A survey of laws and regulations governing the practice of radiology by general practitioners in Malaysis and ten other selected countries wascarried out. It showedvaryingdegrees oflegal restrictions on the use of x-ray machines in the countries studied. Most regulations reflected the concern of radiation protection forpatients andstaff. Only some countries provide training for non-medical persons in the use of x-ray machines. Radiology has an important role in primary care. Undergraduate and post-graduate education should ensure competence in basic radiological practice. KEYWORDS: X-ray, general practice, regulations.
This Islamic Family Law Enactment of Pahang, Malaysia, is based on the model of the Islamic Family Law (Federal Territory) Act, 1984 (Annual Review of Population Law, Vol. 11, 1984, Section 250). It differs from that Law in the following major respects: 1) marriages between Muslims and non-Muslims are prohibited; 2) a wali Hakim (special guardian appointed by the Sultan) is authorized to consent to marriage if the wali (guardian) of the bride unreasonably withholds consent; 3) the grounds for divorce are fewer (failure to maintain and cruelty being omitted), although there is a general provision allowing divorce for any ground that is recognized as valid by Islamic law; 4) a son is to be maintained until the age of 15, not 18; and 5) a religious court, rather than a civil court, may order a putative father to maintain his illegitimate child.
The defendant, an obstetrician and gynaecologist, was accused of voluntarily causing a woman to miscarry, such miscarriage having been performed without good faith and an intention to save the woman's life. The Court upheld the conviction of the defendant, rejecting his argument, supported by an expert witness, that he had performed the abortion in order to avoid the possibility of pulmonary embolism, which might result because the woman had enlarged varicose veins. It held that the argument was not reasonable under the current law and that procuring an abortion was a serious matter to be done only as a last resort to save the life of a woman or to save her from becoming a mental "wreck."
Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia.
PIP: A great deal of attention is being devoted to the use of nonphysicians to provide such fertility control services as contraception, sterilization, and abortion. Legal obstacles exist, however, which must be overcome before the role of nonphysicians can be expanded. Such obstacles include medical practice statutes, nursing and midwifery legislation, and laws and regulations directly related to such fertility control measures as the provision of contraceptions and the performance of sterilizations. On the other hand, the following 3 main approaches have been used to permit increased participation of nonphysicians: delegation of tasks by physicians, liberal interpretation of existing laws, and authorization. Thus, the important elements in expanding the roles of nonphysicians are 1) authorization; 2) training; 3) qualification; 4) supervision; and 5) opportunities for referrals to physicians. The ultimate role of paramedicals will depend upon the continued simplification of technology, the results of research on the quality of care which they can provide, the attitudes of the medical profession, and the elimination of the legal ambiguities and obstacles which exist.
PIP: Observations are made related to the review of family planning activities in East Asia in 1973. The number of new acceptors for the region increased from 2.7 million in 1972 to 3.4 million in 1973. The leaders were Indonesia, which almost doubled its achievement of calendar year 1972, the Philippines, and Korea. In Thailand, the number of new acceptors dropped by about 10%. South Vietnam is the only country in the region without an official policy. Most couples still think that the ideal number of children is 4, with at least 2 sons. Some religious opposition does exist, particularly with reference to sterlization and abortion. More attention is being paid to women in their 20s. Sterilization and condoms are becoming more popular. Korea reports a sharp increase in vasectomies. Better methods and continuation rates should be stressed. In Taiwan a couple who start with 1 method and continue to practice some method lower their reproduction rate by 80%. More responsibility is being delegated to nurses and midwives, but too slowly. In Indonesia, the number of field workers rose from 3774 in 1972 to 6275 in 1973. The Philippines and Thailand are experimenting to see what kind of workers get best results and under what kind of salary and incentive arrangements. In-service training tends to be neglected, but preservice training is improving. Costs, in general, have risen, though in Korea the cost per acceptor has dropped from US$8.00 to US$7.80. Korea and Taiwan have reduced their annual population growth rates by more than 1/3 in 10 years, from 30 to 19-20 per 1000 each. Singapore's rate is 17 and Hong Kong's 14 (exclusive of inmigration). The number of couples currently practicing contraception in Singapore is 71%. Target systems assigning quotas to clinics are generally used except in Thailand and Malaysia, where programs emphasize maternal and child health, rather than population planning. Most programs require about 10 years to get the annual growth rate down to 2% by voluntary family planning. To get it down to 1.5% will probably take another 10 years.