Cuadernos de Bioetica最新文献

The patient's right to know his/her clinical information corresponds with the duty of the health care professional, especially the physician responsible for his/her care, to provide it. However, in the case of patients whose life prognosis is limited, this presents several difficulties. Determining the content of this right is complicated because it depends on the circumstances. This favors the conspiracy of silence, the main cause of which can be found in the maintenance of the patient's hope. However, condemning the patient to a false hope prevents him/her from developing a grieving process, that requires renouncing that hope and embracing another undetermined hope of open content. In this work we try to outline the structure of this dialectical process, which can be explained, in narrative terms, through the structure of the heroic myth, which is functional even when the energetic structure of the moral character is missing and which is adjustable for each person.

Based on the elements that constitute the bases of Western Medicine and a distinction made by Pedro Laín Entralgo from Homeric work, two possible approaches to medical practice are reflected, which could be characterized as ″palliative″ medicine and ″medicine without palliative″. The relationships that these two approaches may have with Philosophy, Ethics and Bioethics are mentioned; the main characteristics and some of the dangers of each one. It shows how the presence, in clinical practice, of palliative care in itself leaves several lessons on the two approaches. It concludes by showing the importance of person-centered medical education with humanistic components. Some ideas are given so that the curricular contents lead to the training of doctors capable of acting with humanism and professionalism, being agents of a cultural change in favor of life.

From a post hoc analysis of the ADENI-UCI study (multicenter, observational, cohort, prospective study, with a follow-up period of 13 months, in 62 Intensive Medicine Services in Spain. geographical differences in the reason for denial of income in UCI as a LTSV measure are analyzed. A total of 2284 with an average age of 75.25 (12.45) years were included. 59.43% male. By means of multinominal regression adjusted by age, sex, APACHE and SOFA, was evident (by choosing the northern for reference) that age in the south was a less significantly exposed reason (OR: 0.48 (IC95%: 0.35-0.65). p.

One of the keys to overcoming the COVID-19 pandemic is the development of the vaccine in order to immunize the population. In addition to the medical complications to obtain the vaccine, we highlight the presence of other problems, such as the dissemination of fake news that add difficulties to overcoming the global problem, especially due to its incidence in the field of anti-vaccine movements, which have developed, with special presence in Italy in recent years. For this, we warn of the need to be prepared to overcome the two pandemics that are developing in parallel, the one caused by the virus and the one generated by the fake news.

To date, healthcare ethics committees (HEC) have been the only ethics consultation model in the hospital setting in Spain, though their usefulness for ethical conflict resolution in daily practice has been questioned. Individual clinical ethics consultation (CEC) is a complementary ethics consultation model, which has proved efficacious in real-time ethical problem-solving. Although CEC is widely used in North America, its implementation in Europe is still marginal. In this document we present the general characteristics of CEC services, comparing their potential advantages and risks to those of HECs. We will then share relevant European experiences in CEC, as well as review the few CEC initiatives in Spain. Finally, we will share our recent CEC implementation strategy in a national, medium-sized, teaching hospital. We will summarise the minimum requirements that such a CEC service must meet in order to carry out its consulting activity: organisational flexibility, well-trained professionals, with sufficient clinical experience, economical support, and organisational dependency on HECs.

The identification, priorization and anticipation of the ethics conflicts, allow the Healthcare Ethics Committees (HEC) a better approach to them, as well as the adoption of measures to prevent its appearance and/or its mitigation. For this purpose, we set ourselves the objective of knowing what they are in the present, how important they are, and what would be the future scenario to face. An qualitative structure research was made whit two focal groups whit the participation of nurses, nurse auxiliary and doctors from the hospitalization area, they also answer a future ethics conflicts Decalogue. The results were tested after by their importance level (Relevance-Frequency-Consistency). The medium age of the participants was 34,7 +- 15,4, whit a medium experience at work of 11,7 +- 15,4 years. A total of 40 ethics conflicts was identify grouped in 5 risk areas: professional, assistance, social, organizational and legal. From there 21 results the more important, between them we find patient abandonment, inexistence of internal performance protocols, patient and relatives false expectations waiting for non-assistance care, unnecessary care at the end of the life, lack of rules for family / caregivers, and ignorance of legality. The more important ethical dilemmas for the future identified by the personal will be patients in abandonment, the lack of sociohealth resources, conflicts with family / caregivers situation and lack of information for decision making at the end of the life. The ethical conflicts between the personal from a chronic patients hospital and the relatives/caregivers was identifying, the most important were prioritized, and futures were anticipated. In these scenarios, we highlight abandonment as the most important. A map of ethics conflicts is a good tool to identify risk areas for ethics conflicts, we see the difference between the ethics conflicts found in other kind of hospitals. The map of ethics conflicts need to be update periodically to keep the validity.

What is the ecological value of the indigenous ways of life? For several years now, there has been a widespread conviction, at the institutional and academic levels, that indigenous or native ways of life are a resource for biodiversity conservation. In contrast to this idea, which leads to strategies with significant implicit dangers, this article defends the thesis that the way of life of the original peoples is a valuable experience that contributes to enhance the necessary wisdom to sustain those actions aimed to genuinely repair the current fracture between humanity and nature. With this in mind, the author explores ecofeminist proposals that offer grounds for acknowledging authority over experiences that have remained at the periphery of the modern mainstream: precisely those that are carried out by indigenous peoples.

The CRISPR editing method is revolutionary. This technique opens the possibility of countless operations in the genome of living beings. However, the risks are high and, in some cases, unpredictable. Therefore, based on an anthropology that recognizes the human person with an inherent dignity that includes the body, this article intends to propose bases for a regulation capable of facing the challenge of CRISPR, especially, given the possibility of confusing its therapeutic resource with the eugenics, also before the imminent risk of unleashing unforeseen consequences such as mutations, malformations and side effects that could be devastating for human life.