Search

The article presents the discussion on genome medicine being integrated into healthcare and research on a large scale in Germany. Topics include externalizing service components of genetic testing and including non-medical disciplines such as bioinformatics; and considering a key to personalized medicine and promising improvements in the field of diagnostics and prevention and treatment.

The procedures of prenatal and preimplantation diagnostics are discussed critically again and again in our community. In addition to the permanently controversial issues of embryo protection and abortion, considerations that discrimination on the basis of disability could occur with problematic consequences also for already born people with disabilities and their relatives now play a central role. [ABSTRACT FROM AUTHOR]

The article reports on the death of Prof. Dr. Dorothea Prütting, an outstanding representative of medical and health law. She was born on November 27, 1949, in Marburg and completed studies in law and pharmacy. She had a successful career in the Ministry of Labor, Health, and Social Affairs of the state of North Rhine-Westphalia and was a sought-after speaker at health law events. Prütting was the author and editor of numerous works on medical and health law and taught at the Faculty of Law at Ruhr University. She is praised as an outstanding representative of medical and health law in theory and practice. [Extracted from the article]

An introduction is presented to a series of articles on the normative framework of public health ethics.

In the context of the COVID-19 pandemic, there has been a scarcity of resources with various effects on the care of cancer patients. This paper provides an English summary of a German guideline on prioritization and resource allocation for colorectal and pancreatic cancer in the context of the pandemic. Based on a selective literature review as well as empirical and ethical analyses, the research team of the CancerCOVID Consortium drafted recommendations for prioritizing diagnostic and treatment measures for both entities. The final version of the guideline received consent from the executive boards of nine societies of the Association of Scientific Medical Societies in Germany (AWMF), 20 further professional organizations and 22 other experts from various disciplines as well as patient representatives. The guiding principle for the prioritization of decisions is the minimization of harm. Prioritization decisions to fulfill this overall goal should be guided by (1) the urgency relevant to avoid or reduce harm, (2) the likelihood of success of the diagnostic or therapeutic measure advised, and (3) the availability of alternative treatment options. In the event of a relevant risk of harm as a result of prioritization, these decisions should be made by means of a team approach. Gender, age, disability, ethnicity, origin, and other social characteristics, such as social or insurance status, as well as the vehemence of a patient's treatment request and SARS-CoV-2 vaccination status should not be used as prioritization criteria. The guideline provides concrete recommendations for (1) diagnostic procedures, (2) surgical procedures for cancer, and (3) systemic treatment and radiotherapy in patients with colorectal or pancreatic cancer within the context of the German healthcare system. [ABSTRACT FROM AUTHOR]

Objectives: Potential opportunities and challenges of predictive genetic risk classification of healthy persons are currently discussed. However, the budgetary impact of rising demand is uncertain. This project aims to evaluate budgetary consequences of predictive genetic risk classification for statutory health insurance in Germany.Methods: A Markov model was developed in the form of a cohort simulation. It analyzes a population of female relatives of hereditary breast cancer patients. Mutation carriers are offered intensified screening, women with a BRCA1 or BRCA2 mutation can decide on prophylactic mastectomy and/or ovarectomy. The model considers the following scenarios: (a) steady demand for predictive genetic testing, and (b) rising demand. Most input parameters are based on data of the German Consortium for Hereditary Breast and Ovarian Cancer. The model contains 49 health states, starts in 2015, and runs for 10 years. Prices were evaluated from the perspective of statutory health insurance.Results: Steady demand leads to an expenditure of €49.8 million during the 10-year period. Rising demands lead to additional expenses of €125.5 million. The model reveals the genetic analysis to be the main cost driver while cost savings in treatment costs of breast and ovarian cancer are indicated.Conclusions: The results contribute to close the knowledge gap concerning the budgetary consequences due to genetic risk classification. A rising demand leads to additional costs especially due to costs for genetic analysis. The model indicates budget shifts with cost savings due to breast and ovarian cancer treatment in the scenario of rising demands. [ABSTRACT FROM AUTHOR]

The renowned legal scholar Prof. Dr. Friedrich E. Schnapp has passed away at the age of 85. He was an expert in the field of social law, particularly health insurance law. Schnapp was a professor of public law at the University of Münster and later at the Ruhr University Bochum. He was also a member of the Institute for Social Law and published significant works, including the Handbook of Contractual Medical Law. Schnapp will be remembered as one of the influential figures in social law and health law. [Extracted from the article]