0000000001151329
AUTHOR
Lucia Craxì
showing 13 related works from this author
La pandemia da COVID-19: mutamento e persistenze
2022
L’analisi dei documenti prodotti in Italia sul tema dell’accesso alle terapie intensive durante la pandemia da COVID-19 indica che la riflessione sulle questioni di accesso alle risorse drammaticamente limitate nel nostro Paese è ancora molto acerba e meriterebbe lavori di indagine più accurata e approfondita con un contributo multidisciplinare. Bioetica. Rivista interdisciplinare ha contribuito alla maturazione e alla crescita delle conoscenze in questo ambito, con la pubblicazione di diversi articoli. Tale apertura verso i temi di giustizia distributiva mostra la capacità della rivista di cogliere e affrontare i temi emergenti nel dibattito bioetico italiano, mostra il suo sapere essere “…
Empiricism and common sense: the management of public health in the Kingdom of Sicily (1575-1860)
2020
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 ins…
Hepatitis: a longstanding companion in human history [L'epatite: Un compagno di lungo corso della storia umana]
2012
L’epatite ha accompagnato la storia dell’umanità fin dalle sue origini, godendo di un’identificabilità immediata grazie alla manifestazione sintomatica dell’ittero; per tale motivo le testimonianze scritte relative al manifestarsi di forme epidemiche di ittero sono rintracciabili già alcuni millenni prima della nascita di Cristo. Va però sottolineata l’inevitabile confusione generata dal sovrapporsi di quadri clinici diversi per le differenti forme di epatite, identificate nel corso del tempo come “ittero epidemico” (epatiti da HAV o da HEV?) e “ittero da siero” (epatiti da HBV o da HCV?). Il percorso che ha portato al riconoscimento dell’eziologia infettiva di tali patologie è stato lungo …
Ethical assessment of hepatitis C virus treatment: The lesson from first generation protease inhibitors
2015
Abstract Since chronic hepatitis C has mostly become curable, issues concerning choice and allocation of treatment are of major concern. We assessed the foremost ethical issues in hepatitis C virus therapy with 1st generation protease inhibitors using the personalist ethical framework within the health technology assessment methodology. Our aim was to identify values at stake/in conflict and to support both the physicians’ choices in hepatitis C therapy and social (macro-) allocation decision-making. The ethical assessment indicates that: (1) safety/effectiveness profile of treatment is guaranteed if its use is restricted to the patients subgroups who may benefit from it; (2) patients shoul…
Ethics of aging
2021
Abstract With a steady increase in the number of older people worldwide and a much higher percentage of older people as part of the overall population, we are on the verge of becoming a mass geriatric society. These gains in extra years are not only a prolongation of individual lives but also result in demographic transitions that will challenge economic, social, and geopolitical systems and chiefly our healthcare systems in many countries. Population aging calls for the reassessment of existing policies and programs, in order to ensure a fair distribution of rights, burdens, and responsibilities between generations and to give the opportunity to older people to live fully a phase of life t…
An ethical algorithm for rationing life sustaining treatment during the COVID-19 pandemic
2020
The burning ethical question raised by the COVID-19 pandemic is how to deal fairly and ethically with a large number of patients simultaneously becoming critically unwell. Across the world, in both developed and developing countries, health systems are grappling with the possibility or the reality that the demand for intensive medical care will outstrip availability. There is a need for ethical guidelines on how to allocate treatment, but such guidelines are potentially highly controversial.1 In this commentary, we set out a simple algorithm (Figure 1), including what we take to be the essential ethical principles that ought to guide resource allocation in any country or setting as well as …
HCV eradication: a duty of the State, an option for the individual
2020
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 gu…
HCV: the best cure possible or the best possible cure?
2015
Progress in medicine goes along with an exponential growth of the cost of drugs and devices. While any person has the right to obtain the best possible benefit from medical care, a state needs to strike a balance between granting the optimal personal benefit to each individual and the needs of the society as a whole. Health systems in all countries therefore are facing a huge problem of distributive justice, as while they should guarantee individual rights, among which the right to health in its broader sense, including physical, psychological and social well-being (therefore not limited to healing, but extending to compliance and quality of life), they must also grant equal access to the h…
"Old Humanities and New Science": Osler's legacy
2018
Nowadays the call for a return to the centrality of man and the thrust toward humanization of medicine are growing stronger: in this respect we think that William Osler’s life can be considered as one of those exemplar lives that changed the course of medicine, as he was able to overcome the duality of science and humanity, focusing on the ethical values capable of bridging the past to the future of medicine.
Opportunistic co-screening for HCV and COVID-19-related services: A creative response with a need for thoughtful reflection.
2022
At a time when hepatitis C virus clearance can be obtained by DAAs in almost all infected patients, global infection burden control is an objective within reach, even if achieving the WHO HCV elimination targets by 2030 may not be attainable. 1 The lowest cost intervention is an awareness campaign to bring in those who are recently diagnosed and those who were previously diagnosed but not treated. Only 30% of all HCV‐diagnosed patients are linked‐to‐care. 2 The next level of intervention is case‐finding for disease control and screening. Screening invites people who do not have symptoms to undergo testing, whereas health professionals are focused on detecting conditions as early as possible…
[Access to hepatitis C treatment: a lesson for the future.]
2018
L’immissione in commercio dei farmaci antivirali ad azione diretta (DAA) di nuova generazione per la terapia dell’infezione cronica da virus dell’epatite C ha rivoluzionato lo scenario precedente e ha messo a dura prova le istituzioni, a causa del prezzo elevato delle terapie. Un’analisi di quanto accaduto negli ultimi tre anni, specialmente in Italia, ci aiuta a comprendere come è stata gestita la contrattazione dei prezzi e soprattutto con quali criteri si è scelto, in una prima fase, di consentire un accesso ristretto in base al bisogno di cura dei pazienti. Ciò consente di mettere a fuoco alcuni temi importanti e di individuare le sfide che ci attendono nel prossimo futuro. The new gene…
Dalla periferia al centro: I Notarbartolo duchi di Villarosa (secoli XVII-XVIII)
2012
Nella seconda metà del Seicento i Notarbartolo, grazie alle attività economiche e alle alleanze matrimoniali portate avanti da Francesco senior (1630-1704) e dai suoi due figli, Gaetano (1655-1705) e Placido senior (1657-1701), costruiscono il nucleo del proprio patrimonio fondiario e passano dalla condizione di possidenti e benestanti di Caltanissetta, alla condizione di feudatari di provincia insigniti di un titolo baronale e in possesso di tre feudi di cospicua estensione. La politica matrimoniale adottata mira all’accrescimento del patrimonio e del potere, attraverso la creazione di una rete di alleanze; talvolta i matrimoni garantiscono, tramite l’apporto delle doti, la solidità econom…