Interdyscyplinary medical law and basic elements of the bioethics 1600-SZD-IPMzEB

Course objectives: to familiarise doctoral students at a basic level with (1.) the philosophical foundations of medical law (traditional professional ethics and bioethics); (2.) ‘material’ medical law, primarily in the scope of the Act on the Rights of Patients and the Patient Ombudsman, as well as the Act on the Professions of Physician and Dentist, and, in part, pharmaceutical law, transplant law and the Act on Medical Activity; (3.) the terminology necessary for (1.) and (2.).

Issues to be discussed:

* Professional ethics in the medical professions (with an emphasis on medical ethics), its historical evolution, the ‘four principles’ of ethics according to Beauchamp and Childress: beneficence and non-maleficence (and the relationship between them), respect for autonomy (including an explanation of the idea of patient autonomy), and justice.
* The concept of entitlement and obligation in the broad sense. Are there any enabling norms? Entitlement, obligation, incomplete obligation, complete obligation, self-executing and on-demand entitlements, dispositive and non-transferable entitlements. Advantages and disadvantages of the ‘language of rights’ in legislation. General comments on the 2008 Patient Rights Act. Proper patient rights and accessory rights, technical competences, competences not related to medical practice, exclusions from patient rights that ‘pretend’ to be rights, apparent rights. Distinction between patient rights and insured person's rights.
* The concept of a patient in the ordinary sense and according to the statutory definition. A person practising a medical profession. ‘Medical activity’ and ‘health service’ in the terminology of Polish medical law. Typology of health services. The category of medical activity; the criterion of therapeutic purpose. ‘Incidental’ health services. Non-therapeutic health services. Medical experiments on humans (‘therapeutic’ and ‘research’) according to Chapter 4 of the Act on Medical Activities. Scientific research on material obtained from humans and its unclear status. ‘Medical experiment’ according to the Act on Medical Activities and ‘clinical trial’ according to the Act on Medical Devices and the Act on Medical Devices and Medical Devices. Collection of cells, tissues or organs from a living donor according to the Act on Transplantation. Blood collection according to the Act on Blood. Termination of pregnancy. Medical activities with an unregulated legal status, not constituting health services, such as cosmetic procedures. Other possible examples of such activities (lawful and unlawful)
* The patient's right to receive health care. Related obligations of medical professionals and health care providers. The right to health care of appropriate quality (‘state of the art’, ‘due diligence’). Possible interpretations of due diligence. Sources of rules of diligent conduct. Determining and proving the content of these rules. Apparent right to request a second opinion or a consultation. Right to pain treatment. ‘Right to queue’ and conflict of duties in medicine.
* The principle of respect for autonomy – details. ‘Hard’ paternalism, ‘moderate’ paternalism and anti-paternalism. Non-paternalistic interference in another person's decisions in their own affairs (due to the goods, rights or interests of third parties). Apparent paternalism. Justification of the right to information. Models of information relations between doctor and patient (doctor-oriented model, patient-oriented model, subjectivist model). The right to information in the Patient Rights Act. General right to information about one's own health. Right to standard and individualised information. The situation of minors under the age of 16. The right to information and the so-called therapeutic privilege. Declaration of non-exercise of the right to information. The right to ‘express one's opinion’. The right to information about the intention to discontinue treatment. The right to information about patient rights. The right to information about the type and scope of services provided.
* Concepts: informed consent, blanket consent, implied consent, presumed consent. Evolution of the legal status until 1991. Original solutions of the Act on Health Care and Medical Aid. Consent in the Act of 2008. Categorisation of patients and their decision-making powers. Treatment in the absence of a known decision. Compulsory treatment. Rights relating to medical records.
* Rights relating to privacy. ‘Right to confidentiality of information’. Right to respect for privacy and dignity. Right to die in peace and dignity. Rights in relation to contact with other persons.
* Other patient rights (including those of an apparent nature). Right to use a deposit. ‘Right’ to report adverse reactions to medicinal products. Right to object to a medical opinion or decision.
* Special circumstances of the patient in specific situations – non-curative health services.
* Special circumstances of the patient in special situations – the Mental Health Act. Compulsory psychiatric examination, compulsory hospitalisation, compulsory placement in a social welfare home, compulsory psychiatric treatment, grounds for the use of direct coercion, so-called psychiatric confidentiality.
* Relations between medical law and civil, criminal and disciplinary (‘professional’) liability.