Bismarckian insurance system in The Netherlands perhaps suggest that a comparison of the two countries is at best limited, and reinforced by the different Enthoven-inspired competitive models each has adopted. However, we contend that there are positive and negative issues arising from introducing competition into health care-, e.g. concerns about equity and benefits of efficiencies-which go beyond national boundaries and different systems and reflect the global paradigm shift towards the use of market forces in previously non-market areas such as health. The article examines the situation in England following the HSCA 2012 and The Netherlands following the 2006 reforms before analysing two areas of common ground: the focus in both countries on competition on quality (as opposed to price) and integrated care, which is assuming ever greater significance. We suggest that our combined insights (as a health lawyer and competition lawyer respectively) coupled with a comparative approach create a novel contribution to current calls for a wider public debate about the real role of markets in health care over and above simple characterisation as a force for good or bad.

Personalized Medicine and Access to Genetic Technologies

La medicina personalizada se inició después del Proyecto Genoma Humano y es un concepto relativamente nuevo que cambiará drásticamente la práctica clínica. Ofrece clara ventajas clínicas mediante la aplicación de pruebas de diagnóstico genético y posterior tratamiento del paciente con medicamentos específicos basados en su composición genética. Su potencial parece prometedor, no obstante surgen muchas consideraciones de carácter jurídico al respecto. Una de estas cuestiones tiene que ver con el derecho a la asistencia sanitaria y el acceso a las tecnologías genéticas. En este artículo, el autor explica el significado de tal derecho la asistencia sanitaria en virtud de las normas de derechos humanos internacionales, su importancia para la prestación de los servicios de genética que pueden recibir financiación pública, cómo hacer frente a problemas de calidad de los ensayos comerciales y, por último, la controversia sobre la patentabilidad y el acceso clínico a la información genética. Aparte de las cuestiones más tradicionales sobre los derechos humanos (consentimiento, privacidad, confidencialidad) y sobre la genética, los Estados deben ser conscientes del significado del concepto de igualdad de acceso en virtud del derecho internacional y sus consecuencias en la introducción de nuevas tecnologías tales como pruebas genéticas y servicios de genética (AU)

Personalized medicine started after the Human Genome Project and is a relative4ly new concept that will dramatically change clinical practice. It offers clear clinical advantages by applying genetic diagnostic test and then treating the patient with targeted medicines based on his or her genetic make-up. Its potential seems promising but there are quite a few legal concerns. One of these questions deals with the right t health care and access to genetic technologies. In this paper, the author explains the meaning of such a right to health care under international human rights law, its relevance for making genetic services eligible for public funding, how to cope with quality concerns of commercial testing, and finally, the patentability controversy and clinical access to genetic information. Apart from more traditional human rights concerns (consent, privacy, confidentiality) and genetics, States should be aware of the meaning of the equal access concept under international law and its consequences when introducing new technologies such genetic testing and services (AU)

Health system reforms in the Netherlands: from public to private and its effects on equal access to health care.

Dutch health system reforms can be characterized by an ambiguous approach, combining competition and private initiatives on several health care markets with restrictive measures inspired by social values. Respecting equal access to necessary health care services on a competitive market appears to be an extremely difficult and bureaucratic exercise, if not impossible.

The pharmaceutical sector inquiry: 'Hamlet' in a nutshell.

In July 2009, the European Commission (DG Competition) published a Communication on the pharmaceutical sector. This inquiry was launched because there were some indications that competition in the pharmaceutical market in the European Union might not be working well. The report examines the reasons for the observed delay. This article analyses the outcomes from a critical standpoint, arguing in favour of enhanced 'soft law' accountability mechanisms in the pharmaceutical sector, defending conditional patenting and the introduction of a Community patent.

Personalized medicine and access to genetic technologies.

Personalized medicine started after the Human Genome Project and is a relatively new concept that will dramatically change clinical practice. It offers clear clinical advantages by applying genetic diagnostic tests and then treating the patient with targeted medicines based on his or her genetic make-up. Its potential seems promising but there are quite a few legal concerns. One of these questions deals with the right to health care and access to genetic technologies. In this paper, the author explains the meaning of such a right to health care under international human rights law, its relevance for making genetic services eligible for public funding, how to cope with quality concerns of commercial testing, and finally, the patentability controversy and clinical access to genetic information. Apart from more traditional human rights concerns (consent, privacy, confidentiality) and genetics, States should be aware of the meaning of the equal access concept under international law and its consequences when introducing new technologies such genetic testing and services.