The paper looks at how to regulate access to genetic testing,other than through a medical practitioner as part of health services provision.It examines the steps by which genetic testing services may be obtained from ...The paper looks at how to regulate access to genetic testing,other than through a medical practitioner as part of health services provision.It examines the steps by which genetic testing services may be obtained from laboratories and the implications of these processes for individual access to testing services.It also discusses the quality assurance and accreditation standards which regulate genetic testing laboratories.Further,this paper looks into issues concerning the availability of home use testing or over-the-counter.Furthermore,we consider whether there should be additional legal protection against the taking and testing of genetic samples without the knowledge and consent of the individual concerned through the use of criminal sanctions.展开更多
The traditional healers play a significant role for people that follow cultural beliefs.There are many traditional healers in PNG and spreading throughout the country.In Papua New Guinea(PNG)urban areas,towns,and citi...The traditional healers play a significant role for people that follow cultural beliefs.There are many traditional healers in PNG and spreading throughout the country.In Papua New Guinea(PNG)urban areas,towns,and cities,traditional healers have been operating in homes and areas not free from the public and government interference.There is no government structure such as an organization where the traditional healers could operate under but there are many of them and no records of their identities.There are reports that the practice of traditional healers and their activities are not allowed in PNG under any law.This paper suggests that to move forward is to recognize the traditional health practice in the country.展开更多
Information about whether genetic information requires special treatment in law varies around the world and many aspects are not clear.In this study,we draw upon knowledge gained from various disciplines,such as genet...Information about whether genetic information requires special treatment in law varies around the world and many aspects are not clear.In this study,we draw upon knowledge gained from various disciplines,such as genetics,medicine,law,philosophy,psychology,sociology,anthropology,insurance,and economics,which have all contributed to the study of genetic information,and discrimination based on genetic traits.With this in mind,we are able to set this research study into perspective.We make no claim on behalf of any field of study.Nevertheless,we say the development in the field of genetics is in its infancy and that knowledge of an individual genome would be essential not only for counseling but could also be used for stigmatization and discrimination.The purpose of the study is to help provide useful links concerning legal and ethical issues in human genetics and particularly where it deals with the laws,regulations,and policies concerning genetic information.We deal with the legal and ethical aspects in human genetics that influence genetic information.We examine government policies and the existing legislation in Papua New Guinea(PNG)that deal with genetic information and analyze discrimination cases due to genetic traits and describe its magnitude in PNG.This study places importance on the examination of qualitative data collected by a questionnaire survey from individual subjects representing various organizations in PNG including Department of Health,Insurance companies,General Federation of Employers’Associations,Trade Unions,and professional workers such as lawyers,District Court magistrates,medical doctors,healthcare workers,students,and private individuals.The study was conducted in towns in PNG although the majority of the participants live in the National Capital District.A sample of individuals(patients)were enrolled in a cross-sectional questionnaire survey.Individual information was obtained to describe the situation of the area.However,this study did not use administrative records based on health information from the Department of Health which describes the prevalence of genetically disordered individuals.All selected individuals or subjects were interviewed or completed a questionnaire.The data were assessed to characterize the study subsets.The findings of this study are made available to clinical practice in law,medical and public health,and private and public institutions including insurance companies,employers’federation,mining companies,and workers’unions in PNG,and academics and researchers.Educational programs on the basic principles of genetics,ethics,and law in relation to insurance will have to be developed to improve the knowledge of insurance,medical,and the cost of long-term care.展开更多
The work in this paper is based on primary research on how to obtain informed consent to medical treatment and or procedure among patients;this study was carried out in Papua New Guinea in both urban and rural health ...The work in this paper is based on primary research on how to obtain informed consent to medical treatment and or procedure among patients;this study was carried out in Papua New Guinea in both urban and rural health settings across customs,cultures,and languages in two provinces,on the basis of qualitative interviews with healthcare professionals including doctors,nurses,other healthcare workers,patients,and traditional healers.We emphasize the views of consent with participants of customs,cultural,and languages regarding informed consent.There are factors between peoples of differing circumstances which can greatly alter how they view consent.Some groups would involve people in the decision-making process that may not traditionally be involved in the decision making of a medical decision.Other groups may dislike certain medical procedures as in Papua New Guinea(PNG).And certain people have different views on what should be disclosed of the patient’s condition.Customs,cultures,and languages are common phenomena which continue to affect the daily lives of many thousands of people.It is unclear in PNG about the characteristics of customs,culture,and language on health care because there is no published information on informed consent and issues that affect the making of informed consent.展开更多
This paper examines informed consent in medical practice.We have explored the notion of consent and determined its underlying theory and important attributes.We argue that consent is a permissive state of mind that wa...This paper examines informed consent in medical practice.We have explored the notion of consent and determined its underlying theory and important attributes.We argue that consent is a permissive state of mind that waives the right to bodily integrity.Once communicated to the actor the permission takes effect by justifying the intervention and legitimizing the virtuous exercise of the doctor’s power.The process is usually formally documented by the reading and signing of a“consent form”by both the patient and the doctor who is proposing the treatment that takes place within a clinical setting.Many people grow up in the traditional communities where the idea of informed consent is undeveloped and tend to be passive in their roles in the informed consent process.We have gathered from this study that people tend to stick to their traditional customs and custom has become a source of their rules,brings people together,shares food,and uses for resolving issues in family,land,water rights,and compensation following disputes.In other words,peoples’ways of life revolve around their traditional customs.Family wellbeing decisions and especially health care are usually a family matter but not an individual.Going to receive health care services at the hospital or modern health care center for medical treatment is enough to make a patient say they do not want to follow through the clinical procedure including the process of informed consent.A medical consent form is a common form used in health care facilities to obtain medical consent for a certain treatment or medical procedure or dental.We found in the interview questionnaires that many patients do not understand the use of consent forms.We examined informed consent in the context of the people’s culture and how the healthcare professionals handle the situation with patients that have widespread customs,beliefs and opinions which they strictly adhere to and practice.展开更多
This study explores how doctors and patients in Papua New Guinea(PNG)perceive informed consent in medical settings.Doctors and patients from National Capital District and Central Province who responded to the survey w...This study explores how doctors and patients in Papua New Guinea(PNG)perceive informed consent in medical settings.Doctors and patients from National Capital District and Central Province who responded to the survey were the participants of the study.Researchers asked the participants to fill out questionnaires regarding their knowledge about informed consent for each group,namely,the doctors and participants.From those who responded,six randomly selected participants were chosen to join the focus group discussion which aimed to get experiences from the doctors and patients regarding medical procedures.Results show that both doctors and patients lack knowledge of the legalities of informed consent.Based on the experiences of doctors,they do not use consent forms when seeking permission from patients.Patients,on the other hand,do not see consent forms as important and only served as a formality.Customs,culture surrounding PNG were found to have an impact on how patients perceived informed consent.展开更多
This work is based on an on-going research on medical informed consent in Papua New Guinea(PNG)with 19 doctors from hospitals,health care centers and private medical establishments in the National Capital District and...This work is based on an on-going research on medical informed consent in Papua New Guinea(PNG)with 19 doctors from hospitals,health care centers and private medical establishments in the National Capital District and Central Province who voluntarily participated in the study.The authors conducted an examination of doctors’understanding of informed consent for medical procedures through a qualitative interview study and we describe our findings.We saw a need to involved patients in decision-making about their care,ethical imperative and concerns about litigation and their complaints highlighted the issue of informed consent.In order for the patients to make an informed decision about medical procedure,the doctors involved in the proposed treatment should conduct the informed consent discussion.The discussion should include the treatment,the risks and benefits of treatment,and alternative therapies with associated risks and benefits.We studied doctors’perspectives of gaining informed consent for routine medical procedures.We used qualitative study methods using structured interviews selected by purposive sampling.The data collected were entered into a data base and were analyzed thematically.The discussion is based on review of legal decisions,commentaries and our personal experience in studying medical malpractice cases.We have utilized case reports and several informative writings that have appeared in the world literature,as well as selections from vast amounts of material available in USA,UK,Australia,India and PNG.The current informed consent processes do not appear to be ideal for many doctors in PNG.In particular,there are inhibiting factors that affect patients from making medical informed decisions,doctors find time not enough to run discussions on informed consent,Department of Health does not have a standard informed consent form,patients complain about no consent form,and they have not signed consent forms.These are but some issues that affect patients when trying to make informed decisions.We say that informed consent process flows from the relationship between doctor and patient,however when this does not occur,serious legal and ethical consequences may result.This report is not intended to be specific advice on any private legal matter.展开更多
In this review article we examine the laws and rulings regarding informed consent.It is well known that the patient must give valid consent to medical treatment;and it is his or her prerogative to refuse treatment eve...In this review article we examine the laws and rulings regarding informed consent.It is well known that the patient must give valid consent to medical treatment;and it is his or her prerogative to refuse treatment even if the said treatment will save his or her life.No doubt this raises many ethical debates and falls at the heart of medical law today.There is widespread refusal of or withdrawal from medical treatment by patients suffering from illnesses,including communicable and non-communicable diseases.In Papua New Guinea(PNG)while a patient has a right to refuse treatment,there is no legal right to demand treatment.The paper seeks to clarify the nature,extent and importance of a patient’s right to respect for autonomy from the practitioner.We will attempt to conceptualise the patient’s autonomy by exploring the legal framework of consent or more specifically informed consent.Where the law of PNG differs from the laws of other parts of the world we have focused on the laws of the former.The legal aspects and guidance by the regulatory authorities apply only to PNG.展开更多
The major challenges militating against the proper practice of informed consent identified in our desk top review are related to cultural issues of the people.Many patients continue to value strongly their kinship tie...The major challenges militating against the proper practice of informed consent identified in our desk top review are related to cultural issues of the people.Many patients continue to value strongly their kinship ties with the past and believe in the traditional methods of healing sickness.The patients must be given some information about what the doctor proposes to do.The underlying spirit of informed consent is new in PNG,and it strives against the traditional attitudes of doctors that they know it best for the patients and the strong culture in customs and patients’misconceptions that affect their perceptions in making important health care decisions.Majority of the patients have some notion of informed consent,however not many people understand what it is.They still hang onto their traditional customs,beliefs and opinions that affect their health care decisions;they often look to their village elders,family and parents for advice in times of sickness or death in the family but where the law implies consent it is not often obtained.Summarization of current laws,reports of legal cases,and personal experiences were examined.Special requirements must be prescribed when patients are subjected to medical treatment.Documentation of a well-defined process,not only on paper,may not only protect the medical doctor from exposure to liability but increases the patient’s autonomy in decisions concerning health and encourages compliance with treatment;and advances the interests of both patient and doctor.Lack of informed consent can reinforce a claim of medical malpractice,and could well undermine relevant health care policy to protect patient autonomy.展开更多
Modern human rights,as they have developed since World War II,have several characteristics that are imperative to how they are viewed.They are universal,indivisible,interdependent and interrelated.That is,they are hel...Modern human rights,as they have developed since World War II,have several characteristics that are imperative to how they are viewed.They are universal,indivisible,interdependent and interrelated.That is,they are held by all people by virtue of the fact that they are human,and apply to all people everywhere.Not all human rights are absolute.That is,some are considered“qualified rights”which may be subject to lawful interference.In the Papua New Guinea(PNG)context,interference will be lawful if it is prescribed by law consistent with the national Constitution and necessary to protect either the rights of others or for other considerations,such as national security,public order or public health.In the ending of life context,the weight that should be given to the consent to,and refusal of,treatment in circumstances where the decision will lead to the death of a patient is debated.This leads to another concern which is the way in which the prerequisites for a refusal of treatment(or valid consent)have been construed.The requirements of competence,voluntariness and information-giving arguably come under more intense scrutiny where the ramifications of the decision have such grave consequences.This paper considers consent as a reflection of the ethical principle of respect for personal autonomy that is often expressed in the law as the principle of self-determination.It also reviews the experiences of healthcare professionals who guide an informed consent process made by individuals,spouses,family members and advisors for the loved ones whose sickness,injury or geriatric age prevent them from having decision-making capacity.The last part summarizes the understanding of the nature of the procedure,benefits and risks which are important to informed consent and offers suggestions as to how the situation can be remedied.展开更多
A number of the constitutions limit recognition of customary law to those customs and/or usages,which have the“force of law”in their respective territories.The question as to whether a custom has the“force of law”...A number of the constitutions limit recognition of customary law to those customs and/or usages,which have the“force of law”in their respective territories.The question as to whether a custom has the“force of law”may be variously interpreted depending upon whether it is the community,the courts,or the legislature,which has the power to identify when a custom becomes law.Determining just when a custom acquires the“force of law”is of much importance for its wider recognition and application.This in turn is linked to the question of proof of customary law.A key aspect of Papua New Guinea(PNG)’s approach is that it brought the multiplicity of regimes of different cultures under a national framework and has given a place to customary law which is now constitutionally recognized as superior to the inherited common law.It places the local and traditional over the inherited and imported law,with the constitution placed over both.In this paper I examine customary law as in the context of the PNG Constitution.展开更多
文摘The paper looks at how to regulate access to genetic testing,other than through a medical practitioner as part of health services provision.It examines the steps by which genetic testing services may be obtained from laboratories and the implications of these processes for individual access to testing services.It also discusses the quality assurance and accreditation standards which regulate genetic testing laboratories.Further,this paper looks into issues concerning the availability of home use testing or over-the-counter.Furthermore,we consider whether there should be additional legal protection against the taking and testing of genetic samples without the knowledge and consent of the individual concerned through the use of criminal sanctions.
文摘The traditional healers play a significant role for people that follow cultural beliefs.There are many traditional healers in PNG and spreading throughout the country.In Papua New Guinea(PNG)urban areas,towns,and cities,traditional healers have been operating in homes and areas not free from the public and government interference.There is no government structure such as an organization where the traditional healers could operate under but there are many of them and no records of their identities.There are reports that the practice of traditional healers and their activities are not allowed in PNG under any law.This paper suggests that to move forward is to recognize the traditional health practice in the country.
文摘Information about whether genetic information requires special treatment in law varies around the world and many aspects are not clear.In this study,we draw upon knowledge gained from various disciplines,such as genetics,medicine,law,philosophy,psychology,sociology,anthropology,insurance,and economics,which have all contributed to the study of genetic information,and discrimination based on genetic traits.With this in mind,we are able to set this research study into perspective.We make no claim on behalf of any field of study.Nevertheless,we say the development in the field of genetics is in its infancy and that knowledge of an individual genome would be essential not only for counseling but could also be used for stigmatization and discrimination.The purpose of the study is to help provide useful links concerning legal and ethical issues in human genetics and particularly where it deals with the laws,regulations,and policies concerning genetic information.We deal with the legal and ethical aspects in human genetics that influence genetic information.We examine government policies and the existing legislation in Papua New Guinea(PNG)that deal with genetic information and analyze discrimination cases due to genetic traits and describe its magnitude in PNG.This study places importance on the examination of qualitative data collected by a questionnaire survey from individual subjects representing various organizations in PNG including Department of Health,Insurance companies,General Federation of Employers’Associations,Trade Unions,and professional workers such as lawyers,District Court magistrates,medical doctors,healthcare workers,students,and private individuals.The study was conducted in towns in PNG although the majority of the participants live in the National Capital District.A sample of individuals(patients)were enrolled in a cross-sectional questionnaire survey.Individual information was obtained to describe the situation of the area.However,this study did not use administrative records based on health information from the Department of Health which describes the prevalence of genetically disordered individuals.All selected individuals or subjects were interviewed or completed a questionnaire.The data were assessed to characterize the study subsets.The findings of this study are made available to clinical practice in law,medical and public health,and private and public institutions including insurance companies,employers’federation,mining companies,and workers’unions in PNG,and academics and researchers.Educational programs on the basic principles of genetics,ethics,and law in relation to insurance will have to be developed to improve the knowledge of insurance,medical,and the cost of long-term care.
文摘The work in this paper is based on primary research on how to obtain informed consent to medical treatment and or procedure among patients;this study was carried out in Papua New Guinea in both urban and rural health settings across customs,cultures,and languages in two provinces,on the basis of qualitative interviews with healthcare professionals including doctors,nurses,other healthcare workers,patients,and traditional healers.We emphasize the views of consent with participants of customs,cultural,and languages regarding informed consent.There are factors between peoples of differing circumstances which can greatly alter how they view consent.Some groups would involve people in the decision-making process that may not traditionally be involved in the decision making of a medical decision.Other groups may dislike certain medical procedures as in Papua New Guinea(PNG).And certain people have different views on what should be disclosed of the patient’s condition.Customs,cultures,and languages are common phenomena which continue to affect the daily lives of many thousands of people.It is unclear in PNG about the characteristics of customs,culture,and language on health care because there is no published information on informed consent and issues that affect the making of informed consent.
基金We would like to thank all the doctors who kindly gave their time to be interviewed for this study.We also thank the nurses and other healthcare workers in the National Capital District and Kwikila District in hospitals,healthcare centers and private medical centers who participated in the research.We also extend our sincere thanks to the traditional healers.Finally we thank the patients who attended the interviews,gave all their valuable times,and assisted the research team throughout the field work.We appreciate and value everyone that gave their support to this research.Authors would like to thank Tharapiyap Holdings(Ltd)(PNG)for providing financial assistance to conduct the research and financial assistance to support the administration expenses.
文摘This paper examines informed consent in medical practice.We have explored the notion of consent and determined its underlying theory and important attributes.We argue that consent is a permissive state of mind that waives the right to bodily integrity.Once communicated to the actor the permission takes effect by justifying the intervention and legitimizing the virtuous exercise of the doctor’s power.The process is usually formally documented by the reading and signing of a“consent form”by both the patient and the doctor who is proposing the treatment that takes place within a clinical setting.Many people grow up in the traditional communities where the idea of informed consent is undeveloped and tend to be passive in their roles in the informed consent process.We have gathered from this study that people tend to stick to their traditional customs and custom has become a source of their rules,brings people together,shares food,and uses for resolving issues in family,land,water rights,and compensation following disputes.In other words,peoples’ways of life revolve around their traditional customs.Family wellbeing decisions and especially health care are usually a family matter but not an individual.Going to receive health care services at the hospital or modern health care center for medical treatment is enough to make a patient say they do not want to follow through the clinical procedure including the process of informed consent.A medical consent form is a common form used in health care facilities to obtain medical consent for a certain treatment or medical procedure or dental.We found in the interview questionnaires that many patients do not understand the use of consent forms.We examined informed consent in the context of the people’s culture and how the healthcare professionals handle the situation with patients that have widespread customs,beliefs and opinions which they strictly adhere to and practice.
文摘This study explores how doctors and patients in Papua New Guinea(PNG)perceive informed consent in medical settings.Doctors and patients from National Capital District and Central Province who responded to the survey were the participants of the study.Researchers asked the participants to fill out questionnaires regarding their knowledge about informed consent for each group,namely,the doctors and participants.From those who responded,six randomly selected participants were chosen to join the focus group discussion which aimed to get experiences from the doctors and patients regarding medical procedures.Results show that both doctors and patients lack knowledge of the legalities of informed consent.Based on the experiences of doctors,they do not use consent forms when seeking permission from patients.Patients,on the other hand,do not see consent forms as important and only served as a formality.Customs,culture surrounding PNG were found to have an impact on how patients perceived informed consent.
文摘This work is based on an on-going research on medical informed consent in Papua New Guinea(PNG)with 19 doctors from hospitals,health care centers and private medical establishments in the National Capital District and Central Province who voluntarily participated in the study.The authors conducted an examination of doctors’understanding of informed consent for medical procedures through a qualitative interview study and we describe our findings.We saw a need to involved patients in decision-making about their care,ethical imperative and concerns about litigation and their complaints highlighted the issue of informed consent.In order for the patients to make an informed decision about medical procedure,the doctors involved in the proposed treatment should conduct the informed consent discussion.The discussion should include the treatment,the risks and benefits of treatment,and alternative therapies with associated risks and benefits.We studied doctors’perspectives of gaining informed consent for routine medical procedures.We used qualitative study methods using structured interviews selected by purposive sampling.The data collected were entered into a data base and were analyzed thematically.The discussion is based on review of legal decisions,commentaries and our personal experience in studying medical malpractice cases.We have utilized case reports and several informative writings that have appeared in the world literature,as well as selections from vast amounts of material available in USA,UK,Australia,India and PNG.The current informed consent processes do not appear to be ideal for many doctors in PNG.In particular,there are inhibiting factors that affect patients from making medical informed decisions,doctors find time not enough to run discussions on informed consent,Department of Health does not have a standard informed consent form,patients complain about no consent form,and they have not signed consent forms.These are but some issues that affect patients when trying to make informed decisions.We say that informed consent process flows from the relationship between doctor and patient,however when this does not occur,serious legal and ethical consequences may result.This report is not intended to be specific advice on any private legal matter.
文摘In this review article we examine the laws and rulings regarding informed consent.It is well known that the patient must give valid consent to medical treatment;and it is his or her prerogative to refuse treatment even if the said treatment will save his or her life.No doubt this raises many ethical debates and falls at the heart of medical law today.There is widespread refusal of or withdrawal from medical treatment by patients suffering from illnesses,including communicable and non-communicable diseases.In Papua New Guinea(PNG)while a patient has a right to refuse treatment,there is no legal right to demand treatment.The paper seeks to clarify the nature,extent and importance of a patient’s right to respect for autonomy from the practitioner.We will attempt to conceptualise the patient’s autonomy by exploring the legal framework of consent or more specifically informed consent.Where the law of PNG differs from the laws of other parts of the world we have focused on the laws of the former.The legal aspects and guidance by the regulatory authorities apply only to PNG.
文摘The major challenges militating against the proper practice of informed consent identified in our desk top review are related to cultural issues of the people.Many patients continue to value strongly their kinship ties with the past and believe in the traditional methods of healing sickness.The patients must be given some information about what the doctor proposes to do.The underlying spirit of informed consent is new in PNG,and it strives against the traditional attitudes of doctors that they know it best for the patients and the strong culture in customs and patients’misconceptions that affect their perceptions in making important health care decisions.Majority of the patients have some notion of informed consent,however not many people understand what it is.They still hang onto their traditional customs,beliefs and opinions that affect their health care decisions;they often look to their village elders,family and parents for advice in times of sickness or death in the family but where the law implies consent it is not often obtained.Summarization of current laws,reports of legal cases,and personal experiences were examined.Special requirements must be prescribed when patients are subjected to medical treatment.Documentation of a well-defined process,not only on paper,may not only protect the medical doctor from exposure to liability but increases the patient’s autonomy in decisions concerning health and encourages compliance with treatment;and advances the interests of both patient and doctor.Lack of informed consent can reinforce a claim of medical malpractice,and could well undermine relevant health care policy to protect patient autonomy.
文摘Modern human rights,as they have developed since World War II,have several characteristics that are imperative to how they are viewed.They are universal,indivisible,interdependent and interrelated.That is,they are held by all people by virtue of the fact that they are human,and apply to all people everywhere.Not all human rights are absolute.That is,some are considered“qualified rights”which may be subject to lawful interference.In the Papua New Guinea(PNG)context,interference will be lawful if it is prescribed by law consistent with the national Constitution and necessary to protect either the rights of others or for other considerations,such as national security,public order or public health.In the ending of life context,the weight that should be given to the consent to,and refusal of,treatment in circumstances where the decision will lead to the death of a patient is debated.This leads to another concern which is the way in which the prerequisites for a refusal of treatment(or valid consent)have been construed.The requirements of competence,voluntariness and information-giving arguably come under more intense scrutiny where the ramifications of the decision have such grave consequences.This paper considers consent as a reflection of the ethical principle of respect for personal autonomy that is often expressed in the law as the principle of self-determination.It also reviews the experiences of healthcare professionals who guide an informed consent process made by individuals,spouses,family members and advisors for the loved ones whose sickness,injury or geriatric age prevent them from having decision-making capacity.The last part summarizes the understanding of the nature of the procedure,benefits and risks which are important to informed consent and offers suggestions as to how the situation can be remedied.
文摘A number of the constitutions limit recognition of customary law to those customs and/or usages,which have the“force of law”in their respective territories.The question as to whether a custom has the“force of law”may be variously interpreted depending upon whether it is the community,the courts,or the legislature,which has the power to identify when a custom becomes law.Determining just when a custom acquires the“force of law”is of much importance for its wider recognition and application.This in turn is linked to the question of proof of customary law.A key aspect of Papua New Guinea(PNG)’s approach is that it brought the multiplicity of regimes of different cultures under a national framework and has given a place to customary law which is now constitutionally recognized as superior to the inherited common law.It places the local and traditional over the inherited and imported law,with the constitution placed over both.In this paper I examine customary law as in the context of the PNG Constitution.
