Shari`ah, Brain Death, and Organ Transplantation

2005 ◽  
Vol 22 (4) ◽  
pp. 1-25 ◽  
Author(s):  
Johannes Grundmann
Keyword(s):  
Brain Death ◽  
Organ Transplantation ◽  
Brain Function ◽  
Public Health System ◽  
Artificial Respiration ◽  
Complete Loss ◽  
Sudden Expansion ◽  
Organ Rejection ◽  
The Public

Introduction In the early 1980s, comprehensive developments in the public health system as well as markedly improved possibilities for organ transplantation due to the introduction of immune suppressants,2 namely, the artificial prevention of organ rejection, led to a sudden expansion of transplantation medicine in the Near and Middle East. Long-term artificial respiration, along with improved and expanded intensive care units, enabled respiration and circulation to be maintained despite the partial or complete loss of brain function. This, in turn, secured the necessary blood supply to the organs until they could be removed. Against this backdrop, a comprehensive process of discussion on the factual connections between postmortem organ transplantation and the criterion for determining brain death developed.

Shari`ah, Brain Death, and Organ Transplantation

2005 ◽  
Vol 22 (4) ◽  
pp. 1-25
Author(s):  
Johannes Grundmann
Keyword(s):  
Brain Death ◽  
Organ Transplantation ◽  
Brain Function ◽  
Public Health System ◽  
Artificial Respiration ◽  
Complete Loss ◽  
Sudden Expansion ◽  
Organ Rejection ◽  
The Public

Introduction In the early 1980s, comprehensive developments in the public health system as well as markedly improved possibilities for organ transplantation due to the introduction of immune suppressants,2 namely, the artificial prevention of organ rejection, led to a sudden expansion of transplantation medicine in the Near and Middle East. Long-term artificial respiration, along with improved and expanded intensive care units, enabled respiration and circulation to be maintained despite the partial or complete loss of brain function. This, in turn, secured the necessary blood supply to the organs until they could be removed. Against this backdrop, a comprehensive process of discussion on the factual connections between postmortem organ transplantation and the criterion for determining brain death developed.

How Dead Can You Be?

1975 ◽  
Vol 15 (2) ◽  
pp. 133-146 ◽  
Author(s):  
Adrienne Van Till-D'Aulnis de Bourouill
Keyword(s):  
Brain Function ◽  
Blood Circulation ◽  
Artificial Respiration ◽  
The Body ◽  
Life And Death ◽  
The Public ◽  
Current Usage ◽  
Anglo American ◽  
Legal Security ◽  
Carotid And Vertebral Arteries

Life and death are defined in terms of function. Four groups of abnormal cases of death are specified and differentiated from normal cases. Murder, active euthanasia and cessation of artificial respiration are differentiated on the basis of the interested party, the cause of death and the purpose of the act. Juridical acceptance of this differentiation and terminology makes cessation of artificial respiration lawful, provided the patient had validly refused this treatment or is irreversibly comatose and also respirator-dependent. This would make it unnecessary to redefine death in terms of coma in order to solve legal and practical problems. Such a redefinition is against current usage (coma presumes life) and is the first step on an extremely slippery road; it is only admissible if done by the legislator after extensive public discussion. Disagreement among doctors about the definition and diagnosis of death causes distrust among the public, aggravates the shortage of donor organs and makes legal security an illusion. Three diagnostic ‘schools’ are compared: the Anglo-American (using Harvard's criteria), the French (using Mollaret's coma dépassé) and the Austro-German (using absence of intracranial blood circulation). On grounds of logic only the Austro-German diagnosis is reliable; it is not based on a statistically irreversible absence of outwardly perceptible manifestations of brain function, but proves and documents with certainty the total and irreversible impossibility of brain function. At present this has to be done by bilateral angiography of both carotid and vertebral arteries; if negative concerning the intracranial part, this proves death. In normal cases the traditional criteria may be used; in abnormal cases where no infringement of the body is foreseeable death need not be a certainty in order to stop therapy, provided the patient is irreversibly comatose and also respirator-dependent; in abnormal cases where an infringement is foreseeable death should be proved and documented to make the infringement lawful, apart from other conditions such as consent. Proof can be obtained by the Austro-German method or by discontinuing resuscitation during at least 15 consecutive minutes where this is legally permissible. Most German and Dutch lawyers concerned share this view.

scholarly journals Long-Term Impact of Disasters on the Public Health System: A Multi-Case Analysis

2020 ◽  
Vol 17 (17) ◽  
pp. 6251
Author(s):  
Nina Lorenzoni ◽  
Verena Stühlinger ◽  
Harald Stummer ◽  
Margit Raich
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Psychosocial Support ◽  
Holistic Approach ◽  
The Public ◽  
Preparedness Planning ◽  
Tunnel Fire ◽  
Long Term Impact

As past events have shown, disasters can have a tremendous impact on the affected population’s health. However, research regarding the long-term impact on a systems level perspective is still scarce. In this multi-case study, we analyzed and compared the long-term impacts on the public health system of five disasters which took place in Europe: avalanche (Austria), terror attack (Spain), airplane crash (Luxembourg), cable-car tunnel fire (Austria), and a flood in Central Europe. We used a mixed-methods approach consisting of a document analysis and interviews with key stakeholders, to examine the various long-term impacts each of the disasters had on health-system performance, as well as on security and health protection. The results show manifold changes undertaken in the fields of psychosocial support, infrastructure, and contingency and preparedness planning. The holistic approach of this study shows the importance of analyzing long-term impacts from the perspective of the type (e.g., disasters associated with natural hazards) and characteristic (e.g., duration and extent) of a disaster, as well as the regional context where a disaster took place. However, the identified recurring themes demonstrate the opportunity of learning from case studies in order to customize the lessons and apply them to the own-disaster-management setting.

scholarly journals Hypertension in Guatemala’s Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meredith P. Fort ◽  
William Mundo ◽  
Alejandra Paniagua-Avila ◽  
Sayra Cardona ◽  
Juan Carlos Figueroa ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Needs Assessment ◽  
Public Health System ◽  
Building Blocks ◽  
Hypertension Control ◽  
The Public ◽  
Multi Level ◽  
Health System Building Blocks

Abstract Background Uncontrolled hypertension represents a substantial and growing burden in Guatemala and other low and middle-income countries. As a part of the formative phase of an implementation research study, we conducted a needs assessment to define short- and long-term needs and opportunities for hypertension services within the public health system. Methods We conducted a multi-method, multi-level assessment of needs related to hypertension within Guatemala’s public system using the World Health Organization’s health system building blocks framework. We conducted semi-structured interviews with stakeholders at national (n = 17), departmental (n = 7), district (n = 25), and community (n = 30) levels and focus groups with patients (3) and frontline auxiliary nurses (3). We visited and captured data about infrastructure, accessibility, human resources, reporting, medications and supplies at 124 health posts and 53 health centers in five departments of Guatemala. We conducted a thematic analysis of transcribed interviews and focus group discussions supported by matrix analysis. We summarized quantitative data observed during visits to health posts and centers. Results Major challenges for hypertension service delivery included: gaps in infrastructure, insufficient staffing and high turnover, limited training, inconsistent supply of medications, lack of reporting, low prioritization of hypertension, and a low level of funding in the public health system overall. Key opportunities included: prior experience caring for patients with chronic conditions, eagerness from providers to learn, and interest from patients to be involved in managing their health. The 5 departments differ in population served per health facility, accessibility, and staffing. All but 7 health posts had basic infrastructure in place. Enalapril was available in 74% of health posts whereas hydrochlorothiazide was available in only 1 of the 124 health posts. With the exception of one department, over 90% of health posts had a blood pressure monitor. Conclusions This multi-level multi-method needs assessment using the building blocks framework highlights contextual factors in Guatemala’s public health system that have been important in informing the implementation of a hypertension control trial. Long-term needs that are not addressed within the scope of this study will be important to address to enable sustained implementation and scale-up of the hypertension control approach.

Long-term impact of the Galtuer avalanche on the public health system

2021 ◽  
Vol 19 (2) ◽  
pp. 197-208
Author(s):  
Nina Lorenzoni, MA ◽  
Margit Raich, PhD
Keyword(s):  
Public Health ◽  
Health System ◽  
Disaster Management ◽  
Public Health System ◽  
The Public ◽  
Disaster Situation ◽  
Long Term Impact ◽  
The Village

On February 23, 1999, an avalanche buried large parts of the village of Galtuer Austria, killing 31 people. The purpose of this paper is to examine the longer-term impact of this avalanche on the public health system. For the case study, we used a mixed-method approach consisting of a document study and expert interviews with people who were involved in the disaster-management operations. Many long-term changes were undertaken in the context of infrastructural measures, disaster-management structures, and coordination and cooperation within the existing system to protect people and property as well as to provide important information for decision makers. The investigation reveals the importance of situational approaches to the post-disaster phase depending on the recovery needs of those affected. Moreover, the value of social capital in a disaster situation is emphasized. 

scholarly journals Financial Burden of Stroke Reflected in a Pilot Center for the Implementation of Thrombolysis

Medicina ◽  
2020 ◽  
Vol 56 (2) ◽  
pp. 54 ◽  
Author(s):  
Diana Uivarosan ◽  
Simona Bungau ◽  
Delia Mirela Tit ◽  
Corina Moisa ◽  
Ovidiu Fratila ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health System ◽  
Financial Burden ◽  
Point Of View ◽  
The Public ◽  
Hospitalization Period ◽  
New Procedures ◽  
Pilot Center ◽  
Total Average

Stroke represents a serious illness and is extremely relevant from the public health point of view, implying important social and economic burdens. Introducing new procedures or therapies that reduce the costs both in the acute phase of the disease and in the long term becomes a priority for health systems worldwide. The present study quantifies and compares the direct costs for ischemic stroke in patients with thrombolysis treatment versus conservative treatment over a 24-month period from the initial diagnosis, in one of the 7 national pilot centres for the implementation of thrombolytic treatment. The significant reduction (p < 0.001) of the hospitalization period, especially of the days in the intensive care unit (ICU) for stroke, resulted in a significant reduction (p < 0.001) of the total average costs in the patients with thrombolysis, both at the first hospitalization and for the subsequent hospitalizations, during the period followed in the study. It was also found that the percentage of patients who were re-hospitalized within the first 24-months after stroke was significantly lower (p < 0.001) among thrombolyzed patients. The present study demonstrates that the quick intervention in cases of stroke is an efficient policy regarding costs, of Romanian Public Health System, Romania being the country with the highest rates of new strokes and deaths due to stroke in Europe.

Brazil's local vaccine production aims for autonomy

2021 ◽  
Keyword(s):  
Public Health ◽  
Health Professionals ◽  
Public Health System ◽  
Risk Groups ◽  
The Elderly ◽  
Vaccine Production ◽  
Health Security ◽  
Content Type ◽  
The Public

Significance Priority groups -- including health professionals, indigenous people, the elderly and those with co-morbidities, teachers, security and prison staff, prisoners and the homeless -- represent 36% of the population and are only expected to be fully vaccinated by September. Impacts Studies reveal that vaccination is already contributing to reduced mortality, but many high-risk groups remain unvaccinated. Slow vaccine roll-outs will extend the severe strain on the public health system. Technological gains being made by Fiocruz and Butantan will contribute to Brazil’s health security in the long term.

Hospitals: N.Y. Appellate Court Denies Move to Privatize Public Hospital

1999 ◽  
Vol 27 (2) ◽  
pp. 202-203
Author(s):  
Robert Chatham
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Public Health System ◽  
Municipal Hospital ◽  
The Public ◽  
Public Benefit ◽  
For Profit ◽  
Benefit Corporation ◽  
The City

The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257 (N.Y. Mar. 30, 1999), that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act (HHCA), establishing the New York City Health and Hospitals Corporation (HHC) as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc. (PHS), a private, for-profit entity.

Sign in / Sign up

Export Citation Format

Share Document