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Bodka za medzinárodnou konferenciou Reprodukčné zdravie ženy v centre záujmu


 | 23.4.2014 | komentárov: 295

V dňoch 10. – 11.4.2014 sa v nových priestoroch konferenčnej sály KOŠICE HOTEL zišli svetoví odborníci zo siedmich európskych krajín z oblasti práva, medicíny, bioetiky, psychológie, farmakológie a morálnej teológie, aby prezentovali svoje názory a podelili sa s účastníkmi o svoje bohaté skúsenosti a na prezentované témy s ostatnými prednášajúcimi a účastníkmi živo diskutovali. Prítomní hostia si pochvaľovali multidisciplinárny charakter konferencie.

Obrazok

Počas dvoch dní vystúpilo na medzinárodnej konferencii Reprodukčné zdravie ženy v centre záujmu s príspevkami tridsať jeden prednášajúcich zo siedmich európskych krajín (Holandsko, Poľsko, Česká republika, Srbsko, Slovensko, Francúzsko, Rakúsko). Tí spolu s diskutérmi vytvorili kvalitný a pestrý odborný program pre viac ako 150 pasívnych účastníkov.

 

Konferencie sa medzi inými  zúčastnili

zástupcovia štátnych orgánov

  • MUDr. Mário Miklosi, PhD. (Ministerstvo zdravotníctva SR)
  • MUDr. Monika Pažinková, MPH, MBA  (Úrad pre dohľad nad zdravotnou starostlivosťou)
  • MUDr. Nataša Regendová, MPH  (Úrad pre dohľad nad zdravotnou starostlivosťou, Košice)

 

zástupcovia stavovských organizácií zdravotníckych pracovníkov

  • MUDr. Marián Kollár (prezident Slovenskej lekárskej komory) 
  • Mgr. Peter Krajčovič (Slovenská lekárnická komora, Lekárnické listy)

právnici

  • JUDr. Vlasta Formánková (sudkyňa, Ústavní soud ČR)
  • JUDr. Ivan Humeník, PhD. (advokát)
  • JUDr. Radek Policar (Masarykův onkologický ústav, Brno) 
  • JUDr. Ing. Lukáš Prudil, PhD. (advokát, Brno)

riaditelia nemocníc a vedúci kliník

  • MUDr. Juraj Vančík, CSc. (Nemocnica Košice - Šaca a.s.,  1. súkromná nemocnica)
  • Univ.-Prof. Dr. Wolfgang Kröll, PLL M, MA  (Univ. Klinik für Anästhesiologie und Intensivmedizin, Graz, Rakúsko)

lekári z praxe asistovanej reprodukcie

  • MUDr. Martin Petrenko, CSc.  (hlavný odborník MZ SR pre reprodukčnú medicínu)
  • MUDr. Miroslav Herman, PhD. (Centrum reprodukčnej medicíny GYNCARE, s.r.o.) Košice
  • MUDr. David Rumpík  (Klinika reprodukční medicíny a gynekologie Zlín, ČR)

biológovia, patológovia

  • RNDr. Zuzana Váczy, MVDr. Ján Rosocha, CSc. - Univerzitná nemocnica L. Pasteura Košice, Združená tkanivová banka
  • MUDr. Jozef Bodnár - HIS-DG, s.r.o. – člen ALPHAMEDICAL, riaditeľ a odborný zástupca
  • MUDr. Peter Bohuš - odborný garant, Medicyt, s.r.o.

významní hostia zo zahraničia

  • Msgr. Jean-Louis Bruguès, O.P. - archivár a knihovník Svätej cirkvi rímskej, Vatikán
  • Dr. Med., Dr. Phil., Dr. Theol. Karl Hunstorfer  - lekár,  Nemocnica Rehole milosrdných bratov, Viedeň, Rakúsko
  • Univ.-Prof. DDr. Walter Schaupp – člen bioetickej komisie rakúskeho kancelára a zástupca Rakúska v Eurotransplantant Ethics Committee
  • em. univ. Prof. Dr. Dr.h.c. Werner Wolbert - Univerzita Salzburg, Rakúsko

a ďalší.

 

Prednášajúci spolu s predsedajúcimi jednotlivých blokov sa pokúsili nájsť odpovede v diskusii na nasledujúce otázky: 
•    Čo je to reprodukčné zdravie?
•    Prevencia v starostlivosti o ženské zdravie a zodpovednosť poskytovateľa
•    Asistovaná reprodukcia - výzva pre právo a etiku
•    Surogačné materstvo
•    Dá sa nájsť konsenzus v kľúčových otázkach reprodukčnej medicíny?
•    Výkony asistovanej reprodukcie na Slovensku
•    Prirodzenosť ako hodnota v starostlivosti o ženu
•    Nové prístupy v nazeraní na ženské reprodukčné zdravie


Ako už pri podujatiach organizovaných Komorou pre medicínske právo – MEDIUS, o.z.  býva dobrým zvykom, celé podujatie sa nieslo v priateľskej atmosfére. Tolerantne prebiehali aj diskusie na mnohokrát konfliktné témy (asistovaná reprodukcia, jej alternatívy, pojem reprodukčného zdravia), v ktorých sa konsenzus hľadá náročnejšie. Diskusia umožnila všetkým prítomným poznať názory expertov z iných odborov, s  ktorými sa zvyčajne na iných podujatiach účastníci nestretnú.  Tento aspekt ocenila väčšina zúčastnených, čo zároveň podčiarklo zmysel organizovať multidisciplinárne podujatia Komorou pre medicínske právo – MEDIUS.


Na konferencii sa otvorili viaceré aktuálne, často aj pálčivé otázky týkajúce sa informovanosti a manažmentu pacienta. Podľa MUDr. Juraja Vančíka, CSc. by nevyhnutnou súčasťou starostlivosti mala byť komunikácia s pacientom. Univ. Prof. Wolfgang Krőll, PLL M, MA  z rakúskeho Grazu túto tému špecifikoval a venoval sa konkrétne problému včasného informovania pacientok a získavaniu informovaného súhlasu s epidurálnou anestéziou. Doc. MUDr. JUDr. Peter Kováč, PhD. et. PhD. z Inštitútu forenzných medicínskych expertíz  upozornil na alarmujúco nedostatočný počet znalcov v jednotlivých odboroch, čo má rozhodujúci vplyv na priebeh dokazovania a výsledok súdneho konania.


V otázke asistovanej reprodukcie boli prvý konferenčný deň otvorené témy výkladu článku 8 Dohovoru na ochranu ľudských práv a základných slobôd v otázkach reprodukčnej medicíny doc. JUDr. Tomášom Doležalom, Ph.D., LL.M z Akademie věd ČR, ďalej morálneho statusu embryí a možnosti/nemožnosti použitia tzv. nadpočetných embryí na ďalší výskum v prípade súhlasu pôvodcov buniek, ktoré embryo tvoria. Neskôr Univ.-Prof. DDr. Walter Schaupp priblížil „rakúsku“ debatu o otvorení prístupu k asistovanej reprodukcii homosexuálnym párom. Tento konferenčný deň zakončila téma surogačného (náhradného) materstva prednáškami MUDr. Davida Rumpíka a JUDr. Ing. Lukáša Prudila, Ph.D., ktorý sa venovali predovšetkým praxi výkonu surogačného materstva v Českej republike, legislatívnej úprave, ako aj zmenám, ktoré priniesol nový Občanský zákonník. V debate sa venovala pozornosť aj otázke medicínskeho turizmu medzi oboma republikami a nastaveniu podmienok uhrádzania zdravotnej starostlivosti (aj asistovanej reprodukcie) na Slovensku.


Druhý konferenčný deň otvoril blok venovaný téme hľadania konsenzu v otázkach reprodukčnej medicíny, významu morálky a svedomia pri poskytovaní zdravotnej starostlivosti.  V prvom bloku vystúpili prestížni zahraniční hostia. Ako prvý prof. Dr. A.H.M. Frederic van Iersel z Univerzity v Tilburgu so svojou prednáškou na tému Is evangelism moral in healthcare? Good healthcare in the perspective of Catholic Social Teaching, ktorá sa týkala významu choroby, ľudského utrpenia ako súčasti ľudského bytia a taktiež dôležitosti vnímania starostlivosti ako pomoci druhému. Druhým nemenej dôležitým rečníkom bol Mons. Prof. Jean- Louis Brugues, OP z Vatikánu, ktorý pokračoval prednáškou o význame svedomia ako univerzálnej morálnej kategórie. Na túto prednášku nadviazala PharmDr. Miroslava Snopková, PhD. z Katedry organizácie a riadenia farmácie Farmaceutickej fakulty UK v Bratislave a s kolegyňou PharmDr. Annou Oleárovou, PhD., MPH priblížila účastníkom výsledky výskumu o vplyve svedomia pri poskytovaní lekárenskej starostlivosti. Posledné vystúpenie bolo vyhradené prednáške Mgr. Martina Luterána M.Jur., M.Phil., D.Phil. ktorý podrobne zanalyzoval argumentáciu v rozhodnutí Ústavného súdu SR ( PL. ÚS 12/01-297), vo veci práva na súkromie a práva nenarodeného dieťaťa na život podľa čl. 15 Ústavy SR.


Ďalší blok sa zameriaval na praktické otázky spojené s výkonom asistovanej reprodukcie na Slovensku. MUDr. Martin Petrenko, CSc., hlavný odborník Ministerstva zdravotníctva pre reprodukčnú medicínu, otvoril otázku potreby zabezpečiť Národný register asistovanej reprodukcie, problematiku reexportov liekov ako aj uhrádzania poskytnutej zdravotnej starostlivosti. Na jeho vystúpenie nadväzovala prednáška JUDr. Ivana Humeníka, PhD., v ktorej sa sústredil na právne problémy vyplývajúce z existujúceho legislatívneho stavu upravujúceho podmienky výkonu asistovanej reprodukcie (Kto je oprávnený na prístup k liečbe? Ako možno nakladať s uskladnenými bunkami? Kedy ich možno zničiť? ). MUDr. Miroslav Herman, PhD. sa zameral na význam predchádzania rizikám pri výkonoch ART, bezpečnosti pacientky a jej dieťaťa, ktoré sleduje metóda tzv. single embryo transferu. V poslednej prednáške tohto bloku sa Ing. Vladimír Synek, CSc. vrátil k problému definície reprodukčného zdravia.


Po obede sa konferencia prehupla do svojej poslednej časti, tematického bloku o význame hodnoty prirodzenosti v starostlivosti o ženu. Tému predošlého bloku doplnila najprv komparatívnou štúdiou právnej úpravy asistovanej reprodukcie v Srbsku a Maďarsku Slavica Karajičíć, MPA, MPH z Health Policy Institute, Bratislava.  Ďalej boli v tejto sekcii prezentované prednášky týkajúce sa domácich pôrodov, a to JUDr. Vlastou Formánkovou, ktorá priblížila rozhodovanie českých orgánov a zvlášť Ústavného súdu ČR vo veci domácich pôrodov a Mgr. Hanou Celušákovou, ktorá sa venovala psychickému prežívaniu ženy počas tehotenstva a pôrodu, ako aj dopadu existujúcich praktík v starostlivosti o tehotné ženy na ich psychiku. Diskusia k tomuto bloku bola vášnivá, ale tolerantná. MUDr. Marián Kollár, ktorý tomuto bloku predsedal,  sa z pozície gynekológa vyjadril za skvalitnenie starostlivosti o tehotné ženy, najmä v smere väčšej časovej investície a lepšieho vybavenia zariadenia a komfortu rodičiek.


Posledný blok konferencie bol venovaný predovšetkým prednáškam z patológie a diagnostiky. Prof. Rudolf Klimek, M.D., DrSc., Dr.h.c., ktorý zavítal na konferenciu z Poľska, predniesol výsledky svojho výskumu. Tie ho viedli k základnej myšlienke, že žena by mala porodiť v určenom termíne s menšími odchýlkami, pretože predčasný pôrod cisárskym rezom ako sa to v praxi vyskytuje čoraz častejšie, predstavuje riziko ako pre ženu, tak pre jej dieťa. V ďalších prednáškach MUDr. Jozef Bodnár z laboratória HIS-DG, s.r.o. vyzdvihol význam vzdelávania v oblasti hygieny a intímneho života pre zlepšenie reprodukčného zdravia, tak ako ho definoval ako schopnosti otehotnieť a donosiť dieťa. Konferenciu zakončil príspevok MUDr. Petra Bohuša, ktorý sa venoval  bčioptickej diagnostike endometriózy.


Ako organizátori, sme veľmi radi, že sa títo odborníci mohli stretnúť počas dvoch dní na jednom mieste. Zároveň si uvedomujeme, že by multidisciplinárnu dvojdňovú konferenciu nebolo možné zrealizovať na tak vysokej a profesionálnej úrovni bez spolupráce partnerov, a to Kancelárie WHO na Slovensku a primátora mesta Košice, ktorí nad podujatím prebrali záštitu, generálneho partnera ako aj finančných partnerov, ktorým týmto ďakujeme za spoluprácu a náklonnosť. FOTOGRAFIE Z KONFERENCIE REPRODUKČNÉ ZDRAVIE ŽENY V CENTRE ZÁUJMU SÚ DOSTUPNÉ NA STRÁNKACH KOMORY - MEDIUS.SK.


Už teraz sa členovia a koordinátori Komory pre medicínske právo – MEDIUS tešia na stretnutie na ďalšej medzinárodnej konferencii, ktorá sa uskutoční v 27. marca 2015. Bude venovaná téme „Istoty zákona vs. neistoty života – Onkologický pacient“. Videopozvánku si môžete pozrieť TU.

 

 

 

(Aktualizované 8. mája 2014)




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