Cuadernos De Bioetica[JOURNAL]
Sun
200 papers
[The Value and Dignity of Terminal Life. Philosophical Prolegomena for a Critique of Euthanasia].
Sánchez Cámara I
Cuad Bioet · 2019 · PMID 30742453
The attitude we adopt towards the lawfulness of euthanasia depends on our position on the value and dignity of the life of the terminal ill patient. Contemporary moral debates lacks of a shared basic position, but it is...
The attitude we adopt towards the lawfulness of euthanasia depends on our position on the value and dignity of the life of the terminal ill patient. Contemporary moral debates lacks of a shared basic position, but it is not impossible to discuss. On human dignity there are two attitudes. For one of them, dignity depends on maintaining of one decisive quality, as autonomy, autodetermination or lack of intense suffering. For the other conception of dignity, it does not depend on any attribute of human life. Sufferance is not a refutation of dignity. This second idea of dignity is more correct in philosophical terms. Anyway, the difference between law and moral must be taken into account.
[Care for the Patient and his Family at the end of Life: Compassionate Advance Care Planning].
Pérez Bret E, Altisent Trota R, Rocafort Gil J … +1 more , Jaman Mewes P
Cuad Bioet · 2019 · PMID 30742452
End of life is frequently accompanied by suffering and hardships that can be alleviated in the Palliative Care (PC) units by applying compassionate advance care. It is the aim of this paper to describe the concept of "co...
End of life is frequently accompanied by suffering and hardships that can be alleviated in the Palliative Care (PC) units by applying compassionate advance care. It is the aim of this paper to describe the concept of "compassionate advance care" as a way of caring for the patient and his family at the end of life from the perspective of both professionals, teachers and students of the health sciences, and persons with advanced disease and their families. A qualitative methodology was used. Data were collected through in-depth interviews and focus groups, and analysed and coded using the theory of Grounded Theory. Approval of an Ethics Committee was obtained. The intentional sample consisted of 29 participants, who were patients and relatives of patients with advanced disease, PC professionals and experts in bioethics, university professors and Health Sciences students. Data were collected in a PC Hospital in Madrid, Spain. The participants positively valued the compassionate advance care provided by professionals: analysing and reflecting on possible complications that may arise from the advanced disease situation suffered by the patient and establishing a dialogue with him about possible actions in this regard. The paper concludes that compassion is a virtue that implies anticipating the needs of patients, thus allowing the patient to make the right shared decisions. This is what the term Compassionate Advance Care Planning entails. Further studies are needed to delve into the characteristics of compassionate Advance Care Planning and how to optimally implement it in patients at the end of life. To admit the opposite is to enter a spiral where the dignity of the human being would become an object of weighting with respect to another value, which, in a hypothetical conflict could be postponed by another. However, Palliative Care takes into account the social dimension of the end of life of the human being. They take care of the sick human being in its entirety. That is why they are the option most in line with the dignity of the human being at the end of his life.
[Social Aspects of Euthanasia].
Germán Zurriaráin R
Cuad Bioet · 2019 · PMID 30742451
This article analyzes the issue of euthanasia, but under a concrete point of view, that of its social implications. It is defended here that euthanasia is not exclusively an individual decision, but has, above all, an im...
This article analyzes the issue of euthanasia, but under a concrete point of view, that of its social implications. It is defended here that euthanasia is not exclusively an individual decision, but has, above all, an important social repercussion. If euthanasia were accepted and legalized, the very nature of the medicine and the physician's own identity would undergo a profound transformation. The doctor-patient relationship based on trust would be broken. Also, if euthanasia were endorsed, it would be encouraged that the human being was not valued for his / her being, but for his capacity to produce. Now, vulnerable, fragile and weak people (dependent, old, sick ...) keep their dignity intact, because we have this because of the simple fact of being born as human beings. All human lives are worth living, however sick and deteriorated their bodies are. To admit the opposite is to enter a spiral where the dignity of the human being would become an object of weighting with respect to another value, which, in a hypothetical conflict could be postponed by another. However, Palliative Care takes into account the social dimension of the end of life of the human being. They take care of the sick human being in its entirety. That is why they are the option most in line with the dignity of the human being at the end of his life.
[Guest Editor's Note: Legalization of the Euthanasia: What is at Stake].
Albert M
Cuad Bioet · 2019 · PMID 30742450
Abstract loading — click title to view on PubMed.
[Euthanasia and Bioethics].
Pastor LM
Cuad Bioet · 2019 · PMID 30742449
Abstract loading — click title to view on PubMed.
[Ethical challenges posed by the use of Artificial Intelligence in the diagnosis and clinical treatment].
Guerra Á, García-Mayor R
Cuad Bioet · 2018 · PMID 30380905
Abstract loading — click title to view on PubMed.
[Commentary on the case: of the patient admitted to the ICU].
Pardo A
Cuad Bioet · 2018 · PMID 30380904
Abstract loading — click title to view on PubMed.
[Case: No admission to the ICU as a limitation of life support].
González Díaz G
Cuad Bioet · 2018 · PMID 30380903
Abstract loading — click title to view on PubMed.
[Thee coethical thought of Robert Spaemann: ethics of benevolence and the care of the natural world].
Pro Velasco ML
Cuad Bioet · 2018 · PMID 30380902
In this work we intend to show the reflections of the contemporary philosopher Robert Spaemann in what refers to ecology. For this reason, in first place, I will make use of the fundamental ethical category of his though...
In this work we intend to show the reflections of the contemporary philosopher Robert Spaemann in what refers to ecology. For this reason, in first place, I will make use of the fundamental ethical category of his thought (benevolent love), as extensible also to the natural world. Following that, I will propose a universal hierarchy of the benevolent love in the ordo amoris. Once we have talked about how to extend this rational love to all beings, I will present Spaemann's view of the world based on two interests of the reason: one dominative and the other one contemplative. To end, I will explain the concept of Mitsein as a proposal for our interaction with the surrounding world.
There relations between professionals in the deontology codes of several professions of health.
Cía Gómez P, Delgado-Marroquín MT
Cuad Bioet · 2018 · PMID 30380901
A good care of people in the health field requires coordination among the professionals responsible for such care, both interdisciplinary and between levels of care. The ethical considerations that underlie, being fundam...
A good care of people in the health field requires coordination among the professionals responsible for such care, both interdisciplinary and between levels of care. The ethical considerations that underlie, being fundamental, have been little studied in a specific way, although all the Codes of Deontology of the professions related to the health collect recommendations and suggestions regarding the relations between professionals. This article makes a reflective review on these recommendations and their importance in our care environment.
[Hastening death by voluntary stopping of eating and drinking. A new mode of assisted suicide?].
Requena P, Andrade Dos Santos AP
Cuad Bioet · 2018 · PMID 30380900
In the last few years, the new catch phrase ″voluntary stopping of eating and drinking″ has made its appearance in the medical and bioethical literature. The practice, whose ″primary intention″ is to hasten the death of...
In the last few years, the new catch phrase ″voluntary stopping of eating and drinking″ has made its appearance in the medical and bioethical literature. The practice, whose ″primary intention″ is to hasten the death of a person who does not want to continue living, has been proposed as an alternative to euthanasia and assisted suicide. Some authors present it as a valid option from both the ethical and legal point of view arguing that it is basically a ″natural death″ in the same line as a limitation of treatment and does not involve suicide. In this article we present a critical review of the recent literature and reach the conclusion that it is very difficult to consider this practice as anything other than a type of suicide. In consequence, healthcare workers should consider it alien to medical ethos and good clinical practice.
[Assessment of the suppression of puberty in children with gender identity problems].
López Guzmán J, González Vázquez C
Cuad Bioet · 2018 · PMID 30380899
The objective of this article is to reflect on the opportunity and risk of the proposed treatments to address gender identity problems in that sector of the population. In most of the protocols for the care of minors wit...
The objective of this article is to reflect on the opportunity and risk of the proposed treatments to address gender identity problems in that sector of the population. In most of the protocols for the care of minors with gender identity problems, the abolition of puberty is proposed as a method of choice. This technique consists in the administration of reversible agonists of GnRH to provoke a suppression of the hormonal expression of the minor and, thus, the development of the sexual characters of their gender. The opportunity or adequacy of the systematic use of reversible GnRH agonists may be questioned for several reasons. The first, because the diagnosis of transsexualism in minors carries a great complexity and difficulty, so there is a wide margin of error. The second, because the suppression of puberty has direct consequences in the development of the child. Thirdly, because the aforementioned treatments have some risks and side effects in minors, some of them not studied and unknown, which, without a doubt, should be weighted. Finally, because the drugs used are neither designed nor experienced, for the care of minors with gender identity problems. Therefore, they are used without being approved by the regulatory agencies of the medicinal product for that purpose. These issues need to be addressed and also transmitted in the information provided to the stakeholders.
[Pain and disease as a transformation. An analysis from phenomenology and narration].
Morales Benito I
Cuad Bioet · 2018 · PMID 30380898
Pain and disease are life experiences difficult to be understood due to different reasons: they both fall under subjective limits; the sufferer feels imprisoned in his own pain and perceives a radical rupture within hims...
Pain and disease are life experiences difficult to be understood due to different reasons: they both fall under subjective limits; the sufferer feels imprisoned in his own pain and perceives a radical rupture within himself, and the sufferer feels he is alone to himself, unable to communicate. All these reasons explain that suffering is a transforming element in life. In modern scientific medicine, regarding the treatment of pain, the physiological approach is the preponderant one. Therefore, other intrinsic dimensions of the person, like the psychic, the spiritual, the relational or the identity are not viewed as detrimental. This is an oversimplification of the reality which implies that the person is treated as an object. This can be interpreted as an attempt to the dignity of the person. This paper is aimed to contribute to a broader understanding of pain and a better patient care. The author lays out the results of combining two different approaches of pain: the story that a writer invents about his own pain and the phenomenological analysis of Toombs and Carel. Four eidetic categories of pain are presented in this paper: the otherness, the metamorphosis and the identity crisis, the placement in the present time and the loneliness and loss of relations. As a conclusion, this paper gives a definition of disease that includes the previous four elements. Moreover, it proposes the ways of narration and expression as a complement to the pharmacological treatment in order to healing and care.
An overview of trends in the regulation of clinical ethics committees: an opinion from the Italian National Bioethics Committee article.
Montanari Vergallo G, Petrini C
Cuad Bioet · 2018 · PMID 30380897
In 2017, the Italian National Bioethics Committee (INBC) released an opinion paper titled ″Clinical ethics committees″. Said document advocates for the creation of ″clinical bioethics committees″ in every suitable settin...
In 2017, the Italian National Bioethics Committee (INBC) released an opinion paper titled ″Clinical ethics committees″. Said document advocates for the creation of ″clinical bioethics committees″ in every suitable setting and lays out a set of guidelines aimed at regulating such committees' functions. The recommendations deal primarily with the independence, requirements for counselling, structures, composition, tasks, placement, coordination, requisite competences, regulations. In the opinion's contents there are: a) the need to entrust counselling and training on ethical issues within clinical practice to different committees than those that deal with ethical assessments of scientific trials and experimentation; b) the laying out of all the various functions and related competencies required of the ethics committees' members; c) the necessity that all counselling practices be carried out by each committee as a whole, rather than by a single expert member; d) Committee's independence. The authors elaborate on each one of the above mentioned aspects and highlight the importance of INBC's recommendations in order to improve the quality standards of care delivered ″to each patient's bed″.
Human Capital and Self-Entrepreneurship. The Concept of Robbed Time.
Musio A
Cuad Bioet · 2018 · PMID 29777606
The notions of ″human capital″ and ″self-entrepreneurship″ are by now widespread. The present work takes a critical look at their pervasive acceptance and stresses the self-exploitation to which they give rise. The conce...
The notions of ″human capital″ and ″self-entrepreneurship″ are by now widespread. The present work takes a critical look at their pervasive acceptance and stresses the self-exploitation to which they give rise. The concept of self-entrepreneurship needs to take into account, in fact, the nature of a revolution in temporal phenomenology. This revolution not only blurs the distinction between time dedicated to life and time dedicated to one's profession. It means that time spent on whatever is traditionally irrelevant to work is potentially time robbed from successful self-entrepreneurship. An analysis is made, lastly, of the relationship between body and ″bio-labor″, recognizable in the emergence of new forms of manual labor. Emblematic, in this sense, is gestational surrogacy. This provides an opportunity to rediscover the pregnancy of M. Foucault's biopolitical interpretation of neoliberalism as opposed to the more recent category of ″psychopolitics″ defined by B.C. Han. In the current scenario, indeed, the body maintains a role that remains as central as it is paradoxical, on account of its configuration as an ″entrepreneurial resource″.
Ethics and/or Aesthetics? Reflections on Cosmetic Surgery for Adolescents.
Vergallo GM, Marinelli E, Napoletano S … +2 more , Di Luca NM, Zaami S
Cuad Bioet · 2018 · PMID 29777605
Cosmetic surgery entails various ethical issues, even more so in cases involving adolescent patients. Cosmetic surgeons need to take into account how modern societies consider physical appearance an essential component o...
Cosmetic surgery entails various ethical issues, even more so in cases involving adolescent patients. Cosmetic surgeons need to take into account how modern societies consider physical appearance an essential component of everyday life, as well as the vulnerability of youths and adolescents. For that reason, it is imperative to thoroughly assess the psychological and emotional states, in addition to the motivations, of minor patients. That goal can be achieved through the use of the DAS-59, (the Derriford Appearance Scale)1 , an effective and dependable tool devised to evaluate the psychological difficulties and distress experienced by people living with problems of appearance. Prior to undergoing cosmetic surgery procedures, adolescents should be required to go through adequate counseling, over multiple sessions and extended to their family members as well, on account of the complex issues inherent in evaluating the risk-benefit ratio and a prospective patient's decision-making capability. A concerted effort on the part of surgeons, psychiatrists or psychologists is key in determining the real motivations behind a minor's decision to opt for cosmetic surgery in the first place. Possible psychiatric conditions may in fact prevent a minor from making a free, informed decision. From an ethical standpoint, cosmetic surgery procedures should be geared to serve the best interest of the minor patient, who may experience distress over his or her body image, from a health and psychological balance perspective and improve his or her social, affective and working life. Besides, cosmetic surgery should not be overly invasive compared to its potential benefits. Those procedures aimed at achieving ″ideal beauty″ are not desirable and ought to be banned. By virtue of such criteria, the authors have set out to evaluate the ethical admissibility of some aesthetic treatments. Thus, doctors should not consent to any request coming from their patients, but rather, intervene only in presence of an objective physical flaw or deformity, e.g. protruding ears, which have a potential to negatively affect social life and interactions.
[Ethical Aspects of the Use of Mirena(r) Iud in the Treatment of Heavy Menstrual Bleeding].
Turiel Miranda M, Agulles Simó P
Cuad Bioet · 2018 · PMID 29777604
The levonorgestrel-releasing intrauterine device known as Mirena IUD(r) (20mcg/24h) is nowadays considered among the leading resources in the treatment of heavy menstrual bleeding. Nonetheless, due to either its effect o...
The levonorgestrel-releasing intrauterine device known as Mirena IUD(r) (20mcg/24h) is nowadays considered among the leading resources in the treatment of heavy menstrual bleeding. Nonetheless, due to either its effect of prevention of conception and especially to the possibility that it may also have an anti-implantation effect, there is a founded concern on whether its therapeutic use may be ethically licit. This article engages in an exhaustive literature review in order to ascertain the mechanism of action of Mirena(r) IUD, in view of an ethical evaluation of its therapeutic use, keeping in mind those two unwanted effects. According to the most recent bibliography, the modification of the cervical mucus in patients carrying Mirena(r) IUD seems to consistently impede the spermatozoa penetration through the cervix, thus keeping down the probability of conception. Therefore, the likelihood of inducing an embryonic loss that can be ascribed to the device seems to be virtually nil. Given that there are no therapeutic alternatives that respect fertility as they address the pathology once the first-line treatments have failed, the prevention of fertilization effect of Mirena(r) IUD may be judged as ethically acceptable. Moreover one cannot conclude that the embryonic loss that might aggravate the moral evaluation of its use actually takes place.
[Communication of the Diagnosis of Down Syndrome: Mother's Stories].
Vargas Aldecoa T, Martin Conty JL, Conty Serrano RM … +1 more , Fernández Pérez C
Cuad Bioet · 2018 · PMID 29777603
The article studies the way in which health professionals communicate the diagnosis of Down syndrome to parents. For that the personal stories of the mothers collected in the answers given by them to the open questions o...
The article studies the way in which health professionals communicate the diagnosis of Down syndrome to parents. For that the personal stories of the mothers collected in the answers given by them to the open questions of a questionnaire on ″communication of the diagnosis″ are analyzed. The results show the mothers' dissatisfaction with the information received during the prenatal and postnatal diagnosis of Down síndrome.
[Suspension of Respiratory Support in Patients with Amyotrophic Lateral Sclerosis].
Silberberg AA, Robetto J, Achával M
Cuad Bioet · 2018 · PMID 29777602
Decision making in advanced Amyotrophic Lateral Sclerosis (ALS) patients keeps on being a controversial issue. The aim of this work is to discuss ethical implications of withdrawing respiratory support treatment in patie...
Decision making in advanced Amyotrophic Lateral Sclerosis (ALS) patients keeps on being a controversial issue. The aim of this work is to discuss ethical implications of withdrawing respiratory support treatment in patients with ALS. Through a bibliographic search on Pubmed database (2010-2016) we investigated whether or not the use of Non-Invasive Ventilation (NIV) and Mechanical Ventilation (MV) would increase survival and quality of life. We included 38 review articles. From these papers, results and ethical implications of initiating and mainly withdrawing respiratory support were analyzed. Survival time increased with NIV and with MV. Quality of life, above all according to physiological criteria, improved with NIV but regarding MV it remained controversial. Implementation and future withdrawal of MV seemed open to medical and ethical discussion. From a perspective of the intrinsic dignity of every human being, whatever its quality of life was, and knowing that no effective therapies for the underlying disease are available, the decision to remove MV in a patient with advanced ALS requires: knowledge of the will of the patient and, above all, evaluating whether this respiratory support measure is becoming objectively disproportionate.
[Informed Consent: Something Unresolved in the Penitentiary Setting].
García Guerrero J
Cuad Bioet · 2018 · PMID 29777601
INTRODUCTION: The exercise of Informed Consent within the penitentiary environment contradicts the ordinary exercise of the same towards the rest of the population. METHODOLOGY: review of legal regulations and constituti...
INTRODUCTION: The exercise of Informed Consent within the penitentiary environment contradicts the ordinary exercise of the same towards the rest of the population. METHODOLOGY: review of legal regulations and constitutional doctrine on IC. Review of the judicial outcomes when a prisoner refuses medical treatment. RESULTS: Normative on IC (Ley 41/2002 y Convenio de Oviedo, Spanish legal framework): with the exception of cases in which IC cannot be taken or under the risk of causong damage to third parties, competent and capable persons can decide over their life and health, and such decisions need to be respected. Biomedical Research Law: no mention of prisons. Penitentiary normative on IC (Ley 1/1979, orgánica, general penitenciaria, Reglamento Penitenciario, Spanish legal framework): the Administration must veil over prisoners' life and health. Constitutional Doctrine: Constitutional Court Sentence (STC) 120/1990; 137/1990 and 11/1991 (Spanish legal framework): constitutional legitimacy to apply forcible feeding on a hunger striker is provisioned as it is compared to medical treatment; justified due to the need to preserve the higher good of human life. STC 37/2011: IC is inherent to the fundamental right to physical integrity. Judicial resolutions: authorisation of forcible medical treatment over a prisoner if, under medical criteria, his life or health are at stake. CONCLUSIONS: limitations over prisoners' rights concerning IC are applied in extreme cases in which his/her life or health are threatened. This practice unveils judicial mandates infringing upon the fundamental and constitutional right to physical integrity, and upon the common legislation on IC.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe