Medicina e Morale最新文献

{"title":"Shared Care Planning for a pregnant patient with uveal melanoma treated with interventional radiotherapy (brachytherapy)","authors":"Salvatore Simone Masilla, B. Fionda, E. Placidi, M. Pagliara, Aniello Viscido, M. Blasi, Barbara Corsano, L. Tagliaferri, A. G. Spagnolo","doi":"10.4081/mem.2024.1299","DOIUrl":"https://doi.org/10.4081/mem.2024.1299","url":null,"abstract":"Introduction: Uveal melanoma (UM) is the most prevalent primary intraocular tumor in adulthood, with an important risk of metastasis, notably to the liver, rendering standard chemotherapy ineffective. Cases of UM onset during pregnancy are rare but can exhibit accelerated tumor growth. For these cases the best conservative treatment is interventional radiotherapy (IRT) also known as brachytherapy (BT). It is a form of radiotherapy that demonstrates efficacy comparable to the more common enucleation, while mitigating any risks of intrauterine toxicity. Objective: We reported the case of M., a 39-year-old pregnant patient, diagnosed with UM and undergoing brachytherapy treatment. Our aim is to make pertinent ethical considerations about: a. The ethical and clinical approach favouring a treatment strategy that preserves the affected organ and its functionality, b. The advance care planning process conducted within a multidisciplinary team. Case discussion: With the objective of preserving the mother’s health and ensuring the protection of the foetus, the team unanimously agreed, through a collaborative decision-making process, to proceed with the viable brachytherapy intervention. This approach results in a lower burden and maximizes benefits for both the patient and the unborn child. Conclusions: Considering a holistic evaluation, especially considering the patient’s pregnancy, the multidisciplinary approach proves fundamental. Collaboration between bioethicists and health-care professionals facilitated the development of a shared document for healthcare ethics planning, expressing the team’s ethical-clinical considerations.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediterranean Bioethics in the bioethically lessknown Mediterranean: a struggle for identity","authors":"Robert Doričić, T. Buterin, Igor Eterović, Marianna Gensabella Furnari, Maria Laura Giacobello, Josip Guć, Eleni Kalokairinou, Željko Kaluđerović, I. Rinčić, Tijana Trako Poljak, Ivana Tutić Grokša, Miltiadis Vantsos, Ivana Zagorac, A. Muzur","doi":"10.4081/mem.2024.1297","DOIUrl":"https://doi.org/10.4081/mem.2024.1297","url":null,"abstract":"Primarly as a reponse to mainstream bioethics – the one narrowed-down to issues related to medical ethics and research – various kinds of regional bioethics have emerged in an attempt to incoporate values other than those typical for the Anglo-Saxon culture. Among the most promising ones, the Mediterranean Bioethics, reflecting all the colorfulness of the Mediterranean microcosm and an expanded interest to the entire bios (faithful to the original ideas of Fritz Jahr and Van Renssealer Potter), has found its footholds particularly in Spain, Italy, Croatia, and Greece. Leaving aside those four countries with abundant literature and well-known contributions to the general history of bioethics, we wish to direct attention to other cultures and countries of the Mediterranean region, revealing a more complex struggle for identity.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":"5 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico-legal and bioethical controversies of the use of puberty blockers in adolescents with gender dysphoria: a comparative perspective between Italy and Spain","authors":"F. Gibelli, Paolo Bailo, A. Caraffa, José López Guzmán, Giovanna Ricci","doi":"10.4081/mem.2024.1294","DOIUrl":"https://doi.org/10.4081/mem.2024.1294","url":null,"abstract":"Background: the administration of puberty blockers to adolescents with gender dysphoria has ignited significant bioethical controversy, especially in light of recent legislative changes in the United States, Australia and several European states, especially the UK, which in March 2024 permanently banned the administration of puberty blockers to children. Italy and Spain, with their distinct legal, cultural, and medical approaches to treating gender dysphoria in minors, serve as focal points for examining these complex issues. Aims: this article aims to explore the bioethical and medico-legal implications of using puberty blockers in adolescents with gender dysphoria, focusing on the regulatory frameworks in Italy and Spain. It seeks to contribute to the international dialogue on best practices for supporting adolescents with gender dysphoria by comparing these two countries’ approaches. Discussion: in recent years in many European states there has been an important evolution in the position on hormone blockade therapy for minors with gender dysphoria, having gone from open policies on puberty blockade treatment to decidedly more restrictive positions. In Italy, the debate on the legitimacy of authorising treatment has been lively for several years, and in the last year has become even more intense due to the decisions taken by countries such as Finland, Sweden, Norway and the United Kingdom. In Spain, a landmark law on trans rights was passed in 2023, but it did not directly regulate hormone-blocking treatment in adolescents with gender dysphoria, which only made an already intense debate even more heated. Conclusion: it is essential to recognise the complexity of gender identity in adolescents and adopt an inclusive approach that considers medical, legal, ethical and social implications. The dynamic nature of the debate on the use of puberty blockers requires ongoing international dialogue. Policy analysis from Italy and Spain can inform best practice globally, promoting inclusive guidelines that prioritise adolescent welfare by addressing the complex bioethical, medico-legal and scientific issues related to the use of puberty blockers.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":"28 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The international protection of the embryo and fetus","authors":"Michelangela Scalabrino Spadea","doi":"10.4081/mem.1989.1288","DOIUrl":"https://doi.org/10.4081/mem.1989.1288","url":null,"abstract":"The Parliamentary Assembly of the Council of Europe recently returned to the issue of the legal protection of human embryos and fetuses. As twice before in the recent past, the collaboration of the Committees on Science and Technology, Social Problems, Health and Family, and Legal Affairs resulted in a recommendation, which stands as a further step in identifying the basic principles of the future domestic and international regulation of intrauterine life.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":" 588","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The medicalization of social problems: The case of Brazil","authors":"Michel Schooyans","doi":"10.4081/mem.1989.1289","DOIUrl":"https://doi.org/10.4081/mem.1989.1289","url":null,"abstract":"Not available","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identity and status of the human embryo","authors":"Comitato Direttivo del Centro di Bioetica della Università Cattolica","doi":"10.4081/mem.1989.1285","DOIUrl":"https://doi.org/10.4081/mem.1989.1285","url":null,"abstract":"The Steering Committee of the Center for Bioethics of the Catholic University of the Sacred Heart, composed of twenty specialists, university professors, of biome- dical, philosophical and juridical disciplines, has deepened during numerous meetings, the theme of the identity and status of the human embryo, following the publication of the Instruction “Donum Vitae” of 22.2.1987 and in view of the numerous studies and debates being carried out by scholars and specialists in every country. At the meeting of14.4.1989, the text that we are publishing on behalf of and by man- given by the Committee itself was approved. This text, made public on22.6.1989, necessarily syn- tetic will be taken up with more analytical studies in our own journal or in subsequent publications.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":" 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141827720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human rights and medicine","authors":"E. Sgreccia","doi":"10.4081/mem.1989.1264","DOIUrl":"https://doi.org/10.4081/mem.1989.1264","url":null,"abstract":"Not available.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":"55 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioethical aspects of alcoholism","authors":"Enrico Tempesta, Ermelinda Zeppetelli","doi":"10.4081/mem.1989.1267","DOIUrl":"https://doi.org/10.4081/mem.1989.1267","url":null,"abstract":"Alcoholism represents one of the major clinical and public health problems in the world and especially in states with higher socio-economic development, where the importance and severity of the problems posed both at the level of the individual and the community. The problems are therefore enormous, yet it is only in recent years that the search for the most appropriate means of combating the phenomenon has been forced upon us. Committed more seriously to directly addressing alcoholism rather than its many consequences.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":"81 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141647335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human rights and bioethical indications in the prescription of psychotropic drugs","authors":"E. Sgreccia","doi":"10.4081/mem.1989.1265","DOIUrl":"https://doi.org/10.4081/mem.1989.1265","url":null,"abstract":"Every medical intervention, or more generally every medical activity, has two purposes or ethical reference values, to be protected simultaneously (they could be compared to the DNA double helix found in every cell): a) the objective value that consists of the life and health of the citizen-patient; b) the subjective value that consists of respect for the freedom-responsibility of the subject or subjects involved in the medical act. This value, considered from the patient's side, is defined as the right to consent.","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La qualità della vita","authors":"E. Sgreccia","doi":"10.4081/mem.1989.1277","DOIUrl":"https://doi.org/10.4081/mem.1989.1277","url":null,"abstract":"\u0000 \u0000 \u0000Questa espressione \"la cultura della vita\" sta diventando un incoraggiante messaggio, carico di orientamenti etici e spirituali, ed anche di programmi operativi. È un'espressione che è diventata centrale e \"sintetica\" all'interno dei lavori e delle proposte del recente convegno della Chiesa Italiana \"A servizio della vita umana\". Ma è anche un 'espressione che viene assunta con un significato diverso dagli ecologisti e ambientalisti e infine nell'ambito delle scienze biomediche e sociali per le quali la espressione viene messa in relazione con l'altra non meno carica di suggestione \"la qualità di vita\". \u0000 \u0000 \u0000","PeriodicalId":36708,"journal":{"name":"Medicina e Morale","volume":"34 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141645423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}