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1.
Pol Merkur Lekarski ; 51(6): 646-653, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38207067

RESUMO

Artificial Intelligence (AI) has undeniably transformed the landscape of healthcare, offering unparalleled potential to enhance patient care, streamline diagnostics, and improve overall healthcare outcomes. As AI continues to make its way into the medical field, it has raised crucial questions about regulation, ethics, and patient safety and that is guiding us to the core question - how that will impact current human rights and freedoms concept, and is this concept ready for such an impact? The aim of the research is to identify and evaluate the potential impact of AI introduction in healthcare on modern human rights and freedoms concept, and on the basis of discovered complexities to propose ways to eliminate them. This study was conducted during June-October of 2023. Through a broad literature review, analysis of international and state regulation acts, scientific researches and opinions of progressive-minded people in this sphere this paper provide a guide to understanding the impact of AI introduction in healthcare on current human rights and freedoms concept. It is based on dialectical, comparative, analytic, synthetic and comprehensive methods.


Assuntos
Inteligência Artificial , Atenção à Saúde , Humanos , Liberdade , Direitos Humanos , Segurança do Paciente
2.
Wiad Lek ; 75(9 pt 2): 2286-2292, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36378710

RESUMO

OBJECTIVE: The aim: Study of the system of pharmaceutical activity legal support in emergency conditions, namely, the period of epidemics outbreak and during the war. PATIENTS AND METHODS: Materials and methods: In the mentioned study, we analyze the state of the governmental pharmaceutical policy during the pandemic and the war in Ukraine. Legal norms and doctrinal positions of scientists regarding the above-mentioned issue are studied. The work analyzes the information presented by specialists in various scientific publications, and also uses scientific methods from a medical and legal point of view. This material is based on dialectical, comparative, analytical, synthetic, and complex research methods. This study analyzes the activities of pharmaceutical enterprises in the emergency state and the problem of ensuring patients' rights to medical care and epidemic safety. As part of the above-mentioned methods, we investigated the problems of pharmacies utilizing questionnaires. A survey of representatives of pharmacy chains, managers of purchasing pharmaceutical products and their pricing, in the cities of Kharkiv, Poltava, Kyiv, Mykolaiv and Lviv in the number of 460 specialists, shows negative trends in price gouging. This is a violation of patients' rights to affordable pharmaceutical products. CONCLUSION: Conclusions: The pharmaceutical industry of Ukraine was not prepared in advance for extraordinary events, such as a pandemic and martial law, as well as for other natural disasters and foreseeable emergencies. This negatively affected and continues to affect the health of patients.


Assuntos
Farmácias , Farmácia , Humanos , Pandemias , Direitos do Paciente , Preparações Farmacêuticas
3.
Wiad Lek ; 73(11): 2523-2527, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33454695

RESUMO

OBJECTIVE: The aim: To inquire into a theoretical and legal basis that regulates relevant areas and processes; use of certain objects, associated with ecological risks, which association, in turn, indicates the likelihood of conditions that can have adverse effects on the environment, human life and well-being. PATIENTS AND METHODS: Materials and methods: In this work we study statutory regulations and scientific positions of scholars regarding the above-mentioned issue. The study analyses generalized information from scientific journals employing scientific methods from a medical and legal perspective. This article is based on dialectical, comparative, analytic, synthetic, and comprehensive research methods. CONCLUSION: Conclusions: The importance of the issue of environmental risks reflects the need in solving the problem of coexistence between human beings and nature. The analysis of theoretical and legal basis within the outlined framework will allow detecting the gaps and will help to understand in what way they are surmountable while regulating the stressors associated with ecological risks, on one hand, and, on another hand - the possible consequences, in order to prevent and eliminate them as promptly as possible and, thus, minimize their adverse effects on the environment and the health of the population.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos
4.
Wiad Lek ; 73(12 cz 2): 2722-2727, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33611272

RESUMO

OBJECTIVE: The aim of the research is to identify specific of AI in healthcare, its nature, and specifics and to establish complexities of AI implementation in healthcare and to propose ways to eliminate them. PATIENTS AND METHODS: Materials and methods: This study was conducted during June-October of 2020. Through a broad literature review, analysis of EU, USA regulation acts, scientific researches and opinions of progressive-minded people in this sphere this paper provide a guide to understanding the essence of AI in healthcare and specifics of its regulation. It is based on dialectical, comparative, analytic, synthetic and comprehensive methods. RESULTS: Results: One of the first broad definitions of AI sounded like "Artificial Intelligence is the study of ideas which enable computers to do the things that make people seem intelligent ... The central goals of Artificial Intelligence are to make computers more useful and to understand the principles which make intelligence possible." There are two approaches to name this technology - "Artificial intelligence" and "Augmented Intelligence." We prefer to use a more common category of "Artificial intelligence" rather than "Augmented Intelligence" because the last one, from our point of view, leaves much space for "human supervision" meaning, and that will limit the sense of AI while it will undoubtedly develop in future. AI in current practice is interpreted in three forms, they are: AI as a simple electronic tool without any level of autonomy (like electronic assistant, "calculator"), AI as an entity with some level of autonomy, but under human control, and AI as an entity with broad autonomy, substituting human's activity wholly or partly, and we have to admit that the first one cannot be considered as AI at all in current conditions of science development. Description of AI often tends to operate with big technological products like DeepMind (by Google), Watson Health (by IBM), Healthcare's Edison (by General Electric), but in fact, a lot of smaller technologies also use AI in the healthcare field - smartphone applications, wearable health devices and other examples of the Internet of Things. At the current stage of development AI in medical practice is existing in three technical forms: software, hardware, and mixed forms using three main scientific-statistical approaches - flowchart method, database method, and decision-making method. All of them are useable, but they are differently suiting for AI implementation. The main issues of AI implementation in healthcare are connected with the nature of technology in itself, complexities of legal support in terms of safety and efficiency, privacy, ethical and liability concerns. CONCLUSION: Conclusion: The conducted analysis makes it possible to admit a number of pros and cons in the field of AI using in healthcare. Undoubtedly this is a promising area with a lot of gaps and grey zones to fill in. Furthermore, the main challenge is not on technology itself, which is rapidly growing, evolving, and uncovering new areas of its use, but rather on the legal framework that is clearly lacking appropriate regulations and some political, ethical, and financial transformations. Thus, the core questions regarding is this technology by its nature is suitable for healthcare at all? Is the current legislative framework looking appropriate to regulate AI in terms of safety, efficiency, premarket, and postmarked monitoring? How the model of liability with connection to AI technology using in healthcare should be constructed? How to ensure privacy without the restriction of AI technology use? Should intellectual privacy rights prevail over public health concerns? Many questions to address in order to move in line with technology development and to get the benefits of its practical implementation.


Assuntos
Inteligência Artificial , Atenção à Saúde , Humanos , Princípios Morais , Software , Tecnologia
5.
Wiad Lek ; 72(10): 2017-2023, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31983146

RESUMO

Introduction: According to the decisions of the European Court of Human Rights and the regulations of the World Health Organization, the right to health and the right to life are interconnected. However, the right to life may be a starting point in the context of the right to health. The issue of ensuring the right to life and health protection of certain sections of society, in particular, children working in agriculture, is on the agenda. The aim: To analyze the provisions of international law and scientific literature on the effects of workplace factors on the health of children working in agriculture and to examine the existing limitations of such effects. Materials and methods: International acts, data of international organizations and conclusions of scientists have been examined and used in the study. The study also summarizes information from scientific journals and monographs from a medical and legal point of view with scientific methods. The article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. Conclusions: In the context of preserving the right to health and the right to life, children are the most vulnerable categories of agricultural workers. Working conditions and workplace safety in agriculture for minors have to be properly organized. The level of traumatization, occupational morbidity and above all, the standard of health of child labourers in agriculture depend on the level of proper organization of occupational safety. In many countries, the state of the working environment and safety for child labourers in agriculture and, accordingly, the standard of their health remain unsatisfactory.


Assuntos
Saúde da Criança , Agricultura , Criança , Direitos Humanos , Humanos , Saúde Ocupacional , Local de Trabalho
6.
Wiad Lek ; 72(12 cz 2): 2421-2426, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32124763

RESUMO

OBJECTIVE: Introduction: The core of physician's non-compete agreements problematics lies in complex system of controversial interests, rights and goals of subjects involved. On the one hand non-compete restrictions and their enforceability is an obvious part of employer's legitimate business interest based on the freedom of contract, on the other - free unrestricted market, preventing of monopolization, availability of medical assistance and healthcare, right to choose a doctor are social standards and thus - a part of public interest, in addition to this - non-compete restrictions impact physician's right to work. Balance between these components is pretty sensitive and hard to achieve. We can find enforceability of physician's non-compete provisions in different types of relations: employment contracts, partnership agreements, sale of medical practice. But complexity of mixing law, ethical, social issues along with different approaches of legal regulations rises the relevance of research. PATIENTS AND METHODS: Material and methods: This study is based on German, British, Spain, Swiss, USA regulation acts, scientific researches and opinions of progressive-minded people in this sphere. The article is based on dialectical, comparative, analytic, synthetic and comprehensive methods. RESULTS: Results: Non-compete agreements may have social benefits in some situations: serve as an instrument to protect trade secrets thus stimulate innovation; reducing of worker's exit probability could increase quality of medical services due to training of employees etc. But also, there are some serious risks to employee, to employer and to society as a whole. Analyzing the sense of non-compete clause in general we can assume that it includes seven main points: the subject; the form; the time; the territory; the scope and type of restrictions; "buy out" of the clause and the compensation. These characteristics are the core of non-compete clause, and, taking into account the principle of freedom in terms of agreement conclusion, it is up to law enforcement practice to determine minimal and maximal limits of such restrictions. US legal concept is clearly based on implementing of legally prescribed restrictions for non-compete with physicians (along with other categories). European practice being pretty similar in view on what non-compete agreement is and what principles it is based on however is obviously different in approach chosen because of absence of special legal provisions for physicians' non-compete regulation. CONCLUSION: Conclusion: Lack of legal regulation and law enforcement practice in this sphere worldwide is obvious, so the starting point in resolving of physician's non-compete enforceability issue will be choosing of suitable concept. Analyzing of proposed concepts, we came to the conclusion that the most perspective will be an approach of specification and clarification of "reasonability" meaning in terms of evaluation physicians' non-compete agreement validity and their impact on public interest.


Assuntos
Médicos , Comércio , Atenção à Saúde , Emprego , Ética Médica , Humanos , Princípios Morais
7.
Wiad Lek ; 70(2 pt 2): 345-347, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29059656

RESUMO

INTRODUCTION: In Ukraine differentiated VAT rates is a matter of debate. Today the Cabinet approved a list of medical products that has been changed three times resulting in changed VAT rates for specific products. European Union provides another method of regulation of VAT rates on medical devices. The abovementioned demonstrates the relevance of this study. MATERIAL AND METHODS: Comparative analysis of Ukrainian and European Union legislation based on dialectical, comparative, analytic, synthetic and comprehensive research methods were used in this article. DISCUSSION: In Ukraine general rate of VAT for all business activities is 20 %. But for medical devices, Tax Code of Ukraine provides special rules. VAT rate of 7% for transactions supplies into Ukraine and imported into the customs territory of Ukraine of medical products on the list approved by the Cabinet. The list generated by the medical product name and nomenclature code that does not correspond to European experience and Council Directive 2006/112/EC. CONCLUSION: In our opinion, reduced VAT rates should to be established for all medical devices that are in a stream of commerce, have all necessary documents, that proved their quality and safety and fall under definition of medical devices.


Assuntos
Comércio , Equipamentos e Provisões/economia , Impostos , União Europeia , Ucrânia
8.
Wiad Lek ; 70(3 pt 1): 456-461, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28711887

RESUMO

INTRODUCTION: Chosen European foreign policy vector for Ukraine establishes its obligation to enforce the process of adaptation of the EU law regulations in the internal legal policy. The approximation of Ukrainian law to the European Union (EU) "acquis communautaire" is not only the instrument for deepening our economic cooperation with the European Union, but also the important measure to enhance further development of Ukraine in general. National legislation, which regulate advertising and promotion of medical devices (MD), is not an exception. Some key points on legal regulation of abovementioned sphere is a base of this study. MATERIALS AND METHODS: Ukrainian legislation, European Union`s Law Acts, EU's member-states law, WHO Acts and Recommendations, European Medical Technology Industry Association (EUCOMED) Acts. Article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. DISCUSSION: In accordance with Ukrainian legislation, there is no special law that concerns advertising on MD in Ukraine, this sphere is regulated by general law that named ≪About advertisement≫, but it doesn't take into account even main characteristics of such a special object as medical devices (MD). Moreover, the law ≪About advertisement≫ contain discrepancies in terms that are used, these contradictions, in our opinion, must be eliminated by appropriate law reforms. CONCLUSION: The advertising and promotion of MD in EU is regulated by a combination of EU and national legislation of EU Member States, national advertising and promotion of MD are not harmonized with the EU MDD for now, resulting in a fragmented legal landscape that differs from one EU Member State to the other. Practice of adopting different codes and guides that regulate advertising, including advertising of MD, is widespread in EU and EU Member States and thus must be used in Ukraine with appropriate reformation of national law.


Assuntos
Publicidade/legislação & jurisprudência , Equipamentos e Provisões/economia , União Europeia , Humanos , Ucrânia
9.
Wiad Lek ; 70(3 pt 1): 480-482, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28711892

RESUMO

INTRODUCTION: Achieved level of technical progress moves us closer and closer to practical use of 3-d bioprinting technologies in real life. Such perspective raise a wide variety of crucial legal issues from the acceptable model of regulation of the science and its' societal effects to problems of the commercialization of the technology and potential restrictions of its use. Some key points on concept of legal regulation of abovementioned sphere is a base of this study. MATERIAL AND METHODS: Scientific discussion on 3-D bioprinting, European Union`s and US experience in patenting of 3-D bioprinting technologies, European Medicine Agency (EMA) or the US Food and Drug Administration (FDA) regulations, European Medical Technology Industry Association (EUCOMED) Acts. Article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. DISCUSSION: General debate of last few years comes down to an attempt to resolve hesitation between legal attempts for regulation of 3-D biobrinting and concept of complete prohibition of such activities. An adequate response to the mentioned challenge is a reasonable position between some aspects of prohibition and self-regulation, resulting in a moderate number of regulations and standards for developing and marketing. Such regulations may concern an intellectual property (IP) rights, regulation of distribution, premarket restrictions, control mechanism etc. CONCLUSION: Scientific approach and regulatory settlement of 3-D bioprinting sphere must unite to achieve a fair balance between the interests of humanity and of individuals - on the one hand, and development of science and business benefits for stakeholders - on the other. The main instruments for this must be balanced regulation of intellectual property (IP) rights, regulation of access and distribution, premarket restrictions, control mechanism etc.


Assuntos
Bioimpressão/legislação & jurisprudência , Patentes como Assunto , União Europeia , Humanos , Estados Unidos , United States Food and Drug Administration/legislação & jurisprudência
10.
Wiad Lek ; 70(3 pt 2): 614-618, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28713093

RESUMO

INTRODUCTION: The need for effective legal regulation of production and sale of medical products in Ukraine due to its social effect is obvious and requires a high level of clarity. The experience of more advanced countries in this area, given the way chosen by Ukraine to harmonize our laws with EU legislation, is certainly could be a useful source of information. The urgency of issues need further intensification of national legal reforms. Some key points on concept of legal regulation of abovementioned sphere is a base of this study. MATERIAL AND METHODS: Legislation of Ukraine, European Union, United States of America, Guidelines, developed by European Commission & Food and Drug Administration's (FDA), recommendations represented by international voluntary group and scientific works. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. DISCUSSION: This study provide a possibility to state that main difference of regulatory systems in EU and US is that the legal framework of the EU is more flexible. This flexibility is grounded on main principle that only basic quality requirements for medical devices is defined by legislative acts however more detailed requirements are defined in standards, technical regulations, specifications, which are discretionary in nature. Contractors are free to choose any technical solution that provides compliance with the essential requirements, they can choose among different conformity assessment procedures and between accredited conformity assessment bodies to which they want to apply. The contractors themselves is interested to pass the conformity assessment procedure and have the right to put a conformity mark on their medical device because it will give them a real competitive advantage. In contrast, US State regulatory system provides strict control over business entities and law act establishes the quality requirements of medical products. The only body that can authorize the introduction of medical products and perform post-market monitoring is Food and Drug Administration (FDA), which has almost unlimited competence in this sphere. CONCLUSION: Taking into account further deepening of the European integration process of Ukraine, establishing of the regulatory system as much similar to that of the EU as possible is a main goal of legal reforms in abovementioned sphere. On the one hand, such system allows to implement effective control of contractors in the sphere of production and sale of medical products and provide safety of medical devices that are introduced, on the other hand, it does not afflict contractors with excessive and total control, allowing them to choose behavior that is most acceptable, understandable and user-specific. However, US's experience also has some positive characteristics, which could be taken into account. Therefore, such complex symbiosis of approaches from our point of view will balance controversial interest of manufacturers, sellers and consumers of medical devices.


Assuntos
Comércio/legislação & jurisprudência , Segurança de Equipamentos/normas , Equipamentos e Provisões/normas , Segurança do Paciente/legislação & jurisprudência , União Europeia , Humanos , Relações Interinstitucionais , Vigilância de Produtos Comercializados , Ucrânia , Estados Unidos , United States Food and Drug Administration
11.
Wiad Lek ; 69(6): 765-767, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28214812

RESUMO

INTRODUCTION: some kind of easiness of entry in creating software products on various computing platforms has led to such products being made available perhaps without due consideration of potential risks to users and patients and the most valuable reason for this have been lack of regulatory clarity. Some key points on legal regulation of abovementioned sphere is a base of this study. MATERIAL AND METHODS: Ukrainian legislation, European Union`s Guidelines on the qualification and classification of standalone software; Guidance for the Content of Premarket Submissions for Software Contained in Medical Devices that works in United States of America. Article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. CONCLUSION: in accordance with Ukrainian legislation, software that has a medical purpose could be a medical device. Ukrainian legislation which is established on European Union Medical Devices Directives divide all medical devices on classes. But there aren't any special recommendations or advices on classifications for software medical devices in Ukraine. It is necessary to develop and adopt guidelines on the qualification and classification of medical device software in Ukraine especially considering the harmonization of Ukrainian legislation with the EU legislation, develop special rules for the application of the national mark of conformity for medical device software and defined the « responsible organization ¼ for the medical device software approval process.


Assuntos
Equipamentos e Provisões , Segurança do Paciente/legislação & jurisprudência , Software/legislação & jurisprudência , União Europeia , Humanos , Software/classificação , Software/normas , Ucrânia
12.
Wiad Lek ; 69(6): 813-817, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28214821

RESUMO

INTRODUCTION: one of the areas of significant growth in medical devices has been the role of software - as an integral component of a medical device, as a standalone device and more recently as applications on mobile devices. The risk related to a malfunction of the standalone software used within healthcare is in itself not a criterion for its qualification or not as a medical device. It is therefore, necessary to clarify some criteria for the qualification of stand-alone software as medical devices Materials and methods: Ukrainian, European Union, United States of America legislation, Guidelines developed by European Commission and Food and Drug Administration's, recommendations represented by international voluntary group and scientific works. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. CONCLUSION: the legal regulation of software which is used for medical purpose in Ukraine limited to one definition. In European Union and United States of America were developed and applying special guidelines that help developers, manufactures and end users to difference software on types standing on medical purpose criteria. Software becomes more and more incorporated into medical devices. Developers and manufacturers may not have initially appreciated potential risks to patients and users such situation could have dangerous results for patients or users. It is necessary to develop and adopt the legislation that will intend to define the criteria for the qualification of medical device software and the application of the classification criteria to such software, provide some illustrative examples and step by step recommendations to qualify software as medical device.


Assuntos
Equipamentos e Provisões , Guias como Assunto , Software/legislação & jurisprudência , Terminologia como Assunto , União Europeia , Software/normas , Ucrânia , Reino Unido , Estados Unidos , United States Food and Drug Administration
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