No abstract
Dementia is associated with the gradual impairment of mental ability. The population of people suffering from dementia is as large as 50 million. Most dementia cases result from various neurodegenerative diseases (NDs) linked by a progressive degeneration of neurons. Among NDs, Alzheimer's disease (AD) is the most frequent cause of dementia and accounts for 60-80% of cases. Certain pathological changes on the cellular and subcellular level occur even 15 years before the manifestation of clinical symptoms of AD. This first asymptomatic phase of AD is considered a preclinical stage, whereas mild cognitive impairment (MCI) is the symptomatic pre-dementia stage. The third, fully symptomatic phase of AD is dementia due to AD. The presence of specific proteins in the cerebrospinal fluid (CSF) may be considered as a characteristic feature of some NDs. The measurement of their CSF concentrations, together with neuropsychological examination and neuroimaging, may be useful for diagnosing AD. The collection of CSF samples is performed by lumbar puncture, which is a medical procedure that requires obtaining informed consent from patients. While asymptomatic AD patients have full legal capacity, those with dementia require a legal guardian who will represent them. Thus, the objective of this study is to compare the legal systems regulating the legal capacity issue in the USA, U.K. (England and Wales), Germany, and Poland. These countries have been chosen as examples of three different types of legal orders, according to the sources of law, i.e., civil law, common law, and case law.
According to the projections of the statistical office of the European Union, Eurostat, nearly one third of EU citizens will be at least 65 in 2060. The U.S. population age 65 and older continues to increase and is projected to nearly double from 48 million to 88 million by 2050. Elderly people are especially exposed to neurodegenerative diseases (NDs). The most common ND is Alzheimer's disease (AD), a chronic and progressive disorder with a variety of pathological changes within neuronal tissue, which begin even 10-15 years before the onset of cognitive impairment symptoms. AD is perceived as a disease continuum and considered to include three basic phases: preclinical (asymptomatic) stage, mild cognitive impairment (MCI), and dementia due to AD. A very important issue, from medical and legal perspectives, is the NDs patient's consent to medical procedures, including diagnostic procedures, such as lumber puncture. NDs patients are not always able to express their consent and do not always understand the information provided by a physician. This applies to a group of patients in the final stages of NDs. This paper presents legal regulations of selected European countries and signalizes the U.S. legal solutions on the issue of NDs patients' informed consent to medical procedures.
Since the mid-1990s, the "Russian Mafia" has been viewed as taking a leading role amongst the most powerful criminal organizations in the world." It is not surprising that the strong position of Russian-speaking criminal groups has a profound influence on the situation in central Europe in general, and in Poland in particular.The political transformation initiated in Poland in 1989 led to a change in the structure of various undesirable phenomena, including an unprecedented escalation of criminal activity which had not been considered to be a major problem until that time. Criminal groups have increased in number and in their level of professionalism; more crimes, including those of an economic nature, are being committed in an organized and pre-planned way." At the same time, organized crime has undergone a process of internationalization which is being facilitated by factors such as, amongst others, universal cash transactions in Poland, the permissible transfer of foreign currency across borders, open borders which are being penetrated by organized crime groups speaking Russian and the system of the protection of legal order which still is not uniform in Poland. An analysis of the threat posed by recognized criminal groups (based on, amongst other things, questionnaires submitted by local police units) indicates that in the year 2000 there were 405 criminal groups in Poland, with a total of 4,201 members.so 48 For instance see Ernesto U. Savona, Sabrina Adamoli , Paola Zoffi (with the assistance of Michael
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