Political Science

Partant du constat des besoins de soins de santé mentale plus élevés pour certains groupes – les femmes, les personnes actives, pauvres, racisées – cette étude a pour double objectif d’évaluer l’utilisation des soins de santé mentale ambulatoires (consultations chez le psychiatre et le psychologue) et d’identifier les obstacles à l’accès à ces soins. Pour ce faire, plusieurs types de données sont utilisées : celles de l’enquête de santé de Sciensano (2018), de l’enquête de la MC sur la prévalence des problèmes psychologiques et la recherche d’aide (2019), les données d’utilisation des soins des membres de la MC (2021) et les listings de prestataires de l’INAMI et de la commission des psychologues (2022). L’analyse de ces données nous permet d’observer que si ces publics n’utilisent pas les soins dans une mesure proportionnelle à leurs besoins, c’est en raison des freins rencontrés dans les quatre dimensions de l’accessibilité : l’incapacité à identifier ses besoins en santé mentale (sensibilité), la réticence à chercher des services (acceptabilité), l’incapacité à payer les services (accessibilité financière) et l’incapacité à atteindre les services ou les patient·es (disponibilité). Les femmes sont ainsi moins sceptiques que les hommes envers l’aide professionnelle, mais elles sous-rapportent leurs problèmes et mettent en avant des inquiétudes liées au coût des soins et au temps disponible pour en bénéficier. Les personnes ayant des difficultés financières, quant à elles, ont davantage honte d’avoir recours à l’aide professionnelle et sont les plus nombreuses à indiquer qu’elles s’inquiètent des coûts des soins, de façon légitime puisque les soins qui ne sont pas remboursés par l’assurance obligatoire leur restent largement inaccessibles  financièrement. Elles utilisent ainsi ces soins psychologiques dans une moindre mesure. En outre, l’offre de prestataires est inégalement distribuée sur le territoire. Tant de difficultés qui débouchent sur des recommandations qui découlent des résultats de notre étude et qui insistent notamment sur l’importance de mesures proportionnées qui permettraient d’atteindre des résultats similaires dans tous les publics.

Adopting an empirical and realistic methodology of approach, the paper starts from considering the latest innovations in the field of genetics by choosing three meaningful phenomena, such as the birth of pharmacogenetic cards, the tendency to universalization of DNA databases, the rising of interconnections between different DNA repositories and "cross" access to archives (by police to biobanks and by researchers to forensic databases). Then, the focus is given to the legal issues coming at stake within each phenomenon (with a peculiar attention to privacy, confidentiality, autonomy, to risks of discrimination, genetic surveillance, reductionism, violation of the presumption of innocence…), so far as to show that recent developments in genetics, although different, seem to lead to one common future perspective: the genetic registry office, whose establishment cannot occur without a careful consideration of human rights. SUMMARY: 1. A "snapshot" of the latest news in genetics; 1.1 Pharmacogenetic cards; 1.2 Universal DNA databases; 1.3 Interconnection of databases and "cross" access to repositories; 2. Relevant legal issues; 2.1 Facets of the right to privacy in the context of pharmacogenetic cards; 2.2 Genetic surveillance, reductionism, determinism and prejudice to democratic states in universal DNA databases; 2.3 Which legal implications for the interconnections between databases and "cross" access?; 3. Wandering around the future: landing at a genetic registry office?

SOMMARIO: 1. Le biobanche: nascita e tipologie; 2. La genetica di popolazione; 3. La biobanca islandese; 4. La libertà di ricerca scientifica, il profitto e la proprietà; 4.1 Interessi pubblici e privati: esclusione reciproca o possibile "incontro"?; 4.2 A chi spetta la proprietà della ricerca e delle risultanze di essa?; 5. Il fallimento di deCODE Genetics; 6. Bilanciamento tramite i Comitati etici o totale esclusione di "ricadute commerciali" in seno alle biobanche di popolazione?; 7. Il superamento del modello proprietario nel caso delle biobanche di popolazione; 8. … e il futuro?.

The necessity of cataloguing information is perceived among different fields of human activity. In the healthcare sector and in the medical one, the need to assemble data belonging to population appears historically from the beginning of the modern State (nineteenth century) for statistical reasons and for the urgency to control the resources settled in the surrounding territory (see Hacking 1982).

Abstract_The paper aims at looking for a model of responsibility that could work within nanoscience and nanotechnology field. For reaching such a purpose, a methodology founded on comparison with another "converging science" -the so-called "synthetic biology" (further "synbio")has been chosen. Therefore, the analysis is developed following two directions: first of all, a rapid "snapshot" of similarities and differences between synbio and nanotechnology is offered; then, the theme of risks and the possible ways of dealing with them is examined. After a brief presentation of the most common models of governance of risks towards new emerging technologies (a pattern based on the three phases of risk assessment, risk management and risk communication), the work focuses on the main principles adopted within such a model, i.e. the precautionary and proactionary principle. The limits and problematic aspects of both the principles are presented, thus showing that they are insufficient and non-operable for a complete governance of risks for nanotechnologies and synbio. At this point, the meaningful contribution of the Report "New directions. The Ethics of Synthetic Biology and Emerging Technologies", drafted by the US Presidential Commission for the Study of Bioethical Issues (PCSBI) in December 2010, is considered. In particular, the principle of "responsible stewardship", that is mentioned therein, appears to be the most suitable and proper basis for building a rational, balanced, transparent, complete, cooperative, and dynamic model of governance and responsibility of emerging technologies, as regards both safety and security risks. I. A. Colussi, Ph.D. candidate, School of Comparative and European Legal Studies, University of Trento, I-Italy (contact: [email protected]).

This paper deals with the emerging synthetic biology, its challenges and risks, and tries to design a model for the governance and regulation of the field. The model is called of "prudent vigilance" (inspired by the report about synthetic biology, drafted by the U.S. Presidential Commission on Bioethics, 2010), and it entails (a) an ongoing and periodically revised process of assessment and management of all the risks and concerns, and (b) the adoption of policies -taken through "hard law" and "soft law" sourcesthat are based on the principle of proportionality (among benefits and risks), on a reasonable balancing between different interests and rights at stake, and are oriented by a constitutional frame, which is represented by the protection of fundamental human rights emerging in the field of synthetic biology (right to life, right to health, dignity, freedom of scientific research, right to environment). After the theoretical explanation of the model, its operability is "checked", by considering its application with reference to only one specific risk brought up by synthetic biologybiosecurity risk, i.e. the risk of bioterrorism.