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The health system is one of the most complex systems in any country. Each state has an obligation to take care and care about the health of its population. The health care system includes the health infrastructure that provides a range of programs and services, and provides health care to individuals, families and communities. The health system must ensure the physical, geographical and economical accessiblity and affordability of integrated and quality health care. It should also provide for the development of health personnel, finance sustainability, decentralization of management and financing of health care and placing the citizens at the centers of the health system. The purpose of the health care system is the preservation and improvement of human health by providing health services, modern as well as traditional medicine, in an efficient manner and at the same time accessible and acceptable to the people. Due to its importance and impact on the population of each country, as well as its large economic impact, the government implemented a series of measures in planning and managing the health care system to ensure stable funding and rational and a quality health care delivery system, and all this in order to provide within the available resources a basic health care. In all the countries, the aging of the population and the introduction of new and expensive technologies present a constantly increasing cost of health care delivery. Modern health care systems differ from each other mainly in the methods of raising funds for health care, as well as in methods of payment for the service providers in the health sector. Problems of health care systems rarely, if ever, can be solved forever. As countries develop, their health care systems must respond to new challenges. ; Zdravstveni sistem predstavlja jedan od najsloženijih sistema u bilo kojoj državi. Svaka država ima obavezu da vodi računa i brine o zdravstvenom stanju svog stanovništva. Sistem zdravstvene zaštite obuhvata zdravstvenu infrastrukturu koja obezbeđuje spektar programa i usluga i pruža zdravstvenu zaštitu pojedincima, porodicama i zajednici. Zdravstveni sistem mora da osigura fizički, geografski i ekonomski dostupnu i pristupačnu, integrisanu i kvalitetnu zdravstvenu zaštitu. Takođe, treba da obezbedi razvoj zdravstvenih kadrova, održivost finansiranja, decentralizaciju upravljanja i finansiranja zdravstvene zaštite i postavljanje građanina u centar zdravstvenog sistema. Svrha sistema zdravstvene zaštite je očuvanje i unapređenje zdravlja ljudi obezbeđivanjem zdravstvenih usluga stanovništvu kako moderne, tako i tradicionalne medicine na efikasan način, a koje su u isto vreme dostupne i prihvatljive ljudima. S obzirom na njegov značaj i uticaj na zdravstveno stanje stanovništva svake države, kao i zbog velikog ekonomskog uticaja, država sprovodi niz mera u planiranju i upravljanju zdravstvenim sistemom kako bi obezbedila stabilno finansiranje i racionalan i kvalitetan sistem pružanja zdravstvene zaštite, a sve to u cilju da se u okviru raspoloživih sredstava stanovništvu obezbedi osnovna zdravstvena zaštita. U svim zemljama je zbog starenja stanovništva i uvođenja novih i skupih tehnologija prisutno stalno povećanje troškova pružanja zdravstvene zaštite. Savremeni sistemi zdravstvene zaštite razlikuju se međusobno najviše u metodama prikupljanja sredstava za zdravstvenu zaštitu, kao i u načinima plaćanja davaoca usluga u zdravstvu. Problemi sistema zdravstvene zaštite retko, ili nikada, ne mogu se rešiti zauvek. Kako se zemlje razvijaju, tako i njihovi sistemi zdravstvene zaštite moraju da odgovore na nove izazove.

Introduction. Every clinical trial has to meet all ethical criteria in addition to the scientific ones. The basic ethical principles in the clinical trials are the following: nonmaleficence, beneficence, respect for autonomy and the principle of justice. Objective. The aim of the study was to analyze clinical cases with the outcomes leading to the changes in regulatory­ethical framework related to the clinical trials, as well as the outcomes of key clinical trials that influenced the introduction of the ethical principles into clinical trials. Methods. This was a descriptive research (methods of analysis and documentation; desk analysis of the secondary data). Results. By analyzing the cases from the secondary sources as well as clinical and ethical outcomes, it may be noticed that the codes, declarations and regulations have been often preceded by certain events that caused their adoption. Moral concern and public awareness of the ethical issues have initiated not only the development of numerous guidelines, codes, and declarations, but also their incorporation into the legislative acts. Conclusion. It is desirable that ethical instruments become legally binding documents, because only in this way will be possible to control all phases of the clinical trials and prevent abuse of the respondents. ; Uvod. Svako kliničko ispitivanje, pored naučnih, mora da zadovolji i etičke kriterijume. Osnovni etički principi u kliničkim ispitivanjima su: neškodljivost, dobročinstvo, poštovanje autonomije i princip pravednosti. Cilj rada. Cilj rada je bio da se analiziraju klinički slučajevi čiji su ishodi doveli do promena u regulatorno­etičkom okviru u vezi s kliničkim ispitivanjima i ishodi kliničkih ispitivanja koja su uticala na uvođenje etičkih principa. Metode rada. Istraživanje je bilo deskriptivno, a primenjene su metoda dokumentacione analize i desk­analiza sekundarnih podataka. Rezultati. Analizom slučajeva iz sekundarnih izvora, te kliničkih i etičkih ishoda, može se primetiti da su kodeksima, deklaracijama i pravilima prethodili događaji koji su uzrokovali njihovo donošenje. Moralna briga i svest javnosti o etičkim problemima pokrenule su razvoj brojnih smernica, kodeksa i deklaracija i njihovo uvrštavanje u zakonska akta. Zaključak. Ukoliko se regulativa svih faza kliničkih ispitivanja zasniva na etičkim postavkama, kontrola i ishod su bazirani na humanim osnovama i prava su mera dobrobiti društva i pojedinca.