[ETHICAL ASPECTS OF INFORMED CONSENT IN REFRACTIVE SURGERY].

With the introduction of the use of Laser assisted surgery, refractive eye surgery knows a very large success. Surgery of well being, it requires that an extensive information is delivered to the patient concerning the benefit and possible side-effects of the available treatments. This information process may reduce the frequency of negligence claims relating to Laser eye surgery.

[End of life care in the elderly].

The increase in life expectancy is associated with a good quality of life until a very old age. However, the unavoidable aging process eventually affects the autonomy of the patient and may force the individual to live in a nursing home. The alteration of sensorial functions and the increased number of degenerative diseases may finally induce a physical and psychological burden that might lead to resort to palliative care, end of life sedation, and in some cases, euthanasia.

[The medical decision for the non-competent patient].

The evolution of the therapeutic relation from a paternalistic to a collaborative one has increased the legal and ethical problems related to the medical care in non competent patients. The recent Belgian law on the rights of the patient (August 22, 2002 ) and the advice of the Belgian Council of the Medical Association on this matter provide the practitioner with clear directives. However, the responsibility of the final decision always remains in the hands of the medical doctor as the protector of the patient.

Plasmatic cystatin C for the estimation of glomerular filtration rate in intensive care units.

Objective: To compare the sensitivity of cystatin C and creatinine in detecting decreased glomerular filtration rate.

Design: Prospective observational study.

Setting: Medical intensive care unit at a university hospital.

[Cystatin C in the evaluation of renal function].

Glomerular filtration rate (GFR) is the best indicator of renal function. GFR is usually estimated by serum creatinine or the creatinine clearance calculated on urine collected over 24 hours or with the Cockcroft formula. These methods are however limited.