OBTAINING INFORMED CONSENT TO MEDICAL PROCEDURES.

Informed patient consent to a medical procedure is a prerequisite for the treatment process to be legal. Actions taken for the good of a person are regulated by the Constitution of the Republic of Poland, international documents, and statutory law. The provisions of the Act on the Professions of Physician and Dentist or the Act on the Professions of Nurse and Midwife are significant here as well. Moreover, the issues of respect for the patient are tackled by the Act on the Patient's Rights and the Patient's Rights Ombudsman. As prescribed in the Medical Code of Ethics, the physician's mission is to protect human life and health, prevent diseases, treat the ill. It is a legal and deontological tool allowing selection of a medical procedure for the patient. Both law and medicine are predominated by the view that any action performed by the physician without the patient's consent is unlawful even if performed for a therapeutic purpose. The border of these two scientific fields is where a clash occurs between legally protected interests: life and health on the one hand, and the right to autonomy on the other. The provisions of Art. 192 of the Polish Penal Code protect the patient's right to self-determination in the scope of agreement to or rejection of therapeutic procedures, also in situations where their life or health are threatened. The paper aims to analyze possible issues related to consents to treatment of adults capable of expressing informed consents.

Changes in the Serum Concentration Levels of Serotonin, Tryptophan and Cortisol among Stress-Resilient and Stress-Susceptible Individuals after Experiencing Traumatic Stress.

BACKGROUND: Stress is a common response to many environmental adversities. However, once dysregulated, this reaction can lead to psychiatric illnesses, such as post-traumatic stress disorder (PTSD). Individuals can develop PTSD after exposure to traumatic events, severely affecting their quality of life. Nevertheless, not all individuals exposed to stress will develop psychiatric disorders, provided they show enhanced stress-resilience mechanisms that enable them to successfully adapt to stressful situations and thus avoid developing a persistent psychopathology. METHODS: The study involved 93 participants. Of them, 62 comprised a study group and 31 comprised a control group. The aim of the study was to assess serotonin, cortisol and tryptophan concentration levels in subjects with PTSD (stress-susceptible; PTSD-SS) and in healthy individuals (stress-resilient; PTSD-SR), who had experienced a traumatic event but fully recovered after the trauma. The subjects were between 18 and 50 years of age (mean 35.56 ± 8.26 years). The serum concentration levels of serotonin, cortisol and tryptophan were measured with an ELISA kit. RESULTS: It was found that the serotonin, tryptophan and cortisol concentration levels were consistent with the features of both PTSD-SR and PTSD-SS patients. It was reported that the mean cortisol concentration levels increased more significantly in the PTSD-SS group than in the PTSD-SR group, versus those in the control group. Similarly, the PTSD-SS group was found to show a larger decrease in the mean serotonin concentration levels than the PTSD-SR group, versus those in the control group. No significant changes were found in the tryptophan concentration levels between the study groups, versus those in the control group. CONCLUSIONS: These findings can be useful when attempting to improve resilience in individuals using neuropharmacological methods. However, it is necessary to conduct more cross-sectional studies that would address different types of negative stress to find out whether they share common pathways.