[Current challenges of external quality assurance in the German healthcare system]. / Aktuelle Herausforderungen der externen Qualitätssicherung im deutschen Gesundheitswesen.

External quality assurance has three main aims: to make service provision in medicine and nursing comparable, to systematically identify deficits in service quality and to support the introduction of measures for quality improvement. This article reflects on three major developments in mandatory external quality assurance in the German healthcare system that took place during the last five years. These developments include the implementation of cross-sectoral quality assurance, the utilisation of new data sources and a new focus on quality deficits and practicability. The article highlights the challenges that come along with these developments.

Clínicas del dolor y cuidados paliativos en México: manejo del estreñimiento inducido por opiáceos. Conclusiones de un grupo de expertos / Pain clinics and palliative care in Mexico: management of opioid-induced constipation. Conclusions of an expert group

A finales de septiembre de 2008, 15 líderes de opinión en el tratamiento del dolor y los cuidados paliativos de México se reunieron en la ciudad de México con el objetivo de elaborar una guía clínica acerca del uso de opiáceos y sus efectos secundarios, con especial acento en el estreñimiento, y se propuso un nuevo esquema de tratamiento. Los participantes trabajan actualmente en unidades de dolor o de paliativos por todo México y algunos son participante activos en la elaboración de medidas reguladoras sobre el uso de opiáceos. Durante la elaboración de esta guía, se ha publicado la Ley de Reforma del Tratamiento Paliativo de México, que ha entrado en vigor el 6 de enero de 2009 (AU)

At the end of September 2008, 15 leading figures in pain treatment and palliative care in Mexico met in Mexico City to design a clinical guideline on the use of opioids and the secondary effects of these drugs, with special emphasis on constipation. A new treatment scheme was proposed. The participants currently work in pain or palliative care units throughout Mexico and some are active participants in the design of regulatory measures on opioid use. During the drafting of this guideline, the law reforming palliative treatment in Mexico was passed and came into effect on 6th January, 2009 (AU)

Ultimate doctor liability: a myth of ignorance or myth of control?

Ultimate medical doctor responsibility for the care delivered to patients by all professionals is a myth. Legally Lord Denning dismissed the myth in the mid-20th century in England. The assumption that a medical doctor is responsible for the care delivered by nurses has not existed in English and Australian law since that time, and it has been actively refuted. Yet it is a myth that continues to circulate influencing health service, state and federal health policy. For some it is a myth of ignorance and for others it is a means of control. This paper outlines the relevant case law to debunk the myth of ultimate medical doctor control.