Juškevičius, Jonas

Despite the increasing availability of direct-to-c onsumer (DTC)genetic testing, it is currently unclear how such services are regulated in Europe, due to the lack of EU or national legislation specifically addressing this issue. In this article, we provide an overview of laws that could potentially impact the regulation of DTC genetic testing in 26 European countries, namely Austria, Belgium, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, the Netherlands and the United Kingdom. Emphasis is placed on provisions relating to medical supervision, genetic counselling and informed consent. Our results indicate that currently there is a wide spectrum of laws regarding genetic testing in Europe. There are countries (e.g. France and Germany) which essentially ban DTC genetic testing, while in others (e.g. Luxembourg and Poland) DTC genetic testing may only be restricted by general laws, usually regarding health care services and patients' rights.

Straipsnyje apibūdinama lytinio identiteto sąvoka, transseksualumo fenomenas bei nagrinėjamos problemos, kylančios taikant Kanonų teisę, kai susiduriama su lytinio identiteto sutrikimais (transseksualizmu). Didelis dėmesys skiriamas santuokos sudarymo, jos negaliojimo, pašvęstojo gyvenimo klausimams bei krikšto sakramentui ir transseksualų galimybei tapti krikšto tėvais.

Embryo genetics and epigenetics analyzes genes and their associations with environment that has impact on prenatal human development. In prenatal diagnostics informed patient consent is necessary, especially if the pregnancy has occurred after in vitro fertilization. Doctors knowledge about fetal physiology is mandatory applying reproductive technologies. During 2007 – 2011 years 1156 patients were examined and 49 (4.2%) alterations of karyotype were determined, out of which 30 (61%) are related to Down syndrome, 14 (29%) to Edwards syndrome and 5 (10%) are related to Patau syndrome. After studying the data of the questionnaire and case records, on the basis of the statistical reliability of data analysis, the influence of the main reproductive factors (abortions, contraceptives) and other risk or environmental factors (smoking, genetic diseases and the use of medicines) to fetal anomalies was determined.

In the Hospital of Lithuanian university of health sciences were counseled two couples which in the past used unsuccessfuly intensive infertility treatment regimen. The first couple was unable to conceive for 7 years: they applied two unsuccessful IVF procedures, however gave birth to a healthy boy. The second couple applied two IVF procedures and did not conceive for four years. After the karyotype testing a chromosome translocation was identified: in the case of the first couple to a female, in the case of second couple to a male. The karyotypes of the first couple were the following: 45 XY, der(13;14)(q10;q10)of a male and 46XX of a female. The karyotypes of the second couple were respectively 46XY and 45 XX , der(13;14)(q10;q10) The possibility of miscarriage and of anomaly were explained and further recomendations to couples were provided. After the counseling families are better able to decide on further family planning and prenatal diagnostics, if necessary. These cases present the importance of quality of health care services for the adjustment of the diagnosis, and the need of genetic counseling and appropriate genetic testing before ART because the main requirements for the informed consent include rationality, sufficient and clear information, free will and the form of consent conforming to the legal acts.

Gydytojo profesijos visuminis pobūdis gali būti apibūdintas visų pirma kaip misija ar pašaukimas pagelbėti pacientui sunkiomis jam egzistencinėmis aplinkybėmis. Dėl šios priežasties gydytojo veiklai keliami aukšti etiniai standartai, kuriuos laikui bėgant suformulavo pati medikų profesinė bendruomenė. Profesinių standartų vaidmuo pripažįstamas ir teisėje, todėl nenuostabu, kad teismai, vertindami gydytojų atsakomybę dėl netinkamai suteiktų sveikatos priežiūros paslaugų, atsižvelgia ir į profesinių standartų laikymąsi teikiant šias paslaugas. Straipsnis nagrinėja Lietuvos teismų praktikos požiūrį į gydytojų profesinės etikos reikšmę atsakomybės atvejais.

European Union’s (EU) Regulation No. 1394/2007 has introduced a new regulatory category of medicines – advanced therapy medicinal products, into the EU legal system. They are divided at present into three major groups: gene therapy, somatic cell therapy and tissue engineered medicinal products. The reasons for such classification are complex and vary in a broad spectrum comprised from political-legislative to scientific concerns. The aim of the paper is to discuss some classification issues that arise from the reluctance of the European legislator to address in a clearer way some important ethical issues with regard to those advanced therapies.