Cuadernos de Bioetica最新文献

Epigenetics deals with the study of structural modifications in the regions of the genome, by methylation of DNA or chromosomal histones, or other mechanisms that affect the expression of genes without altering the base composition of DNA. Cell differentiation, which is established in embryonic development from blastocyst status, is the consequence of differential cell reprogramming, based on programmed epigenetic modifications, which establish differences in the epigenome of cells and tissues. Maternal and paternal genomes of the gametes have genomic imprinting differences due to DNA methylation or other epigenetic modifications established in the germinal cells during gametogenesis. Maternal and paternal parental genomes present differences of genomic imprinting, which are established by DNA methylation or other epigenetic modifications during embryonic development, in the primordial germ cells. Unscheduled epigenetic modifications may also occur under the influence of uncontrolled environmental factors, which can lead to health disturbances. However, all epigenetic modifications are erased after fertilization and those affecting the germ line of the embryo or fetus during their development are not inherited beyond the second generation, - F2 -. Epigenetics should not be considered a new type of inheritance with transgenerational consequences, but as a set of mechanisms related to genetic regulation.

The interaction between doctors and pharmaceutical companies has been and is common, occurs in multiple ways and has proven, in many cases, to be necessary for the development of medicine. However, some of the sales techniques of the pharmaceutical industry are not ethically acceptable and can compromise the independence of physicians. An ethical dilemma arises from a real case in which the search for vulnerability in prescription based on a donation by a pharmaceutical company was not easy to identify.

Gender was an important component in the May '68 revolution. However, what was originally proposed as an effort for equality and the defense of the legitimate prerogatives of women, evolved into a movement, gender post-feminism, which it set aside their real interests and needs, pursuing other, even contradictory, goals. This article tries to justify the previous statement, starting from some of the main currents of thought what were at the base of the revolution.

Lately, number of divorces is increasing, nevertheless, a parents' divorce can become a traumatic problem for paediatric patients. Consequently, the aim of this study was to analyze the ethical conflicts that appear in the relationship between physician/parents/son/daughter, and more specifically those that a divorce generates. A descriptive study was developed through a survey composed by 39 items. Previously, an exhaustive bibliographic analysis was carried out. Our results show that only 35% of paediatricians interviewed have been educated in bioethics although this issue is important in daily practice. Other items show that 57,5% would not cancel a pharmacological treatment in order to improve quality of life. Also, they would react against a wrong parents' decision (82,5%). They give low value to the minor`s decision (6,05%), and rarely inform exclusively to adolescents (5%). In contrast, paediatricians sometimes ask to adolescents (20%) in first place and involved them to decide in 90% of cases. Besides, there are differences in the relation with fathers and mothers, 17,5% of mothers are informed exclusively, a fact that never happens with fathers. Ethics has an intrinsic value very important in daily clinical decisions in order to respect the rules and to adapt them to the situation of every paediatric patient. When an important ethical conflict become, as a divorce is, it is essential to know who must be informed and the rights everyone has to make a decision. It is complicated to the paediatricians yet to develop 41/2002 law for Patient's autonomy.

The crisis of COVID-19 leaves us a teaching in the form of reminiscence. We do not learn anything new from it, but it reminds us of something we knew and forgot. It shows us in a new light our vulnerability, the impossibility of protecting ourselves perfectly through prediction and control. The sciences do not predict with certainty and the technologies do not manage to have everything under control, although the former and the latter have many other and worthwhile functions. Ideologies do not see the future, no matter how much they pretend to do so. However, we are not without reliable guidance in deciding our actions. This orientation must be sought in being, not in the future. It is fidelity to our common human nature that must advise us. It is the full realization of our personal being, of our peculiar vocation, that guides us. So, the means for self-realization consists in the development of a virtuous character. The same character that has mitigated the ravages of the pandemic, given that, to some degree, it was already present in many of our fellow citizens. The same that would have alleviated the suffering even more if it had been available in more people and to a greater degree.

The article deals with the analysis of the criteria for the allocation of scarce health resources during the pandemic produced by the COVID 19 virus in Spain. It critically analyses the absence of a legal-constitutional perspective in the elaboration of such criteria and suggests the incorporation of the criterion of equity as a guarantee of the effective exercise of the constitutional right to health protection by vulnerable persons.

The public health crisis caused by COVID-19 disease has bring again to the public arena the old debate of the role in decision-making process of politics and science. In this paper we analyze, in the context of the current pandemics, how politics has left a stellar role for science, either because science has anticipated in its proposals to politics, or because politics has opted for it as a premeditated strategy. The references to the opinion of scientists as a decision-making criterion or, furthermore, their presence as true spokesmen for authority have been so frequent. This means rediscovering science and health as instruments of power, in terms that remind us of what Foucault denounced almost fifty years ago with his Biopolitics.

The crisis in the health system caused by COVID-19 has left some important humanitarian deficits on how to care for the sick in their last days of life. The humanization of the dying process has been affected in three fundamental aspects, each of which constitutes a medical and ethical duty necessary. In this study, I analyze why dying accompanied, with the possibility of saying goodbye and receiving spiritual assistance, constitutes a specific triad of care and natural obligations that should not be overlooked - even in times of health crisis - if we do not want to see human dignity violated and violated some fundamental rights derived from it.

With the arrival of the COVID-19 pandemic, the risk of a possible lack of care for the elderly in nursing homes became evident. We summarize the experience of a multidisciplinary team with volunteer professionals from different specialties who carried out support for healthcare professionals in nursing homes. This team was implemented from both Primary and Specialty Care managements. Its work paradigm was proposed by our home hospitalization team, which included direct care of the most complex patients and general counselling on isolation, hygiene and preventive measures within the nursing homes. Thanks to this support, the elderly population placed there, with suspected or diagnosed COVID-19, received adequate care from an interdisciplinary team, which led part of the pressure to be released from their professional workers, and many family members were aware that there was no neglect of the elderly. Commitment from various levels of care in a coordinated effort has prevented a vulnerable population from being left unattended during the pandemic.