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欧盟器官捐赠医疗保健领域向混合治理的跨越。

A Leap to Hybrid Governance for European Union Healthcare on Organ Donations.

作者信息

Ahmed Tasnim

机构信息

Liverpool John Moores University.

出版信息

J Law Health. 2018;31(1):118-144.

PMID:30889336
Abstract

This article evaluates two proposals that the Organs Directive along with the commission's Action Plan 2009-2015 can be viewed as a form of hybrid governance. The Organs Directive is the first legally-binding supranational risk regulation devised in the field of organ donation and transplantation. The Directive is modelled on the earlier Directive dealing with blood, tissue, and cells. The Action Plan, which is soft law, will complement the Directive. The Directive and Action Plan requires additional administration procedures from the Member States with the EU Commission regularly monitoring the implementation of the work programme to ensure it is manageable for them. Before probing the Directive, the Impact Assessment (IA) undertaken by the EU Commission on organ donations, which is used to determine the rationale behind the adoption of the stringent Directive with the Action Plan, will be examined. The social, economic, and health impacts of the four regulatory options available to the Commission will be considered. The Directive and the Action Plan, which are finally adopted, will be discussed in detail, before the arguments are placed highlighting the fact that the Directive and Action Plan display a mode of hybrid governance. Next, the advantages and disadvantages of hybrid governance are laid out and conclusions are drawn as to whether the hybrid model was the best form of action in EU healthcare. In the conclusion, the article proposes the emergence of an "integrated model" within the Organs Directive, which is based on the fusion of the three governance structures: the OMC, comitology, and agencies.

摘要

本文评估了两项提议,即《人体器官指令》以及委员会的《2009 - 2015年行动计划》可被视为一种混合治理形式。《人体器官指令》是在器官捐赠与移植领域制定的首个具有法律约束力的超国家风险监管规定。该指令是以早期涉及血液、组织和细胞的指令为蓝本制定的。作为软法的《行动计划》将对该指令起到补充作用。该指令和《行动计划》要求成员国采取额外的管理程序,欧盟委员会会定期监督工作计划的实施情况,以确保成员国能够应对。在探究该指令之前,将先审视欧盟委员会就器官捐赠所做的影响评估(IA),该评估用于确定通过这项严格指令及《行动计划》背后的理由。将考量委员会可采用的四种监管选项所产生的社会、经济和健康影响。在阐述支持《指令》和《行动计划》呈现出混合治理模式这一观点之前,将详细讨论最终通过的《指令》和《行动计划》。接下来,将阐述混合治理的优缺点,并就混合模式是否为欧盟医疗保健领域最佳行动形式得出结论。在结论部分,本文提议在《人体器官指令》中形成一种“综合模式”,该模式基于开放式协调方法(OMC)、委员会程序和机构这三种治理结构的融合。

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