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Philippines finally passes AIDS Act
POLICY AND PEOPLE
Overseas-trained doctors allowed places in Australian medical schools n an attempt to overcome hunger strikes in Sydney and Melbourne by some overseas-trained doctors (OTDs) who have been refused registration—even those who are Australian citizens—the Minister for Health and Family Services has agreed to provide an extra 100 places in Australian medical schools. The offer to OTDs who have not completed the Australian Medical Council assessment process is open for 1999 only and includes the following elements: any OTD who has not completed the AMC assessment
I
process may apply; selection will be based on merit and will be decided by the individual medical schools; OTDs with recognised refugee status will be prioritised; and the medical school will decide the appropriate entry level for each individual. It is anticipated that OTDs will enter into any year from the fourth year of a 6-year course. Participation by medical schools will be optional, and OTDs will be subject to the same course conditions as other graduates. The government is clearly aiming to address another problem—the
dearth of rural doctors—by making it a condition of the programme that OTDs agree to become part of the rural medical workforce during their internship, clinical assistantship, and then for a further 5 years after completing their postgraduate training. But the government’s response is ironic, since it comes in the context of a generally perceived oversupply of doctors in Australia which has resulted in pressure on medical schools to reduce intakes. Stephen Cordner, Kathy Ettershank
Austrian moves on euthanasia come at sensitive time
W
doctor to kill human beings.” The group could not have picked a politically worse time to ask for help. The government, always sensitive to comparisons with its wartime past, is currently investigating a doctor, Heinrich Gross, for the murder of handicapped children by overprescription of painkillers during the Nazi euthanasia programme. The government is unlikely to want a public euthanasia debate in Austria today.
e must lift the veil of hypocrisy and averted gazes, urged philosopher Peter Kampits, who was speaking as part of a working group of doctors, lawyers, and philosophers that is pressing the Austrian government to legalise passive and active euthanasia. The group, lead by Sepp Wille, past leader of the Social Democrat Parliamentary Party, presented their Manifesto for Self Determination to Parliamentary President Heinz Fischer last week. Arnulf Fritsch of Vienna
University, representing the doctors, said that where the condition of the patient would soon lead to death, the doctor should be allowed the possibility of active euthanasia, providing that the will of the patient always prevailed. The pressure group also asked for doctors to be freed of the legal consequences in situations in which they give pain relief that could accelerate death. But the President of the Austrian Doctors Association, who was not part of the group, rejected active euthanasia. “It’s not the task of a
Philippines finally passes AIDS Act
Inquiry explains neonatal deaths in Brazil
A
Claire Wallerstein
734
five newborn babies died in one day. Overcrowding and lack of personThe inspection by the commission nel are to blame for the high mortallasted 2 days, and one of its members ity rate among newborn babies in told the local press two public maternity that he had a good hospitals in the city impression of the of Rio de Janeiro, in facilities in the two January. This conclumaternity hospitals. sion was made by a “The problem”, he commission from the told Folha de São Regional Council of Paulo, a nationwide Medicine of the State daily newspaper, of Rio de Janeiro “is overcrowding”. which inspected the During the visit to two hospitals in early Alexander Fleming February. Fight for life, fight for space? hospital, there were From the begin18 newborn babies in the intensive ning of January until the commiscare unit, and only 12 available beds. sion’s visits in early February, The high death toll was widely 59 babies died in the wards publicised by the local and national of Alexander Fleming hospital press. After the scandal, it was (Rio’s west region) and Fernando announced that ten paediatricians, Magalhães hospital (north region). In four nurses, and 37 other health proAlexander Fleming, 27 premature fessionals were to start work in and other high-risk babies died in February at the Alexander Fleming January, almost 50% more than the maternity ward. average mortality rate for high-risk neonates in that facility. On Jan 26, when the situation was most critical, Claudio Csillag Sean Sprague/Panos Pictures
fter 3 years of political wrangling, the Philippines passed an AIDS bill last week. The Act, backed up by a P20-million (US$500 000) budget, will provide comprehensive nationwide education to break down the taboos surrounding the disease in this staunchly Catholic country. The Act also promises the full protection of the human and civil rights of Filipinos infected with HIV, but will penalise those found guilty of deliberately infecting others. The passage of the new bill was delayed for 3 years due, in part, to opposition from the Catholic Church. Although the Act does emphasise the benefits of “sexual abstinence and faithfulness within marriage”, it also recognises the importance of condoms in a country where they are hard to obtain and rarely used. WHO estimates that 23 000 Filipinos are HIV positive—a further 10 000 people could be infected by 2000.
Nigel Glass
THE LANCET • Vol 351 • March 7, 1998
Overseas-trained doctors allowed places in Australian medical schools n an attempt to overcome hunger strikes in Sydney and Melbourne by some overseas-trained doctors (OTDs) who have been refused registration—even those who are Australian citizens—the Minister for Health and Family Services has agreed to provide an extra 100 places in Australian medical schools. The offer to OTDs who have not completed the Australian Medical Council assessment process is open for 1999 only and includes the following elements: any OTD who has not completed the AMC assessment
I
process may apply; selection will be based on merit and will be decided by the individual medical schools; OTDs with recognised refugee status will be prioritised; and the medical school will decide the appropriate entry level for each individual. It is anticipated that OTDs will enter into any year from the fourth year of a 6-year course. Participation by medical schools will be optional, and OTDs will be subject to the same course conditions as other graduates. The government is clearly aiming to address another problem—the
dearth of rural doctors—by making it a condition of the programme that OTDs agree to become part of the rural medical workforce during their internship, clinical assistantship, and then for a further 5 years after completing their postgraduate training. But the government’s response is ironic, since it comes in the context of a generally perceived oversupply of doctors in Australia which has resulted in pressure on medical schools to reduce intakes. Stephen Cordner, Kathy Ettershank
Austrian moves on euthanasia come at sensitive time
W
doctor to kill human beings.” The group could not have picked a politically worse time to ask for help. The government, always sensitive to comparisons with its wartime past, is currently investigating a doctor, Heinrich Gross, for the murder of handicapped children by overprescription of painkillers during the Nazi euthanasia programme. The government is unlikely to want a public euthanasia debate in Austria today.
e must lift the veil of hypocrisy and averted gazes, urged philosopher Peter Kampits, who was speaking as part of a working group of doctors, lawyers, and philosophers that is pressing the Austrian government to legalise passive and active euthanasia. The group, lead by Sepp Wille, past leader of the Social Democrat Parliamentary Party, presented their Manifesto for Self Determination to Parliamentary President Heinz Fischer last week. Arnulf Fritsch of Vienna
University, representing the doctors, said that where the condition of the patient would soon lead to death, the doctor should be allowed the possibility of active euthanasia, providing that the will of the patient always prevailed. The pressure group also asked for doctors to be freed of the legal consequences in situations in which they give pain relief that could accelerate death. But the President of the Austrian Doctors Association, who was not part of the group, rejected active euthanasia. “It’s not the task of a
Philippines finally passes AIDS Act
Inquiry explains neonatal deaths in Brazil
A
Claire Wallerstein
734
five newborn babies died in one day. Overcrowding and lack of personThe inspection by the commission nel are to blame for the high mortallasted 2 days, and one of its members ity rate among newborn babies in told the local press two public maternity that he had a good hospitals in the city impression of the of Rio de Janeiro, in facilities in the two January. This conclumaternity hospitals. sion was made by a “The problem”, he commission from the told Folha de São Regional Council of Paulo, a nationwide Medicine of the State daily newspaper, of Rio de Janeiro “is overcrowding”. which inspected the During the visit to two hospitals in early Alexander Fleming February. Fight for life, fight for space? hospital, there were From the begin18 newborn babies in the intensive ning of January until the commiscare unit, and only 12 available beds. sion’s visits in early February, The high death toll was widely 59 babies died in the wards publicised by the local and national of Alexander Fleming hospital press. After the scandal, it was (Rio’s west region) and Fernando announced that ten paediatricians, Magalhães hospital (north region). In four nurses, and 37 other health proAlexander Fleming, 27 premature fessionals were to start work in and other high-risk babies died in February at the Alexander Fleming January, almost 50% more than the maternity ward. average mortality rate for high-risk neonates in that facility. On Jan 26, when the situation was most critical, Claudio Csillag Sean Sprague/Panos Pictures
fter 3 years of political wrangling, the Philippines passed an AIDS bill last week. The Act, backed up by a P20-million (US$500 000) budget, will provide comprehensive nationwide education to break down the taboos surrounding the disease in this staunchly Catholic country. The Act also promises the full protection of the human and civil rights of Filipinos infected with HIV, but will penalise those found guilty of deliberately infecting others. The passage of the new bill was delayed for 3 years due, in part, to opposition from the Catholic Church. Although the Act does emphasise the benefits of “sexual abstinence and faithfulness within marriage”, it also recognises the importance of condoms in a country where they are hard to obtain and rarely used. WHO estimates that 23 000 Filipinos are HIV positive—a further 10 000 people could be infected by 2000.
Nigel Glass
THE LANCET • Vol 351 • March 7, 1998