[Abortion in Italy (Law n.194/1978): what role for non-objecting doctors?].

Recently, talking about abortion, the Pope has spoken harshly regarding the role played by non-objecting doctors. The article discusses: 1) the ethical and health aspects that the denial of the right to terminate pregnancy entails; 2) the positive results obtained by non-objecting doctors 50 years after the implementation of Law no. 194/1978, in terms of safeguarding women's health and guaranteeing the implementation of a state law.

[Towards the revision of the Italian code of medical ethics: thoughts of an extremist.].

In November 2022 the Italian medical council (Federazione nazionale degli ordini dei medici chirurghi e odontoiatri) started the revision of the Italian Code of medical ethics (Cme) with the first race dating back ten years. Since then, the Italian doctors are dealing with the scientific, ethical and economic challenges together with the more recent ones posed by the Sars-CoV-2 pandemic to the National health system underlying the ongoing crisis of the medical profession. Additionally, this critical context requires the doctors to develop new technological skills, a complete and effective adherence to the Ebm principles, a new view regarding the relationship with the other health care professionals and the related changes of clinical practices fostering a responsible use of resources.

[The banality of evil in the migrants era.].

In early November the Italian government, after having prevented two NGO ships with 751 migrants on board from docking in the port of Catania, allowed disembarkation only to migrants in critical health conditions, refusing it to others and ordering then to the ships to set sail. This episode, the latest in a series started in Italy between 2018 and 2019 during the previous right-wing government, is part of a sovereignist ideal and political framework, while the racist tendencies are clearly growing up in the country long ago. The event referred to and the social and political climate in which it took place evokes the theme of banality of evil about which Hannah Arendt and Primo Levi have written after the experience personally lived during the Nuremberg trial by the first author and in the Auschwitz killing field by the second one.

[Task shifting: a derby between doctors and nurses or a resource for patients and health care systems?].

As proved through a sound evidence, task shifting (TS) - the rational redistribution of tasks among health workforce teams - is an important strategy aimed at improving health of the most vulnerable and disadvantaged populations of the low- and middle-income countries by providing essential services and reducing or eliminating health inequalities. Clinical and epidemiological efficacy of many TS interventions has also been demonstrated in high-income countries. Systematic reviews show that TS can reduce morbidity and mortality by providing essential care for infectious and non-communicable diseases, for maternal and child health, for critically ill and injured patients.

[Abortion: memories and thoughts of a physician.].

In light of the recent ruling of the US Supreme Court overturning abortion rights, and drawing inspiration from a case came to his observation of hemorrhagic shock complicating an illegal abortion, the author briefly comments on the health, ethical, political and economic aspects that the denial of the right to terminate pregnancy entails for women, health care professionals and for the society as a whole.

[The dark price that non-covid patients are paying to covid pandemic: the "chinese boxes" of the public health crisis.].

In Italy, as in the other Western countries, during the different pandemic surges, the health care systems have undergone an unprecedented imbalance between health care resources demand and supply due to the huge number of patients affected by covid-19. In this dramatic scenario the access to the necessary hospital care for non-covid patients has been limited or precluded. Delays in diagnostic procedures or in caring for many acute or chronic diseases can result in a dangerous increase in their severity with a consequent increase in short and long-term related mortality.

[The Italian National Healthcare System and the SARS-CoV-2 pandemic: a foretold debacle? Reflections for changing.].

Almost two years after the first official report from World Health Organization (WHO), the SARS-CoV-2 pandemic (covid-19) outreached 200 mln of cases around the world with an overall mortality equal to 2% (more than 4.5 mln of cases). In many countries, when the surge in cases of severe covid-19 respiratory failure has exceeded the availability of intensive healthcare resources (intensive care beds, respirators, human resources) clinicians were forced to triage intensive care unit (ICU) admissions.

COVID-19 pandemic in ICU. Limited resources for many patients: approaches and criteria for triaging.

The COVID-19 pandemic has shattered the illusion that healthcare resource shortages that require rationing are problems restricted to low- and middle-income countries. During the pandemic surges, many high-income countries have been confronted with unprecedented demands for healthcare systems that dramatically exceeded available resources. Hospitals capacities were overwhelmed, and physicians working in intensive care units (ICUs) were often forced to deny admissions to patients in desperate need of intensive care.

Why and how to open intensive care units to family visits during the pandemic.

Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe precise strategic goals are essential and operational guidance is needed on how to achieve them. Even during the pandemic, we consider it a priority to share strategies adapted to every local setting to allow family members to enter intensive care units and all the other hospital wards.

[The handover in clinical practice of anesthesiologists and intensivists.].

The handover among healthcare professionals has been a topic of increasing interest over recent years. Many studies have shown that ineffective communication during handover can be critical, particularly for anaesthesiologists and intensivists because of the highly complex needs of patients under their care. Numerous studies have identified the information transfer process as the greatest risk of errors and adverse events (AEs), which results in harm to patients, increases legal issues and damages relations between health professionals.

How to communicate with families living in complete isolation.

Importance: During the SARS-CoV-2 pandemic, a complete physical isolation has been worldwide introduced. The impossibility of visiting their loved ones during the hospital stay causes additional distress for families: in addition to the worries about clinical recovery, they may feel exclusion and powerlessness, anxiety, depression, mistrust in the care team and post-traumatic stress disorder. The impossibility of conducting the daily meetings with families poses a challenge for healthcare professionals.

[Clinical ethics recommendations for the allocation of intensive care treatments, in exceptional, resource-limited circumstances.].

On February 21st, 2020 the first case of severe acute respiratory syndrome due to the coronavirus 2 (SARS-CoV-2) causing the CoViD-19 disease, was identified in Italy. In the following days, despite the restrictive public health measures aimed to avoid the infection's spread, the number of cases increased. As of March 8th, 2020, Italy is the 2nd most affected country in the world.

[Open doors, closed ports: can medicine suggest something to society?].

Western countries are today experiencing a profound mutation of their immigration policies. Integration and hospitality have been taken over by closure and rejections. The policy of "closed ports" gained ground as never before.

[The Italian emergency medical system between evidence and risk of corporatism: the "Bologna case". Part I: the evidence / Part II: medical ethics and law.].

Scientific issues. An effective pre-hospital emergency care needs trained health care professionals, technological and therapeutic resources, but not always the emergency systems performance is data-driven. There are three fundamental models of pre-hospital care.

[The Physician's advance directives.].

On December 2017 the Italian Parliament approved the law n. 219/2017 on the advance directives (ADs) and the appointment of a health care proxy (HCP). The law has been considered as a civil conquest for defending the rights of sick people.