Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social de... more Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social determinants of health (SDoH) affect liver cancer risk factors and access to care in order to improve health outcomes equitably. This paper summarises the available evidence on the differential distribution of liver cancer risk factors, incidence, and health outcomes in the European Economic Area and the United Kingdom from an SDoH perspective. Vulnerable and marginalised populations have low socioeconomic and educational levels and are the most affected by liver cancer risk factors. Reasons for this include varied access to hepatitis B virus vaccination and limited access to viral hepatitis B and C screening, harm reduction, and treatment. Additionally, alcohol-related liver disease remains highly prevalent among individuals with low education, insecure employment, economic instability, migrants, and deprived populations. Moreover, significant variation exists across Europe in the proportion of adults with steatotic liver disease, overweight/obesity, and diabetes, based on geographical area, gender, socioeconomic and educational background, and density of ultra-processed food outlets. Inequities in cirrhosis mortality rates have been reported, with the highest death rates among individuals living in socioeconomically disadvantaged areas and those with lower educational levels. Furthermore, insufficient healthcare access for key populations with primary liver cancer is influenced by complex healthcare systems, stigmatisation, discrimination, low education, language barriers, and fear of disclosure. These challenges contribute to inequities in liver cancer care pathways. Future studies are needed to explore the different SDoH-interlinked effects on liver cancer incidence and outcomes in European countries. The ultimate goal is to develop evidence-based multilevel public health interventions that reduce the SDoH impact in precipitating and perpetuating the disproportionate burden of liver cancer in specific populations.
Italy has had the highest prevalence of hepatitis C virus (HCV) infection and mortality from HCV-... more Italy has had the highest prevalence of hepatitis C virus (HCV) infection and mortality from HCV-related liver cancer in Europe. Although direct-acting antivirals (DAA) were initially restricted to persons with advanced fibrosis, their use has since been extended to all infected individuals; more than 244 000 persons have been treated to date. HCV liver-related mortality is expected to decline by 75% by 2030, achieving the World Health Organization target for mortality. However, Italy risks failing to meet the overall goal of eliminating HCV infection by 2030. In this light, €71.5 million have been allocated for screening initially specific target populations (persons who inject drugs, prison inmates, and the 1969–1989 birth cohort). Herein, we outline the challenges and recommendations for how to move Italy toward HCV elimination, including expanding screening programs in other populations, increasing awareness through strategic communication, sustaining DAA access, and tailoring c...
Lack of available organs poses a significant challenge in meeting the needs of patients with life... more Lack of available organs poses a significant challenge in meeting the needs of patients with life-threatening liver disease who could benefit from liver transplantation (LT). Psychosocial vulnerability markers have been linked to post-transplant outcomes, raising questions about their use in patient selection. However, their incorporation into selection criteria raises concerns about health equity and potential discrimination. As a result, there is a pressing need to refine fair allocation systems that consider both clinical and psychosocial factors to ensure equitable access and optimize post-transplant outcomes. The Equitable Benefit Approach (EBA) proposed in this paper by the multidisciplinary group of clinical experts in LT from the Italian Society for the Study of the Liver seeks to address these concerns. It presents four procedural principles, the two allocative principles usually applied in transplantation (urgency and utility) and introduces a new one, the principle of health equity. The EBA aims to prioritize patients with the highest transplant benefit while addressing health inequalities. It emphasizes evidence-based decision-making and standardized assessment tools to reliably evaluate psychosocial risk factors. Implementing the EBA involves a multi-step process, including stakeholder engagement, prospective studies to validate its efficacy, development of institutional policies and algorithms, and ongoing monitoring and revision. By following these steps, health care providers can ensure that LT allocation decisions are transparent and responsive to evolving clinical and social contexts. Ultimately, the EBA should offer a comprehensive framework for fair patient selection in LT, considering both biomedical and psychosocial aspects.
Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social de... more Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social determinants of health (SDoH) affect liver cancer risk factors and access to care in order to improve health outcomes equitably. This paper summarises the available evidence on the differential distribution of liver cancer risk factors, incidence, and health outcomes in the European Economic Area and the United Kingdom from an SDoH perspective. Vulnerable and marginalised populations have low socioeconomic and educational levels and are the most affected by liver cancer risk factors. Reasons for this include varied access to hepatitis B virus vaccination and limited access to viral hepatitis B and C screening, harm reduction, and treatment. Additionally, alcohol-related liver disease remains highly prevalent among individuals with low education, insecure employment, economic instability, migrants, and deprived populations. Moreover, significant variation exists across Europe in the proportion of adults with steatotic liver disease, overweight/obesity, and diabetes, based on geographical area, gender, socioeconomic and educational background, and density of ultra-processed food outlets. Inequities in cirrhosis mortality rates have been reported, with the highest death rates among individuals living in socioeconomically disadvantaged areas and those with lower educational levels. Furthermore, insufficient healthcare access for key populations with primary liver cancer is influenced by complex healthcare systems, stigmatisation, discrimination, low education, language barriers, and fear of disclosure. These challenges contribute to inequities in liver cancer care pathways. Future studies are needed to explore the different SDoH-interlinked effects on liver cancer incidence and outcomes in European countries. The ultimate goal is to develop evidence-based multilevel public health interventions that reduce the SDoH impact in precipitating and perpetuating the disproportionate burden of liver cancer in specific populations.
Lack of available organs poses a significant challenge in meeting the needs of patients with life... more Lack of available organs poses a significant challenge in meeting the needs of patients with life-threatening liver disease who could benefit from liver transplantation (LT). Psychosocial vulnerability markers have been linked to post-transplant outcomes, raising questions about their use in patient selection. However, their incorporation into selection criteria raises concerns about health equity and potential discrimination. As a result, there is a pressing need to refine fair allocation systems that consider both clinical and psychosocial factors to ensure equitable access and optimize post-transplant outcomes. The Equitable Benefit Approach (EBA) proposed in this paper by the multidisciplinary group of clinical experts in LT from the Italian Society for the Study of the Liver seeks to address these concerns. It presents four procedural principles, the two allocative principles usually applied in transplantation (urgency and utility) and introduces a new one, the principle of health equity. The EBA aims to prioritize patients with the highest transplant benefit while addressing health inequalities. It emphasizes evidence-based decision-making and standardized assessment tools to reliably evaluate psychosocial risk factors. Implementing the EBA involves a multi-step process, including stakeholder engagement, prospective studies to validate its efficacy, development of institutional policies and algorithms, and ongoing monitoring and revision. By following these steps, health care providers can ensure that LT allocation decisions are transparent and responsive to evolving clinical and social contexts. Ultimately, the EBA should offer a comprehensive framework for fair patient selection in LT, considering both biomedical and psychosocial aspects.
The case of Indi Gregory is paradigmatic of the ethical and legal issues in- volved in the decisi... more The case of Indi Gregory is paradigmatic of the ethical and legal issues in- volved in the decision to withdraw life support from an infant. The purpose of this paper is to analyze the case from a dual perspective, ethical and legal, discussing the issue of best interest of the infants.
The research analyzes the recent Italian draft laws on Medical Assistance in dying, their strengt... more The research analyzes the recent Italian draft laws on Medical Assistance in dying, their strengths and several shortcomings, comparing them with other European laws on this subject. The Italian draft laws are not fully hinged on the exercise of self-determination of the suffering person but remain bound to the reference to a condition of proximity to death or the presence of life-sustaining treatments, which in fact cause unjustified inequities in access to a health service aimed at protecting the dignity of the person. Furthermore, the articulation of the procedures for requesting and assessing suitability outlined in the Italian bills does not allow to fully protect the person in a condition of vulnerability from the risk of abuse and conditioning, nor to fully protect procedural justice.
The research outlines the evolution of the public health management system in the Kingdom of Sici... more The research outlines the evolution of the public health management system in the Kingdom of Sicily between the second half of the 16th century and the first half of the 19th century, emphasizing the specific features of the Sicilian case and highlighting the possible causes. It frames the evolution of public health institutions in Sicily both in the process of centralization and organization of the administrative apparatus of modern State, and in the development of medical theories concerning contagion. Through the analysis of the legislation and of the documentation produced by the competent bodies, it has been proved that there is no break in continuity in the activity of the various institutions that manage public health along the time span investigated. Special attention is devoted to the role of doctors within these institutions and to the relationship with medical science. The analysis shows that the competent bodies based their choices on an empirical approach, making prudential choices that took into account both the miasmatic theory and the contagionist theory
Our study examines several autobiographical works that express life lived, a privileged access ke... more Our study examines several autobiographical works that express life lived, a privileged access key to understand suffering people and the afflicted, and which reveal the ethico-anthropological dimension of medicine
La storia di questa struttura psichiatrica rappresenta uno straordinario esempio di come innovazi... more La storia di questa struttura psichiatrica rappresenta uno straordinario esempio di come innovazione medica, letteratura e architettura si intreccino formando un\u2019unica trama storica che merita di essere letta e tenuta in considerazion
The infectious diseases are the most prevalent illnesses in prisoners, and they have a relevant b... more The infectious diseases are the most prevalent illnesses in prisoners, and they have a relevant burden for the society. Several studies have shown that the screening and the treatment of the infectious diseases inside prisons may be effective in reducing their burden in the general community. The main aim of the study was to determine between 2019-2021 the incidence and the prevalence of HIV, HBV, HCV, TB and syphilis in the people inside Padua prisons. The study has demonstrated that the screening of the infectious diseases in detainees was very high, raising in 2021 in the entrant people the 100%. The research also has shown that during 2021 the most prevalent incidence of infectious diseases was for TB (16.3%), followed by HCV (11.3%), HBV (7.9%) and HIV (1.6%). Interestingly, our data has indicated how during 2021 versus the previous years the prevalence of the infectious diseases increased for HBV (41.5%), HCV (18.8%), and TB (48.1%). These data indicate as different conditions...
SUMMARY BETWEEN HORROR AND SCIENCE: THE BIRTH OF A CABINET OF PATHOLOGICAL ANATHOMY AT THE UNIVER... more SUMMARY BETWEEN HORROR AND SCIENCE: THE BIRTH OF A CABINET OF PATHOLOGICAL ANATHOMY AT THE UNIVERSITY OF PALERMO This paper outlines the history of the Cabinet of Pathological Anathomy at the University of Palermo, describes rapidly its current status and analyzes the composition of its displays in 1859. It aims to highlight the analogies with other collections of a similar kind and to pinpoint potential actions to endorse and develop this important scientific asset. Introduzione Fonte di meraviglia e di ribrezzo per il grande pubblico, oggetto di curiosità per i medici, le collezioni di Anatomia Patologica presenti in numerosi atenei italiani ed europei rappresentano oggi un patri-monio straordinario ma poco fruibile, proprio perché concepite come materiale didattico. Per comprenderne origine e natura, è necessario immergersi in un mondo in cui la quantità di immagini a disposi-zione era infinitamente minore: in tal senso i Gabinetti di Anatomia Patologica forniscono una testimonianza importante per comprende-re come venissero trasmesse le informazioni sui fenomeni biologici,
This story is about a government, which considered the management of madness not a medical issue ... more This story is about a government, which considered the management of madness not a medical issue but a matter of law and order, and a 64 years old official who became the director of a madhouse having no medical nor managing expertise in mental disease, but just humanity and dedication. But most of all its the story of their attempt to project an image of themselves and of what they had done, that turned out in something completely different: a literary myth which went so far to reach the pen of Alexandre Dumas and Edgar Allan Poe
The present article aims at giving an ethical-anthropological interpretation of the body wounded ... more The present article aims at giving an ethical-anthropological interpretation of the body wounded by the disease, under the perspective of the wounded self-portrait, a genre selected by some artists who, between the nineteenth and the twentieth century, pictured their physical or psychological malaise (Van Gogh, Kahlo, Munch, Bacon, Klee). Getting acquainted with artistic language, particularly when it arises from personal experience, has an educational value for healthcare professional, as it helps to catch \u201cthe history from below\u201d, as Roy Porter called it, which is the history from the patient\u2019s perspective.Dans cet article les auteurs donnent une interpr\ue9tation anthropologique au corps humain bless\ue9 par la maladie, illustr\ue9e par un autoportrait d\ue9figur\ue9 par la blessure, genre choisi par un nombre d\u2019artistes qui au XIXi\ue8me et XXi\ue8me si\ue8cle peignaient leur malaise physique ou mental (Van Gogh, Kahlo, Munch, Bacon, Klee). Une meilleure compr\ue9hension du language artistique, en particulier quand celui-ci \ue9mane d\u2019une experience personelle, repr\ue9sente une valeur \ue9ducative pour le professionnel des soins de sant\ue9, puisqu\u2019elle aide \ue0 saisir \u2018l\u2019histoire par l\u2019int\ue9rieur\u2019, comme le disait Roy Porter, c\u2019est-\ue0-dire l\u2019histoire du point de vue personnel du patient
Costs of new anti Hepatitis C regimens and access to care: the case for prioritization or univers... more Costs of new anti Hepatitis C regimens and access to care: the case for prioritization or universal cur
Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social de... more Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social determinants of health (SDoH) affect liver cancer risk factors and access to care in order to improve health outcomes equitably. This paper summarises the available evidence on the differential distribution of liver cancer risk factors, incidence, and health outcomes in the European Economic Area and the United Kingdom from an SDoH perspective. Vulnerable and marginalised populations have low socioeconomic and educational levels and are the most affected by liver cancer risk factors. Reasons for this include varied access to hepatitis B virus vaccination and limited access to viral hepatitis B and C screening, harm reduction, and treatment. Additionally, alcohol-related liver disease remains highly prevalent among individuals with low education, insecure employment, economic instability, migrants, and deprived populations. Moreover, significant variation exists across Europe in the proportion of adults with steatotic liver disease, overweight/obesity, and diabetes, based on geographical area, gender, socioeconomic and educational background, and density of ultra-processed food outlets. Inequities in cirrhosis mortality rates have been reported, with the highest death rates among individuals living in socioeconomically disadvantaged areas and those with lower educational levels. Furthermore, insufficient healthcare access for key populations with primary liver cancer is influenced by complex healthcare systems, stigmatisation, discrimination, low education, language barriers, and fear of disclosure. These challenges contribute to inequities in liver cancer care pathways. Future studies are needed to explore the different SDoH-interlinked effects on liver cancer incidence and outcomes in European countries. The ultimate goal is to develop evidence-based multilevel public health interventions that reduce the SDoH impact in precipitating and perpetuating the disproportionate burden of liver cancer in specific populations.
Italy has had the highest prevalence of hepatitis C virus (HCV) infection and mortality from HCV-... more Italy has had the highest prevalence of hepatitis C virus (HCV) infection and mortality from HCV-related liver cancer in Europe. Although direct-acting antivirals (DAA) were initially restricted to persons with advanced fibrosis, their use has since been extended to all infected individuals; more than 244 000 persons have been treated to date. HCV liver-related mortality is expected to decline by 75% by 2030, achieving the World Health Organization target for mortality. However, Italy risks failing to meet the overall goal of eliminating HCV infection by 2030. In this light, €71.5 million have been allocated for screening initially specific target populations (persons who inject drugs, prison inmates, and the 1969–1989 birth cohort). Herein, we outline the challenges and recommendations for how to move Italy toward HCV elimination, including expanding screening programs in other populations, increasing awareness through strategic communication, sustaining DAA access, and tailoring c...
Lack of available organs poses a significant challenge in meeting the needs of patients with life... more Lack of available organs poses a significant challenge in meeting the needs of patients with life-threatening liver disease who could benefit from liver transplantation (LT). Psychosocial vulnerability markers have been linked to post-transplant outcomes, raising questions about their use in patient selection. However, their incorporation into selection criteria raises concerns about health equity and potential discrimination. As a result, there is a pressing need to refine fair allocation systems that consider both clinical and psychosocial factors to ensure equitable access and optimize post-transplant outcomes. The Equitable Benefit Approach (EBA) proposed in this paper by the multidisciplinary group of clinical experts in LT from the Italian Society for the Study of the Liver seeks to address these concerns. It presents four procedural principles, the two allocative principles usually applied in transplantation (urgency and utility) and introduces a new one, the principle of health equity. The EBA aims to prioritize patients with the highest transplant benefit while addressing health inequalities. It emphasizes evidence-based decision-making and standardized assessment tools to reliably evaluate psychosocial risk factors. Implementing the EBA involves a multi-step process, including stakeholder engagement, prospective studies to validate its efficacy, development of institutional policies and algorithms, and ongoing monitoring and revision. By following these steps, health care providers can ensure that LT allocation decisions are transparent and responsive to evolving clinical and social contexts. Ultimately, the EBA should offer a comprehensive framework for fair patient selection in LT, considering both biomedical and psychosocial aspects.
Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social de... more Given the increasing burden of liver cancer in Europe, it is crucial to investigate how social determinants of health (SDoH) affect liver cancer risk factors and access to care in order to improve health outcomes equitably. This paper summarises the available evidence on the differential distribution of liver cancer risk factors, incidence, and health outcomes in the European Economic Area and the United Kingdom from an SDoH perspective. Vulnerable and marginalised populations have low socioeconomic and educational levels and are the most affected by liver cancer risk factors. Reasons for this include varied access to hepatitis B virus vaccination and limited access to viral hepatitis B and C screening, harm reduction, and treatment. Additionally, alcohol-related liver disease remains highly prevalent among individuals with low education, insecure employment, economic instability, migrants, and deprived populations. Moreover, significant variation exists across Europe in the proportion of adults with steatotic liver disease, overweight/obesity, and diabetes, based on geographical area, gender, socioeconomic and educational background, and density of ultra-processed food outlets. Inequities in cirrhosis mortality rates have been reported, with the highest death rates among individuals living in socioeconomically disadvantaged areas and those with lower educational levels. Furthermore, insufficient healthcare access for key populations with primary liver cancer is influenced by complex healthcare systems, stigmatisation, discrimination, low education, language barriers, and fear of disclosure. These challenges contribute to inequities in liver cancer care pathways. Future studies are needed to explore the different SDoH-interlinked effects on liver cancer incidence and outcomes in European countries. The ultimate goal is to develop evidence-based multilevel public health interventions that reduce the SDoH impact in precipitating and perpetuating the disproportionate burden of liver cancer in specific populations.
Lack of available organs poses a significant challenge in meeting the needs of patients with life... more Lack of available organs poses a significant challenge in meeting the needs of patients with life-threatening liver disease who could benefit from liver transplantation (LT). Psychosocial vulnerability markers have been linked to post-transplant outcomes, raising questions about their use in patient selection. However, their incorporation into selection criteria raises concerns about health equity and potential discrimination. As a result, there is a pressing need to refine fair allocation systems that consider both clinical and psychosocial factors to ensure equitable access and optimize post-transplant outcomes. The Equitable Benefit Approach (EBA) proposed in this paper by the multidisciplinary group of clinical experts in LT from the Italian Society for the Study of the Liver seeks to address these concerns. It presents four procedural principles, the two allocative principles usually applied in transplantation (urgency and utility) and introduces a new one, the principle of health equity. The EBA aims to prioritize patients with the highest transplant benefit while addressing health inequalities. It emphasizes evidence-based decision-making and standardized assessment tools to reliably evaluate psychosocial risk factors. Implementing the EBA involves a multi-step process, including stakeholder engagement, prospective studies to validate its efficacy, development of institutional policies and algorithms, and ongoing monitoring and revision. By following these steps, health care providers can ensure that LT allocation decisions are transparent and responsive to evolving clinical and social contexts. Ultimately, the EBA should offer a comprehensive framework for fair patient selection in LT, considering both biomedical and psychosocial aspects.
The case of Indi Gregory is paradigmatic of the ethical and legal issues in- volved in the decisi... more The case of Indi Gregory is paradigmatic of the ethical and legal issues in- volved in the decision to withdraw life support from an infant. The purpose of this paper is to analyze the case from a dual perspective, ethical and legal, discussing the issue of best interest of the infants.
The research analyzes the recent Italian draft laws on Medical Assistance in dying, their strengt... more The research analyzes the recent Italian draft laws on Medical Assistance in dying, their strengths and several shortcomings, comparing them with other European laws on this subject. The Italian draft laws are not fully hinged on the exercise of self-determination of the suffering person but remain bound to the reference to a condition of proximity to death or the presence of life-sustaining treatments, which in fact cause unjustified inequities in access to a health service aimed at protecting the dignity of the person. Furthermore, the articulation of the procedures for requesting and assessing suitability outlined in the Italian bills does not allow to fully protect the person in a condition of vulnerability from the risk of abuse and conditioning, nor to fully protect procedural justice.
The research outlines the evolution of the public health management system in the Kingdom of Sici... more The research outlines the evolution of the public health management system in the Kingdom of Sicily between the second half of the 16th century and the first half of the 19th century, emphasizing the specific features of the Sicilian case and highlighting the possible causes. It frames the evolution of public health institutions in Sicily both in the process of centralization and organization of the administrative apparatus of modern State, and in the development of medical theories concerning contagion. Through the analysis of the legislation and of the documentation produced by the competent bodies, it has been proved that there is no break in continuity in the activity of the various institutions that manage public health along the time span investigated. Special attention is devoted to the role of doctors within these institutions and to the relationship with medical science. The analysis shows that the competent bodies based their choices on an empirical approach, making prudential choices that took into account both the miasmatic theory and the contagionist theory
Our study examines several autobiographical works that express life lived, a privileged access ke... more Our study examines several autobiographical works that express life lived, a privileged access key to understand suffering people and the afflicted, and which reveal the ethico-anthropological dimension of medicine
La storia di questa struttura psichiatrica rappresenta uno straordinario esempio di come innovazi... more La storia di questa struttura psichiatrica rappresenta uno straordinario esempio di come innovazione medica, letteratura e architettura si intreccino formando un\u2019unica trama storica che merita di essere letta e tenuta in considerazion
The infectious diseases are the most prevalent illnesses in prisoners, and they have a relevant b... more The infectious diseases are the most prevalent illnesses in prisoners, and they have a relevant burden for the society. Several studies have shown that the screening and the treatment of the infectious diseases inside prisons may be effective in reducing their burden in the general community. The main aim of the study was to determine between 2019-2021 the incidence and the prevalence of HIV, HBV, HCV, TB and syphilis in the people inside Padua prisons. The study has demonstrated that the screening of the infectious diseases in detainees was very high, raising in 2021 in the entrant people the 100%. The research also has shown that during 2021 the most prevalent incidence of infectious diseases was for TB (16.3%), followed by HCV (11.3%), HBV (7.9%) and HIV (1.6%). Interestingly, our data has indicated how during 2021 versus the previous years the prevalence of the infectious diseases increased for HBV (41.5%), HCV (18.8%), and TB (48.1%). These data indicate as different conditions...
SUMMARY BETWEEN HORROR AND SCIENCE: THE BIRTH OF A CABINET OF PATHOLOGICAL ANATHOMY AT THE UNIVER... more SUMMARY BETWEEN HORROR AND SCIENCE: THE BIRTH OF A CABINET OF PATHOLOGICAL ANATHOMY AT THE UNIVERSITY OF PALERMO This paper outlines the history of the Cabinet of Pathological Anathomy at the University of Palermo, describes rapidly its current status and analyzes the composition of its displays in 1859. It aims to highlight the analogies with other collections of a similar kind and to pinpoint potential actions to endorse and develop this important scientific asset. Introduzione Fonte di meraviglia e di ribrezzo per il grande pubblico, oggetto di curiosità per i medici, le collezioni di Anatomia Patologica presenti in numerosi atenei italiani ed europei rappresentano oggi un patri-monio straordinario ma poco fruibile, proprio perché concepite come materiale didattico. Per comprenderne origine e natura, è necessario immergersi in un mondo in cui la quantità di immagini a disposi-zione era infinitamente minore: in tal senso i Gabinetti di Anatomia Patologica forniscono una testimonianza importante per comprende-re come venissero trasmesse le informazioni sui fenomeni biologici,
This story is about a government, which considered the management of madness not a medical issue ... more This story is about a government, which considered the management of madness not a medical issue but a matter of law and order, and a 64 years old official who became the director of a madhouse having no medical nor managing expertise in mental disease, but just humanity and dedication. But most of all its the story of their attempt to project an image of themselves and of what they had done, that turned out in something completely different: a literary myth which went so far to reach the pen of Alexandre Dumas and Edgar Allan Poe
The present article aims at giving an ethical-anthropological interpretation of the body wounded ... more The present article aims at giving an ethical-anthropological interpretation of the body wounded by the disease, under the perspective of the wounded self-portrait, a genre selected by some artists who, between the nineteenth and the twentieth century, pictured their physical or psychological malaise (Van Gogh, Kahlo, Munch, Bacon, Klee). Getting acquainted with artistic language, particularly when it arises from personal experience, has an educational value for healthcare professional, as it helps to catch \u201cthe history from below\u201d, as Roy Porter called it, which is the history from the patient\u2019s perspective.Dans cet article les auteurs donnent une interpr\ue9tation anthropologique au corps humain bless\ue9 par la maladie, illustr\ue9e par un autoportrait d\ue9figur\ue9 par la blessure, genre choisi par un nombre d\u2019artistes qui au XIXi\ue8me et XXi\ue8me si\ue8cle peignaient leur malaise physique ou mental (Van Gogh, Kahlo, Munch, Bacon, Klee). Une meilleure compr\ue9hension du language artistique, en particulier quand celui-ci \ue9mane d\u2019une experience personelle, repr\ue9sente une valeur \ue9ducative pour le professionnel des soins de sant\ue9, puisqu\u2019elle aide \ue0 saisir \u2018l\u2019histoire par l\u2019int\ue9rieur\u2019, comme le disait Roy Porter, c\u2019est-\ue0-dire l\u2019histoire du point de vue personnel du patient
Costs of new anti Hepatitis C regimens and access to care: the case for prioritization or univers... more Costs of new anti Hepatitis C regimens and access to care: the case for prioritization or universal cur
Adv Exp Med Biol - Advances in Microbiology, Infectious Diseases and Public Health, 2019
In recent years, the debate on ethical issues related to hepatitis C virus
therapies has been foc... more In recent years, the debate on ethical issues related to hepatitis C virus therapies has been focused on the problem of drug prices and access to therapies. Nonetheless, the goal of hepatitis C virus eradication set by the World Health Organization in 2016 is raising new ethical issues, since governments are faced with a new challenge: reaching through screening, diagnosis and treatment a large amount of subjects with undiagnosed hepatitis C infection. National governments, especially high-income countries with a Welfare State, are compelled to provide access to therapies, but also to involve those who are still unaware of their disease status. Since people cannot be forced but should be guided towards the choice of screening, diagnosis and treatment, three concepts will be instrumental in the success of any HCV elimination policy: involvement, communication and protection of vulnerable individuals. Given the importance of diagnosis and treatment both in terms of individual benefit and social benefit, while respecting individual freedom and autonomy, the government has a moral obligation to try to drive individuals on the path of therapy. Even if it fails to get a complete success, the hepatitis C virus eradication campaign will lead to a significant reduction in the incidence of the disease and it will convey a very important message: today more than ever public health interventions must be thought in a global perspective, far beyond the borders of National States.
Uploads
Papers by Lucia Craxì
therapies has been focused on the problem of drug prices and access to
therapies. Nonetheless, the goal of hepatitis C virus eradication set by the
World Health Organization in 2016 is raising new ethical issues, since
governments are faced with a new challenge: reaching through screening,
diagnosis and treatment a large amount of subjects with undiagnosed
hepatitis C infection. National governments, especially high-income
countries with a Welfare State, are compelled to provide access to
therapies, but also to involve those who are still unaware of their disease
status.
Since people cannot be forced but should be guided towards the choice of
screening, diagnosis and treatment, three concepts will be instrumental in
the success of any HCV elimination policy: involvement, communication
and protection of vulnerable individuals.
Given the importance of diagnosis and treatment both in terms of
individual benefit and social benefit, while respecting individual freedom
and autonomy, the government has a moral obligation to try to drive
individuals on the path of therapy. Even if it fails to get a complete success,
the hepatitis C virus eradication campaign will lead to a significant
reduction in the incidence of the disease and it will convey a very important
message: today more than ever public health interventions must be thought
in a global perspective, far beyond the borders of National States.