Cuadernos De Bioetica[JOURNAL]
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200 papers
The therapeutic proportionality standard: a new content for the best interests standard.
González-Melado FJ, Di Pietro ML
Cuad Bioet · 2020 · PMID 32304197
The standard of the patient's best interests is the main bioethical standard used in the decision-making process that involves incompetent patients (i.e. neonatology, pediatric patients and incompetent adults). This stan...
The standard of the patient's best interests is the main bioethical standard used in the decision-making process that involves incompetent patients (i.e. neonatology, pediatric patients and incompetent adults). This standard has been widely criticized as being self-destructive, individualistic, vague, unknown, dangerous and open to abuse. With the purpose of defending it, several reforms of this standard have been proposed, especially in the pediatric field. We propose a redefinition of the standard based on two concepts: 1) medical futility as a negative criterion, and 2) the principle of proportionality as a positive criterion. Our work includes a new relationship between concepts in classical moral theology (i.e. ordinary / extraordinary; proportionate / disproportionate) applied to the bioethics of life-sustaining treatments for incompetent patients.
[Bioethics and spirituality at the end of life].
Costa Gomes C, Borges Neto RDS
Cuad Bioet · 2020 · PMID 32304196
Understanding suffering and hope with people - children, youth and adults who die! Being with so many people waited, despaired, cried the lives of parents, children and friends, we will better understand the pain and suf...
Understanding suffering and hope with people - children, youth and adults who die! Being with so many people waited, despaired, cried the lives of parents, children and friends, we will better understand the pain and suffering and spirituality of those at the end of life. With this essay, we intend to raise the reflection of health professionals to experience spirituality in caring for the end-of-life person. Study and hermeneutic analysis based on texts by Daniel Serr)o, Walter Osswald and Filipe Almeida. Results. Medicine and nursing are aware of human finitude, but of a finitude that is not identified with nothingness, emptiness, absence, but an ethic of hope ″(Moltmann, 2012). Bioethics in clinical practice calls for the humanization and spirituality of the dying process. Each sick person calls for a therapeutic response on the horizon of friendship, which refuses, therefore, disagreements generated in the corridors inhabited by moral strangers. Spirituality is also the therapeutic window of a universe that awaits intensity of glances, cuddling with outstretched hands, respect in the dignity that is recognized.
[Professor, researcher and pioneer of bioethics].
Pastor LM
Cuad Bioet · 2019 · PMID 31618596
Abstract loading — click title to view on PubMed.
[Abstracts of the XII International Congress of AEBI. University CEU Cardenal Herrera, Valencia 25-26 October 2019].
Cuad Bioet · 2019 · PMID 31618594
Abstract loading — click title to view on PubMed.
[Ethics in the communication of down syndrome diagnosis].
Vargas Aldecoa T
Cuad Bioet · 2019 · PMID 31618593
Down Syndrome diagnosis communication has got serious ethical implications, since the aim thereof can be either eugenic or therapeutic. The purpose of this paper is, on the one hand, to highlight the fundamental role whi...
Down Syndrome diagnosis communication has got serious ethical implications, since the aim thereof can be either eugenic or therapeutic. The purpose of this paper is, on the one hand, to highlight the fundamental role which sanitary proffesionals play in diagnosis communication and the subsequent decission of the mother. On the other, recommendations on the way to communicate a diagnosis are set out. Finally, in order to analize the state of play in Spain the results of a cross-sectional descriptive study with a sample of 352 mothers are exposed. In this study the mothers express, by means of a survey, their personal experiencies of how they have received the news. It is concluded that the communication of Down syndrome diagnosis can be improved in many aspects.
[Clinical information, informed consent and medical deontology. A recent relationship].
García-Guerrero J
Cuad Bioet · 2019 · PMID 31618592
In Spain, the right to clinical information and informed consent as a practical expression of the principle of autonomy, are legal conquests achieved in the late twentieth century. From the law they have been transferred...
In Spain, the right to clinical information and informed consent as a practical expression of the principle of autonomy, are legal conquests achieved in the late twentieth century. From the law they have been transferred to the codes of medical deontology. The aim of this work is to study the pace of this transfer. Historical review of the different codes of medical deontology in Spain since the Civil War, seeking the presence of these ideas in them. Until code of medical deontology of 1979, the idea of clinical information did not appear in the contemporary deontological norm, and the rules on consent did so in very restricted cases. As of that date, their appearance is progressive in the successive codes. Currently, both concepts are fully developed in Spanish deontological regulations. Medical Deontology has take on the ideas of patient information and informed consent. This has been a long process which have brought considerable changes the deontological orientations of the traditional form of doctor-patient relationship. In these aspects, medical deontology has drifted, from emphasizing the prudence of the doctor, to emphasize the duty to inform and give ample space to the patient's decisions, which he recognizes as an autonomous and reflective moral agent, capable of taking his own decisions about your health.
[Genetic edition and theological ethics].
Borgoño Barros C
Cuad Bioet · 2019 · PMID 31618591
This paper tries to look forward to the incoming ethical challenges related with genetic editing. It begins with contextualizing genetic edition within the specific nature of modern technology. Afterwards it presents the...
This paper tries to look forward to the incoming ethical challenges related with genetic editing. It begins with contextualizing genetic edition within the specific nature of modern technology. Afterwards it presents the contrast between natural beings and artifacts that sheds light for answering the question about the real possibility of replacing natural beings, as they are, with technologically projected living beings. In the third place, after acknowledging the scarce attention given by contemporary theology to technology, it shows the convergence of the Christian concept of creation with the respect for balance in nature, as most part of the contemporaty ecological sensibility upholds. Building on this common ground it shows that the Christian attitude towards technology is not technofobical but the integration of technology -a central element of contemporary culture- with nature, accepting the limitation of any natural being including mankind. In this way, vulnerability, as a visible consequence of this finitude, is the very attribute of human beings that makes ourselves equal and requieres recongnition of our common dignity, way over the idea of acquiring an ideal perfection through technology, even if it was accesible to all.
[Proposal of a deontological framework for spanish biologists].
Díez Fernández JA, Rodríguez-Peña FM
Cuad Bioet · 2019 · PMID 31618590
Deontology is the set of duties and obligations in which the correct act is specified in the exercise of a profession. The Deontological Codes (CD), in addition to respecting the legal framework in which they are inserte...
Deontology is the set of duties and obligations in which the correct act is specified in the exercise of a profession. The Deontological Codes (CD), in addition to respecting the legal framework in which they are inserted, must go beyond the laws insofar as they are a reflection of the ethical commitment of each profession; commitment to deontological principles, which also helps to shape your identity. The aim of this project is to provide, based on the bibliography and current legal and deontological regulations, a proposal to serve as a guide for the accomplishment of Ethic Codes for Biologists (CDB), which currently does not exist in Spain, taking as a basis the revision of the ethics codes of other professions related to Biology. Under this purpose, a systematic and comparative review has been carried out of other health professions ethics codes, of the ethical guidelines emanating from scientific societies (above all, from the Anglo-Saxon area) and of the regulations applicable to those professions. The result is the proposal of the most important sections that we believe this Code should contain.
[Bioethics theories, the protection of life and natural law].
Lorenzo Izquierdo D
Cuad Bioet · 2019 · PMID 31618589
Principlist Bioethics by Beauchamp and Childress has reached a prominent status in contemporary Bioethics. Nevertheless, it includes some important theoretical problems: some lacks when defining some concepts, a tendency...
Principlist Bioethics by Beauchamp and Childress has reached a prominent status in contemporary Bioethics. Nevertheless, it includes some important theoretical problems: some lacks when defining some concepts, a tendency to ethical relativism, etc. Among the ethical alternative approaches from which such problems can be solved, we think that the most appropiate is the Natural Law theory. It offers a reasoned reflection on the concept of good and on human basic goods and their relation with moral general principles. From such goods, this ethical theory supports the existence of actions that are always maleficent acts, that is, intrinsically and universally evil acts. The article applies the Natural Law theory to issues related to the protection of human life (abortion, euthanasia, self-defense and genetic manipulation)..
[Ethical analysis of the principle of health vulnerability].
Macpherson I, Roqué-Sánchez MV
Cuad Bioet · 2019 · PMID 31618588
The concept of vulnerability has determined multiple actions in the health field. In recent years, this concept has originated various holistic models that oscillate between considering vulnerability as a descriptive ele...
The concept of vulnerability has determined multiple actions in the health field. In recent years, this concept has originated various holistic models that oscillate between considering vulnerability as a descriptive element of an accidental situation until it is considered a guiding principle of medical practice. The need to deepen this phenomenon from the point of view of moral philosophy is perceived. The moral reflection reveals an imbalance in the binomial autonomy-dependence, generating opposite solutions in decision-making. Although autonomy has so far supported much of the medical action, the dependency raises a new perspective on vulnerability, rooted in the ethics of care. This perspective allows us to overcome the consideration of vulnerability as a characteristic, an accident or a principle. Vulnerability appears as an intrinsic dimension of the human being that, far from altering its dignity or autonomy, makes it posible to demonstrate the need of others to reach their fullness.
[Validity of the concept of human dignity in health care: a literary perspective].
Bellver Capella V
Cuad Bioet · 2019 · PMID 31618587
In 2003 Ruth Macklin published a short paper questioning the usefulness of the concept ″human dignity. ″ Since then the debate has been kept alive, although in the world of Law, ethics and clinical practice, this concept...
In 2003 Ruth Macklin published a short paper questioning the usefulness of the concept ″human dignity. ″ Since then the debate has been kept alive, although in the world of Law, ethics and clinical practice, this concept continues to be used normally. In the spotlight of that criticism was the bioethics of Leon Kass, built on the concept of dignity and sustained in a narrative methodology. In homage to Leon Kass, in this work I approach the concept of dignity from a literary perspective and focusing on nursing health care, in which the usefulness of the concept of human dignity is especially visible.
[Risk of medicines in pregnancy: a problem of knowledge transfer with ethical implications].
Alegre-Del Rey EJ, Fénix-Caballero S, Díaz-Navarro J
Cuad Bioet · 2019 · PMID 31206299 · Publisher ↗
Drug use in pregnancy is essential and beneficial, but it is needed to check their safety. Available scientific evidence is poor and difficult to interpret. Risk classifications (FDA, ADEC) have shown to be too simple an...
Drug use in pregnancy is essential and beneficial, but it is needed to check their safety. Available scientific evidence is poor and difficult to interpret. Risk classifications (FDA, ADEC) have shown to be too simple and categorical; they lead to inaccurate perceptions of risk and unfortunate decisions, such as interrumption of medication, or abortion. This has become clear with antidepressants or the antiretroviral efavirenz. Although abortion is not justified, misinformation contributes even more to the problem. Information tends to obviate that not every risk in pregnancy is teratogenic, that the existence of risk does not imply high probability, and that the nature and probability of the risk vary according to the stage.
[Some considerations about the contract of surrogate mother in view of the spnanish legislation on adoption].
Azpiroz Villar JE
Cuad Bioet · 2019 · PMID 31206298 · Publisher ↗
Spanish law, article 177 of the Civil Code, and the European Convention on the minors' adoption require for the validity of the mother's consent, the passing of six weeks after the birth, as a guarantee of her freedom, c...
Spanish law, article 177 of the Civil Code, and the European Convention on the minors' adoption require for the validity of the mother's consent, the passing of six weeks after the birth, as a guarantee of her freedom, consciousness and adequate information. In contrast, in the agreements of surrogate mother, the woman contracted for the pregnancy must give her irrevocable consent to give the child at birth, ex ante the process, leaving her unprotected: preventing the revocation of her (apparent) initial choice at the end of the pregnancy and knowing her child already born. In addition to the illegality of the object of this contract, despite the existence of a law that makes it positive, the consent given must be considered null and void.
[CRISPR-CAS9. The greatest advancement in genetic edition techniques requires an ethical reflection].
Gómez-Tatay L, Aznar J
Cuad Bioet · 2019 · PMID 31206297 · Publisher ↗
The adaptation of the CRISPR system as a genetic editing tool has led to a revolution in many fields of application, as this technique is considerably faster, easier to perform and more efficient than predecessor techniq...
The adaptation of the CRISPR system as a genetic editing tool has led to a revolution in many fields of application, as this technique is considerably faster, easier to perform and more efficient than predecessor techniques. However, some of these applications raise objective ethical issues that must be addressed. In this paper we discuss, based on the most recent data, the different issues related to CRISPR applications on the germ line, its introduction in clinical trials, the genetic edition of animals and plants for human consumption and the novel gene drive.
[Sexual revolution and neovitalism. The gestational services in the social reconfiguration, as reproductive, of the queer people].
Burguete Miguel EE
Cuad Bioet · 2019 · PMID 31206296 · Publisher ↗
This paper links the Sexual Revolution with queer neovitalism, framing both in the emancipatory impulse that underlies European culture. Impulse does not imply the confrontation between tradition and progress, but the co...
This paper links the Sexual Revolution with queer neovitalism, framing both in the emancipatory impulse that underlies European culture. Impulse does not imply the confrontation between tradition and progress, but the confrontation of tradition with itself. After analyzing its epistemological referents of 68, our research shows that the conceptualization of desire as the genuine ″revolutionary instance″ and the synthesis of the relationships between language, power and politics, forged the myth of the Sexual Revolution. In addition, that this, by dissociating the sexual encounter of procreation, inspired the current gender perspective, the culture of performativity and the critique of heteronormativity. Linking the queer perspective with transhumanism, this work reveals the constroversial nature of its neovitalist current and highlines its eugenics and bio-colonial potential. Eugenic and bio-colonial potential that is evidenced by the use of genetic material and foreign bodies as a ″product″ for the social reassignment, as procreator, of the queer collective. Finally, the work reveals the inherent contradiction of the Sexual Revolution, concluding that it did not bring the emancipation that it promised, but that it implied a relapse in the state of nature, in the instinctive centrality that orders praxis to the submission of the environment, propitiating a new form of social control and a new conformity.
[Ethical character and prudence: analysis of the human act in clinical-ethical decisions].
Pastor LM
Cuad Bioet · 2019 · PMID 31206295 · Publisher ↗
First, the mutual interiority that exists in every human action between its ethical and technical dimension is analyzed, more specifically in relation to health practice. It is established that by means of technical or e...
First, the mutual interiority that exists in every human action between its ethical and technical dimension is analyzed, more specifically in relation to health practice. It is established that by means of technical or ethical habits, or applying certain deliberative guidelines, alone it is not possible to discern between the goodness or not of a certain action. For this to be possible, it is necessary to adopt a personal perspective, both as regards oneself and when judging the actions of others. Secondly, then, the virtue of prudence is essential to choose the most best path in a specific context. This ethical habit is greatly influenced by the overall ethical character of the person and by their deliberative capacity and knowledge of ethical principles. With regard to the second, it is necessary to follow the usual ways by which the person makes decisions and considers a certain action as good or bad. Therefore, it cannot be pretend using technical decision-making methods health professionals will deliberate and make ethical decisions. In conclusion, it is necessary that the prudence of professionals be based both on the personal ethical character and on an analysis of ethical cases in consonance with the natural way in which human reason acts.
Reconceiving bioethical proceduralism: an ontological perspective.
Taylor MD
Cuad Bioet · 2019 · PMID 31206294 · Publisher ↗
This year marks the 40th anniversary of the Belmont Report that formally ushered in an era of principlism and proceduralism in the field of bioethics, an era which shaped the form of bioethical debate according to the co...
This year marks the 40th anniversary of the Belmont Report that formally ushered in an era of principlism and proceduralism in the field of bioethics, an era which shaped the form of bioethical debate according to the combination of Enlightenment-inspired dualism and Liberal pragmatism characteristic of the United States. While ostensibly seeking to protect the vulnerable in a pluralistic society, in reality, recent critiques have argued, the development of bioethics has been directed at legitimizing the bureaucratization of ethics into a self-referential and isolated instrument for socio-political control. As a result, bioethical proceduralism often subverts the very values it is supposed to defend. These critiques, while valuable, do not reach the heart of the problem, which is rooted in the ontological level. The philosophical heritage of modern bioethics -the ontological presuppositions about human nature, freedom and the supposed ″neutrality″ towards any claims about the good, among others- must be rectified so bioethics may better achieve its stated goals and uphold its own principles. While recounting the entire ontological vision that would undergird such a renewal is beyond the scope of this paper, reconceiving the presuppositions behind the notions of freedom, consensus, and autonomy through an understanding of the human being as a person-in-community constitutively related to others opens a path through which principles and procedures can be preserved, not subverted, within bioethics today.
[Dialectics or Eristics. The Hermeneutic Approach to Biomedical Ethics as a Problem or as a Solution].
Vergara Lacalle Ó
Cuad Bioet · 2019 · PMID 31206293 · Publisher ↗
This paper aims to highlight the conditions in which the hermeneutical approach can make an irreplaceable contribution to biomedical ethics. This contribution is understood in the light of one of the main shortcomings of...
This paper aims to highlight the conditions in which the hermeneutical approach can make an irreplaceable contribution to biomedical ethics. This contribution is understood in the light of one of the main shortcomings of current methodologies (in this work we will refer basically to Principlism and Casuistics), which ultimately operate as mere chains of transmission of the moral agent's prejudges. Although prejudices cannot be avoided, however, it does not mean that they cannot be overcome, if, with Gadamer, we realize that understanding is in some way directed towards the truth of things. This postulate allows us to connect Gadamerian Hermeneutics with Aristotelian Ethics -something which Gadamer himself does, but only to the effects of defining his notion of understanding- and to try to offer a way out for the aforementioned weakness of current methodologies.
[A Case of Uterine Rupture during Pregnancy].
Di Pietro ML, Pietro Faggioni M
Cuad Bioet · 2019 · PMID 30742455
The article presents a rare case of uterine rupture at the 19th week of gestation, in the presence of a scar after a caesarean section practiced two years earlier. The fetus was pulled out alive, but given the gestationa...
The article presents a rare case of uterine rupture at the 19th week of gestation, in the presence of a scar after a caesarean section practiced two years earlier. The fetus was pulled out alive, but given the gestational age, died within a few minutes. The uterus was preserved, but the woman was advised to proceed with tubal ligation and, in any case, to absolutely avoid a new pregnancy. The literature on uterine rupture is examined focusing on the problem of uterine rupture resulting after a caesarean section, analyzing the possibility of monitoring the risk of rupture through ultrasound evaluation. Finally, the article conducts a moral analysis of the case in the light of catholic moral, questioning in particular the acceptability of a hysterectomy under certain conditions. The illegitimacy of direct sterilization is reaffirmed, that is to say, an intervention whose purpose is the impediment of procreation, but it is emphasized that direct sterilization cannot occur when it comes to the moral certainty that that uterus, because of its conditions , cannot carry on a pregnancy until the viability of the fetus. In fact, an intervention that affects a uterus that is objectively incapable of carrying out its natural function cannot be qualified as anti-procreative.
[Is There a Right to Die?].
Serrano Ruiz-Calderón JM
Cuad Bioet · 2019 · PMID 30742454
The right to death is defined from the oblivion of death, characteristic of contemporary society. The defense of euthanasia, far from being a contradiction with that forgetfulness, constitutes its verification. Affirmed...
The right to death is defined from the oblivion of death, characteristic of contemporary society. The defense of euthanasia, far from being a contradiction with that forgetfulness, constitutes its verification. Affirmed as an altruistic and benevolent act conceals the need to forget suffering and death, and the inability to observe the death of others. As a right, the right to death is presented as the prohibition of the law and the community to interfere in the act of love for oneself or for another. But as an effect, a right of a social nature and ethical indication that constitutes a risk for dependent life is established.
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