Cuadernos de Bioetica最新文献

Medicine today is a field of permanent tensions: between structures and individuals, between public policies and individualised patient care, and between patients and their therapists. This article reflects on the notion of care as a way of resolving the problems encountered by health professions by considering one of their fundamental concepts. For this purpose, research was carried out in the medical literature in order to understand the definitions in which care is discussed in current medicine. Based on the findings, three paradigms or constructs related to the notion of care are detailed: a) Patient Centered Care, b) the ethics of care, and c) the idea of Whole Person Care. Even with the notable differences between these constructs, it is possible to rescue the framework of care: the objective being for the good of the patient. Thus, a proposal for the reflection on caring for others is developed, based on what is the concept of ″objective good for the person″ in accordance with the thinking of the philosopher Dietrich von Hildebrand.

Medical and scientific advances have made it possible to carry out more and more early procedures involving human life within the mother's womb. Based on the above, the dilemma surrounding the perception or experience of fetal pain has emerged and its implications in various fields such as: prenatal diagnosis, fetal surgery and especially around abortion. This document seeks to carry out an approach to the embryological development of pain pathways and their components, to assess the relevance of the current definition of pain in this context, and the bioethical implications of the different interventions carried out on the fetus. We consider that despite the need for scientific evidence in this field, the available knowledge indicates that it is possible to experience pain in the mother's womb especially since the 20th week of gestation, so it is important to reflect on fetal pain and the need to become aware of this, before performing any intervention involving the fetus as a patient.

This article discusses the situation of childbirth in general and home birth in particular from a legal perspective. Taking the context of the social, health and bioethical crisis brought about by Covid-19 as a starting point, we examine the principles that should guide birth care and analyse obstetric violence as denial of these principles. In light of abuse of medicalisation and medical interventionism, it seeks to find the best ways to humanise and dignify the care for the whole birth process. To this end, we consider the main pronouncements on the subject by international and domestic institutions and courts, as well as the case law of the European Court of Human Rights, with emphasis on rulings concerning home births, which deal with possible violations of rights and, in particular, the right to respect for private and family life.

In pediatric medical practice, there is the case of children and young persons under 18 with gender dysphoria or gender discordance, characterized by an incongruity between biological sex and gender identity. In this way, the medical and juridical possibility of gender affirmation treatment is offered to minors. Although this treatment has been endorsed by some scientific associations, it has also been the subject of serious questioning due to the possible irreversibility of the procedures performed on the minor's body. For this reason, although the law recognizes some autonomy to the minor to make the decision to initiate a gender affirmation treatment, the lack of maturity to understand and assume the information that is provided could affect the validity of the informed consent.

The practice of medicine and the search for professional excellence in current times force us to rethink whether only the principles of personalistic and principled bioethics are enough to be able to be better and better health agents; a renewed interest in the ethics of virtues and their implementation is probably the answer to this question. The intention of this article is to concisely explain some of the virtues that we believe a good health professional should have and how they influence their daily practice.

Illness and disability are forms of vulnerability to which human beings are victims; they limit a person's ability to act and his real possibilities are reduced. These forms of vulnerability may correspond to the loss of capabilities. Armatya Sen presents the capabilities approach as a new theory of social justice, a new way of thinking about human well-being that overcomes the shortcomings of utilitarianism, the dominant approach of his time. Capability refers to what a person is really capable of doing. Medical care, therefore, appears as a form of help whose objective is to fight against vulnerability by re-mobilizing the capabilities of the patient who, at some point in his existence due to the disease, is found more or less momentary deprived of them. The development of the power to act and the power to be of the patient, through the care provided by the caregivers, consists of strengthening their capabilities that allow them to participate effectively and actively in social life and in the management of care and health system. The objective of this article is to highlight the contributions of capabilities to patient's care. For us, it will be a matter of considering capabilities as the basis of a new paradigm for understanding the care of sick and vulnerable people in medical practice.