Cuadernos De Bioetica[JOURNAL]
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200 papers
[Retraction notice: Is Sexual Identity Optional? A Study of the Genetics of Transsexuality. Cuadernos de Bioética. 2017; 28 (94): 343-353].
Cuad Bioet · 2018 · PMID 29406766
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[Descriptive Study on the Application of Informed Consent in Health Centers of Galicia Spain].
Rodríguez Piñero JE, Tabernero Duque MJ, Rodríguez Calvo MS
Cuad Bioet · 2018 · PMID 29406765
OBJECTIVES: The aims of this study were to know the opinion and general knowledge of patients about the informed consent (IC), and their participation in the decision-making (DM) process. MATERIAL AND METHODS: A descript...
OBJECTIVES: The aims of this study were to know the opinion and general knowledge of patients about the informed consent (IC), and their participation in the decision-making (DM) process. MATERIAL AND METHODS: A descriptive, transversal, observational, qualitative and quantitative study was designed with 120 patients randomly surveyed at the 8 University Hospital Complexes of Galicia, Spain. RESULTS AND DISCUSSION: The mean age was 52.14 years, with 50% of men. 84.21% of the ICs provided by non-medical personnel were limited to delivering and reading it. 90% of patients after signing the IC, trust their doctor. Only 50% of the professionals tried to involve the patient in DM. 53.33% of the patients participated in DM. 45.83% patients signed for having understood and accepted the explanation, being completely satisfied 95 of the patients surveyed (79.17%). CONCLUSIONS: It is essential to change the attitude of non-medical health professionals involved in the DM process, because their involvement is not being promoted. Although less than half of the respondents have signed the IC for having understood, the degree of satisfaction and confidence in the doctor was not compromised.
[Doctor-Patient Relationship from the Perspective of Medical Students' Portfolio].
Girela Pérez B, Rodríguez Cano MA, Girela López E
Cuad Bioet · 2018 · PMID 29406764
Doctor-patient relationship is of paramount importance for a good medical practice, however as long as medicine has been increasingly influenced by technology and science, it may be at risk of losing contact with basic h...
Doctor-patient relationship is of paramount importance for a good medical practice, however as long as medicine has been increasingly influenced by technology and science, it may be at risk of losing contact with basic human values of respect for the beliefs and preferences of the other person. In this study, we have analyzed the deontological vision of the physician-patient relationship perceived through clinical situations reflected in the portfolios carried out by 225 students of the 5th year of the Degree of Medicine at the University of Córdoba, during the courses 2014/15 and 2015/16. 201 out of 833 deontological considerations on articles of the Code of Medical Ethics constitute non-compliances. It is noteworthy that these breaches to the Code of Medical Ethics considered refer mainly (73%) to Chapter III (doctor-patient relationship). It is particularly interesting that the problems most frequently detected are those related to attitude, forms or language and lack of understanding/confidence of the physician with the patient (article 8 with 46 noncompliances), as well as problems in providing information (articles 12.1 and 15, with 18 and 42 noncompliances respectively).
[Surrogacy in Maternity. A Depersonalising Human Relationship Phenomenology].
Casciano A
Cuad Bioet · 2018 · PMID 29406763
Ethical and bioethical problems, which are typical of the practice of surrogate motherhood, refer to its protagonists: the couple that orders it, due to its demand to satisfy the desire of paternity and maternity and the...
Ethical and bioethical problems, which are typical of the practice of surrogate motherhood, refer to its protagonists: the couple that orders it, due to its demand to satisfy the desire of paternity and maternity and the promptness of having a female body to fulfill its aspirations; the expectant mother, and the physical and psychic repercussions coming from the role performed in the surrogacy contract, as well as the risks of manipulation and exploitation, related to her position; the baby and his right to grow counting on the certainty of his parental relationships and on the preservation of his emotional balance. The human and anthropological importance of these issues, along with the growing development of this practice in the world, has questioned our moral conscience. In this context, the expectant mother, the weakest and the most affected part among the parts involved in the surrogacy contract, demands a particular attention. In this sense, the aim of this work is to lead a phenomenological analysis of the different steps of the practice of surrogacy, from the first stage of collection and classification of the information referring to the candidates, to the stage of the insemination and of its consequences about to the private life of the expectant. On the other hand, this work tries to justify the existence of a parallelism, as for the exploitation of the female body, between the practice of surrogate motherhood and prostitution. Finally, the issue relating to the effective social emancipation of the surrogate women in poor countries, the real autonomy and the freedom of their decision, as well as the typical features of the desire of paternity of the ordering couple are dealt with. The carried out study has allowed to conclude that this practice always implies a degree of physical, psychic and moral exploitation of the expectant mother, which suggests its prohibition at global level.
[Critical Review of Gender Ideology in the Light of Metaphysical Realism].
Burguete Miguel EE
Cuad Bioet · 2018 · PMID 29406762
The implementing of gender ideology in the imaginary of current welfare-state societies owes much to a long process in the history of thought, which has culminated in an accommodation of post-feminist discourse. This pap...
The implementing of gender ideology in the imaginary of current welfare-state societies owes much to a long process in the history of thought, which has culminated in an accommodation of post-feminist discourse. This paper sets out the epistemological principles that are present in gender ideology, as a response to both its recent and more-remote antecedents. It is furthermore framed by an urge for emancipation that began with medieval scholasticism, the latest manifestation of which lies in the post-structuralist deconstructionism that outlines the concept of queer. This concept has dissociated the categories of sex and gender to the point of making them irrelevant for the determination of sexual identity, leaving the latter susceptible to being infinitely de- and reconstructed. This article also reviews the liberal-hedonistic context of the new postmodern setting, while showing how the concepts of ″a subjective feeling of happiness″ and ″a life fulfilled″ do not express similar content. The paper goes on to challenge the theory of gender from the perspective of metaphysic realism; stressing that the human being only appears as a real person via the possibility of anticipating another's contemplation, thereby cancelling out the abstraction of pure subjectivity. It finally offers its conclusions, with certain substantive recommendations in the field of education.
[Is Ethic the Use of Electroconvulsive Therapy?].
Romero-Tapia Á, Gamboa-Bernal GA
Cuad Bioet · 2018 · PMID 29406761
Electroconvulsive therapy (ECT) is an effective and safety medical procedure, broadly utilized in several countries for the treatment of multiple mental disorders, including major depressive disorder, which is a prevalen...
Electroconvulsive therapy (ECT) is an effective and safety medical procedure, broadly utilized in several countries for the treatment of multiple mental disorders, including major depressive disorder, which is a prevalent disease. However, due the records of their use, technical inappropriate of application, adverse effects and even cases of death associated to the procedure, it has been stigmatized, disused and considered unethical treatment. This paper reviews the main components of ECT and discuss in it is a bioethical treatment.
[Commentary on the Case of Therapeutic Indocility].
Pardo A
Cuad Bioet · 2017 · PMID 28964003
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[Case: HIV-Positive Male that Does not Follow the Patient Treatment But It May Go to Revised Consultations].
Hospital Comarcal de Laredo CÉA
Cuad Bioet · 2017 · PMID 28964002
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[Is Sexual Identity Optional? A Study of The Genetics of Transsexuality].
Fernández García RM, Pásaro Méndez E
Cuad Bioet · 2017 · PMID 28964001
Transsexualism in the ICD-10 (International Classification of Diseases, Tenth Revision), Gender Dysphoria in adolescents and adults in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), is...
Transsexualism in the ICD-10 (International Classification of Diseases, Tenth Revision), Gender Dysphoria in adolescents and adults in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), is characterized by a marked incongruence between one's experienced gender and biological sex. The etiology is complex, but some hypotheses suggest that Gender Dysphoria (GD) arises from discrepant cerebral and biological sexual differentiation. Increasing evidence supports the idea of genetic vulnerability. Henningsson et al, (2004) found significant differences when they examined estrogen receptor β (ERβ) in a male-to- female (MtF) population. They suggested that a long ERβ polymorphism is more common in MtFs. Hare et al, (2009) also examined an MtF population and found a significant association between the androgen receptor (AR) and GD. Our group analyzed the same polymorphisms and found an association between ERα, ERβ and AR in GD. Our results suggest a genetic basis of GD in MtF and FtM populations. Our data corroborate the implication of the two estrogen receptors, ERα and β, and the androgen receptor in the genetic basis of GD, and advise the importance of estrogens and androgens in cerebral masculinization. Our data also confirm that sexual identity is not optional, but is determined prenatally by the genes, although it has a very important hormonal component. Therefore, its substrate is cerebral, not ideological.
[The Hypertrophy of Autonomy in the Bioethical Debate].
Martínez Otero JM
Cuad Bioet · 2017 · PMID 28964000
In the current bioethical debate personal autonomy is frequently used as an argument to justify the legalization of new options for the subject. This is the case, for instance, of the controversies around surrogated moth...
In the current bioethical debate personal autonomy is frequently used as an argument to justify the legalization of new options for the subject. This is the case, for instance, of the controversies around surrogated motherhood, organ free market, euthanasia or egg freezing in order to postpone motherhood. This paper aims to show how legalizing certain options can be harmful to people, and would justify and perpetuate situations of domination of some human beings over others. In this regard, the importance of recognizing the unavailability of certain goods and human rights is underlined.
[Communicate Medical Errors or Hide Them? In Relation to the Henry Marsh's Memoirs].
Moure González E
Cuad Bioet · 2017 · PMID 28963999
″Do no harm″ is the work of Henry Marsh, an English neurosurgeon who, in the epilogue of his professional career at the National Health Service, remembers not only his professional successes but also his failures. This i...
″Do no harm″ is the work of Henry Marsh, an English neurosurgeon who, in the epilogue of his professional career at the National Health Service, remembers not only his professional successes but also his failures. This is the starting point to propose a system of notification of medical errors in Spain that allows to comply with the hippocratic key principle that gives title to the book: ″primum non nocere″. With this objective, our proposal is, in first place, to analyze the extent to which there is a conflict of loyalties in the professional performance of any doctor (institution vs. patient) that conditions the possibility of communicating the errors that may occur, concluding that there are normative counterweights to comply with this principle: to inform the patient respecting other rights in conflict. The balance between the right to be informed and the right to defend oneself against further actions of responsibility has the faithful of that imaginary balance in the canonical idea that to learn from error the starting point is to recognize it, and the second to analyze why it occurred. Only from learning can the error be avoided and, thus, improved the quality of care assistance. In our analysis of the Spanish system of adverse effects communication (SiNASP), we conclude that it does not meet the standards we set ourselves, and not only from an ethical and legal analysis, but also taking as reference the systems with the same Objective in our European environment - including the references of treaties and international agreements in this area. The final conclusion to which we arrive as the culmination of all the previous reflection is that for a system of communication of errors to actually function, it has to be obligatory and anonymous for the informant, transparent and conclusive for the informed and, above all, reflexive and didactic for the institution, so that it fulfils with the duty to inform and it also avoids that the error is repeated.
Preventive Newborn Male Circumcision: What Is the Child's Best Interest?
Di Pietro ML, Teleman AA, Di Pietro ML … +3 more , Poscia A, González-Melado FJ, Panocchia N
Cuad Bioet · 2017 · PMID 28963998
Preventive newborn male circumcision has been at the center of scientific debate for many years. The reason for promoting preventive newborn male circumcision, is the reduction of the incidence of UTIs (in the first six...
Preventive newborn male circumcision has been at the center of scientific debate for many years. The reason for promoting preventive newborn male circumcision, is the reduction of the incidence of UTIs (in the first six months of life), penile cancer, transmission of STDs/HIV infection/AIDS. However preventive interventions in the newborn involving violations of bodily integrity elicit several ethical questions. In this article, we reviewed the literature regarding circumcision, the prevention of UTIs, penile cancer, transmission of STDs/HIV infection/AIDS and complications of this practice in the neonatal period. The very limited reduction of incidence of UTIs and the uncertain preventive role of newborn male circumcision towards penile cancer, STDs/HIV infection and AIDS, makes it difficult to justify male circumcision in newborns. Moreover, the challenge in obtaining a unanimous opinion on newborn male circumcision derives from the fact that, as a preventive intervention, it requires evaluation criteria that are not comparable to those of therapeutic treatments. Since preventive male circumcision determines permanent alteration of the body, some authors believe that it can be used only in subjects that are capable of giving their valid consent. In the case of a newborn, the ″child's best interest″ should be used as a standard, but preventive newborn male circumcision does not satisfy it.
[The Woman and the Care of Life. Historical Understanding and Future Perspectives].
Massé García MC
Cuad Bioet · 2017 · PMID 28963997
Over the ages of humanity, women has established a special relationship life care's with the most vulnerable. Women dedicated to the professional care have always existed, also to the unpaid home care of the sick, elderl...
Over the ages of humanity, women has established a special relationship life care's with the most vulnerable. Women dedicated to the professional care have always existed, also to the unpaid home care of the sick, elderly, with some disability, and children. This study has been carried out a historical and current verification of this question, marking its most characteristic and significant features. From that perspective, we tried to answer these key questions: causes that have motivated this fact, its social consequences and, finally, the most important future implications for all, men and women that, surely, we will be caregivers and strapped for care in our illness.
[Ethical Dilemas in Pediatrics].
Moreno Villares JM
Cuad Bioet · 2017 · PMID 28621965
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[The Best Interest of the Child in the Case of Surrogate Maternity].
Garibo Peyró AP
Cuad Bioet · 2017 · PMID 28621964
This article claims to analyze the situation of children born by means of surrogate maternity contract since these babies are one of the most vulnerable parts of this agreement, so their rights and interests could be aff...
This article claims to analyze the situation of children born by means of surrogate maternity contract since these babies are one of the most vulnerable parts of this agreement, so their rights and interests could be affected in many ways. In order to study that situation, in the first place, has been accomplished a brief analysis of the concept of the best interest of the child. Afterwards it is examined the possible violation of the best interest of the child in the cases that have already been examined by Doctrine and Jurisprudence, that is, first the case of registration of these children in the country of origin Civil Registry of the intentional parents, and, in second place, the case of maternity benefit for intentional mothers. The article concludes with a reflection about other situations in where the best interest of children can be affected , such as their right to know their biological origins or the cases of identity problems.
[Taking Altruistic Surrogacy Seriously].
Bellver Capella V
Cuad Bioet · 2017 · PMID 28621963
Since two years ago Spanish public opinion is living an intense debate on the ethical and legal aspects about surrogacy. There is a shared concern about the risks of exploitation for women related to commercial surrogacy...
Since two years ago Spanish public opinion is living an intense debate on the ethical and legal aspects about surrogacy. There is a shared concern about the risks of exploitation for women related to commercial surrogacy. To get rid of them, and make possible at the same time that people who is not able to gestate could become father/mother, it has been proposed to regulate altruistic surrogacy. In order to defend this proposal it is said that there is an analogy between altruistic organ donation and altruistic surrogacy: you can help a person in need giving an organ or your ability to gestate. In this paper I confront both considerations. First, there is not a real analogy between organ donation and altruistic surrogacy. And second, if we think seriously a possible regulation for altruistic surrogacy we will find many problems with difficult or impossible solutions.
[Language Manipulation, Surrogacy, Altruism].
Serrano Ruiz-Calderón JM
Cuad Bioet · 2017 · PMID 28621962
The Newspeak propitiates a change of the sense of the words and next to the double thinking forms the picture of totalitarianism described by Orwell in 1984. The purpose of the Newspeak is to make all other forms of thou...
The Newspeak propitiates a change of the sense of the words and next to the double thinking forms the picture of totalitarianism described by Orwell in 1984. The purpose of the Newspeak is to make all other forms of thought impossible. In bioethics the Newspeak is applied, not because Bioethics is a new science but by the manipulative intention. The twentieth-century political language has, according to Orwell, the intention to remove the ″mental image ″ of what really happens. This is clear in the terms ″surrogacy ″. On the one hand, the mother is deprived of her child. On the other, there is no legal subrogation. As has been said the technique reduces a woman to the condition of a vessel. The excuse of gratuity does not change the exploitative relationship, since gratuitousness in the provision of women is not the altruism of all those involved in surrogacy.
[Economic Dimension of Surrogacy Maternity (″Rooms For Rent″)].
López Guzmán J
Cuad Bioet · 2017 · PMID 28621961
Maternity by subrogation has an important economic dimension that, in the last years, has been even more potentiated. It is a multimillion-dollar industry that, on the other hand, takes advantage of women with low econom...
Maternity by subrogation has an important economic dimension that, in the last years, has been even more potentiated. It is a multimillion-dollar industry that, on the other hand, takes advantage of women with low economic resources. Faced with this, there is an important criticism, carried out by different groups, that refer to this sector with such questionable terms as ″uterine rental industry″, ″baby farms″, ″children's factories″, etc. These criticisms are being strongly counteracted by maternity centers by subrogation. To this they dedicate enormous budgets with strategies that, based on great doses of sentimentality, manage to transmit a positive image of the process. The objective is to provide tranquility to users and to society in general. To this end they distort the ethical and legal implications of the process; in particular, deny the exploitation of women and the instrumentalization of the children that, necessarily, implies this technique.
[The Reproductive Exploitation of Women and the Myth of Altruistic Surrogacy: An Overview of the Phenomenon of Gestation by Substitution].
Albert MM
Cuad Bioet · 2017 · PMID 28621960
The article approaches the issue of surrogacy from a global point of view. Surrogacy is analysed from international and comparative law perspective, as well as the effects of the legalization of altruistic surrogacy in t...
The article approaches the issue of surrogacy from a global point of view. Surrogacy is analysed from international and comparative law perspective, as well as the effects of the legalization of altruistic surrogacy in the first-world countries on vulnerable women in other parts of the world. The paper concludes extrapolating the conclusions of this analysis to the current debate about legalization of altruistic surrogacy in Spain.
[Surrogate Motherhood and Woman Dignity].
Aparisi Miralles Á
Cuad Bioet · 2017 · PMID 28621959
Motherhood by subrogation is an issue that directly affects human rights and, ultimately, human dignity. Therefore, if we want to give an adequate response to this issue, it is essential to reflect on how this practice a...
Motherhood by subrogation is an issue that directly affects human rights and, ultimately, human dignity. Therefore, if we want to give an adequate response to this issue, it is essential to reflect on how this practice affects the dignity and rights of the people involved in it and, more specifically, the pregnant mother. This study tries to show how in relation to the latter, maternity by subrogation directly contradicts some basic requirements of human dignity, since it reifies, instrumentalizes, convert into an object of commerce, and disregards the personal uniqueness of pregnant women.
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