Thèses sur le sujet « Medical innovations – Law and legislation »

South Africa’s Constitution and the Employment Equity Act have a major impact on the performance of medical examinations within the employment relationship. Health and safety statutes list a number of occupational medical examinations, which an employer must perform. Other legislation permits the execution of medical examinations. After listing the different statutory references to occupational medical examinations, this treatise examines under which conditions medical testing is required or permissible. The fairness of employment discrimination based on medical facts, employment conditions, social policy, distribution of employee benefits and inherent job requirement is analysed through a study of the legal texts, experts’ opinions and case studies. The particularities of the ethical and legal duties of the medical professional, performing the occupational medical examination, are also examined. Finally, a comprehensive analysis of the different forms of occupational medical examinations is compiled by combining legal and policy-related job requirements and is attached as an annexure. This is the practical result of the research in this treatise combined with the personal experience of the author.

Labour law in South Africa has evolved over the past century at an ever increasing pace. The establishment of a democratic government in 1995 has been the trigger for a large number of labour law statutes being promulgated, particularly with reference to the laws governing the employment relationship and dismissal. From very humble and employer biased dispute resolution application under the common law of contract, labour law in this country has evolved through the various acts culminating in a labour law system which is highly regulated and codified. Dismissal for medical incapacity in this treatise is reviewed with regard to the applicable statutes and the various codes of good practice as the law has evolved and developed from the period covered by the common law through that covered by the 1995 LRA up to and including the current period. Particular attention is paid to both substantive and procedural requirements as well as the remedies applicable under the different legal regimes and the pertinent tribunals and courts. Regard is also given to the duration and causes of incapacity and the effect this may have on the applicable remedy applied by these tribunals. It will become apparant that the medically incapacitated employee occupied a relatively weak and vulnerable position under the common law as opposed to the current position under the 1995 LRA. The influence of the remedies applied by the tribunals under the 1956 LRA are clearly evident in the current regulations and codes under the 1995 LRA which contain specific statutory provisions for employees not to be unfairly dismissed. Distinctions are drawn between permissible and impermissible dismissals, with medical incapacity falling under the former. Furthermore, a distinction is drawn statutorily between permanent and temporary illhealth/injury incapacity with detailed guidelines for substantive and procedural fairness requirements to be met by employers. The powers of the specialist tribunals (CCMA, Bargaining Councils and Labour Courts) are regulated by statutory provisions and deal with appropriate remedies (reinstatement and/or compensation) a wardable in appropriate circumstances. Certain specific areas nonetheless still remain problematic for these tribunals and hence questions that require clear direction from the drafters of our law are: How to distinguish misconduct in alcohol and drug abuse cases? What degree of intermittent absenteeism is required before dismissal would be warranted? In certain other areas the tribunals have been fairly consistent and prescriptive in their approach and remedies awarded. Included here would be permanent incapacity, HIV cases and misconduct. It will emerge, however, that under the 1995 LRA the position of employees and the protections afforded them have been greatly increased.

Because of its perceived ability to predict future health and its relevance for family members, genetic information challenges the traditional justifications for medical confidentiality. This thesis examines the question whether a health care professional should have the discretion or a duty to breach confidentiality in order to inform a patient's relatives of their increased genetic risk. There is currently no exception to the statutory, common law and ethical duties of confidentiality for the non-consensual disclosure of genetic information to relatives. Precedents developed in the context of threats of harm and communicable diseases are of limited value. The law should not recognise the existence of a duty to warn in the context of genetics. As a last resort, health care professionals should be authorized, but not required, to disclose genetic risk information when there is a serious risk of preventable harm and when the potential harm of non-disclosure outweighs that of disclosure.

Competing successfully in globalized markets requires a complex mix of product, price, promotion and distribution. It requires novel approaches to ownership in overseas involvement and the development of new modes of global relationships. In response to these needs, new types of alliances are emerging as corporations endeavor to meet the global challenge. At the forefront of globalization, the telecommunications industry is experiencing a high-rate of cross-border alliance formation.
This thesis attempts to straddle both business and legal domains, on national and international levels, to survey the evolution of the telecommunications industry and to envisage the future prospects of multinational telecom carriers with respect to the conduct of transnational alliances for international expansion. Chapter 1 describes the changes occurring in the field of telecommunications, while Chapter 2 and Chapter 3 provide an essential understanding of the motivations and the modalities of cross-border strategic alliances and propose contracting techniques for the purpose of surmounting managerial and operational challenges that may be confronted when engaging in global strategic alliances. With a focus on the telecommunications industry, Chapter 4 explores the motives of and difficulties encountered by multinational telecom carriers in using alliances to expand globally, and examines their business strategies and performing phases. Chapter 5 further questions the necessity of using cross-border strategic alliances in an increasingly international competitive environment by examining the current national and international regimes with respect to the transactions of telecom services. The Conclusion reviews significant factors that may infringe upon the use of strategic alliances as a business strategy.

Convergence has blurred the artificial limits that traditionally existed between separated sectors and services. In particular, technological convergence united cable and telephone networks as convenient platforms for the provision of numerous new telecommunications services. The advent of the Internet and the development of other services started a race for the acquisition of broadband transmission that has, in part, prompted a number of corporate mergers between the major telephone, cable, and Internet service providers.
This thesis analyzes the legal implications of the convergence of cable operators and telephone carriers in the United States of America (U.S.). The analysis was conducted in light of the 1996 Telecommunications Act's provisions, the Federal Communications Commission's reports and orders, and under the critical approaches of the cable and telephone industries. This thesis presents recommendations addressed to promote an equal regulatory treatment for all telecommunications competitors in the U.S.

Healthcare fraud is a major problem within the healthcare industry. The study examined medical fraud, its laws, and punishments on federal and state levels. It compared medical fraud to non-fraud crimes done in the healthcare industry. This comparison will be done on a state level. The study attempted to analyze the severity of fraud against non-fraud and that doctors would commit fraud offenses more often than non-fraud offenses.

Discourse ethics relates to an argumentative discussion about our moral norms and their foundations. The purpose of my research is to describe and evaluate the functioning of several institutions of discourse ethics as sources of normativity for the regulation of new medical technologies and to propose some possible interactions between law and these institutions.
The institutions of discourse ethics I will look at are: national commissions of experts, national ethics committees, technology assessment committees and consensus conferences. Used in these institutions, argumentative discussion has the capacity to influence the meaning we give to our moral norms as well as the context and the conditions for their application. These discussions generate a special kind of normativity, which ought to be recognised by our legal system. Law itself would benefit from an interaction with such normativity.

Thesis (Ed. D.)--University of Missouri-Columbia, 2007.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on December 12, 2007) Vita. Includes bibliographical references.

This study showed that state laws and policies constrain the locational preferences of alternative health care providers to varying degrees, depending on the particular profession and level of legal status. Three separate surveys were conducted, focusing on acupuncturists, chiropractors and homeopaths in Maryland, Virginia, North Carolina, and the District of Columbia. The acupuncture findings revealed intraprofessional divisions that lead to a strong influence of legal constraints on the locational behavior of non-MD acupuncturists. Results from the chiropractic survey reflected an established profession with a less pronounced, but moderate, influence of state laws and policies on location and mobility. The homeopathy findings, while based on a much smaller sample, did not reveal a strong relationship between legal constraints and spatial characteristics, except in the extreme case of North Carolina's recent prohibition. This study also postulated a model to explain the progression of alternative health care professions toward legitimation. The variables of public acceptance and legal constraints on location were plotted on the model to identify particular levels of progression. The importance of this research is highlighted by impending health care reforms, the need for access to professional health services, skyrocketing biomedical costs, and the documented utilization of alternative health care in this country.
Master of Science

No previous study has attempted to clarify and articulate administrator attitudes regarding DNR orders in the school setting. Administrative school staff are responsible for development and implementation of school policy therefore understanding administrators' attitudes would assist discussion and decision making related to DNR orders in the school setting.

The purpose of this paper is to identify gaps in regulatory policies resulting from the emergence of Internet radio. To accomplish this purpose, the paper seeks to: 1) provide insights into agencies that may have direct involvement in potentially regulating Internet radio; 2) explore the concepts of jurisdiction in cyberspace; and 3) address the regulatory challenges that exist when traditional country borders no longer apply.

When the Australian Labor Party member for Kalgoorlie, Ian Taylor, presented his Private Member's Bill - the Medical Care of the Dying Bill (1995), he laid the foundation for this thesis. Mr Taylor introduced his Bill to the Western Australian Legislative Assembly on 28 March 1995. The Bill codified the terminally ill patient's right to refuse medical treatment, which clarified common law. This thesis attempts to overcome the dearth of literature in Western Australian lobbying concerning conscience-vote issues. It also identifies the key issues in understanding political lobbying, the form of pressure group activity that takes place and why certain groups respond in different ways. The pressure groups selected for this case study are examined, classified and evaluated resulting in a prescription for lobby group activity for similar conscience-vote issues. According to the Bill's sponsor, Ian Taylor, the legislation was needed to deal with the inconsistencies in common law of the medical treatment of terminally ill people. The Law Reform Commission in its 1991 Report on Medical Treatment for the dying, stated that there was a need to deal with the issue in Western Australia. Due to the advances in medical treatment practices in the past 50 years, doctors can prolong the life of patients for whom there is no cure. The major problem, however, is the Criminal Code: doctors and care providers can be at risk of prosecution and conviction if the patient's wishes are respected and medical treatment is withdrawn, leading to the patient's death. At present there is a general common law right to refuse medical treatment. According to Mr Taylor, the difficulty lies in the fact that in Western Australia, the common law is overridden by the Criminal Code. The Bill also highlighted the role of palliative care and the treatment of the dying. The opinion of most pressure groups was that the rights of terminally ill patients should be protected and enhanced. Of the groups selected for this case study, only the Coalition for the Defence of Human Life objected to the Bill. Other groups supported the principles of the Bill, while some hoped for voluntary euthanasia legislation and others gave tacit approval. Of all the groups the L. J. Goody Bioethics Centre distinguished itself as a key organisation which tended to monopolise political influence. Media exposure of the issue was high, particularly in The West Australian. The "right to die" issue was canvassed and often was reported with references to euthanasia. At the same time the Northern Territory legislation, the Rights of the Terminally Ill Bill (1995), was receiving much media attention. The issue of euthanasia was necessarily discussed in the context of national and international arenas. The political masters of thought on citizen participation and group theory were introduced early in the thesis. John Locke, Jean -Jacques Rousseau, James Madison, Alexis de Tocqueville, Thomas Paine and John Stuart Mill provided valuable insight into the nature of modern political thought on this interesting aspect of political activity. Contemporary political writers such as Trevor Matthews. Dean Jaensch and Graham Maddox were also consulted. The eight pressure groups selected for the study were the: • West Australian Voluntary Euthanasia Society Inc. • Coalition for the Defence of Human life • Australian Medical Association (WA Branch) • Australian Nursing Federation (WA Branch) • L. J. Goody Bioethics Centre • Silver Chain Nursing Association Inc. • Uniting Church of Australia • Anglican Church of Australia Information from the groups formed a significant part of this thesis. An attempt was made in the conclusion to ascertain the effectiveness of the various strategies utilised by the pressure groups and provide an insight into lobbying practices. Ultimately, though, the contentious Bill was not given a third reading. Nor was it debated in the Legislative Council. At one stage it was considered likely that the Bill would be recommitted to parliament. The monitoring of the Medical Care of the Dying Bill (1995) undertaken in this thesis, indicates that this would have been a lengthy and divisive process.

In the face of the extensive changes resulting from the Post-Industrial Age, many are questioning "the gifts of the chip," or, more specifically, the ability of computer technologies to deliver the comfort predicted. The objective of this thesis is to examine the law's response to computer technology concerning occupational health and safety. This inquiry is necessary due to the dramatic changes that have occurred in the workforce, altering the profile of workplace health.
The thesis begins with a reference to The Gift of Stones, a fictional account of the difficulties that stone workers experienced when the Bronze Age arrived. Modern labourers face parallel struggles due to the arrival of the Post-Industrial Age characterized by technological innovation and restructuring. The legitimacy and effectiveness of occupational health and safety law is challenged by changes to social institutions and by computer related work injuries.
In many jurisdictions, the state has responded to these changes by enacting ergonomic standards that seek to minimize the harmful effects of computer use. The thesis examines the trend towards ergonomic standards with particular focus on Canadian initiatives. In conclusion, it argues that ergonomic regulations are an important means of promoting safer computer practices. Additionally, ergonomic standards provide a mechanism for continued state regulation of occupational health and safety. The challenge for rule makers is ensuring that the standards are a component of comprehensive legal reforms.

2014 - 2015
Over the last two decades there has been a proliferation of literature on program evaluation. Many researches in economics look at the causal effect of exposure of units to programs on some outcomes through econometric and statistical analysis. The units are typically economic agents such as individuals, households, markets, firms, counties, states or countries. The programs can be job search assistance programs, educational programs, vouchers, laws or regulations, drug therapies, environmental exposure or technology shocks. Rubin potential outcomes framework seems to be the dominant framework in which the aim is to compare the two potential outcomes for the same unit when he or she is exposed and not exposed to the program (or treatment)1. However, each unit can be only exposed to one levels of program: an individual may enrol or not in a training program or he (or she) may be subjected or not to policy. We can refer to this as the fundamental problem of causal inference (Holland, 1986; Imbens andWooldridge, 2008). The impossibility to compare the same individual at different treatment status induces to resolve the issue thinking in term of counterfactual. We need to compare distinct units at different levels of treatment. This means to compare different physical units or the same physical unit observed at different times. But each individual or unit who chooses to enrol in a program is (by definition) different from that who chooses not to enrol. These differences may invalidate causal comparison of outcomes by treatment status. Indeed, the fear in this econometrics literature is traditionally related to endogeneity, or self-selection, issues2. The simplest case for analysis is when assignment to treatment is randomized, and thus independent from the covariates as well as the potential outcomes. It is straightforward to obtain attractive estimators for the average effect of treatment in randomized experiments (e.g. the difference in means by treatment status). Although there have been some example 1Starting from the seventies, Rubin (1974, 1977, 1978) proposed to interpret the causal effect as comparison of so-called potential outcomes, namely pairs of outcomes define for the same unit given different levels of exposure to the treatment. This represent the dominant approach to the analysis of causal relationship in observational studies known with the label of Rubin Causal Model. 2Many of the initial theoretical studies focused on the use of traditional methods for dealing with endogeneity, such as fixed effect methods from panel data analyses and instrumental variables methods. Subsequently, the econometrics literatures has developed new approaches, requiring fewer functional form and homogeneity assumptions (Imbens and Wooldridge, 2008). 3/ 12 of experimental evaluations, they remain relatively rare in economics. More common is the case where economists analyse data from observational studies. Observational data generally create challenges in estimating causal effects referred to unconfoundedness, exogeneity, conditional independence, or selection on observable characteristics3. Estimation and inference of causal effect under unconfoundedness assumption requires that conditional on observed covariates there are no unobserved factors that are associated both with the assignment and with the potential outcomes4. Without unconfoundedness assumption there is no general approach to estimating treatment effects and various methods have been proposed (for a review, see Imbens and Wooldridge 2008). Where additional data are present in the form of samples of treated and control units before and after the treatment comparisons can be made through a difference-in-difference approach. The simplest setting is one where outcomes are observed for units observed in one of two groups (i.e. treated and control) and in one of two time periods (i.e. pre-treatment and post-treatment). Only units in one of the two groups, in the second time period, are exposed to a treatment. There are no units exposed to the treatment in the first period, and units from control group are never observed to be exposed to the treatment. To estimate the causal effect, the average change over time in the outcomes of control group is subtracted from the change over time in the outcomes of treated group. This double differencing removes biases in second period comparisons between the treatment and control group, that could be the result from permanent differences between those groups, as well as biases from comparisons over time in the treatment group, that could be the result of time trends unrelated to the treatment. Where the assignment of treatment is a deterministic function of covariates, comparisons can be made exploring continuity of average outcomes as a function of covariates. This setting, known as the regression discontinuity design, has a long tradition in statistics though only recently it has attracted much attention in the economics literature5. The basic idea is that assignment to the treatment is determined, either completely or partly, by the value of a predictor (i.e. an individual’s observable characteristic) being on either side of a common threshold. This generates a discontinuity in the conditional probability of receiving the treatment as a function of this particular predictor. Any other characteristic, between elected and unelected individual, is assumed to be smooth. As a result, any discontinuity of the conditional distribution of the outcome, as a function of this covariate at the threshold, is interpreted as evidence of a causal effect of the treatment6. 3For a review on this literature, see Imbens and Wooldridge (2008). 4Unconfoundedness implies that we have a sufficiently rich set of predictors for the treatment indicator, such that adjusting for differences in these covariates leads to valid estimates of causal effect. 5For recent review in the economics literature, see Van der Klaauw (2008), Imbens andWooldridge (2008) and Lee and Lemieux (2010). 6It may be useful to distinguish between two general setting, the sharp and the fuzzy regression discontinuity design. In the sharp regression discontinuity design, the assignment to treatment is a deterministic function of one of the observable covariates. In the fuzzy regression discontinuity design the probability of receiving the treatment 4/ 12 This thesis presents three essays of policy evaluation using the above quasi-experimental approaches. The research covers two different type of policies. On the one hand, we assess the effects on crime induced by a marijuana decriminalization policy exploiting the reforms still ongoing in the United States, on the other hand, we evaluate the impacts of the labour market reforms on labour market outcomes by using the recent changes in Italy occurred after the law 92/2012 (the so-called Fornero reform) like identification tool. Depending on the specific subject, the analysis is carried out from a specific empirical point of view. The first essay sheds light on the relationship between Medical Marijuana Laws and crimes in United States using counties level data. The set of judicial rules on the therapeutic consumption, production and distribution of cannabis at State level—started since 1996 in the United States—is known as Medical Marijuana Law (MML). It recognises the medical value of marijuana and provides a legal defence for patients who used and possessed marijuana under recommendation of a physician. The purpose of policy was the pain reduction for which the States allow doctors to prescribe marijuana as a pain killer also for general complaints related to pain, such as migraines, back pain and other pathologies. But, since the list of illness is quite broad, de facto, MML allows wide possibility for recreational use of marijuana masked like therapeutic consumptions (Chu, 2012). Hence, the assessment of policy on crime seems suitable. The research closely examining the importance of policy dimensions and the timing of the core elements of MMLs. In the U.S. States there have been three main actions that have involved the cannabis use for medical purpose: the mere decriminalization of marijuana, the permission of home cultivation for patients and caregivers, the licence for selling marijuana in authorized dispensaries. We interpret dimensions as design choices of policy maker on legal marijuana market by distinguishing between demand side approach, aimed to merely decriminalize cannabis, and supply side approach, directed to provide legal sources of supply for marijuana. This permits to explain the possible transmission channel trough which Medical Marijuana State Laws can affect crime. We test three possible links between drugs liberalization reforms and crime (i.e. pharmacological, economic, and systemic channels) finding evidence for only one of them (i.e. systemic channel). The analysis uses the Uniform Crime Reporting Program Data (UCR, 2013) which reports the number of arrests by type of offence from 1994 to 2014 at the U.S. county level. Since we have data of treated and control counties before and after the implementation of MML, we employ difference-in-difference approach by considering several types of crime such as violent and property crimes, and also felonies for narcotic possession (i.e. cocaine, heroine need not change from zero to one at the threshold. The design only requires a sufficiently large discontinuity in the probability of assignment to the treatment at the threshold. 5/ 12 etc.). We exploit the assessment of Medical Marijuana Law to highlight an important question in program evaluation concerning the heterogeneity of treatment effect. Even if the average treatment effect is zero, it may be important to establish whether a targeted implementation of intervention or different levels of treatment across the population could affect average outcome. We find that a simple dichotomous indicator of Medical Marijuana Law (i.e. the average treatment effect on all the U.S. States that passed the policy) may mask crucial dynamics underlying the relationship between policy and crime. Assuming a homogeneous impact of policy on crime, regardless the action implemented, the dichotomous indicator of MML captures only the net effect of the regulatory tools put in place by the legislator. On the contrary, the policy decomposition in key dimensions allows to discover different results which suggests a heterogeneous effects on crime according to the specific regulatory actions put in place by the legislator. In detail, for burglaries, larcenies, and cocaine drug possession, the mere application of demand side approach increases the crime in counties that passed the policy compared to counties without MML. While, the joint application of demand and supply approach— which establish legal sources for supply marijuana — may be able to realize a crowding-out effect on these offences. The findings support the idea that the licit competition on the marijuana market, triggered by the policy, could push out the illegal trade decreasing the crime. Finally, we find a net reduction in murders and a net increase in synthetic drug possession for the U.S. counties subject to the Medical Marijuana Law relatively to counties never passed the policy. The second and the third essays assess the impact of law 92/2012, implemented in Italy in 2012 (the so-called Fornero reform), on different labour market outcomes. The law 92/2012 introduced numerous changes regarding employment relationships amending past discipline. First. It substantially changed the discipline concerning the dismissals in firms above 15 employees. The reform established that in case of unfair dismissal, the dismissed worker has no longer the right to be reinstated as in the pre-reform period and receives a monetary compensation that ranges between 12 and 24 months pay. Thus the reform significantly reduces the firing cost borne by large firms. Second. Starting from January 2013, the Fornero reform also changed the discipline on apprenticeships concerning to the minimum duration of contract (no less than six months), the maximum number of apprentices that an employer can hire per each skilled worker (passed from 1:1 to 3:2), and the minimum number of apprentices that an employer must stabilize into permanent contracts for hiring a new apprentice (at least the 30% of apprentices hired in the last 12 months). Third. The Fornero reform implemented a new incentive program in favour of employers that recruit (on fixed-term or open-ended contracts) or stabilize into permanent agreements a worker aged 50 or more years. 6/ 12 The second essay (carried out with Giovanni Pica) estimates the effect of employment protection legislation on the flow of monthly hirings on open ended contracts using the aforesaid labour market reform passed in Italy in 2012. Much empirical research has focused on the effects of dismissal costs on labour market outcomes. The evidence suggests that EPL decreases employment inflows and outflows with little effect on employment and unemployment stocks. The reason is that firing costs act, in expected discounted value, as hiring cost reducing the willingness of the firms to both fire and hire workers (Bentolila and Bertola, 1990; Blanchard and Portugal, 2001). The most recent studies identify the causal impact of employment protection on labour market outcome exploiting within-county variation in EPL either across firms (e.g. of different size) or workers (e.g. of different age and/or tenure). The essay presented is in the line with within-county approach which allows to better control for time-varying unobserved characteristics that may affect labour market outcomes (act as confounding factors) compared to cross-country analyses. The presence of both treated and control firms observed before and after the policy — where the assignment of treatment depends in deterministic way from the number of workers employed — allows to implement a difference-in-difference approach jointly to a regression discontinuity design. We thus exploit the differential law change between firms with more and less than 15 workers comparing hirings in firms just above and below the 15 employee threshold before and after the reform (July 2012). The analysis is based on monthly data drawn from Italian Social Security (INPS) record for the period 2012 and 2014. The data provide information on the number of newly hired workers by firms size, province, sector, contract type, age and gender at a monthly frequency. The findings suggest that the reform raises monthly hirings on open-ended contracts by about 5.1 percentage points. The quantification of results reveals that the reduction of dismissal costs after the reform have induced about 4000 hirings per month in firms with more than 15 workers relative to firms with less than 15 workers. The effect of the reduction in EPL is not homogeneous across workers’ types. The increase seems to be more pronounced for full-time, young, and blue-collar workers. Conversely, we find no significant effect on the number of conversions of temporary contracts into permanent ones. The third essay evaluates the impact of labour policies aimed to improve the job possibilities for workers categorized as vulnerable (particularly in labour markets with stringent employment protection)7. Given the increasingly complicated transition from school to works, the youth appear a group more vulnerable compared to the past. Here the apprenticeship contract performs a crucial role by improving the job possibility and the stability of young workers (Berton et al., 2007; Casale et al., 2014). At the same time, the low employment rates for older workers pushed most OECD countries 7Evidences suggest that labour market prospects for youth and other marginal groups seem to worsen as a consequence of stringent EPL (Allard and Lindert, 2007; Bertola et al., 2007; Skedinger, 2010). 7/ 12 to experiment specific employment protections with the purpose to protect them from unemployment or/and to improve their job finding rates (Chéron et al., 2011). The Fornero reform intervenes by changing the discipline of apprenticeship in Italy and implementing a new incentive program for workers aged 50 or more years. The reform asymmetrically acted on the apprenticeships by changing the discipline in firms with more than 10 employees leaving the rules for firms below 10 unchanged. Likewise, the new incentive program for workers aged 50 or more years, passed with the Fornero reform, cut the hiring costs in firms that recruit workers over-50, leaving unaffected the costs for hiring workers under-50. These discontinuities in the regulation as well as the simultaneous presence of treated and control groups observed before and after the policy allow to implement a difference-in-deference method jointly to a regression discontinuity design. This quasi-experimental method permits to evaluate the causal effect of reform on the monthly hirings of apprentices and workers over-50. We thus exploit the differential law change in apprenticeships between firms with more and less than 10 employees, comparing the hirings and the conversions into open-ended contracts of apprentices in firms just below and above the 10 employees threshold before and after the reform (January 2013). Similarly, we compare the recruitments and the conversions into permanent contracts of workers with more and less 50 years before and after the reform. Also this analysis uses monthly data draw from Italian Social Security (INPS) record for the period 2012 and 2014. The findings suggest that the change in apprenticeships increase the stabilization of apprentices into open-ended contracts by about 3.9 percentage points in firms with more than 10 employees relative to firms with less than 10. We also find a positive association between law 92/2012 and the new recruitments of apprentices by about 7.1 percentage points in firms with more than 10 employees relative to firms with less than 10 employees. The employer incentives for hiring and stabilizing the workers aged 50 or more years positively affect the recruitments into open-ended contracts of workers over-50 relative to workers under-50 by about 1.6 percentage point. We also find a positive association between the incentive program and the hirings into fixed-term contracts of workers over-50 relative to workers under-50. Conversely, we don’t find effects for the conversions into open-ended contracts of workers aged 50 or more years. [edited by author]
Proposito della tesi di dottorato, dal titolo “Three Essays on Policy Evaluation”, è quello di sottolineare come l’impatto di una politica (economica e non) possa essere valutato secondo un approccio rigoroso, quasi-sperimentale, quando architettata adeguatamente a tale scopo. A tal proposito, sono mostrati tre esempi di valutazione delle politiche, nel corso dei quali si espongono ed affrontano le principali problematiche legate a questo tipo di esercizio. L'interesse dell'approccio adoperato nella presente tesi è dato dall'ampia utilizzazione del metodo difference-in-difference che consente di stimare, in vari contesti, gli impatti che politiche di differente natura possono avere sulle variabili socio-economiche. Ciascuno degli esercizi di valutazione costituisce un capitolo della tesi. Ogni uno di essi ha comportato una rassegna della letteratura in materia (allo scopo di inquadrare il tema trattato), la ricerca dei dati e l’elaborazione di uno specifico modello econometrico finalizzato all’identificazione del nesso causale. Il primo capitolo valuta l’impatto che le politiche di decriminalizzazione della cannabis per scopi terapeutici (Medical Marijuana Laws), adottate nei singoli Stati degli Stati Uniti, hanno avuto sulla criminalità a livello di contea. L’impatto della riforma è valutato rispetto a differenti tipologie di crimini, tratti dal UCR del FBI, classificabili in reati legati alla persona (i.e. omicidi), alla proprietà (i.e. furti) e all’uso di altre sostanza stupefacenti (i.e. cocaina). Dal lavoro emerge come ciascuno Stato americano si differenzi dagli altri sia per le tempistiche che per le modalità attuative della decriminalizzazione. L’originalità del lavoro sta nello sfruttare questa eterogeneità. Esso, infatti, propone una scomposizione della politica di decriminalizzazione della cannabis in interventi chiave, legati alle specifiche azioni adottate in tema di approvvigionamento e di distribuzione della marijuana. Tale scomposizione permette di identificare come l’impatto sui crimini commessi vari a seconda del timing e delle modalità di approvazione della decriminalizzazione. La scomposizione consente, inoltre, di ipotizzare un possibile canale di trasmissione attraverso il quale la Medical Marijuana Law impatterebbe sui crimini. I risultati empirici suggeriscono che la semplice decriminalizzazione della marijuana avrebbe un impatto positivo sulla criminalità se non accompagnata da (contestuali) interventi finalizzati ad istituire fonti legali di approvvigionamento della sostanza. Il secondo capitolo studia il ruolo che i meccanismi di protezione dell’occupazione (employment protection legislation) esercitano sui flussi in entrata del mercato del lavoro. A tale scopo, il lavoro stima l’impatto sulle assunzioni (e conversioni) in contratti a tempo indeterminato indotto dalla riforma del mercato del lavoro in Italia – legge n. 92 del 2012 (cd. riforma Fornero) – che ha ridotto i costi di licenziamento in carico alle imprese con più di 15 dipendenti, lasciando inalterata la situazione per le imprese con meno di 15 dipendenti. Il lavoro, oltre ad inquadrare la tematica con una rassegna della letteratura, sfrutta l’asimmetrico impatto della riforma (per le imprese appena sopra e appena sotto i 15 dipendenti) per stimare un modello difference-in-difference in un contesto di regression discontinuity design, utilizzando dati mensili INPS. I risultati empirici suggeriscono che la riduzione delle protezioni del lavoro incrementi le assunzioni in contratti a tempo indeterminato. Tale effetto risulta non omogeneo tra i diversi gruppi di lavoratori, mostrandosi più pronunciato per gli assunti full-time, più giovani ed operai. Al contrario, non emerge un chiaro effetto rispetto alle conversioni in contratti a tempo indeterminato. Infine, il terzo capitolo esamina le politiche del lavoro aventi l’obiettivo di aumentare le possibilità occupazionali di categorie ritenute più vulnerabili, quali i giovani lavoratori e gli over-50. A questo scopo, si utilizza la riforma dell’apprendistato e l’introduzione di un nuovo schema di incentivi per i lavoratori over-50, in forza in Italia a partire da gennaio 2013 (legge 92/2012), per stimare l’impatto che tali tipologia di interventi hanno sulle nuove assunzioni (sia a tempo determinato che indeterminato) e sulle conversioni in contratti a tempo indeterminato. Nello specifico, la riforma dell’apprendistato ha introdotto, per le imprese con più di 9 dipendenti, nuovi obblighi di stabilizzazione degli apprendisti assunti ed ha innalzato il rapporto tra gli apprendisti e i lavoratori qualificati presenti in azienda. Al contrario, la riforma lascia inalterata la situazione per le imprese sotto i 10 dipendenti. Lo schema di incentivi per l’assunzione e la stabilizzazione dei lavoratori over-50 consta, invece, in un significativo abbattimento (50 per cento) dei contributi a carico impresa per i lavoratori con più di 50 anni, lasciando inalterata la situazione per i soggetti più giovani. Le suddette circostanze hanno reso possibile l’implementazione di un modello difference-in-difference in un contesto di regression discontinuity design, utilizzando dati mensili INPS. I risultati empirici dimostrano che la riforma dell’apprendistato ha effettivamente favorito la stabilizzazione degli apprendisti in contratti a tempo indeterminato. Lo schema di incentivi per gli over-50 sembrerebbe indurre nuove assunzioni tanto in contratti a tempo indeterminato quanto a tempo determinato. L’effetto sulle conversioni, invece, sembrerebbe trascurabile. [a cura dell'autore]
XIV n.s.

Thesis (MBA)--Stellenbosch University, 2007.
ENGLISH ABSTRACT: This study provides an overview of the medical aid industry in South Africa and highlights the impact of the formation of the Council for Medical Schemes through the implementation of the Medical Schemes Act of 1998. The regulatory framework that governs the medical aids in South Africa is analysed. In this study. different medical aid funds are compared in terms of administration costs, required solvency levels and membership numbers relative to the acceptable industry averages. The main cost drivers of medical aid funds that could also threaten the future of private medical care are identified, as these services may not be affordable to most South Africans in the future. The new vision of government in terms of healthcare is outlined, and the regulations that will be implemented to transform the healthcare sector into a Social Health Insurance system, and ultimately into a National Health Insurance system. are analysed. The proposed mechanisms, such as the Risk Equalisation Fund, the Government Employees Medical Scheme and lowincome medical schemes, are discussed, highlighting all their advantages as well as the associated risks for the sustainability of private medical care. The proposed new legislation and the potential negative financial impact on the private medical industry are analysed with detailed reference to the Medical Schemes Act of 1998 and the Medicines and Related Substance Control and Amendment Act of 1997. The implications of fundamental changes proposed in private health insurance, such as community risk rating versus the traditional individual risk rating, are discussed. The negative impact of prescribed minimum benefits (which include HIV/Aids) on the financial sustainability of the medical aid industry is highlighted. The impact of HIV/Aids on the sustainability of the medical aid industry is discussed and some conclusions and recommendations are made regarding the financial sustainability of the medical aid industry and hence the future of private medical care in South Africa.
AFRIKAANSE OPSOMMING: Hierdie studie is 'n oorsig van die mediesefondsbedryf in Suid·Afrika, en beklemtoon die impak van die totstandkoming van die Raad van Mediese Skemas deur die impJementering van die Wet op Mediese Skemas van 1998. Hierdie regulatoriese raamwerk, wat mediese fondse in SuidAfrika tans reguleer, word in die studie ondersoek. In hierdie studie word van die grootste mediese fondse in tenne van administratiewe koste, voorgeskrewe fondsreserwes en lidmaatskapgetalle relatief tot die aanvaarde bedryfsnonne met rnekaar vergelyk. Die belangrikste koste-items vir mediese fondse wat die voortbestaan van privaat gesondheidsorg kao bedreig, word ontleed cmdat hierdie dienste in die toekoms vir die rneeste Suid-Afrikaners onbekostigbaar kan word. Die regering se nuwe visie vir gesondheidsorg word uiteengesit. asook die regulasies wat germplementeer sal word om die gesondheidsektor na 'n sosiale gesondheidsversekeringstelsel en uiteindelik na tn nasionale gesondheidstelsel te transfonneer. Die voorgestelde meganismes, seos die Risiko-egalisasiefonds, GEMS en laeinkomste-mediesefondse word bespreek, met al die relevante voor- en nadele, tesame met die geassosieerde risiko's vir die voortbestaan van privaat mediese dienste. Die voorgestelde wetgewing en die gevolglike negatiewe finansiele impak op die privaat gesondheidsbedryf, met spesifieke verwysing na die Wet op Mediese Skemas van 1998 asook die Wet op die Beheer van Medisyne en Verwante Middels van 1997, word ondersoek. Die implikasies van fundamentele veranderinge wat in terme van gesondheidsversekering voorgestel word, soos gemeenskapsrisikogradering teenoor individuelerisikogradering, word bespreek. Voorgeskrewe minimum voordele (wat MIV insluit) wat nou ingevolge wetgewing ten volle deur fondse betaal moet word, se potensiele negatiewe impak op die finansiele lewensvatbaarheid van mediese fondse word beklemtoon. Die potensiele negatiewe impak van die MIV-epidemie op die lewensvatbaarheid van die mediesefondsbedryf word bespreek en gevolg deur aanbevelings om die fmansiele lewensvatbaarheid en toekoms van die privaat gesondheidsbedryf in Suid-Afrika te verseker.

Thesis (LLM)--Stellenbosch University, 2012.
Includes bibliography
ENGLISH ABSTRACT: In South Africa gender-based violence (hereafter “GBV”) has reached extreme levels. This violent manifestation of gender inequality is compounded by the fact that women are disproportionately affected by poverty, the HIV/AIDS epidemic and inadequate health care services. This is in spite of South Africa’s progressive constitutional and legislative framework which appears highly conducive to combating gender inequality and GBV. For example, the Constitution protects the right to equality (section 9), human dignity (section 10), life (section 11), freedom and security of the person (section 12) and the right to have access to health care services, including reproductive health (section 27(1)(a)). Extensive legislation has also been enacted for the protection of women. For example, the preamble to the Domestic Violence Act 116 of 1998 (hereafter “DVA”) recognises domestic violence as a serious social evil. While the DVA is notably silent as to the role of the health care sector, the DVA is progressive in that it contains a broad definition of domestic violence, and recognises a wide range of relationships. The Criminal Law (Sexual Offences and Related Matters) Amendment Act 32 of 2007 also seeks to afford complainants of sexual offences “the maximum and least traumatising protection that the law can provide”. In addition to this, South Africa has international law obligations to address GBV and gender inequality. For example, under the Convention on the Elimination of All Forms of Discrimination against Women (1979), States are obliged to address private acts of violence and to remove discrimination against women in all fields, including health. However, despite this progressive framework of rights, some interpretations of these integral rights have been unduly formalistic, in addition to being disengaged from the lived reality of many women. There is also a substantial gap between policy and practice, with the implementation of existing legislation a continuing problem. It is therefore imperative that we analyse the right to have access to health care services through a gender lens so as to transcend a purely legalistic perspective and to interrogate gendered social processes and power relations. This thesis analyses how existing law and policy can be transformed so as to be more responsive to these lived realities and needs of survivors of GBV.
AFRIKAANSE OPSOMMING: Geslagsgebaseerde geweld (hierna ‘GGG’) in Suid-Afrika het uiterste vlakke bereik. Hierdie gewelddadige manifestasie van geslagsongelykheid word vererger deur die feit dat vroue buite verhouding erg deur armoede, die MIV/vigs-epidemie en ontoereikende gesondheidsorgdienste geraak word. Dit is ondanks Suid-Afrika se vooruitstrewende grondwetlike en wetsraamwerk wat op die oog af hoogs bevorderlik vir die bestryding van geslagsongelykheid en GGG voorkom. Die Grondwet verskans, byvoorbeeld, die reg op gelykheid (artikel 9), menswaardigheid (artikel 10), lewe (artikel 11), vryheid en sekerheid van die persoon (artikel 12) en toegang tot gesondheidsorgdienste, met inbegrip van reproduktiewe gesondheidsorg (artikel 27(1)(a)). Omvattende wetgewing oor vrouebeskerming is ook reeds uitgevaardig. Die aanhef tot die Wet op Gesinsgeweld 116 van 1998 (hierna die ‘WGG’) identifiseer, byvoorbeeld, huishoudelike geweld as ’n ernstige maatskaplike euwel. Hoewel die WGG swyg oor die rol van die gesondheidsorgsektor, is dit nietemin vooruitstrewend aangesien dit ’n uitgebreide omskrywing van huishoudelike geweld bevat en ’n wye verskeidenheid verhoudings erken. Die Wysigingswet op die Strafreg (Seksuele Misdrywe en Verwante Aangeleenthede) 32 van 2007 is ook daarop afgestem om klaagsters van seksuele oortredings “die omvattendste en mins traumatiese beskerming te gee wat die wet kan bied”. Daarbenewens verkeer Suid-Afrika onder internasionale regsverpligtinge om GGG en geslagsongelykheid aan te spreek. Ingevolge die Konvensie vir die Uitwissing van Alle Vorme van Diskriminasie teen Vroue (1979), byvoorbeeld, is state verplig om privaat geweldsdade teen te staan en diskriminasie teen vroue op alle gebiede te verwyder, insluitend gesondheid. Nietemin, benewens hierdie vooruitstrewende menseregteraamwerk is sommige interpretasies van hierdie onafskeidbare regte nie net oormatig formalisties nie, maar ook verwyderd van die daaglikse realiteit van baie vroue. Daar is ook ʼn wesenlike gaping tussen beleidsmaatreëls en die praktyk, terwyl die uitvoering van bestaande wetgewing ʼn voortgesette probleem verteenwoordig. Dit is dus gebiedend om die reg op toegang tot gesondheidsorgdienste deur ʼn geslagslens te analiseer om sodoende ʼn bloot regsgedrewe perspektief te bo te gaan en om maatskaplike prosesse en magsverhoudinge in oënskou te neem. Hierdie tesis analiseer hoe bestaande wetsraamwerke en beleidsmaatreëls getransformeer kan word om beter te reageer op die realiteite en behoeftes van oorlewendes van GGG.
Stellenbosch University Hope Project
Bradlow Foundation

This thesis seeks to demonstrate, by way of a multidisciplinary study, that consent is, despite its legal definition which refers to the free and enlighted expression of individual will, in fact, at times limited if not eliminated, by social considerations, arising from the medical, economic and legal context. These considerations reflect what one might call the social norm. An appropriate understanding of consent serves, therefore, to express the social norm as a constraint, which, in turn, acts as a measure of what it means to belong in society. Thus, while consent is often presented as the fundamental principle to be respected in biomedical research, it is in reality, merely one principle to respect among others. These limitations connected to consent are exacerbated in emergency situations where consent is sometimes reduced to mere signature, and in some cases it has been recognized that research can be undertaken without the subject's prior consent.

Thesis (LLM)--University of Stellenbosch, 2004.
ENGLISH ABSTRACT: The monitoring of electronic communication is likely to face all employers sooner or later. The rapid advancement in technology aimed at helping to monitor electronic communication, makes it easier than ever before for employers to monitor the electronic communications of their employees. There are important questions to consider when dealing with the topic of monitoring electronic communication. Examples include "mayan employer legally monitor electronic communications?" and "how does monitoring affect the employee's right to privacy?" This thesis is an attempt to answer these and other related questions by analysing, inter alia, South African legislation, the Constitution and case law, as well as comparing the law as it applies in the United Kingdom and the United States of America. The analysis and conclusion offered in this thesis aim to provide theoretical consideration to academics and practical application for employers that are faced with the reality of monitoring electronic communications.
AFRIKAANSE OPSOMMING: Alle werkgewers sal waarskynlik die een of ander tyd met die monitering van elektroniese kommunikasie gekonfronteer word. Die snelle voortuitgang in tegnologie wat daarop gemik is om te help met die monitering van elektroniese kommunikasie, maak dit vir werkgewers makliker as ooit tevore om sodanige kommunikasies van hulle werknemers te monitor. Daar is egter belangrike vrae wat oorweeg moet word wanneer die onderwerp van monitering van elektroniese kommunikasie ter sprake kom. Voorbeelde hiervan is "mag 'n werknemer regtens elektroniese kommunikasies monitor?" en "hoe raak monitering die werknemer se reg tot privaatheid?" Hierdie tesis is 'n poging om hierdie en ander verwante vrae te beantwoord deur die ontleding van, onder andere, Suid-Afrikaanse wetgewing, die Grondwet en die reg soos deur hofuitsprake ontwikkel, sowel as vergelyking van die reg soos wat dit van toepassing is in die Verenigde Koninkryk en die Verenigde State van Amerika. Die ontleding en gevolgtrekking wat in hierdie tesis aangebied word, is gemik op die verskaffing van teoretiese oorweging aan akademici en praktiese toepassing vir werkgewers wat met die realiteit van die monitering van elektroniese kommunikasies gekonfronteer word.

This thesis examines the legal protection of public employees who are HIV-infected or have AIDS in Canada and the United States. Emphasis is placed on the dealing with mandatory HIV-testing schemes in each country. To this end, the first section presents medical facts about the disease itself, the transmission risks, and testing methods as ethical considerations about HIV-testing schemes. The second section addresses the protection standards guaranteed by the Constitution of the United States and compares them to the standards set out by the Canadian Charter of Rights and Freedoms . Finally, the third section compares protection offered under the Rehabilitation Act of 1973, the Americans with Disabilities Act, and the Canadian Human Rights Act.

Lack of access to essential medicines has proven to be a persisting problem which is in conflict with the goal of realising the right to health envisaged by the South African constitution and international human rights instruments. With more than twenty years of democracy, South Africa is still plaguing with a multiplicity of pandemics such as HIV and AIDS, cancer, malaria, tuberculosis, among others, leading to premature death and untold suffering of the people. According to a 2015 United Nations AIDS (UNAIDS) Gap report, South Africa is still regarded as the epicentre of HIV and other infectious diseases. The 2015 UNAIDS Gap report states that South Africa has more women than men living with HIV and AIDS. The report further indicates that the impact of this pandemic is worsened by the inaccessibility of essential medicines that are vital for life saving. This dissertation posits that the epidemiological health crisis described above can be largely eradicated through the utilisation of the right to health. The right to health, according to this dissertation, contains a legal and transformative power which can be utilised to limit the negative impact of patent laws on access to essential medicines in South Africa. This dissertation validates the long held view that World Trade Organisation (WTO) intellectual property laws have contributed to the inaccessibility of essential medicines through causing patent ever greening, patent linkages and pharmaceutical company’s monopolies. Consequently, many marginalised groups in South Africa lack access to essential medicines owing to the higher prices charged for such medicines thus violating the right to health, life and other fundamental human rights. The right to health which is the immediate right infringed when there is lack of access to essential medicines form the core theme of this dissertation. This dissertation argues that access to essential medicine is a fundamental part of the right to health protected under international and national human rights instruments. This dissertation further argue that the right to health imposes obligations which requires South African government to take reasonable legislative and other measures, within its available resources, to provide access to essential medicines. The dissertation‘s key contribution is its proposed solutions on how to ensure that patents rules in South Africa are tamed with obligations consistent with the right to health. If properly implemented, these solutions have the potential to give greater specification to the normative commitments imposed by the right to health in the patent claims scenarios.

The use of medical devices and drugs is constantly increasing in the United States. New techniques are developed, pharmaceutical companies manufactured thousands drugs and medical devices each year, these products are put on the market immediately; therefore, the consequences can be terrible.
In the US, thousands even millions of people suffer from personal injuries because they use a defective medical product; this is referred as a mass tort. The class action procedure is often used in order to repair these personal injuries. Plaintiffs always ask for the use of this procedure, but the federal American courts always refuse the certification of the class because the conditions of Rule 23(b)(3) are not fulfilled. This is what is called "the new trend of American courts".
The non application of the class action procedure leads to terrible results; victims of a defective medical product cannot receive compensation for the injury they are suffering from. These victims choose the class action procedure because of its advantages, if the class action is not certified they won't sue individually. If the real problem was the non respect of Rule 23(b)(3)'s conditions, a modification or a reform of the Rule would have been done. Unfortunately the laxity of the federal judges tends to influence the American Congress who ignores the need for a reform of this rule. This makes us wonder what the real justifications motivating this refusal of certification are.

Digital rights activism constitutes an exemplary case of how internet affordances can be mobilised to engender political change. The values and principles stemming from the hacker imaginaire, and free and open source software practices, underpin digital rights activism, which uses the internet as a tool, object and platform for the protection of rights in the digital realm. The analysis focuses on how digital rights activists use and adapt the political affordances of the internet to intervene in European Union policy-making. Two original case studies of internet-based campaigning at the European level (the “No Software Patents” and the “Telecoms package” campaigns) provide in-depth insight into the campaigning processes and their impact upon parliamentary politics. The cases highlight the complementarity of online and offline collective action, by examining processes of open collaboration, information disclosure and internet-assisted lobbying. The success of the “Telecoms package” campaign is then assessed, along with the perspective of the targets: members and staff of the European Parliament.

The belief in values of freedom, decentralisation, openness, creativity and progress inspires a particular type of activism, which promotes autonomy, participation and efficiency. The empirical evidence suggests that this set of principles can, at times, conflict with practices observed in the field. This has to do with the particular opportunity structure of the European Union and the characteristics of the movement. The EU favours functional integration of civil society actors who are expected to contribute technical and/or legal expertise. This configuration challenges internet-based protest networks that rely on highly independent and fluctuating engagement, and suffer from a lack of diversity and cohesion. The internet does not solve all obstacles to collective action. It provides, however, a networked infrastructure and tools for organising, coordinating and campaigning. Online and offline actions are not only supportive of each other. Internet-based campaigning can be successful once it reaches out beyond the internet, and penetrates the corridors of political institutions.

Doctorat en Information et communication
info:eu-repo/semantics/nonPublished

Thesis (MPhil)--University of Stellenbosch, 2002.
ENGLISH ABSTRACT: The implementation of eugenic policies reached its peak during the zo" century when thousands of people with intellectual disabilities and other "undesirable qualities" were involuntary sterilized. Although most of the eugenic policies have been removed, countries such as South Africa, still make legally provision for the involuntary sterilization of people with intellectual disabilities. Torbjërn Tannsjë (1998) used the "argument from autonomy" to argue that involuntary sterilization practices are wrong because it involves compulsion. According to him, society should never interfere with people's reproductive choices and people should never be required to qualify for the right to have children. The aim of this assignment was to systematically assess the "argument from autonomy" as far as the policy of involuntary sterilization of people with intellectual disabilities is concerned. To this end, the concept of autonomy and the principle of respect for autonomy are discussed and applied to the intellectually disabled. It is argued that autonomy and respect for autonomy are useful concepts to apply to some people with intellectual disabilities. These individuals should not be automatically assumed to be incompetent, but their competence needs to be determined on an individual level, with reference to the complexity of the decision to be made. Special effort is needed from health care professionals to obtain (where possible) informed consent from people with intellectual disabilities. The application of the principle of respect for autonomy to matters of reproduction leads to the conclusion that people with severe to profound levels of disability, are unable to provide informed consent for sexual intercourse. Therefore some form of paternalistic protection is needed for these individuals. People with mild to moderate intellectual disabilities who are however competent to consent to sexual intercourse should never be prohibited from procreation by means of involuntary sterilization. State interference in matters of reproduction should be limited to interventions where (i) children are seriously harmed by parents and (ii) to protect those who are incompetent to consent to sexual interactions with others. Apart from these exceptions, the intellectually disabled is entitled to the same procreative rights as all other citizens.
AFRIKAANSE OPSOMMING: Die implementering van eugenetiese beleid het gedurende die 20 ste eeu 'n hoogtepunt bereik met die onwillekeurige sterilisering van duisende persone met intellektuele gestremdhede en ander "ongewensde kwaliteite". Alhoewel meeste van die eugenetiese wetgewing verwyder is, maak lande soos Suid-Afrika steeds wetlik voorsiening vir die onwillekeurige sterilisasie van persone met intellektuele gestremdhede. Torbjërn Tannsjo (1998) maak gebruik van die "outonomie argument" om te argumenteer dat onwillekeurige sterilisasie praktyke onaanvaarbaar is omdat dit dwang bevat. Hy voer aan dat die samelewing nooit in die reproduktiewe keuses van mense behoort in te meng nie en dat dit nooit vir mense nodig moet wees om vir ouerskap te kwalifiseer nie. Die doel van hierdie werkstuk was om sistematies die "outonomie argument" te analiseer ten opsigte van die beleid van die onwillekeurige sterilisasie van persone met intellektuele gestremdhede. Met hierdie doel voor oë word die konsep outonomie en die beginsel van respek vir outonomie bespreek en toegepas op die intellektueel gestremde persoon. Daar word aangevoer dat outonomie en respek vir outonomie nuttige beginsels is om in ag te neem in kwessies rakende intellektueel gestremdes. Hierdie individue moet nie outomaties as onbevoeg beskou word nie, maar hul bevoegdheid moet eerder op 'n individuele basis beoordeel word, inaggeneem die kompleksiteit van die besluit wat geneem moet word. Voorts word daar van gesondheidsorgpersoneel verwag om moeite te doen met die verkryging van oorwoê toestemming (waar moontlik) by persone met intellektuele gestremdhede. Die toepassing van die beginsel van respek vir outonomie op aspekte rakende reproduksie, lei tot die gevolgtrekking dat persone met ernstige intellektuele gestremdhede nie in staat is om toestemming tot seksuele omgang te verleen nie. Dus, is 'n vorm van paternalistiese beskerming in hierdie gevalle aangedui. Persone met intellektuele gestremdhede wat egter wel bevoeg is om toestemming tot seksuele omgang te verleen, moet nooit weerhou word van voortplanting deur middel van onwillekeurige sterilisering nie. Inmenging deur die staat in kwessies rakende reproduksie moet beperk word tot intervensies waar (i) kinders ernstige skade berokken word en (ii) die beskerming van persone wat onbevoeg is om toestemming tot seksuele interaksies met ander te verleen, benodig word. Afgesien hiervan, is die intellektuele gestremde persoon geregtig op dieselfde reproduktiewe regte as alle ander landsburgers.

Includes bibliographical references (leaves 280-305). Argues that despite the liberal use of social control theory in the literature on the social history of venereal diseases, rationale discourses do not necessarily lead to government intervention. Comparative analysis reveals that culturally similar locations can experience similar impulses and constraints to the development of social policy under differing constitutional arrangements.

Mental health treatment in state prisons is revealed to be highly variable, under-funded, and systematically inadequate. Existing literature exposes this injustice but fails to provide a comprehensive proposal for reform. This paper attempts to fill that gap, outlining a cost-effective, evidence-based treatment proposal, directly addressing the deficits in care revealed through analysis of our current system. In addition, this paper provides historical overviews of the prison system and mental health treatment, utilizing theoretical perspectives to contextualize this proposal in the present state of affairs. Lastly, the evidence is provided to emphasize the potential economic and social benefits of improving mental health treatment in state prisons. Significant findings suggest a clear financial, legal, and moral incentive for states to address this issue, while the proposal provides a viable method of doing so.

Objects of dissertation: the quality in health care inpatient institutions and health damage compensation in medical malpractice litigation cases. This work is a scientific assessment of the implementation of the patients‘ rights to quality in health care and health damage compensation in Lithuania, where the functioning of two patients' rights is assessed in a systematic and integrated manner, both in the medical and the legal aspect. Research: the modified Picker Institute‘s questionnaire was used for the scientific research of 1917 patients treated in hospitals in order to examine and assess their opinions on the quality of health care provided to them and evaluate the opportunities to realize their right to health care of good quality. The study analyzed 32 medical malpractice lawsuit cases of general jurisdiction courts in terms of the principles of health damage compensation, procedural characteristics and efficiency. Conclusions: statutory regulation of patients 'rights to quality in health care services and health damage compensation in Lithuania meets international and European patients' rights protection principles. The research showed that the vast majority of surveyed patients (nine out of ten) realized their right to quality in health care service in the hospital. However, six out of ten plaintiffs received the health damage compensation, plaintiffs were awarded only nearly a fifth of the requested overall pecuniary and non-pecuniary damages.
Disertacijos objektai: sveikatos priežiūros paslaugų kokybė stacionarinėse asmens sveikatos priežiūros įstaigose ir žalos sveikatai atlyginimas gydytojų civilinės atsakomybės bylose. Šis darbas - pacientų teisių į kokybišką sveikatos priežiūros paslaugą ir žalos sveikatai atlyginimą įgyvendinimo mokslinis vertinimas Lietuvoje. Iki šiolei paciento teisė į kokybišką sveikatos priežiūros paslaugą nacionaliniuose moksliniuose darbuose buvo analizuojama kokybės vadybos aspektu, o teisė į žalos sveikatai atlyginimą buvo vertinama pagal galiojančius teisės aktus ir Lietuvos teismų praktiką. Tai pirmasis mokslinis darbas, kuomet dviejų pacientų teisių funkcionavimas vertinamas sistemiškai ir integruotai, kartu tiek medicininiu, tiek teisiniu požiūriais. Tyrimai. Pritaikius Europos Picker instituto modifikuotą klausimyną tirta 1917 stacionarinėse asmens sveikatos priežiūros įstaigose gydytų pacientų nuomonė apie jiems suteiktų sveikatos priežiūros paslaugų kokybę ir vertintos pacientų galimybės realizuoti teisę į kokybišką sveikatos priežiūros paslaugą. Analizuotos 32 LR bendrosios kompetencijos teismų civilinės bylos dėl žalos sveikatai atlyginimo, vertinant patirtos žalos sveikatai kompensavimo principus, procesinius ypatumus bei efektyvumą, atskleidžiant probleminius paciento teisės į žalos sveikatai atlyginimą įgyvendinimo aspektus. Disertacijos išvadose konstatuojama, kad paciento teisių į kokybišką sveikatos priežiūros paslaugą ir žalos sveikatai atlyginimą įstatyminis... [toliau žr. visą tekstą]

As empresas de manufatura necessitam integrar seus processos internos digitalmente para se tornarem mais competitivas e entregarem produtos com maior qualidade ao mercado consumidor. Informações definidas nas primeiras etapas de projeto precisam ser recuperadas em todas as fases do ciclo de vida de um produto. Para alcançar este objetivo são necessários modelos de informação que incorporem inteligência e permitam a representação do mundo real. Por outro lado, fabricantes de produtos eletroeletrônicos precisam cumprir requisitos ambientais presentes em marcos regulatórios, como a Diretiva RoHS, para poderem vender seus equipamentos em diversos países. O presente trabalho propõe a aplicação de modelos semânticos para ajudar as empresas a cumprir os requisitos estabelecidos pela Diretiva RoHS. O modelo, criado usando uma ontologia de referência, estabelece relações semânticas entre entidades que representam fases do ciclo de vida do produto, estruturas de produtos e objetos de negócios. Processos de negócio modelados permitem identificar fluxos de informação, bem como atividades que estão ligadas aos requisitos RoHS, percebidas por meio da geração de relatórios disponíveis no framework denominado Projeto Essential. O modelo semântico resultante é, portanto, útil para converter as necessidades relacionadas com o meio ambiente, endereçando requisitos através de um processo de desenvolvimento de produtos que aborda a diretiva RoHS. Um produto eletroeletrônico fabricado por indústrias nacionais foi selecionado para demonstrar a viabilidade da solução proposta.
Manufacturing companies need to integrate their internal processes digitally to become more competitive and deliver higher quality products to the consumer market. Information defined at early design stages needs to be recovered at all stages of the life cycle of a product. To accomplish this, information models that incorporate intelligence and enable the representation of the real world are necessary. On the other hand, electronic products manufacturers need to comply with environmental requirements present in regulatory frameworks as the RoHS Directive in order to offer their products in several countries. The present work proposes the application of semantic models for helping companies meet the requirements established by the RoHS Directive. A model, created using a reference ontology, establishes semantic relationships between entities that represent product lifecycle stages, product structure and business objects. Business processes, modeled in the form of activity and information flows, are linked to RoHS requirements that can be viewed through the reports in the Essential Project open source framework. The resulting semantic model is, therefore, useful for converting environment-related needs to design requirements through a product development process that addresses the RoHS Directive. A consumer electronics product has been selected for demonstrating the feasibility of the proposed solution.

Thesis (MA)--University of Stellenbosch, 2002.
ENGLISH ABSTRACT: This thesis is a descriptive and interpretive study into the political economy of intellectual property rights, the conceptual and practical implications for the phenomenon of global governance, and how developing countries experience problems with the implementation of national policies that infringe on international intellectual property rights. The specific area of interest is the generic medicine debate that ensued in South Africa after the alleged violation of patent rights of anti-HIV/Aids drugs by the Department of Health. The research question that is addressed is to what extent has the existing international intellectual property rights regime been influenced and/or undermined by South Africa's intended application of WTO regulations in terms of compulsory licensing and parallel imports of "essential" medicines. In doing so, the paper examines the roles of the important states, international organisations, institutions, and private sector firms within the sphere ofthe political economy of intellectual property and how they impede upon or improve the functioning of the intellectual property rights regime. The methodology entails analytical inquiries into documentary evidence on the nature of the international intellectual property rights regime. Areas that are examined are the agendas of the important actors, namely states and their respective departments; individuals and firms; and international organisations. The concept of intellectual property is examined to determine its dynamic role within the generic medicine debate. The thesis concludes that the agendas of pharmaceutical firms and states are exploiting current political stalemates in the negotiations for a fair intellectual property rights regime. National health agencies, and specifically the South African Department of Health, are under enormous pressure to provide affordable health services. Specifically, the US Government and US pharmaceutical firms are dominating discussions on the architecture of the international intellectual property law regime. By using an analysis incorporating systemic, domestic interest, institutional, and ideational perspectives, it is argued that South Africa's drive for a more distributive intellectual property rights regime has placed the issue of health, Aids and generic medicine firmly within the sphere of the political economy of trade agreements.
AFRIKAANSE OPSOMMING: Hierdie tesis is 'n deskriptiewe en 'n interpretiewe studie oor die politieke ekonomie van intellektuele eiendomsregte, die konseptuele en praktiese implikasies vir die verskynsel van globale regering, en hoe ontwikkelende lande probleme ervaar met die implimentering van nasionale beleid wat internasionale intellektuele eiendomsregte aantas. Die spesifieke area van belang is die generiese medisyne debat wat onstaan het na die beweerde skending van patentregte van anti-HIVNigs medisyne deur die Departement van Gesondheid. Die navorsingsvraag wat beantwoord word behels die omvang van die impak van Suid- Afrika se voorgenome toepassing van WTO bepalinge, met betrekking tot die verpligte lisensiering en parallelle invoer van "essensiele" medisyne, op die bestaande internasionale intellektuele eiedomsreg regime. Hierdie tesis ondersoek vervolgens die rol van state, internasionale organisasies, instellings, en privaat sector firmas binne die sfeer van die politieke ekonomie van intellektuele eiendom en hoe hulle afsonderlik die funksionaliteit van die intellektuele eiendomsregte regime beïnvloed. Die metodologie behels 'n analitiese ondersoek van die literatuur oor die aard van internasionale intellektuele eiendomsreg regimes. Areas wat ondersoek word, is die agendas van belangrike akteurs, naamlik die staat en sy onderskeie departemente; individue en firmas; asook internasionale organisasies en instellings. Die konsep van intellektuele eiendom word ondersoek om die dinamiese uitwerking daarvan op die generiese medisyne debat te verstaan. Hierdie tesis voer aan dat die agendas van firmas, spesifiek farmaseutiese firmas en state die huidige politieke dooiepunt in die onderhandeling rondom 'n regverdige intellektuele iendomsregte-regime, uitbuit. Nasionale instellings, soos die Suid-Afrikaanse Departement van Gesondheid, is onder groot druk om bekostigbare gesondheidsdienste te lewer. Die VSA en farmaseutiese firmas domineer onderhandelinge vir 'n nuwe struktuur vir die internasionale eiendomsregte-regime. Deur gebruik te maak van 'n analitiese raamwerk wat sistemiese, interne belange, institusionele, en ideologies perspektiewe inkorporeer, word daar geargumenteer dat Suid-Afrika se pogings om 'n meer distributiewe intellektuele eiendomsregte regime te verseker, die probleem van gesondheid, Vigs, en generiese medisyne binnne die sfeer van die politieke ekonomie van handelsooreenkomste, plaas.

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The Brazilian public health system is deficient and doesn't fully meet the needs of the population. As a result, the private health care market has grown in recent years, which has changed the role of the state from executive to regulator of that sector. Regulation includes tackling the economic and financial issue. Our study aimed to identify the behavior of financing strategies adopted by medical cooperatives and group medicines to meet the regulatory benchmarks of the supplementary health care sector in Brazil. The survey results show that the mandatory Guaranteeing Assets (Ativos Garantidores, AG), 1st regulatory moment, resulted in a significant increase of both the overall and the long term indebtedness indexes, which reveals the use of Third-party capital instead of Equity capital. Only the Medical Cooperatives featured increased Overall Indebtedness, which means that the Medical Cooperatives, unlike Group Medicines, are capitalized by third party funds rather than by Equity Capital. Both modalities adopted the strategy of increasing their long-term debt and reducing their short term debt (debt composition). With the introduction of the Health Guarantor Fund (Fundo Garantidor da Sa??de, FGS), 2nd regulatory moment, the Overall and Current Liquidity indexes decreased, showing that the goal of the FGS program to reduce financial guarantees and to improve working capital wasn't met. Medical Cooperatives managed to reduce their overall debt, whereas the overall debt of Group Medicines increased. We conclude that there was a balance between the Indebtedness indexes and Liquidity over the period and that operators who wish to remain in the market must comply with the rules, adapting and improving the quality of their management
A rede p??blica de sa??de no Brasil ?? prec??ria e n??o atende de forma plena ??s necessidades da popula????o. Consequentemente, o mercado privado de assist??ncia ?? sa??de tem crescido nos ??ltimos anos e com isso a fun????o do Estado vem se alterando, passando de executor para regulador deste setor de atividade. Um alvo da regula????o ?? a quest??o econ??mico-financeira. Nesse sentido, este trabalho tem como objetivo identificar o comportamento das estrat??gias de financiamento adotadas pelas cooperativas m??dicas e medicinas de grupo frente aos marcos regulat??rios do setor de sa??de suplementar no Brasil. Os resultados da pesquisa indicam que com a obrigatoriedade dos Ativos Garantidores - AG, 1?? momento regulat??rio, os ??ndices de Endividamento, tanto geral quanto de longo prazo tiveram um aumento significativo, o que indica a utiliza????o de Capital de Terceiros ao inv??s do Capital Pr??prio. Observou-se que apenas as Cooperativas M??dicas apresentaram um aumento no Endividamento Geral. Isso indicou que as Cooperativas M??dicas, diferentemente, das Medicinas de Grupo, se capitalizaram com recursos de terceiros ao inv??s do Capital Pr??prio. Notou-se que ambas as modalidades adotaram a estrat??gia de aumentar a d??vida de longo prazo e reduzir as de curto prazo (composi????o do endividamento). Com a institui????o do Fundo Garantidor da Sa??de - FGS, 2?? momento regulat??rio, os ??ndices de Liquidez Geral e Corrente diminu??ram, indicando que a proposta do programa FGS, de reduzir as garantias financeiras e melhorar o capital de giro, n??o ocorreu. Observou-se que para as Cooperativas M??dicas o endividamento geral diminuiu e em contrapartida para as Medicinas de Grupo aumentou. Contudo, conclui-se que houve um equil??brio entre os ??ndices de Endividamento e Liquidez ao longo do per??odo e que para as operadoras se manterem no mercado ter??o que atender as regras, adaptando-se e melhorando a qualidade da sua gest??o

Examining Board: Professor Giovanni Sartor, Institut Universitaire Européen (directeur de thèse); Professor Serge Gutwirth, Vrije Universiteit Brussel (codirecteur de thèse); Professor Yves Poullet, Université de Namur; Professor Loïc Azoulai, Institut Universitaire Européen.
Defence date: 12 December 2012
PDF of thesis uploaded from the Library digital archive of EUI PhD theses
Grâce au développement de technologies de plus en plus complexes susceptibles de s’immiscer dans l’organisme, corps et artéfacts semblent en passe de connaître un degré d’hybridation jamais atteint jusqu’alors. Certaines technologies prothétiques émergentes - comme les bio-implants ou les puces électroniques - sont incontestablement de nature à bouleverser nos représentations du corps humain, si ce n’est notre nature anthropologique elle-même. A ce titre, ces technologies sont à la source de nombreuses inquiétudes et nourrissent, dans le champ juridique et éthique, un très vif débat qui se situe principalement sur le versant politique de la réglementation et de la gouvernance. L’objectif de la présente étude est d’élargir le champ de l’investigation consacrée aux rapports entre droit et nouvelles technologies en portant l’attention sur la pratique juridictionnelle, afin de mettre en évidence les problèmes posés par l’hybridation à partir de litiges auxquels les cours et tribunaux ont déjà été confrontés. Ceux-ci étant souvent en première ligne lorsqu’une technologie inédite affecte l’une ou l’autre sphère d’activité humaine, il est alors possible d’observer comment le droit s’adapte au changement technologique. A partir de trois cas d’étude distincts, relevant du droit travail, du droit antidiscriminatoire et du droit du sport, nous montrons d’une part comment les juges résorbent les tensions résultant d’une pluralité des manières de saisir l’hybridation entre homme et artéfacts dans le chef des protagonistes du litige. D’autre part, ous mettons l’accent sur les dispositifs et moyens - qu’ils soient externes au droit (les axinomies, les mesures, les statistiques de la biomédecine) ou internes (les standards, les atégories, les critères) - qu’utilisent les protagonistes d’un litige, et en particulier le juge, orsqu’ils sont confrontés à l’irruption d’entités problématiques, comme l’est le corps hybride, ans des situations litigieuses. Cette approche pragmatique permet de faire apparaître la ingularité du travail réalisé par les juges pour concilier l’émancipation de la personne par la echnique et son intégration et sa participation à un ordre commun.

This thesis makes an historical and contemporaneous analysis of patenting of methods of medical treatment of human beings in Australia and other common law jurisdictions that derived their origin from the UK law. The issue of patenting of methods of medical treatment has never been an easy question to discuss for it raises public policy considerations surrounding this area. The main difficulty derives from the conflict between the intellectual property and practice of medicine. There is a public policy concern that in order to ensure the best possible health treatment, physicians must always be free in their choice of treatment. Since a patent may restrict this freedom, many countries around the globe prohibit methods of medical treatment from being granted patent protection. Yet, Australian courts decided to depart from those exclusions. This thesis examines how courts deal with express exclusions of patents for method of medical treatment and how such exclusions can be avoided by creative drafting of patent specifications. It will also examine the approach taken in Australia where there are no express exclusions. It first provides the descriptive background of the case law in UK, Member States of the European Patent Convention, Canada, Israel, New Zealand, US and Australia in order to make a comparative analysis of the approaches adopted in these countries in dealing with the issue, and in order to establish the framework around which the doctrinal issues can be analysed. Against this background an examination of the origins of the patent law is necessary in order to fully assess the interpretation of patent legislation by courts and consequences of such interpretation for medical profession. The thesis investigates the pre-enacting history of the 1624 Statute of Monopolies in order to analyse whether patenting of methods of medical treatment of human beings is 'generally inconvenient' within the meaning of the proviso to s 6 of the Statute of Monopolies, which in turn, form a part of s 18 (1) of the Patents Act 1990 (Cth). The analysis of early patent law cases at the time they were argued and decided will lead to the conclusion that the actual original meaning of the term 'generally inconvenient' has been wrongly interpreted and applied by modern courts. The thesis considers the role of the courts in deciding whether methods of medical treatment should be granted patent protection and whether judges should and/or have ability to make moral or public policy judgments in interpreting statutes. The thesis explore the consequences of interpretation of 'generally inconvenient' as a main public policy objection to granting patents for methods of medical treatment. It concludes that it is questionable whether the term 'generally inconvenient' includes public policy considerations in its scope, and though there may be some circumstances where a patent to method of medical treatment should be rejected on public policy grounds, 'generally inconvenient' does not provide a basis upon which patents to methods of medical treatment can be denied. The thesis is that such methods should not be expressly excluded from patenting. Each method must be treated equally with other inventions and examined on its merits, on case by case basis. The tensions associated with patents for methods of medical treatment can be resolved within patent legislation by making the public policy ground for objection a separate criterion for patentability, equally relevant for any invention. Accordingly, the author argues that legislative amendments are necessary to rectify the existing problem and makes a number of proposals to this effect. The author also suggests the involvement of an independent body to make public policy decisions.

The practice of torture is an affront to human dignity. Freedom from torture is an absolute human right. Laws that violated human rights and entrenched racial divisions characterized the apartheid era in South Africa. However, the transition from a repressive state to a democratic one, gave “birth” to a Constitution characterized by fundamental human rights, social justice and open democratic societal values. In order to have any real meaning, the human rights enshrined in the Constitution and various National and International instruments, needs to be realized in everyday life. These rights are valuable in that they provide the tools to empower victims, or rather, survivors of torture and other cruel, inhuman and degrading treatment. A Criminal Justice System that focuses on victims’ rights and empowerment has the ability to transform the current maze that one must navigate to access justice. In keeping with its obligations as a signatory in 1984 to the UN Convention against Torture, South Africa has 29 years later, in 2013, passed in its parliament the first Legislative Act creating the specific offence of torture. This paper critically appraises the current state of legislative and other provisions in the light of South Africa’s position against torture and analyses its fresh new law with the objective of establishing how effective these measures will be and what future recommendations are required for reinforcing its prevention.
Thesis (LL.M.)-University of KwaZulu-Natal, Durban, 2014.

Submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Durban University of Technology, 2014.
Background: The function and roles of legislation primarily provide a protective function for the public by preserving their fundamental rights. Legislation also maintains the legitimacy of the professions and aids in defining the scope of practice within the profession. Legislation may however affect the international migration of practitioners, in addition to geographical proximity, shared language, customs and educational curricula as well as historical links. There is no published literature that compares chiropractic legislation in regulated countries, thus no understanding of where possible similarities and differences exist and the impact they may have on the migration of chiropractors Objective: The main objective of the study is to aid in increasing the understanding of the values, structures and operations of various international chiropractic regulatory systems with the goal of identifying the similarities and differences (viz. compare) between these chiropractic regulatory systems. Method: Six countries with chiropractic Legislation were selected using purposive sampling based on the number of practicing chiropractors. The USA was divided into states with the top three selected according to practicing chiropractors, Canada was divided and the top province selected based on practicing chiropractors. Information and data was obtained via desk based research and additional information was gathered by the researcher from the registrar of the respective regulatory bodies. Results: A variety of factors were identified that may either aid in or hinder the mobility of chiropractors across jurisdictions. By analysing the legislative documents, it was found that regulatory bodies remain similar in content and structure however significant differences were also found. Conclusion: In conclusion, regulatory bodies and their governing documents and procedures remain similar in content and structure. However the study revealed differences factors that could possibly affect the mobility of chiropractors across jurisdictions. These areas identified included: Educational standards and processes, competency maintenance, registration requirements (local and foreign), disciplinary procedure and processes and constraints placed by supranational bodies.

Defence date: 22 December 2017
Examining Board: Professor Giorgio Monti, European University Institute (Supervisor); Professor Hans-Wolfgang Micklitz, European University Institute; Dr. Okeoghene Odudu, University of Cambridge; Professor Daniel Sokol, Levin College of Law, University of Florida
Healthcare markets have started being created in Europe. Indeed, some European countries, such as the UK and the Netherlands, have started adopting the choice and competition model for healthcare delivery. Taking as a starting point that as health systems in Europe move towards market driven healthcare delivery, the application of competition law in these systems will increase, the goal of this doctoral thesis is (a) to identify some of the competition problems that may be raised in light of the reality that especially in hospital and medical markets the pursuit of competition and the pursuit of essential dimensions of healthcare quality may inevitably clash (b) to demonstrate that competition authorities would be unable to address some of these competition problems if they did not pose and address a fundamental question first: how should we define and assess quality in healthcare? How should we take healthcare quality into account in the context of a competition analysis? In delving into these questions, this doctoral thesis explores how the notion of healthcare quality is defined from antitrust, health policy and medicine perspectives and identifies three different models under which competition authorities may actually assess how a specific anticompetitive agreement or hospital merger may impact on healthcare quality. These are: (a) the US market approach under which competition authorities may define quality in healthcare strictly as choice, variety, competition and innovation (b) the European approach under which competition authorities may extend the notion of consumer welfare in healthcare so that it encompasses not only the notions of efficiency, choice and innovation, but also the wider objectives and values European health systems in fact pursue (c) the UK model under which competition authorities may cooperate with health authorities when they assess the impact of a specific transaction on healthcare quality. The thesis identifies the main merits and shortcomings of these models and emphasizes that what is crucial for the adoption of a holistic approach to healthcare quality is not only the model under which healthcare quality is actually integrated into a competition analysis but also competition authorities’ commitment to protect all dimensions of this notion.
Chapter IV ‘Integrating healthcare quality concerns into the US hospital merger cases : a mission impossible’ of the PhD thesis draws upon an earlier version published as an article 'Integrating healthcare quality concerns into the US hospital merger cases : a mission impossible' (2016) in the journal 'World competition'

Defence date: 11 June 2005
Examining board: Prof. Giafnranco Poggi (supervisor, European University Institute, Florence) ; Prof. Simone Bateman (University of Paris V) ; Prof. John Griffiths (University of Groningen) ; Prof. Martin Kohli (European University Institute, Florence)
PDF of thesis uploaded from the Library digitised archive of EUI PhD theses completed between 2013 and 2017

M.Cur.
The legal limitations in the practice of the Primary Health Care nurse (PHC nurse)' in the RSA have direct implications for the achievement of the goal "Health for all by the year 2000". The questions which had to be answered by means of the research are in relation to the legal limitations, the nature and scope of the limitations as well as to how these limitations should be addressed in order to facilitate the practice of the PHC nurse. A content analysis of selected health legislation was done and recommendations formulated to amend and/or clarify certain health legislation. The research design is an exploratory descriptive study with a qualitative research orientation. A content analysis of certain professional and relevant health legislation showed legal limitations in the practice of the PHC nurse. Experts in the field of PHC who were interviewed confirmed that there are limitations in the practice of the PHC nurse. The limitations identified were the following: • limitations in certain health professions and other health legislation • limitations caused by the interpretation of legislation by health professions • limitations due to the attitudes and perceptions of medical practitioners, pharmacists and nurses in respect of the role and functions of the PHC nurse The conclusions indicate that there are limitations in the practice of the PHC nurse which have direct implications for the achievement of the objectives of the National Health Policy, 1989. Recommendations include the amendment of certain health legislation, addressing limitations caused by attitudes and perceptions at educational, professional, policy making and management levels, for nurses, medical practitioners and pharmacists.

Gender reassignment procedures are performed for the treatment of the gender dysphoria syndrome (transsexualism). Although this modality of treatment is therapeutic in nature and therefore not contra bonos mores, the legal status of the post-operative transsexual remains that of his/her previous sex. The purpose of the gender reassignment procedures is that of acceptance within the community as a person of the sex indicated by his/her changed appearance. Nothing will be achieved by the successful completion of treatment if the person's changed sexual appearance is not recognised by the law as a change in sexual status as well. The law, by keeping aloof of the problem of the post-operative transsexual, has created a legal "vacuum" where there is social and judicial acceptance of reassignment procedures, but a refusal to give legal effect to the change in status that the transsexual obsessively desires and the operation simulates. This work will analyse the medical issues associated with gender reassignment procedures. The legal status of the transsexual after reassignment procedures will be explored, and in doing so, the human rights violations with which such people have to contend, will be highlighted. The constitutionality of the lack of a legal recognition of the post-operative transsexual's sexual status will be examined. It will be shown that there are compelling reasons for legislation to be introduced as a matter of urgency to safeguard the fundamental rights of the post-operative transsexual.
Thesis (LL.M.)-University of Natal, 2000.