Cuadernos de Bioetica最新文献

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.

The main aim of this paper is to define an answer, in a key time before COVID19, if it is indeed possible to do so, as to the difference between pain and suffering. In order to do so, we will refer to, although not exclusively, the reflexions of the German philosopher Robert Spaemann. To finish, the question of death will briefly be analysed.

Transgenesis is a parcel of biotechnology that allows the introduction of genetic information not proper to the genome of living beings, apart from the mechanisms of natural genetic exchange. This made possible to address important applications in bacteria, animals and plants with significant benefits in health, food and environmental aspects. Since its origin, the production of genetically modified organisms (GMOs) caused some controversy due to the possible negative influence of these organisms or their derived products on health and the environment. Over time, genetic modification techniques have renewed, giving way to others of greater precision, simplicity and safety. Currently the CRISPR-Cas9 technique is widely used, which allows to edit, modify or eliminate specific DNA sequences, with multiple applications in the same fields of transgenesis, but adding greater simplicity, security and lower cost. This work presents the main techniques, applications and ethical implications of using these methods and their perspectives in an ever-evolving world. The bacteria for obtaining products of pharmacological interest, new varieties of cultivated plants of higher production, more resistance to growth limiting agents and better nutritional quality and domestic animals modified genetically, offer a set of advantages needed to address the global challenges that affect the lives of many people around the world.

To show hospital health professionals' knowledge on ABC. Observational, descriptive, transversal and analytical research using questionnaires designed ad hoc. Comparative statistical analysis applying Ji-square by Pearson and Fisher tests. Binary logistic regression model to determine the odd ratios (O.R) having education level and sex as independent variables. A 4% accuracy was accepted, as well as a confidence Interval of 95% and a p value inferior to 0.05. The data was processed by IBM SPSS Statistics v.20 software. Required sample of 351 professionals (108 doctors and other related graduate; 144 nurses and 99 clinical assistants (TCAE)). 276 participants (78,6%; IC95%: 74,0-82,2); of which 84 doctors (77,8%; IC95%: 68,8-85,2); 120 nurses (83,3%; IC95%: 76,2-89,0) y 71 TCAE (71,7%; IC95%: 61,7-80,3), predominantly women (194, 70,3%). 228 (82,6%) were aware of the existence of ABC. Both doctors and nurses had more knowledge of ABC than clinical assistants (p 0,0001 for both), however there was not significative difference between doctors and nurses (p=0,836; OR:0,901; IC95%: 0,334-2,228). 124 (45,1%) knew the functions of ABC, with doctors displaying more knownledge than both nurses and clinical assistants (p=0,002 and p 0,0001 respectively) and nurses showing more familiarity than clinical assistants (p=0,008). 129(47,6%) communicated ethical conflicts, showing no significative difference between doctors and nurses (p=0,119). However, clinical assistants displayed different behabiour than the other two groups in this regard (p 0,0001 and p=0,001 respectively). Of all, 47 (22,4%) communicated they had ethical conflicts regarding the beginning and end of life. The knowledge on the existence of the ABC is high, however there is poor knowledge around its functions. Among health professionals, doctors and nurses know him better than TCAE. Matters related with the beginning and end of life cause most of ethical conflicts.

The authors make an interdisciplinary approach to prostitution, with emphasis on women. From the psychological point of view, they adopt a systemic approach, and validate the expression ″persons in prostitution situation″; they review the state of the art in legal matters and public policies, making a critical analysis based on the tradition of realistic thinking. They argue that one of the fundamental issues involved is the unity of the human person and the role that intimacy plays in it, polemicizing against usual objections. Finally, they state their conclusions, which implies affirming that prostitution considers human person as object, and therefore it is contrary to her or his dignity.