Medical Law Research Articles

Assessment of Knowledge and Attitude about Medical Negligence and Law Related Medical Practice among Para-Clinical and Clinical Medical Students

Background: Knowledge of medical negligence and law related medical practice is mandatory for all healthcare professionals. The objective of the study to gaze the extent of knowledge and attitude of undergraduate medical students regarding this. Materials and methods: A cross-sectional survey was conducted during the period from July to October 2023 on 300 para-clinical and clinical medical students of Chattagram Maa-O-Shishu Hospital Medical College (CMOSHMC). A pretested questionnaire was used and data analyzed by SPSS V.22. Results: Out of 300 respondents from medical students of phase II, phase III and phase IV MBBS, the number of students were predominantly female and religion were Islam. The age range of the participants was from 20 – 25 years. Conclusion: The undergraduate medical students had a reasonable knowledge and positive attitude towards medical negligence and law related medical practice. However, the teaching of medical negligence and law related medical practice should be part of the medical curriculum to strengthen these attitudes. This will expose the students to the training classes using real case scenarios, workshops and seminars on medical negligence and law related medical practice, so that once they become doctors, they are not face difficulty in dealing with ethical issues. IAHS Medical Journal Vol 7(1), June 2024; 4-7

Enhancing medical students’ understanding of end-of-life care ethics and law through video-triggered expert-led debriefing: a two-stage study

BackgroundTaiwan enacted the Hospice Palliative Care Act in 2000 and the Patient Autonomy Act in 2016. However, medical education has emphasized palliative care skills over ethical and legal integration. This study developed a curriculum for pre-clinical students, focusing on applying these issues in end of life care.MethodsThe participants were fourth-year medical students enrolled in a 1-credit medical ethics and law course at a medical school in Taiwan. The study employed a two-stage design, combining quantitative pretests and posttests with qualitative data obtained through the Know-Want-Learn strategy. The curriculum, called the video-triggered expert-led debrief module, included a video scenario on end of life care, insights shared by three interprofessional experts, and students debrief. In 2021, 168 students participated, and a quantitative questionnaire using a pretest-posttest design was applied to assess the curriculum’s impact on students’ knowledge and attitudes toward end of life care. In 2022, 157 students participated, and the survey used open-ended questionnaires (the Know-Want-Learn strategy) to evaluate what students already knew and what they wanted to know before the module, as well as what they had learned afterward.ResultsIn 2021, we collected 166 (98.8%) valid responses in the quantitative questionnaire. Seven of the eight knowledge-based questions and four of the seven learning motivation items showed significant improvement in the posttest (P < 0.05). In 2022, 81 (51.6%) valid responses were obtained from the qualitative questionnaire. Before the module, students’ understanding was superficial and focused on literal meanings. Three themes emerged in what they wanted to know: medical decision-making, ethics and laws, and empathetic communication, with eight subthemes. After the module, three themes and six subthemes were identified in the “what I learned” section. Students reported gaining knowledge related to ethics and laws, and empathetic communication.ConclusionsThe video-triggered expert-led debrief module can effectively teach the application of medical ethics and laws in end of life care. This approach has shown positive results among young medical students. It enhances students’ learning motivation, deepens their understanding of ethics and laws, and empathetic communication. It further encourages them to reflect deeply on the meaning of healthcare.

Comparison of document-based and on-site inspections of hospitals based on medical law: A case report from Osaka City during the COVID-19 pandemic

Objectives On-site inspections of hospitals were conducted in Osaka City during fiscal years 2018 and 2019, whereas document-based inspections were performed during the COVID-19 pandemic in fiscal year 2021. This case report aimed to compare the outcomes of these two methods and provide a good indication of the method that should be selected in case of a pandemic.Methods For on-site inspections, documents, including checklists, were sent to 351 hospitals from the Osaka City Public Health Office, and responses from each hospital were returned. On-site inspections were conducted, and the written instructions that indicated inadequate aspects and guidance were mailed to hospitals.For document-based inspections, documents were sent to 176 hospitals, and responses were returned. For hospitals that answered "incomplete" regarding the categories of medical safety management systems and hospital-acquired infection control, public health physicians called to confirm and instruct their inadequate responses, and the same step as the on-site inspection was executed. We compared and examined the outcomes of the on-site and document-based inspections.Results In the on-site inspections, 12 of the 351 hospitals (3.4%) were recognized as inadequate because of a shortage of healthcare workers. In the document-based inspections, eight out of 176 hospitals (4.5%) were identified, and there was no significant difference.Regarding the medical safety management system, 95 of the 351 hospitals (27.1%) on on-site inspection and 21 of the 176 hospitals (11.9%) on document-based inspection received written instructions. The proportion of hospitals that received written instructions was significantly higher for on-site inspections than for document-based inspections (P < 0.001).For hospital-acquired infection control, 65 of 351 hospitals (18.6%) on on-site inspection and 17 of 176 hospitals (9.7%) on document-based inspection got written instructions. The proportion of hospitals that received written instructions was significantly higher for on-site inspections than document-based inspections (P = 0.007).Conclusion Document-based inspection can easily unify the guiding criteria with fewer public health physicians. However, because of the limited amount of information available without checking the documents retained in hospitals, it is difficult to monitor the matters that need instructions. Thus, on-site inspection is preferable. However, if onsite inspection is difficult, inspection combined with online methods should be considered.

AXIOLOGICAL FOUNDATIONS OF THE ORGANIZATIONAL AND LEGAL MECHANISM FOR THE CONVERGENCE OF EU ACTIVITIES IN THE FIELD OF HEALTH POLICY

Abstract. The article addresses the issues of developing and implementing a unified strategy in the field of health policy and medical law in the European Union. The main focus is on analyzing differences between national legislations, assessing the institutional capacity of member states to adapt European standards, and studying the impact of a unified strategy on pan-European health effectiveness. Particular attention is given to the role of the European Parliament in shaping health policy and the potential of technological innovations to improve the quality of medical services. The purpose of the research. The purpose of the research is to determine and summarize the axiological aspects of the convergence of the European Union's activities in the field of health policy. Methodology. The methodological basis of the research includes an axiological analysis of national and European legislative acts, a comparative analysis of national approaches to medical standards, and an assessment of the institutional capacity of EU member states to adapt European standards. Scientific novelty. The scientific novelty of the work lies in the comprehensive analysis of the convergence of health policy in the EU and the study of the impact of a unified strategy on pan-European health effectiveness, with a focus on the harmonization of medical standards and regulations. Conclusions. The effective implementation of the EU's convergence strategy in health policy is a key factor in improving public health, preventing diseases, and eliminating threats to physical and mental health at the pan-European level.

Paediatric systemic inflammatory response syndrome (SIRS) and the development of patient-specific therapy: ethical perspectives through experts' opinions.

Research for personalised therapies concerning the Systemic Inflammatory Response Syndrome (SIRS) in children involves the utilisation of OMICS technologies and Artificial Intelligence (AI). To identify specific ethical challenges through the perspective of healthcare professionals, we conducted 10 semi-structured interviews. The development of interview questions for the interviews was preceded by a systematic review of the scientific literature. To address the complexities of paediatric emergency research, informed consent, and data processing, experts with expertise in paediatric intensive care, computer science, and medical law were sought. After the transcription and anonymisation, the analysis followed established guidelines for qualitative content and thematic analysis. Interviewees highlighted the intricacies of managing consent in personalised SIRS research due to the large amount and complexity of information necessary for autonomous decision-making. Thus, instruments aimed at enhancing the understanding of legal guardians and to empowering the child were appreciated and the need for specific guidelines and establishing standards was expressed. Medical risks were estimated to be low, but the challenges of securing anonymisation and data protection were expected. It was emphasised that risks and benefits cannot be anticipated at this stage. Social justice issues were identified because of possible biases within the research population. Our findings were analysed using current ethical and legal frameworks for research with a focus on the particularities of the patient group and the emergency background. In this particular context, experts advocated for an enabling approach pertaining to AI in combination with OMICS technologies. As with every new technological development, ethical and legal challenges cannot be foreseen for SIRS-personalised treatment. Given this circumstance, experts emphasised the importance of extending the ethics-legal discourse beyond mere restrictions. The organisation of supervision should be reconsidered and not limited only to the precautionary principle, which per se was seen as impeding both the medical progress and clinical flexibility. It was noted that the establishment and monitoring of guidelines were emergent and should evolve through an interdisciplinary discourse. Therefore, it was recommended to enhance the qualifications of physicians in the field of computer science, impart ethics training to AI developers, and involve experts with expertise in medical law and data protection.

Problems of experimentation and medical law: a review of the current debate

Problems of experimentation and medical law: a review of the current debate

Comparative Analysis of the Response Accuracies of Large Language Models in the Korean National Dental Hygienist Examination Across Korean and English Questions.

Large language models such as Gemini, GPT-3.5, and GPT-4 have demonstrated significant potential in the medical field. Their performance in medical licensing examinations globally has highlighted their capabilities in understanding and processing specialized medical knowledge. This study aimed to evaluate and compare the performance of Gemini, GPT-3.5, and GPT-4 in the Korean National Dental Hygienist Examination. The accuracy of answering the examination questions in both Korean and English was assessed. This study used a dataset comprising questions from the Korean National Dental Hygienist Examination over 5 years (2019-2023). A two-way analysis of variance (ANOVA) test was employed to investigate the impacts of model type and language on the accuracy of the responses. Questions were input into each model under standardized conditions, and responses were classified as correct or incorrect based on predefined criteria. GPT-4 consistently outperformed the other models, achieving the highest accuracy rates across both language versions annually. In particular, it showed superior performance in English, suggesting advancements in its training algorithms for language processing. However, all models demonstrated variable accuracies in subjects with localized characteristics, such as health and medical law. These findings indicate that GPT-4 holds significant promise for application in medical education and standardized testing, especially in English. However, the variability in performance across different subjects and languages underscores the need for ongoing improvements and the inclusion of more diverse and localized training datasets to enhance the models' effectiveness in multilingual and multicultural contexts.

Exploring the prescription laws of bone flaccidity in ancient chinese medical texts based on association rules and latent structure model

Objective: To analyze the identification and typing of bone flaccidity and the law of medication in ancient books based on the Encyclopaedia of TCM (Traditional Chinese medicine) using the hidden structure model. Methods: The formulations for bone flaccidity were searched in the Chinese Medical Code (software), based on which an Excel sheet was created to conduct frequency analysis and construct a matrix of high-frequency medications. The high-frequency medications for bone flaccidity were then analyzed using the Latent 5.0 software and a latent structure model. With SPSS Modeler and Latent 5.0 as the main analysis methods, Chinese medications with a frequency &gt;1.00% were investigated using the latent structure model and association rules, and the medication rules in treating bone flaccidity with TCM were dissected based on the data of frequency. Results: A total of 223 TCM prescriptions were included, with 270 extracted TCM and a total medication frequency of 2340 times. Among them, Achyranthis Bidentatae Radix, Poria, Angelicae Sinensis Radix, Eucommiae Cortex, Rehmanniae Radix Praeparata, and Ginseng Radix Et Rhizoma. They were the high-frequency medicines for treating bone flaccidity, and the efficacy of tonifying medicinal, heat-clearing medicinal, and blood activating and stasis-resolving medicinal were the high-frequency medicinal categories. Through the analysis of the evidence by formula, it was concluded that spleen-kidney yang deficiency, kidney deficiency and blood stasis, kidney yang deficiency, qi deficiency/qi stagnation and blood stasis, and liver and kidney yin deficiency were the 6 main types of bone flaccidity, which was generally in line with the etiology of bone flaccidity, which was caused by kidney yang deficiency and accompanied by malfunction of the liver and kidneys. In ancient books, the regulation of the kidney is put into an important position. In this study, 19 correlative principles for the treatment of bone flaccidity were derived, whose main combinations are Paeoniae Radix Alba - Angelicae Sinensis Radix, Eucommiae Cortex + Poria-Ginseng Radix Et Rhizoma, Dioscoreae Spongiosae Rhizoma + Cuscutae Semen-Eucommiae Cortex. Conclusion: The medication law of bone flaccidity in the Encyclopaedia of TCM mainly shows that it attaches importance to the regulation of tonifying the liver and kidney to strengthen the tendons and bones and emphasizes that the regulation of the three Zang–fu organs, namely the kidney, the liver and the spleen, can play an important role in the treatment of bone flaccidity.

The Combined Relationship of Prescription Drug Monitoring Program Enactment and Medical Cannabis Laws with Chronic Pain-Related Healthcare Visits.

U.S. state electronic prescription drug monitoring programs (PDMPs) are associated with reduced opioid dispensing among people with chronic pain and may impact use of other chronic pain treatments. In states with medical cannabis laws (MCLs), patients can use cannabis for chronic pain management, reducing their need for chronic-pain related treatment visits and moderating effects of PDMP laws. Given high rates of chronic pain among Medicaid enrollees, we examined associations between PDMP enactment in the presence or absence of MCL on chronic pain-related outpatient and emergency department (ED) visits. We created annual cohorts of Medicaid enrollees with chronic pain diagnoses using national Medicaid claims data from 2002-2013 and 2016. Negative binomial hurdle models produced adjusted odds ratios (aOR) for the likelihood of any chronic pain-related outpatient or ED visit and incident rate ratios (IRR) for the rate of visits among patients with ≥ 1 visit. Medicaid enrollees aged 18-64years with chronic pain (N = 4,878,462). A 3-level state-year variable with the following categories: 1) no PDMP, 2) PDMP enactment in the absence of MCL, or 3) PDMP enactment in the presence of MCL. Healthcare codes for chronic pain-related outpatient and ED visits each year. The sample was primarily female (67.2%), non-Hispanic White (51.2%), and ages 40-55years (37.2%). Compared to no-PDMP states, PDMP enactment in the absence of MCL was not associated with chronic pain-related outpatient visits but PDMP enactment in the presence of MCL was associated with lower odds of chronic pain-related outpatient visits (aOR = 0.81, 95% CI:0.71-0.92). PDMP enactment was not associated with ED visits, irrespective of MCL. During a period of PDMP and MCL expansion, our findings suggest treatment shifts for persons with chronic pain away from outpatient settings, potentially related to increased use of cannabis for chronic pain management.

EVALUATION OF PROBLEMS ARISING IN EMERGENCY SERVICES FROM THE PERSPECTIVES OF MEDICAL and CRIMINAL LAW: THE EXAMPLE OF “TÜRKİYE"

IntroductionIn recent years, the field of medical malpractice has attracted growing attention, and despite the long history of research in this area, there are still unexplored aspects of this phenomenon. In this article, we aimed to explore the realm of medical malpractice, focusing on cases involving healthcare professionals in emergency services in Türkiye. It examines the surge in medical malpractice lawsuits, the consequences of such cases, and the prevalence of criminal liability faced by healthcare professionals. Material and methodA comprehensive analysis of healthcare-related cases from 2017 to 2022 was carried out using the electronic decision database known as "LEGALBANK". We scrutinized these cases from both medical and criminal law perspectives, aiming to shed light on the complex dynamics of medical malpractice in emergency services. ResultsThe findings reveal that professionals in emergency services are confronted with a notable number of criminal cases. Among these cases, doctors are the most frequently implicated, followed by nurses, midwives, ambulance drivers, and other healthcare professionals. Crimes attributed to these professionals vary but primarily include involuntary manslaughter, misuse of public duty, forgery of documents, and reckless injury. DiscussionIn Türkiye, there is a notable prevalence of examinations conducted in emergency services and criminal cases involving healthcare professionals in this field. This dual prominence underscores the unique significance of examining medical malpractice from both criminal law and medical perspectives within the Turkish context. This study categorizes the multifaceted challenges of medical malpractice as personal, system-related, and legal, offering valuable insights into the intricate landscape of this phenomenon in Türkiye's emergency services. ConclusionThis research contributes to a deeper understanding of medical malpractice, particularly its criminal dimensions in the Turkish context, and calls for improved healthcare, enhanced patient safety, and error prevention in emergency settings.

Human infection with an infectious disease agent: analysis of constructive objective features of criminal offences

With a view to confirming the hypothesis that the ineffectiveness of criminal law provisions under Articles 130, 131, 133 of the Criminal Code of Ukraine is due to the shortcomings of their legislative design, the author analyses the definitions used by the legislator to determine the constructive objective features of criminal offences under Articles 130, 131, 133 of the Criminal Code of Ukraine. The author establishes that they are inconsistent with the terminology of healthcare regulations which should be used when qualifying encroachments on biological safety manifested in infection of a person (persons) with infectious disease agents. The article states that current legislation does not contain any lists of incurable and venereal diseases. On this basis, it is concluded that the qualification of the relevant criminal offences is not based on the provisions of legislation, but on the previous court practice, common sense of law enforcement officers and the level of their legal awareness. The view is supported that the indication of a virus as an instrument of criminal offences (Articles 130, 131 of the Criminal Code of Ukraine) significantly limits the criminalisation of encroachments on biological security in the form of spread of infectious diseases. Attention is drawn to the discrepancy between the constructions of the objective side of the corpus delicti of criminal offences under Articles 130 and 133 of the Criminal Code of Ukraine, which provide for an identical mechanism of causing harm to the victim. It is established that the absence of any references in the disposition of Article 133 of the Criminal Code of Ukraine to the means of infection (live pathogen) unjustifiably delays the moment of termination of this criminal offence until the victim develops clinical manifestations of the disease. Finally, the conclusion is made that the gradual widening of the gap between the substantive criminal law and medical law makes it increasingly difficult to qualify the infection of another person with dangerous infectious diseases and creates problems in delimiting related corpus delicti of criminal offences. The editorial wording of the unified basic elements of a criminal offence consisting in infecting a person with a pathogen which is dangerous to his/her life is proposed.

Policing of youth in the hospital

BackgroundEach year millions of children seek care in emergency departments, many of whom are from marginalized and minoritized groups who lack access to primary and preventive care. Law enforcement personnel are also commonly present in pediatric and adult emergency departments serving in a range of roles. Therefore, pediatric emergency departments sit at the nexus of the health system and the legal system for many vulnerable youth and families. ObjectiveHerein, we explore several common specific legal issues surrounding policing of youth in the hospital setting: patient privacy and disclosure of information, questioning and visitation restriction, autonomy and decision making, restraints and use of force, and patient property. MethodsOur team of legal scholars and clinician researchers examined the literature on policing of youth in healthcare settings and patients' legal rights in healthcare settings through searches using PubMed, Westlaw, and Lexis. FindingsThrough rigorous analysis of the medical literature, legal scholarship, and relevant case law, several important themes were identified which present challenges to clinicians caring for vulnerable children. Conclusions and relevancePediatric clinicians, highly trained professionals in the medical and social care of youth and children, are often unaware of legal rules and procedures that guide law enforcement interaction with youth. This lack of knowledge may result in unknowing and unwitting violations of patients' rights while also compromising the quality of health care provided. Therefore, it is imperative that clinicians are educated on their roles and their institutions' roles in safeguarding patients' privacy and autonomy while still promoting effective collaboration with law enforcement.

Measuring the Impact of Medical Cannabis Law Adoption on Employer-Sponsored Health Insurance Costs: A Difference-in-Difference Analysis, 2003-2022.

Recent studies suggest that medical cannabis laws may contribute to arelative reduction in health insurance costs within the individual health insurance markets at the state level. We investigated the effects of adopting a medical cannabis law on the cost of employer-sponsored health insurance in the United States. We analyzed state-level data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) Private Sector spanning from 2003 to 2022. The outcomes included log-transformed average total premiumcosts per employee for single, employee-plus-one, and family coverage plans. We utilized the Sun and Abraham (J Econometr 225(2):175-199, 2021) difference-in-difference (DiD) method, looking at the overall DiD and event-study DiD. Models were adjusted for various state-level demographics and dichotomous policy variables, including whether a state later adopted recreational cannabis, as well as time and unit fixed effects and population weights. For states that adopted a medical cannabis law, there was a significant decrease in the log average total premium per employee for single (-0.034, standard error [SE] 0.009(-$238)) and employee-plus-one (-0.025, SE 0.009(-$348)) coverage plans per yearconsidering the first 10 years of policy change compared with states without such laws. Looking at the last 5years of policy change, we saw increases in effect size and statistical significance. In-time placebo testing suggested model robustness.Under a hypothetical scenario where all 50 states adopted medical cannabis in 2022, we estimated that employers and employees could collectively save billions on healthcare coverage, potentially reducing healthcare expenditure's contribution to GDP by 0.65% in 2022. Adoption of a medical cannabis law may contribute to decreases in healthcare costs. This phenomenon is likely a secondary effect and suggests positive externalities outside of medical cannabis patients.

Consensus Statement of the National Association of EMS Physicians International Association of Fire Chiefs and the International Association of Chiefs of Police: Best Practices for Collaboration Between Law Enforcement and Emergency Medical Services During Acute Behavioral Emergencies

Emergency Medical Services (EMS) and law enforcement (LE) frequently work as a team in encounters with individuals experiencing acute behavioral emergencies manifesting with severe agitation and aggression. The optimal management is a rehearsed, coordinated effort by law enforcement and EMS providing the necessary interventions to address behaviors that endanger the patient, the responders, and the public. The purpose of this document is to provide guidance and direction in the shared responsibility of managing and caring for a person displaying behavioral instability with irrational, agitated, and/or violent behavior. This is a discussion of the roles of law enforcement, 9-1-1 call centers (hereafter referred to as the Emergency Call Centers or “ECCs”), Fire, and EMS. A coordinated and unified response enhances the safety and effective management of potentially serious situations posed by individuals experiencing such acute behavioral emergencies. This paper provides the framework for an approach endorsed by NAEMSP, IACP, and the IAFC.

GPT-4o vs. Human Candidates: Performance Analysis in the Polish Final Dentistry Examination.

Background This study aims to evaluate the performance of OpenAI's GPT-4o in the Polish Final Dentistry Examination (LDEK) and compare it with human candidates' results. The LDEK is a standardized test essential for dental graduates in Poland to obtain their professional license. With artificial intelligence (AI) becoming increasingly integrated into medical and dental education, it is important to assess AI's capabilities in such high-stakes examinations. Materials and methods The study was conducted from August 1 to August 15, 2024, using the Spring 2023 LDEK exam. The exam comprised 200 multiple-choice questions, each with one correct answer among five options. Questions spanned various dental disciplines, including Conservative Dentistry with Endodontics, Pediatric Dentistry, Dental Surgery, Prosthetic Dentistry, Periodontology, Orthodontics, Emergency Medicine, Bioethics and Medical Law, Medical Certification, and Public Health. The exam organizers withdrew one question. GPT-4o was tested on these questions without access to the publicly available question bank. The AI model's responses were recorded, and each answer's confidence level was assessed. Correct answers were determined based on the official key provided by the Center for Medical Education (CEM) in Łódź, Poland. Statistical analyses, including Pearson's chi-square test and the Mann-Whitney U test, were performed to evaluate the accuracy and confidence of ChatGPT's answers across different dental fields. Results GPT-4o correctly answered 141 out of 199 valid questions (70.85%) and incorrectly answered 58 (29.15%). The AI performed better in fields like Conservative Dentistry with Endodontics (71.74%) and Prosthetic Dentistry (80%) but showed lower accuracy in Pediatric Dentistry (62.07%) and Orthodontics (52.63%). A statistically significant difference was observed between ChatGPT's performance on clinical case-based questions (36.36% accuracy) and other factual questions (72.87% accuracy), with a p-value of 0.025. Confidence levels also varied significantly between correct and incorrect answers, with a p-value of 0.0208. Conclusions GPT-4o's performance in the LDEK suggests it has potential as a supplementary educational tool in dentistry. However, the AI's limited clinical reasoning abilities, especially in complex scenarios, reveal a substantial gap between AI and human expertise. While ChatGPT demonstrates strong performance in factual recall, it cannot yet match the critical thinking and clinical judgment exhibited by human candidates.

“They made me feel like I mattered”: a qualitative study of how mobile crisis teams can support people experiencing homelessness

BackgroundMobile crisis teams (MCTs) can be important alternatives to emergency medical services or law enforcement for low-acuity 911 calls. MCTs address crises by de-escalating non-violent situations related to mental health or substance use disorders and concurrent social needs, which are common among people experiencing homelessness (PEH). We sought to explore how an MCT in one city served the needs and supported the long- and short-term goals of PEH who had recently received MCT services.MethodsWe conducted 20 semi-structured interviews with service recipients of the Street Crisis Response Team, a new 911-dispatched MCT implemented in San Francisco in November 2020. In the weeks after their encounter, we interviewed respondents about their overall MCT experience and comparisons to similar services, including perceived facilitators and barriers to the respondent’s self-defined life goals. We analyzed interview transcripts with thematic analysis to capture salient themes emerging from the text and organized within a social-ecological model.ResultsNearly all respondents preferred the MCT model over traditional first responders, highlighting the team’s person-centered approach. Respondents described the MCT model as effectively addressing their most immediate needs (e.g., food), short-term relief from the demands of homelessness, acute mental health or substance use symptoms, and immediate emotional support. However, systemwide resource constraints limited the ability of the team to effectively address longer-term factors that drive crises, such as solutions to inadequate quality and capacity of current housing and healthcare systems and social services navigation.ConclusionsIn this study, respondents perceived this MCT model as a desirable alternative to law enforcement and other first responders while satisfying immediate survival needs. To improve MCT’s effectiveness for PEH, these teams could collaborate with follow-up providers capable of linking clients to resources and services that can meet their long-term needs. However, these teams may not be able to meaningfully impact the longstanding and complex issues that precipitate crises among PEH in the absence of structural changes to upstream drivers of homelessness and fragmentation of care systems.

Legal, ethical and moral aspects of the fight against aids as a social dangerous disease

The scientific article examines the relevant regulatory framework for the development of legal, ethical and moral regulation in the fight against HIV/AIDS, and provides recommendations for improving medical treatment and control mechanisms. In the research work, a comparative analysis of domestic legal acts with international legal norms as the current legal basis for the fight against the AIDS epidemic is considered, and the directions for the adoption of the legislation and judicial practice of model countries in the field of medical law for the Republic of Azerbaijan are stated. Based on case studies and empirical research, the article provides an assessment of the challenges and opportunities for strengthening legal protection, especially for people living with HIV/AIDS, and legal mechanisms for increasing access to care and treatment. Also, innovative methods and strategies are explored to protect the rights of people suffering from HIV/AIDS, to protect against discrimination and stigmatization through the application of directly mentioned coping strategies, as well as to create more sensitive and effective treatment mechanisms of the health care system. It is proposed to refine the legislation of the Republic of Azerbaijan and eliminate the loopholes in the law. Overall, the article emphasizes the importance of a strong legal framework for the development of the fight against AIDS and suggests practical steps to bring it to the agenda in today’s world. In the context of the ongoing global struggle against HIV/AIDS, our research emphasized the crucial role of legal regulation in the development of a comprehensive care system for individuals affected by this disease. The article underscored the significance of legal frameworks in ensuring unhindered access to care, treatment, and support for individuals living with HIV/AIDS. By establishing guidelines and standards for healthcare providers, legal regulation enables the delivery of high-quality care while safeguarding the rights of individuals affected by HIV/AIDS. Furthermore, the rule of law plays a vital role in combating stigma and discrimination, which remain significant obstacles to effective efforts to prevent and treat HIV/AIDS. It is also highlighted various tools and strategies for improving care for individuals living with HIV/ AIDS, including the integration of HIV services into existing healthcare systems, community-based care models, and the promotion of holistic and patient-centered approaches to care. In conclusion, our research demonstrates that legal regulation is a vital component of the global response to HIV/AIDS, as it enables the provision of comprehensive care and support to individuals affected by this disease. Moreover, the implementation of innovative care models and strategies outlined in international legal instruments can further enhance the quality and effectiveness of HIV/AIDS treatment services.

The relationship between criminal and medical law in the era of cybernetic civilization

The article offers for consideration separate results of comprehensive scientific research on the relationship between criminal and medical law in the era of cybernetic civilization. Attention is focused on the issue of prospects for the formation of elements of artificial intelligence in the medical field with extrapolation and judicial proceedings regarding the criminal responsibility of medical workers. Attention is also drawn to the so-called "criminal medical cases". In the theory of criminal law, criminology and criminology, such a concept as "cases concerning professional medical offenses" is also used in relation to criminal medical cases, in the sense of intentional or negligent acts committed by medical workers in the performance of their professional duties, prohibited by criminal law under the threat of punishment . Analyzing the general issues of responsibility of medical workers for professional criminal offenses, it is proposed to consider them in two aspects of manifestation: professional medical crimes; official medical crimes. Criminal acts of medical workers, for which they are held criminally liable on general grounds, are proposed to be separated separately from the composition of medical crimes. It is shown that today one of the means of systematic resolution of legal conflicts in jurisprudence is the possibilities of achievements in the field of informatics, cybernetics for the proper management of human behavior with the use of electronic communication technologies, which is the essence of the era of cyber civilization, cybernetic society, in particular, in what determines the essence of industry artificial intelligence systems.For the qualitative creation of branch systems of artificial intelligence, legal science faces the task of properly setting tasks for the developers of such systems, taking into account the relevant regulatory and legal array, its incorporation and consolidation, including at the conceptual level. In terms of prospects for further research, it is proposed to pay attention to the problems of systemic improvement of the medical sphere of society, including for the qualitative implementation of the achievements of informatics and cybernetics, in particular through the formation of artificial intelligence. In this regard, legal science should create an appropriate array of structured, interrelated knowledge at the interdisciplinary level under the conventional name of medical and legal informatics.

On the Seventh All-Russian scientific and practical conference with international participation “December readings in forensic medicine at Peoples’ Friendship University of Russia: the main issues of forensic medicine and medical criminology”

The Seventh All-Russian scientific and practical conference with international participation “December Readings in Forensic Medicine at Peoples’ Friendship University of Russia: The Main Issues of Forensic Medicine and Medical Criminology” took place on December 22, 2023. The conference was held at the Department of Forensic Medicine of the Medical Institute of the Peoples’ Friendship University of Russia named after Patrice Lumumba. The conference traditionally covers a wide range of topics related to organizational and procedural, theoretical, and practical issues of forensic medicine, medical criminology, and medical law. It was participated by Russian and foreign specialists, postgraduate students, residents, and students. Participants and guests of the conference noted the high scientific and methodological level of the event and wished for new scientific meetings for specialists and young scientists at the Peoples’ Friendship University of Russia named after Patrice Lumumba.

EMS Paramedics and Law Enforcement Officers' Experiences with Joint-Response Efforts on Suspected Opioid Overdose Calls: A Qualitative Study.

In the United States, the opioid crisis remains a nationwide public health emergency. Narcan laws have increased medical collaboration between emergency medical services (EMS) paramedics and law enforcement officers (LEOs), yet research on joint opioid-response efforts with these first responders remains underexplored. Using a phenomenological approach, this study explores EMS paramedics and LEOs' experiences with joint-response efforts on suspected opioid overdose calls amidst the ongoing opioid crisis. Researchers conducted semi-structured interviews with 14 first responders (n = 8 EMS paramedics; n = 6 LEOs) from a large Central Florida emergency services district covering urban, suburban, and rural areas. Four major themes emerged: (1) facilitators to joint-response efforts; (2) barriers to joint-response efforts; (3) concerns for patient co-occurring behavioral health conditions; and (4) perceived solutions. Overall, participants described mutual respect, reliance, and communication as key facilitators, while barriers included conflicting on-scene priorities and differences in Narcan protocols. Concerns for co-occurring behavioral health (i.e., addiction and mental health) conditions among overdose patients included difficulties in assessing mental health and the availability of wraparound services, yet these concerns remained secondary to medical treatment during an opioid-related emergency. Key solutions included enhanced Narcan training for LEOs and increased availability of behavioral health services for long-term patient care. This research contributes to existing literature on opioid overdose response by specifically examining joint-response efforts between EMS paramedics and LEOs. These findings may be applicable to other partnering agencies such as mental health crisis teams and should be explored across behavioral health collaborations.