Now showing items 1-20 of 785

    • Ethical Dilemmas and Principles in Organ Transplantation in China

      Zhang, Zhen; Zang, Zheng (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-10-01)
      Abstract In medical clinical practice, organ transplantation is mainly applied to patients with end-stage organ lesions and organ failure. However, with the development of organ transplantation, many ethical issues and controversies have arisen. From the perspective of bioethics, the article compares the relevant ethical and legal regulations of organ transplantation in various countries. Due to the complexity of the real situation, many ethical dilemmas arise in organ transplantation in China. The article analyzes and researches three aspects of organ donation, distribution, and trading, and finds that there are various ethical problems in these three aspects of organ transplantation in China, such as whether the principle of presumed consent is ethical, whether brain death is legalized, the selection and determination of transplant patients, and whether human organ trading is legalized, etc. With the help of the four principles of bioethics and the current development of organ transplantation in China, the article proposes that organ transplantation in China should follow four ethical principles: the principle of respect for life, the principle of do no harm/benefit, the principle of respect for autonomy, and the principle of justice, in order to provide a defense for the legitimacy of organ transplantation.
    • Legislation for disabled people in Brazil. From human dignity to social inclusion. Advancing capabilities as an ethical imperative

      Nascimento das Mercês Rocha, Rosylane; Cruz Bezerra, Josierton; Cortes Fernandes, Francisco; Correia, Mónica; Nunes, Rui (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-10-01)
      Abstract The study analyzes the ethical and legal basis of Brazilian legislation for people with disabilities and verifies whether the instruments used therein are in line with national and international law. It also investigates the coherence and cohesion of the law and its ethical norms to build an inclusive and just society. Through an exploratory and integrative review, it analyzed the legal provisions in force in Brazil published on the official websites of the Brazilian federal government and available on the Internet. It was evaluated whether the definition used for persons with disabilities follows the United Nations Convention on the Rights of Persons with Disabilities. Also, whether it is necessary to evaluate disabilities and who should perform this task professionally. Thirty-three legal norms were found, among which only three laws and two decrees are in line with the recommendations of the UN Convention. It is necessary to review the existing norms and promote the consolidation of laws, decrees, ordinances and normative instructions regarding the rights of persons with disabilities in a uniform manner, on an adequate technical-scientific basis. This review should be consistent with the provisions of the 1988 Federal Constitution, the International Convention on the Rights of Persons with Disabilities and the Brazilian Inclusion Law.
    • Views of University Students on Death Anxiety and Near-Death Treatments

      DEĞİRMEN, Nuriye (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-10-01)
      Abstract The study was planned to evaluate the views of university students about death anxiety and near-death treatments. Between October and December 2018, the Andel Khalek death anxiety scale and the survey questions were applied to 742 university students. 66% of the participants are female. The Cronbach Alpha values of the dimensions were found to be 0.909 for fear of dead body cemetery, 0.820 for fear of terminal illness, and 0.724 for fear of post-mortem. The death anxiety score of women was higher than that of men. The majority of the participants stated that death was associated with distressing social conditions and psychological problems. They are undecided about the usefulness of drug treatments and individual autonomy. A relationship was found between these statements and the death anxiety scale dimension scores. The majority of them stated that there should be qualified treatments, the importance of providing economic opportunities, and that gender discrimination should not be made. In the study, it was concluded that university students have death anxiety and are sensitive to end-of-life treatments. It is suggested that their anxiety can be reduced with health education, improvement of social conditions and psychological support.
    • Enhancing John Rawls’s theory of justice to cover health and social determinants of health

      Ekmekci, Perihan Elif; Arda, Berna (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2015-11-01)
      The vast improvements in medical technology reviled the crucial role of social determinants of health for the etiology, prevalence and prognosis of diseases. This changed the content of the right to health concept from a demand of health services, to a claim of having access to all social determinants of health. Thus, the just allocation of scarce resources of health and social determinants of health became an issue of ethical theories. John Rawls developed a theory of justice. His theory suggests that the principles of justice should be determined by individuals in a hypothetic initial position. In the initial position, individuals agree on principles of justice. Rawls puts forth that the institutions of the society should be structured in compliance with these principles to reach a fair social system. Although Rawls did not justify right to health in his theory, the efforts to enlarge the theory to cover right to health flourished quite fast. In this paper first the basic components of Rawls theory is explained. Then the most outstanding approaches to enlarge his theory to cover right to health is introduced and discussed within the discourse of Rawls theory of justice.
    • The Right to Be Forgotten versus the Right to Disclosure of Gamete Donors’ ID: Ethical and Legal Considerations

      Correia, Mónica; Rego, Guilhermina; Nunes, Rui (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Abstract: 15. The anonymity of gamete donors in the context of medically-assisted reproduction techniques (ART) and the right of the offspring to know their genetic or biological parents’ identity is a controversial and widely debated topic in the scientific literature. The positions on the issue in each country are different. Sometimes they are in opposition to each other even in countries with strong similarities, such as those in the European Union (EU), in the framework of shared ethical values. Although some countries still enshrine the rule of anonymity, there is an undeniable tendency to guarantee the right to know one’s origins by creating relevant exceptions or abolishing donor anonymity status altogether. 16. This article offers ethical and legal considerations of whether the so-called ‘right to be forgotten’ (RTBF) could be extended to include gamete donors’ right to remain anonymous. This perspective goes against the general trend, certainly in Europe, of recognizing that offspring born from donor gametes have a right to access information relating to their genetic progenitors. The novel addition is to question whether the General Data Protection Regulation (GDPR) might provide fertile ground for questioning this approach, and effectively support those jurisdictions where anonymity is still possible.
    • Challenges and Opportunities in Clinical Ethics with the Implementation of Korea’s End-of-Life Act

      Junga-Kim, Claire (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2019-12-01)
      Abstract: This paper examines the possible impacts of the Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life in Korea (Korea’s end-of-life act), legislated in 2016, on the development of hospital ethics committees and clinical ethics consultation services in South Korea. Clinical ethics in Korea has not made much progress in comparison to other subdisciplines of biomedical ethics. While the enactment of this law may give rise to beneficial clinical ethics services, it is possible that customary practices and traditional authorities in Korean society will come into conflict with the norms of clinical ethics. This paper examines how the three main agents of Korean society—family, government, and medical professionals—may clash with end-of-life stage norms in clinical ethics, thus posing obstacles to the development of hospital committees and consultation services. A brief outline of what lies ahead for the progress of clinical ethics practice is explored.
    • Tensiones en torno a la inclusión de personas con el diagnóstico de demencia en investigación científica

      Gajardo Jauregui, Jean; Aravena, José Miguel (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2017-07-01)
      Resumen: La demencia -Trastorno Neurocognitivo Mayor- se caracteriza por deterioro cognitivo adquirido y otros síntomas psicológicos y conductuales que impactan en la capacidad de la persona para responder efectivamente a las demandas del ambiente. El número de personas con demencia aumenta de forma consistente en el mundo, volviéndose una prioridad para la salud pública y elevando la urgencia de contar con estrategias para enfrentar su impacto. La investigación científica biomédica, clínica y psicosocial es fundamental en toda estrategia de abordaje de la demencia. Este artículo sintetiza elementos relacionados con la inclusión de personas con demencia en investigación científica desde diferentes perspectivas, incluyendo el impacto del déficit cognitivo y la jurisprudencia local. Entre los dilemas bioéticos vinculados a investigación en demencia se encuentra la evaluación de capacidad de consentimiento. Las leyes 20.120 y 20.584 levantan controversias en el caso de la discapacidad, atingentes a la participación de personas con demencia en investigación científica. El presente manuscrito busca aportar una síntesis de elementos clave para el análisis de la participación de personas con demencia en investigación científica.
    • Bioethical debate regarding gyms’ need for medical certificates for amateur sportsmen

      Palhares, Dario; Squinca, Flávia; Rodrigues, Antônio Carlos (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2016-06-01)
      Sports Medicine comprises two branches: one, related to professional athletes and the other, related to the general population vis a vis sports and physical activity. The bioethical conflicts involving professional athletes are different from those of amateur practitioners. There is a constant deliberation related to the requirement of medical evaluation before admission to a gym. There are regional laws that make the medical certificate an obligatory document. It is observed that in the creation of these laws, the arguments are guided by a way to transfer responsibility from the gym to the physician who has attended the client. In a sense, the laws that indiscriminately require medical certificates subvert the ethics of the medical practice because the medical officer is not capable to assure that a given patient has no medical issue; instead the medical work is to try to identify the cause to a complaint. The gyms provide clients with orientation and supervision by providing them with qualified professionals. Although the need for medical certificates for everybody is unethical, a detailed medical evaluation is needed for gym clients who may present clinical manifestations during exercise or have some specific clinical conditions.
    • Evaluation of moral intelligence of healthcare professionals via the “Survey for Measuring Moral Intelligence in the Provision of Healthcare Services”

      Ozturk, Hulya; Sayligil, Omur; Yildiz, Zeki (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Abstract: Moral intelligence -through which an individual makes mental evaluation before taking action about a decision- is important in individual-centered healthcare. Using Lawshe Method, we designed the “Survey for Measuring Moral Intelligence in the Provision of Healthcare Services” with “equality”, “empathy”, “moral intelligence”, “justice”, “tolerance”, “self-control”, and “politeness” dimensions (α=.966). Age of the population (physicians and nurses) was 36.44±9.52, consisting 517 (65.5%) women, 538 married participants, 653 employed in public hospitals, and 352 had work experience of
    • “Brain death”, autonomy, and the future of organ transplantation

      Iftime, Oana (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2019-06-01)
      Abstract: Autonomy and its companion, informed consent is regarded as fundamental in contemporary medical ethics. Still, the individuals are deprived of the possibility to make a genuinely informed choice with respect to organ donation in the event of “brain death”. It can be easily argued, scientifically speaking, that the status of the “brain dead” patients is that of living beings, able to process nutrients and drugs and even to harbour and nourish their progeny into the womb. A philosophical, not scientific distinction between the “un-meaningful” lives of the “brain dead” and “meaningful” human life underlines the “brain death” concept. Yet, the public is told that the “brain dead” are dead, i. e. lacking life. Not only that this situation collides with the principle of autonomy, but it also poses a risk for public trust in organ transplantation. It is obvious that people have certain expectancies from health care professionals and the decision makers, and finding out about such inconsistences might drive the public reject organ transplantation, with the recourse to the “brain death” concept ultimately leading to the aggravation of the organ shortage, instead of the alleviation that it was expected to bring.
    • Preclinical Students’ Views on Medical Ethics Education: A Focus Group Study in Turkey

      Can Bilgin, Ahmet; Timbil, Sevgi; Huseyin Guvercin, Cemal; Ozan, Sema; Semin, Semih (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2018-06-01)
      Abstract: 18. Aim: We aimed to receive the opinions of the preclinical medical students on medical ethics education, and to present some suggestions for the education program. Methods: Focus group discussions were held with third-grade medical students. The analyses were implemented using Creswell’s six-step qualitative data analysis. Results: During the data analysis, themes with the following titles were identified: necessity of the education, content, education methods, assessment, participation, contribution of the education, moving to clinical training and suggestions. Discussion: The students stated that the discussions on movies/books/case-based scenarios are more useful than lectures. Although they believed that student assessment was necessary for the medical ethics education, they had negative attitudes towards Multiple Choice Questions. At the stage of moving to the clinical training, their feelings and thoughts about the learning outcomes they would gain from ethical education were contradictory. Conclusion: Each theme and code obtained from the students’ expressions may contribute to improving medical ethics education for all institutions. Besides student education, it is also necessary the faculty development programs on medical ethics education for clinical teachers. Additionally, further studies can be conducted on the actions that need to be taken to help students internalize the ethical issues and feel the need of learning more.
    • “Lo ético es transversal y cotidiano”: dimensiones éticas en la formación y práctica en psicología comunitaria

      Winkler, María Inés; Alvear, Katherine; Olivares, Bárbara; Pasmanik, Diana (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2012-11-30)
      La psicología comunitaria ha vivido grandes transformaciones asociadas al devenir histórico y contextual en nuestro país, comportando una serie de cuestiones éticas que no han sido abordadas ni en la formación ni en la deontología disciplinar. Objetivo de esta investigación fue indagar la percepción de estudiantes y profesionales respecto de la ética en la práctica y la formación en psicología comunitaria. Nuestros participantes fueron expertos chilenos, estudiantes en práctica y estudiantes de dos programas de Magíster en psicología comunitaria con tres fuentes de datos: panel Delphi (8 expertos), entrevistas en profundidad (7 maestrandos) y grupos focales (20 estudiantes en práctica comunitaria). Aplicando los principios de la teoría fundamentada empíricamente, el análisis de datos decantó en la identificación de cuatro temas: noción de lo ético, tipos de situaciones éticas, formación ética y deontología. Entre los resultados destaca el carácter, simultáneamente, “transversal y cotidiano” así como “vago” de la dimensión ética en el discurso de nuestros participantes. Frente a situaciones concretas, éstos identificaron principios éticos generales, verbalizados como Respeto por el Otro y Autonomía.
    • Prevalence and Quality of Informed Consent for Patients Undergoing Cosmetic Procedures: A Cross Sectional Study

      Saud Alsaidan,Mohammed; Abuyassin,Aisha H.; Alammar,Hanin S.; Hussien,Ghaiath (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Abstract: Background: Failure of the physician to disclose potential risks and benefits associated with cosmetic procedures is one of the main causes of legal disputes over informed consent. The objective was to assess the prevalence and quality of the informed consent given by patients who undergone cosmetic procedures and its association with post-procedure adverse events. Methods: It was a cross-sectional, online, questionnaire-based study conducted during September and October 2020. Eligible adult male and female patients who were attending a governmental dermatology clinic at Al-Kharj city (Saudi Arabia) were invited to join the study. Results: A total of 246 patients were included in the study. Out of 246, 111 (45.1%) patients performed at least one cosmetic procedure before, and 89 (80.2%) of them signed an informed consent. 62 (69.7%) of them signed a consent before the procedure, 17 (19.1%) reported post-procedure adverse events, 16 (18.0%) reported dissatisfactions, and 27 (30.3%) reported either. None of the consent characteristics were significantly associated with higher prevalence of post-procedure adverse events or non-satisfactions. Conclusions: The prevalence and the quality of informed consent before cosmetic procedures are inadequate. Urgent corrections are required to protect the patient’s rights and to legally protect the treating physician.
    • Ageísmo como fenómeno sociocultural invisible que afecta y excluye el cuidado de personas mayores

      Campillay-Campillay,Maggie; Calle-Carrasco,Ana; Rivas-Rivero,Edith; Pavéz-Lizarraga,Amaya; Dubó-Araya,Pablo; Araya-Galleguillos,Fabián (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Resumen: El ageísmo en la vejez se ha relacionado con el imaginario social, responsable de mantener prejuicios y estereotipos hacia personas mayores. Prevaleciendo como fenómeno común en países occidentalizados como Chile, replicando una imagen de vejez llena de carencias y deterioro corporal. Este artículo reflexiona sobre el fenómeno de ageísmo que promueve conductas que excluyen a las personas mayores de la vida en sociedad y del cuidado formal. Para ello, se contextualizará sobre los imaginarios que predominan en la sociedad chilena sobre la vejez, y que afectan transversalmente a la familia, las instituciones y las profesiones; en segundo lugar se describirán algunas teorías explicativas sobre el ageísmo para mayor comprensión del fenómeno y su impacto generacional, y finalmente, sobre el abandono inicial de las personas mayores durante la pandemia por Covid-19 resultado del ageísmo de Estado. Visibilizar este tema favorece el debate social informado y la promoción de nuevas políticas públicas en favor de inclusión de personas mayores.
    • Consentimiento informado en las prestaciones de salud

      Hernández Paulsen,Gabriel; Chahuán Zedan,Felipe (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Resumen: Por regla general, las prestaciones de salud requieren el consentimiento informado del paciente. Los fundamentos éticos detrás de esta exigencia son la autonomía del paciente para decidir sobre su propio cuerpo y el respeto a su dignidad, que impide instrumentalizarlo. La manera en que el ordenamiento jurídico materializa estos fines es consagrando deberes de información y de consejo, y disciplinando las condiciones bajo las cuales debe prestarse el consentimiento. Jurídicamente, estos deberes delimitan la relación médico-paciente y ayudan a definir hipótesis de responsabilidad civil. En este artículo se revisan las condiciones para la satisfacción de estos deberes, así como los supuestos en que su infracción pueden dar lugar a responsabilidad civil.
    • Desafíos bioéticos del DSM-5: ¿ruptura, recalibración o más de lo mismo?

      Figueroa,Gustavo (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Resumen: 11. 1] El DSM-5 representa la incorporación de la psiquiatría a la medicina basada en la evidencia. 2] La psiquiatría, propia de la intención, se transformó en la fundamentada en la validación empírica. 3] El DSM-5 es expresión de la ciencia moderna que da prioridad al saber calculador, objetivador, clasificador y operacional. 4] A la ética de la beneficencia, propia de la intención, se superpuso una ética de la autonomía y de la equidad, características de la validación. 5] El DSM-5 no puede determinar si los trastornos psiquiátricos son entidades naturales, tipos prácticos hechos por los investigadores, entes construidos socialmente, rótulos que se agrupan formando un sistema.
    • The Right to Be Forgotten and COVID-19: Privacy versus Public Interest

      Correia,Mónica; Rego,Guilhermina; Nunes,Rui (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Abstract: Recent studies highlight the importance of digital surveillance to gather individual health information due to the global pandemic caused by the new COVID-19 disease. This paper analyses its legal and ethical implications at the interface between the individual right to privacy and the collective interests of public health. We framed the discussion in law, deontology and utilitarianism. The lasted theories and human rights, especially privacy, are crucial in our argument. Health-derived dilemmas and efforts to solve them, especially by information technologies, bioethics and law, exist at these perspectives' interface. In particular, we analysed the intersection between autonomy, the right to privacy, and the so-called ‘right to be forgotten’ in the public health context. In other words, we studied the right to obtain from the controller the erasure of health data - a radical means of control over personal data established in Article 17 of the General Data Protection Regulation (GDPR). Given the lack of specifics regarding collection and re-use of such data under the broad scope of public health purposes, implied consent does not address the issue of proportionality. We highlight legal safeguards’ insufficiency, suggesting applying the ‘right to be forgotten’ according to an ethical interpretation.
    • Prison research: a bioethics or an ethics issue?

      Fanega,Manuel (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
      Abstract: The hypothesis of reducing aggressiveness through transcranial direct current stimulation was recently tested on a cohort of inmates in Spain. The experiment, including 1.5 mA electric shocks, was an external research initiative that received the initial acquiescence of the carceral system. An alarm was raised at the time the research was published, encouraging the directorate of prisons to stop the ongoing replication of the experiment. Nevertheless, no (bio)ethics committee, in the universities or among bioethics experts, has questioned the research. In this think piece, we aim to again discuss some ethical approaches to these clinical interventions on crime. After its positivistic period, the field of criminology has been questioning the simple psychobiological approach to crime because of the reductionistic view of this phenomenon and its harmful consequences. Thus, we address academic experimentation under prison governance and the “re” roles of prisons. We argue that the minor disadvantages of such research, if performed with consent, could be positive if the research can minimize the harmfulness of prison itself; thus, penitentiary treatment and science should go together. Prison administrations, in addition to their duty to protect the individuals under their control from ethically biased research, must promote reintegration. We conclude that human rights are over criminal policy and science and that ethics are over narrower bioethics.
    • Recensiones

      Agar Corbinos,Lorenzo (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)
    • “Translational humanities” y bioética como diálogo

      Lolas Stepke,Fernando (Centro Interdisciplinario de Estudios en Bioética, Universidad de Chile, 2021-06-01)