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OBJECTIVE: Although Brazil became the first country worldwide to ban the sale of all tobacco products with any additive that could alter their flavours and tastes in 2012, its implementation was effectively halted by tobacco industry lawsuits, including a constitutional challenge filed in the Federal Supreme Court in 2013. This study aimed at examining, for the first time in the country, the evolution over time of the new registrations of tobacco products with additives that would have been banned if not for the tobacco industry's interference ('counterfactual scenario'). METHODS: We used the newly available public database on the registration of tobacco products developed by the Health Regulatory Agency (from 2008 onwards). All types of tobacco products intended for the domestic market that contained 'banned additives in a counterfactual scenario' and were registered between January 1 and December 31 of each year were selected. RESULTS: Between 2012 and 2023, a total of 1112 new registrations of tobacco products with 'banned additives' were recorded. The spread of hookah tobacco registrations started in 2014, and by 2023, the cumulative incidence of registrations containing 'banned additives' was 641. Both manufactured cigarettes and hookah products reached their peaks in new registrations in 2020. CONCLUSIONS: After 12 years since the resolution intended to ban all additives that change the aroma and taste of tobacco products in Brazil, primarily to prevent smoking initiation, the tobacco industry's interference continues to successfully block its implementation. Countries facing similar challenges in tobacco control could consider generating comparable national data that might help expose the adverse impacts of tobacco industry interference on public health.

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The right to health is linked to life and human dignity. Among the instruments to make it effective, the phenomenon of health litigation has become prominent. In Brazil, courts are increasingly faced with the task of rendering verdicts concerning matters related to health. Nowadays, judges have to deal with issues about health policies, technology incorporations, drug supplies, human autonomy, genetics, and biotechnologies, among others. Lawsuit sentences are now to be built upon the resolution of ethical, legal and philosophical questions. Bioethics presents itself as an instrument and method to help solve legal cases involving the right to health. This paper intends to show that bioethics can be applied in verdicts of lawsuits regarding to right to health in Brazil. It highlights that bioethics can be considered a source of law due to its normative dimension, as well as a hermeneutic method. This essay also aims to show the role for bioethics to help interpret the law and solve hard cases within health law and the right to health. Lastly, it aims to justify the presence of bioethics as legal reasoning to be used by judges in the foundation of their verdicts in lawsuits involving the right to health.

El derecho a la salud está vinculado a la dignidad humana. Entre los instrumentos para hacerlo efectivo se ha destacado el fenómeno de la judicialización de la salud. En Brasil, los tribunales cada vez más deben decidir sobre asuntos relacionados con el derecho a la salud. Jueces deben tratar temas sobre políticas de salud, biotecnologías, medicamentos, autonomía humana, genética, entre otros. Las sentencias judiciales ahora deben resolver cuestiones éticas, legales y filosóficas. La bioética se presenta como un instrumento y un método para ayudar a resolver los casos legales del derecho a la salud. Este estudio pretende mostrar que la bioética puede ser aplicada en sentencias judiciales sobre casos de derecho a la salud en Brasil. Se destaca que la bioética puede ser considerada una fuente de derecho por su dimensión normativa, así como un método hermenéutico. Este ensayo también tiene como objetivo mostrar el papel de la bioética para ayudar a interpretar el derecho y resolver casos difíciles dentro del derecho a la salud. Por último, pretende justificar la presencia de la bioética como razonamiento jurídico a ser utilizado por los jueces en la fundamentación de sus veredictos en juicios que involucren el derecho a la salud.

O direito à saúde está vinculado à dignidade humana. Dentre os instrumentos para efetivá-la, o fenômeno da judicialização da saúde tem se destacado. No Brasil, os tribunais se deparam cada vez mais com a tarefa de julgar processos relacionadas ao direito à saúde. Atualmente, os juízes têm que lidar com questões sobre políticas de saúde, incorporação de tecnologias, fornecimento de medicamentos, autonomia, genética, biotecnologias, entre outros. As sentenças judiciais devem ser construídas com base também na resolução de questões éticas, legais e filosóficas. A bioética apresenta-se como instrumento e método para auxiliar na resolução de casos jurídicos envolvendo o direito à saúde. Este trabalho pretende mostrar que a bioética pode ser aplicada no julgamento de ações judiciais relativas ao direito à saúde no Brasil. Destaca que a bioética pode ser considerada fonte do direito por sua dimensão normativa, bem como método hermenêutico. Este ensaio também visa mostrar o papel da bioética para ajudar a interpretar a lei e resolver casos difíceis dentro do direito sanitário e do direito à saúde. Por fim, visa justificar a presença da bioética como fundamentação jurídica a ser utilizada pelos magistrados na fundamentação de suas sentenças em ações que envolvam o direito à saúde.

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ABSTRACT Objectives: to analyze judicial demands for medications in Campo Grande, Brazil, between July 2018 and June 2020. Methods: the four dimensions of the Manual of Indicators for Evaluation and Monitoring of Judicial Demands for Medications were examined. Results: 676 judicial processes were identified, corresponding to 1006 requests for 284 different medications. In 92.74% of the processes, access to medications was granted, with 88.80% granted on an urgent basis. The median time between the decision and delivery of the medication was 146 days. The average monthly cost of acquiring medications was R$ 2,183.68 Brazilian reais. Among the identified medications, 90.22% had at least one therapeutic alternative available in the public healthcare system. Conclusions: characterizing and analyzing judicial demands related to medications can support discussions on updating medication lists and clinical protocols, organizing healthcare services, allocating resources, and implementing actions to reduce judicialization.

RESUMEN Objetivos: analizar las demandas judiciales de medicamentos en Campo Grande, Brasil, entre julio de 2018 y junio de 2020. Métodos: se analizaron las 4 dimensiones del Manual de Indicadores de Evaluación y Monitoreo de Demandas Judiciales de Medicamentos. Resultados: se identificaron 676 casos judiciales, correspondientes a 1006 solicitudes para 284 medicamentos diferentes. En el 92,74% de los casos, se concedió acceso a los medicamentos, siendo el 88,80% de ellos de carácter urgente. El tiempo mediano entre la decisión y la entrega del medicamento fue de 146 días. El costo medio mensual de adquisición de los medicamentos fue de R$ 2.183,68 reales. Entre los medicamentos identificados, el 90,22% tenían al menos una alternativa terapéutica disponible en el sistema público de salud. Conclusiones: la caracterización y análisis de las demandas judiciales relacionadas con medicamentos pueden respaldar las discusiones sobre la actualización de las listas de medicamentos y los protocolos clínicos, la organización de los servicios de salud, la asignación de recursos y las acciones para reducir la judicialización.

RESUMO Objetivos: analisar as demandas judiciais por medicamentos em Campo Grande, Brasil, entre julho de 2018 e junho de 2020. Métodos: foram analisadas as 4 dimensões do Manual de Indicadores de Avaliação e Monitoramento de Demandas Judiciais de Medicamentos. Resultados: 676 processos judiciais foram identificados, correspondendo a 1006 solicitações para 284 diferentes medicamentos. Em 92,74% dos processos o acesso aos medicamentos foi concedido, sendo 88,80% em caráter de urgência. O tempo mediano entre a decisão e entrega do medicamento foi 146 dias. O custo médio mensal de aquisição dos medicamentos foi R$ 2.183,68 reais. Dentre os medicamentos identificados, 90,22% tinham pelo menos uma alternativa terapêutica disponível no sistema público de saúde. Conclusões: a caracterização e análise das demandas judiciais relacionadas a medicamentos pode apoiar as discussões sobre atualização das listas de medicamentos e protocolos clínicos, a organização dos serviços de saúde, a alocação de recursos e as ações para reduzir a judicialização.

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Este artículo muestra que la experiencia acumulada por la Corte Suprema chilena en juicios sobre responsabilidad civil y ambiental, debiera permitirle abordar los problemas ético-ambientales y jurídicos que el calentamiento global implica, sea previniendo daños mediante la imposición a los principales emisores de gases de efecto invernadero, incluido el Estado, del deber de reducir acelerada y significativamente las emisiones, sea exigiendo y haciendo cumplir la obligación de adaptación al cambio climático mediante la atribución de responsabilidad extracontractual o ambiental.

This article shows that the experience accrued by the Chilean Supreme Court in lawsuits on tort and environmental liability, should allow it to address the ethical-environmental and legal issues that global warming implies, either by preventing harm through the imposition on the major emitters of greenhouse gases, including the State, of the duty to reduce emissions rapidly and significantly, or by demanding and enforcing the obligation to adapt to climate change through the attribution of tort liability or environmental liability.

Esse artigo mostra que a experiência acumulada pela Corte Suprema chilena em julgamentos sobre responsabilidade civil e ambiental, deveria permitir-lhe abordar os problemas ético-ambientais e jurídicos que o aquecimento global implica, seja prevenindo danos mediante a imposição aos principais emissores de gases de efeito estufa, incluindo o Estado, do dever de reduzir acelerada e significativamente as emissões, seja exigindo e fazendo cumprir a obrigação de adaptação à mudança climática mediante a atribuição de responsabilidade extracontratual ou ambiental.

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Resumen En estos tiempos de pandemia, la Real Expedición Filantrópica de la Vacuna (1803-1813) cobra vigencia por la amplitud de su dimensión geográfica y por su carácter de expedición sanitaria inspirada en un objetivo de salud pública pionero en su época: propagar la recién descubierta vacuna contra la viruela. Acometida por un reducido número de expedicionarios, fue dirigida por Francisco Xavier Balmis, a quien acompañaba, entre otros, Antonio Gutiérrez Robredo, su discípulo predilecto. Esta investigación, realizada con fuentes primarias, explora la relación entre ambos, la cual pasó de la mutua confianza a la enemistad debido a un conflicto nimio. El estudio de la correspondencia previa y la tardía resolución del pleito interpuesto por Balmis contra Gutiérrez permite ahondar en sus perfiles biográficos. Como consecuencia directa de aquel litigio, Gutiérrez nunca retornó a España, aunque llegó a ser catedrático en México; por el contrario, Balmis disfrutó honores y reconocimientos en Madrid.

Abstract The Royal Philanthropic Vaccine Expedition (1803-1813) becomes relevant in these pandemic times due to the breadth of its geographical dimension and its nature of a health expedition inspired by a pioneering public health objective of its time: to spread the newly discovered vaccine against smallpox. Undertaken by a small number of participants, the expedition was directed by Francisco Xavier Balmis, who was accompanied, among others, by Antonio Gutiérrez Robredo, his favorite disciple. This research, carried out using primary sources, explores the relationship between both, which went from mutual trust to enmity due to a trivial conflict. The study of previous correspondence and late resolution of the lawsuit filed by Balmis against Gutiérrez allows us to delve into their biographical profiles. As a direct consequence of that litigation, Gutiérrez never went back to Spain, although he became a professor in Mexico; in contrast, Balmis enjoyed honors and recognition in Madrid.

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BACKGROUND: The judicialization of health care can be understood as a societal response to pressing healthcare needs, which probably are not being adequately addressed by the current healthcare system. This phenomenon increases the strain on service resources, both in the health sector and in the judiciary system as well, demanding an institutional reorganization to manage judicial actions. It is believed that each institution has developed strategies for coping with the problem in isolation and with little public disclosure. The purpose of this review will be to identify institutional strategies implemented and to investigate their effects in approaching the judicialization of health care. METHODS: Electronic searches will be conducted up to December 2021 on 11 databases, supplemented with gray literature and references lists of secondary studies. The descriptor "judicialization of health" will be the basis for conducting the main research. Studies describing any strategy implemented by public institutions to approach the judicialization of health care will be included. Results related to the quality of services provided by the implemented strategy reported in the studies and those that report accessibility, usability, and potential adverse effects or harms caused by the implemented strategy will be investigated. In addition, it will be explored if there have been changes related to the value or characteristics of health litigation. Two reviewers will independently screen all citations, abstract data, and full-text papers. The risk of bias in each study will be appraised using a tool suggested by Cochrane Effective Practice and Care Organization Group (EPOC). Subsequently, the reviewers will also extract the data of interest and classify the findings of these studies according to their performance at the institutional level. The results obtained will be described as a narrative synthesis. DISCUSSION: This review may provide evidence on the effects of the strategies implemented to approach the judicialization of health care. It will potentially benefit health care and legal professionals, decision-makers, and researchers by identifying the types and characteristics of strategies that have the potential to improve service delivery in the future. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020160608.

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This Article aims to show how the food industry has instrumentalized the right to freedom of expression to oppose innovative laws in Chile aimed at creating healthier food environments.

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Predicting case outcomes is useful for legal professionals to understand case law, file a lawsuit, raise a defense, or lodge appeals, for instance. However, it is very hard to predict legal decisions since this requires extracting valuable information from myriads of cases and other documents. Moreover, legal system complexity along with a huge volume of litigation make this problem even harder. This paper introduces an approach to predicting Brazilian court decisions, including whether they will be unanimous. Our methodology uses various machine learning algorithms, including classifiers and state-of-the-art Deep Learning models. We developed a working prototype whose F1-score performance is ~80.2% by using 4,043 cases from a Brazilian court. To our knowledge, this is the first study to present methods for predicting Brazilian court decision outcomes.

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The Royal Philanthropic Vaccine Expedition (1803-1813) becomes relevant in these pandemic times due to the breadth of its geographical dimension and its nature of a health expedition inspired by a pioneering public health objective of its time: to spread the newly discovered vaccine against smallpox. Undertaken by a small number of participants, the expedition was directed by Francisco Xavier Balmis, who was accompanied, among others, by Antonio Gutiérrez Robredo, his favorite disciple. This research, carried out using primary sources, explores the relationship between both, which went from mutual trust to enmity due to a trivial conflict. The study of previous correspondence and late resolution of the lawsuit filed by Balmis against Gutiérrez allows us to delve into their biographical profiles. As a direct consequence of that litigation, Gutiérrez never went back to Spain, although he became a professor in Mexico; in contrast, Balmis enjoyed honors and recognition in Madrid.

En estos tiempos de pandemia, la Real Expedición Filantrópica de la Vacuna (1803-1813) cobra vigencia por la amplitud de su dimensión geográfica y por su carácter de expedición sanitaria inspirada en un objetivo de salud pública pionero en su época: propagar la recién descubierta vacuna contra la viruela. Acometida por un reducido número de expedicionarios, fue dirigida por Francisco Xavier Balmis, a quien acompañaba, entre otros, Antonio Gutiérrez Robredo, su discípulo predilecto. Esta investigación, realizada con fuentes primarias, explora la relación entre ambos, la cual pasó de la mutua confianza a la enemistad debido a un conflicto nimio. El estudio de la correspondencia previa y la tardía resolución del pleito interpuesto por Balmis contra Gutiérrez permite ahondar en sus perfiles biográficos. Como consecuencia directa de aquel litigio, Gutiérrez nunca retornó a España, aunque llegó a ser catedrático en México; por el contrario, Balmis disfrutó honores y reconocimientos en Madrid.

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Several countries maintain universal health coverage, which implies responsibility to organize delivery formats of healthcare services and products for citizens. In Brazil, the health system has a principle of universal access for more than 30 years, but many deficiencies remain and the country observes a day practice for those seeking judicial decisions to determine provision of healthcare.

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Resumo O sistema de justiça faz mais do que apenas "controlar" a legalidade de políticas públicas e sua execução. O caso da judicialização da saúde no Brasil ilustra como juízes/as, advogados/as públicos/as e promotores/as se envolvem cada vez mais ativamente com a gestão da política de saúde. Esse envolvimento resulta na reorganização da gestão pública assumindo as ações judiciais ajuizadas contra a administração do Sistema Único de Saúde (SUS) como um "problema social" que merece respostas organizadas e coordenação interinstitucional. Este artigo descreve tais respostas com base em padrões de colaboração interinstitucional entre atores do sistema de justiça e profissionais da gestão da saúde em 4 estados brasileiros: São Paulo, Rio de Janeiro, Santa Catarina e Rio Grande do Sul. A partir de tipologia de McNamara (2012, 2016), o texto compara os diferentes graus de integração dessas respostas entre órgãos e traça o "perfil" colaborativo do estado em relação à judicialização da saúde.

Resumen El sistema de justicia hace más que simplemente "controlar" la legalidad de las políticas públicas y su implementación. El caso de la judicialización de la salud en Brasil ilustra cómo los jueces, los abogados públicos y los fiscales están cada vez más involucrados en la gestión de la política de salud. Esta participación resulta en la reorganización de la gestión pública. Las demandas presentadas contra la administración del Sistema Único de Salud se transforman en un "problema social" que merece respuestas organizadas y coordinación interinstitucional. Este artículo describe esas respuestas con base en estándares de colaboración interinstitucional entre actores del sistema de justicia y gestores de salud pública en cuatro estados brasileños: São Paulo, Río de Janeiro, Santa Catarina y Rio Grande do Sul. Operacionalizando la tipología de McNamara (2012, 2016) este estudio compara el grado de integración de las respuestas entre esos organismos y rastrea el "perfil" colaborativo de cada estado en relación con la judicialización de la salud.

Abstract The Brazilian justice system does more than simply review the legality of public policies and oversee their implementation. Looking at health litigation in Brazil reveals how judges, public lawyers, and prosecutors are increasingly involved in policy management, as they comprehend that the rising number of lawsuits seeking healthcare treatment requires management and inter-organizational coordination. This article explores this phenomenon by assessing initiatives of inter-institutional collaboration between actors in the justice and healthcare systems in four Brazilian states: São Paulo, Rio de Janeiro, Santa Catarina, and Rio Grande do Sul. By operationalizing the typology developed by McNamara (2012, 2016), this study compares the levels of integration in these responses and traces the collaborative "profile" of each state's approach to dealing with health litigation.

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O artigo examinou o critério procedimental baseado na accountability para a razoabilidade (accountability for reasonableness) como um método auxiliar ao controle jurisdicional nos litígios de saúde, sobretudo diante da criação da Comissão Nacional de Incorporação de Tecnologias no Sistema Único de Saúde. Estudou-se como o influxo do pragmatismo na atuação das cortes sugere um modelo judicial diverso para a concretização do direito à saúde, na tentativa de desjudicializar o debate e diminuir os riscos à equidade na distribuição dos recursos. Utilizaram-se dados empíricos colhidos por meio de revisão bibliográfica para análise da atuação concreta da Comissão. Concluiu-se que o maior controle jurisdicional do procedimento de tomada de decisão do administrador acerca da inclusão de medicamento nas listas públicas pode ser uma postura judicial pragmática tendente a produzir melhores resultados, ao exigir que a administração pública preste contas de sua atuação e demonstre as razões das decisões alocativas na assistência farmacêutica, bem como ao estimular a participação social no procedimento.

The article analyzed the procedural criteria based on "accountability for reasonableness" as an auxiliary method to the jurisdictional control in health care litigation, especially after the creation of the Brazilian National Committee for Health Technology Incorporation in the Brazilian National Health System. It was studied how the influence of pragmatism in the courts suggests a different judicial model for the materialization of the right to health in an attempt to reduce litigation in the debate and the risks to equity in the distribution of the resources. Empirical data from literature review was collected to analyze the National Committee's concrete performance. It was concluded that the greater jurisdictional control over the decision-making procedure by health authorities regarding the inclusion of medicine on public lists may be a judicial pragmatic approach tending to produce better results, by making public authorities accountable for their actions and requiring them to explicit the reasons of the allocative decisions on pharmaceutical assistance, as well as stimulating the social participation in the procedure.

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BACKGROUND: The judicialization of health care is a social claim concerning the right to the access to health care. It usually occurs due to gaps in public policy or failures in its application. In Brazil, several public institutions have implemented strategies to approach this phenomenon. However, these strategies have not yet been systematized into functional categories. OBJECTIVE: To categorize and analyze the strategies implemented by public institutions in Brazil to approach the judicialization of health care. METHOD: A systematic scoping review was developed following the method proposed by the Joanna Briggs Institute. The descriptor 'judicialization of health' was used to conduct the searches for studies in 18 electronic databases and other types of documents in the gray literature until March 2019. Documents containing the reports of strategies implemented in public institutions to approach the judicialization of health care in Brazil were included. Two independent reviewers assessed the eligibility of the documents and extracted the data. The strategies identified were categorized using definitions from the World Health Organization and existing Brazilian legislation. RESULTS: Seventy eight implemented strategies were identified and organized into nine categories: i. Technical support to the judiciary; ii. State health committees; iii. Organization of assistance; iv. Compliance with court orders, v. Computerized information systems; vi. Administrative proceeding; vii. Defense of the public authority; viii. Pharmacy and therapeutics committee; ix. Alternative dispute resolution. These categories are not mutually exclusive and often act in concert or complement each other's activities. They represent services either existing or provided for in legal provisions by the public administration to meet various types of demands. CONCLUSIONS: The categories proposed to approach the judicialization of health care represent some of the recommendations for qualifying public administration or are provided for in Brazilian legislation, or both. The existence of recommendations and legislation facilitate, but do not guarantee, the implementation of strategies by public institutions.

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BACKGROUND: Brazilian patients have legal right to access unlicensed medicines undergoing clinical research, if there is evidence of efficacy and safety. This study investigated the occurrence of serious adverse events related to very high-cost medicines from clinical studies, expanded access and compassionate use programs, obtained by patients though health litigation. METHODS: A descriptive study using secondary data investigated unlicensed medicines obtained through lawsuits from 2010 to 2017, costing more than 1 million Brazilian reais (BRL), adjusted by the Brazilian Consumer Index to July 2017. Data sources were the Brazilian Health Surveillance Agency Registry (DATAVISA) and Adverse Events in Clinical Studies (NotivisaEC) Databases. Medicines were categorized by the Anatomical Therapeutic Chemical classification to level 03 and events by the WHO Adverse Drug Reaction Terminology. The study received ethical approval by the University of Brasilia Institutional Research Board. RESULTS: In the period, 812 drugs were obtained through litigation, and of these, 78 exceeded cost of 1 million BRL; 44 of them presented reports of 1,248 serious adverse events. Total Brazilian Government expenditure with these drugs was 3.2 billion BRL. Class L04A (n=7) showed greater expenditures (over 1.8 billion BRL). One hundred ninety-six deaths occurred and L01X was the most involved category (49.5%). Most other serious events (n=419) and sequelae (n=10) were related to L01X. CONCLUSION: Very high-cost drugs paid for by the government and obtained through health litigation presented deaths and serious adverse events in expanded access and compassionate use programs in Brazil.

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Resumen: La comunidad científica coincide en que la emisión de gases de efecto invernadero genera calentamiento global y éste a su vez produce cambio climático. El cambio climático está y seguirá causando daños graves, incluso catastróficos, a la salud de las personas y al medioambiente. En este contexto, este artículo argumenta que la responsabilidad civil extracontractual puede contribuir en las tareas de mitigación y adaptación relacionadas con el daño que emana del cambio climático. Sin embargo, para lograr este objetivo, en futuros juicios indemnizatorios por cambio climático en Chile, los demandantes deberán proporcionar a los tribunales evidencia que demuestre la existencia de un nexo causal directo y necesario entre las emisiones de gases de efecto invernadero —producidas por una o más personas naturales o jurídicas— y el daño concretamente sufrido por la víctima.

Resumo: A comunidade científica concorda que a emissão de gases de efeito estufa gera aquecimento global e este por sua vez produz mudança climática. A mudança climática está e seguirá causando danos graves, inclusive catastróficos, à saúde das pessoas e ao meio ambiente. Neste contexto, este artigo argumenta que a responsabilidade civil extracontratual pode contribuir nas tarefas de mitigação e adaptação relacionadas com o dano que emana da mudança climática. Sem dúvida, para alcançar este objetivo, em juízos indenizatórios futuros pela mudança climática no Chile, os demandantes deverão proporcionar aos tribunais evidência que demonstre a existência de um nexo causal direto e necessário entre as emissões de gases de efeito estufa - produzidos por uma ou mais pessoas físicas ou jurídicas - e o dano concretamente sofrido pela vítima.

Abstract: The scientific community agrees that the emission of greenhouse gases generates global warming which in turn produces climate change. Climate change is -and will continue- causing serious, even catastrophic harm to the people's health and the environment. In this context, this article argues that tort liability can make a contribution to the mitigation and adaptation efforts related to the harm arising from climate change. In order to achieve this aim in future tort litigation for climate change in Chile, however, the claimants will have to provide courts with evidence showing the existence of a direct and necessary causal link between the emissions of greenhouse gases -produced by one or more natural persons or legal entities- and the harm actually suffered by the victim.

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RESUMEN: El objetivo de este trabajo fue analizar los datos epidemiológicos y jurídicos de los casos por responsabilidad médica fallados por la Corte Suprema de Justicia chilena (CSJ) el año 2017, para relevar los escenarios de alto riesgo, aportando a su prevención. Se realizó un estudio retrospectivo, revisando los fallos de la CSJ en la base de datos electrónica del Poder Judicial chileno. Se seleccionaron y analizaron los fallos por responsabilidad médica. Se detectó un total de 61 casos por responsabilidad médica que alcanzaron la CSJ en 2017. Todos correspondieron a causas civiles. La duración promedio de los juicios fue 41,9 meses. La especialidad más demandada y condenada fue ginecología. La mayoría de las demandas y condenas afectó al Sistema Público de salud. Los casos que dan origen a las demandas son, en su mayoría, de atención de urgencias por sobre las programadas, y de tratamiento por sobre procedimientos quirúrgicos. El 54,8 % de los casos resultaron en la muerte del paciente. La mitad de los fallos condenatorios involucraba el fallecimiento del usuario afectado. Se deben investigar los factores de riesgo no sólo de la ocurrencia de mal-praxis, si no de la judicialización de los conflictos médico-paciente, especialmente en el área gineco-obstétrica, incluyendo los casos de instancias anteriores a la CSJ. Se debe investigar así mismo los factores de riesgo para la mayor propensión de los profesionales de sexo masculino de ser demandados y condenados por malpraxis médica.

ABSTRACT: The objective of the present study is to characterize the epidemiologic and juridical data for medical malpractice cases ruled by the Chilean Supreme Court (CSC) in 2017, to highlight the high risk scenarios, as a contribution to their prevention. A search of the CSC electronic database was conducted to identify and analyze CSC rulings for medical malpractice cases. In this study 61 malpractice cases ruled by CSC were identified. The CSC received only civil cases of medical malpractices during the studied period. The average duration of the trial was 41.9 months. Gynecologists faced suits and received sentences more frequently than any other type of specialist. The majority of prosecuted cases and convictions were associated with the public health system. A greater number of claims were related to emergency care than with scheduled procedures. Likewise, more claims were associated with non-surgical treatment than with surgical procedures. 54.8 % of all cases resulted in the patient's death. Half of the cases that lead to conviction, were related to the death of a patient. Risk factors should be investigated, not only of the occurrence of malpractice, but also of the judicial process of doctor-patient conflicts, especially in the obstetrics and gynecology area, including the analysis of cases of prior judicial instances. The risk factors for the higher propensity of male professionals to be prosecuted and convicted for medical malpractice should also be investigated.

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This paper discusses the complexity of contemporary struggles for collective health in Colombia, by analysing the efforts of different actors to inscribe abortion as a matter of public health and as a human right. In 2006 the Colombian Constitutional Court (Sentence C 355 of 2006) partially decriminalised abortion in specific circumstances. Such a change in regulation was the result of the strategic coordination of international organisations, researchers and women's social movements. These groups produced a powerful network of international regulation and epidemiological data about abortion's mortality and burden of disease in order to move the discussion from the moral field to public health and international law. Despite the significance of the sentence in terms of civil rights, ten years after the regulation there is no clarity about its impact. Conservative sectors within the government have limited the operation of the regulation, through eliciting convoluted rules for hospitals and care providers. On the other hand, data about safe abortions are weak and precarious. Recently groups opposed of abortion have exploited such weakness to undermine the impact of the decriminalisation and to criticise the justification of legalising abortion as a matter of public health.

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Introduction The objective of the present study was to review the epidemiological aspects of malpractice in neurosurgery and to identify preventive measures regarding malpractice for neurosurgeons. Methods The following terms (alone or in combination) were searched in the PubMed and Biblioteca Virtual em Saúde databases: neurosurgery (neurocirurgia), lawsuits (ações judiciais), malpractice (erro médico), and litigation (litígio) and identifying studies on these topics published from 2000 to April 2018. Literature Review In Brazil, 6.9% of the physicians are sued per year. The most common type of malpractice alleged in litigation is negligence. According to the literature, the neurosurgical disease that has sparked the most litigation is spinal disease. The outcomes of these cases vary: sometimes the neurosurgeon prevails, and at other times the plaintiff prevails. To prevent or reduce malpractice claims, the neurosurgeon should take the following precautions: 1. follow medical protocols; 2. perform surgeries in an environment consistent with good medical practice; 3. evaluate and monitor antibiotic prophylaxis; 4. develop a good relationship with the patient based on ethics, good faith and transparency; 5. request the presence of the patient and of his or her family when there is a problem in order to didactically explain the case; 6. keep good medical records to document all of the actions performed (informed consent and description of the surgery and of the pre and postoperative); 7. always seek technical improvement (continuing education/professional development); 8. in the case of attending physicians, monitor patients, treating any postoperative complications; and 9. conduct multidisciplinary team meetings to optimize treatment decisions and to share responsibility for making difficult decisions.

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Resumen: En el presente artículo, los autores tratan el tópico de admisibilidad en Chile de las acciones de responsabilidad civil de wrongful conception o anticoncepciones fallidas. Utilizando referencias hacia la práctica en el derecho comparado y al derecho internacional de los derechos humanos, los autores argumentan a favor de fundamentar su reparación en el derecho a la autodeterminación reproductiva de las mujeres.

Abstract: In this article, the authors refer to the wrongful conception claims, particularly the controversy of their admission in Chile. On the basis of comparative and human rights international law, the authors argue in favor of the women's right to reproductive self-determination as the foundation of their compensation.

Resumo: Neste artigo, os autores abordam o tema da admissibilidade no Chile das ações de responsabilidade civil de wrongful conception ou anticoncepções fracassadas. Com base em referências para a prática no direito comparado e no direito internacional dos direitos humanos, os autores argumentam a favor de fundamente sua reparação o direito à autodeterminação reprodutiva das mulheres.

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OBJECTIVE: Describe the process of enacting and defending strong tobacco packaging and labelling regulations in Uruguay amid Philip Morris International's (PMI) legal threats and challenges. METHODS: Triangulated government legislation, news sources and interviews with policy-makers and health advocates in Uruguay. RESULTS: In 2008 and 2009, the Uruguayan government enacted at the time the world's largest pictorial health warning labels (80% of front and back of package) and prohibited different packaging or presentations for cigarettes sold under a given brand. PMI threatened to sue Uruguay in international courts if these policies were implemented. The Vazquez administration maintained the regulations, but a week prior to President Vazquez's successor, President Mujica, took office on 1 March 2010 PMI announced its intention to file an investment arbitration dispute against Uruguay in the International Centre for the Settlement of Investment Disputes. Initially, the Mujica administration announced it would weaken the regulations to avoid litigation. In response, local public health groups in Uruguay enlisted former President Vazquez and international health groups and served as brokers to develop a collaboration with the Mujica administration to defend the regulations. This united front between the Uruguayan government and the transnational tobacco control network paid off when Uruguay defeated PMI's investment dispute in July 2016. CONCLUSION: To replicate Uruguay's success, other countries need to recognise that strong political support, an actively engaged local civil society and financial and technical support are important factors in overcoming tobacco industry's legal threats to defend strong public health regulations.

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