{"title":"[The prenatal maternal representations in primiparous women with unplanned pregnancies].","authors":"Vania Andrea Barriga Torres","doi":"10.30444/CB.166","DOIUrl":"https://doi.org/10.30444/CB.166","url":null,"abstract":"<p><p>This paper analyses the prenatal representations on motherhood of 15 Spanish primiparous women who were in the dilemma of whether or not to continue with their pregnancies. Based on a qualitative methodological approach, semi-structured interviews were carried out which included in their design theoretical approaches of the so-called Maternal Constellation of Daniel Stern (1997). Through a content analysis of the interviews, an absence of mental representations of the baby in terms of both physical and characterological appearance was found in the sample, possibly due to the emotional impact generated by the news of the pregnancy. This absence of representations of the baby would reveal the importance of support and/or accompaniment by social and health care providers. It would also reveal the importance of the law in force maintaining the time for reflection, which, implemented with personalised, face-to-face and verbal counselling, would allow women who find themselves in this situation to choose freely, by providing them with all the information on alternatives for continuing their pregnancy with support and accompaniment.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"35 113","pages":"59-69"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909445","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":"[Health care for trans people: a bioethical reflection].","authors":"José López Guzmán","doi":"10.30444/CB.159","DOIUrl":"10.30444/CB.159","url":null,"abstract":"<p><p>Health care for trans people has not been among the priorities of Bioethics, so that in most of the manuals of this discipline there is no reference to this issue, or it is covered in a rather simple or measured way. However, it is necessary to note that in the last decade the bioethical debate, on gender issues in general and on transsexualism in particular, has increased significantly. This work seeks to offer the transsexual person, the health professional or the student on the trans topic tools to articulate their particular bioethical reflection. It has two clearly differentiated parts. In the first, the aspects that are considered necessary to consider when assessing the ethics of a gender change intervention are presented. In the second part, a reflection is offered on the lines of argument that support the different bioethical currents..</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"34 112","pages":"309-324"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399693","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 principles of bioethics in teaching: difficulties and proposal].","authors":"Antonio Pardo Caballos","doi":"10.30444/CB.158","DOIUrl":"10.30444/CB.158","url":null,"abstract":"<p><p>It is common base the teaching of bioethics on the learning of the principles of autonomy, beneficence, non-maleficence and justice, widely used today. In terms of ethical practice, these principles suffer from a notable inadequacy, leaving aside their ambiguity and other problems. Nevertheless, as a teaching method, they show a special incongruity, for several reasons: a) little adequacy of the terms to the concepts that want to be expressed, b) formalism that hinders the approach to reality, c) little adaptation to the needs of the student and d) be specialized terms in a field that should be fundamentally informative. These four limitations, which advise another approach in the teaching of bioethics, are examined in detail; a final reflection is provided on the difference between the principles of bioethics and ethics.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"34 112","pages":"297-308"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399694","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":"[Eugenic abortion: Between prenatal diagnosis and uninformed consent].","authors":"Ana Jiménez Moliner","doi":"10.30444/CB.157","DOIUrl":"10.30444/CB.157","url":null,"abstract":"<p><p>The so-called ″eugenic″ abortion has an extraordinary differential nuance compared to the other legally established modalities of abortion, which is specified in the way the woman's decision is formed, which is not prior, but a consequence of medical information received about the foetus; a decision, moreover, in which there is a clear ″discriminatory″ component, since the abortion is produced exclusively because of the disability of the foetus. This uniqueness requires attention to the context in which eugenic decisions are made, because they involve three fundamental elements which, depending on how they are made, may or may not lead to abortion: firstly, the opportunity to carry out certain prenatal tests in the absence of risk factors. Secondly, the enormous responsibility of health professionals in informing parents about the results of a prenatal test. Thirdly, the point of view of future parents, who should avoid a eugenic conception of parenthood, being aware that what is developing in the woman's womb is their son or daughter, not a generic embryo affected by anomalies; and that a son or daughter is a personal reality,beyond his o her capabilities. The paper addresses these three issues, which make eugenic abortion a discriminatory and avoidable practice, since the aim is not to prevent the woman's decision to abort, but to endorse her primary decision to continue with the pregnancy on the basis of a positive, non-eugenic view of disability.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"34 112","pages":"279-295"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399691","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}
Álvaro Sanz Rubiales, María Luisa Del Valle Rivero, Francisco Barón Duarte, Elvira Morán Cuadrado, Paula Molina Terrón, Luis Alberto Flores Pérez
{"title":"[25 Years from Di Bella affair: what ethical lessons does it leave us?]","authors":"Álvaro Sanz Rubiales, María Luisa Del Valle Rivero, Francisco Barón Duarte, Elvira Morán Cuadrado, Paula Molina Terrón, Luis Alberto Flores Pérez","doi":"10.30444/CB.156","DOIUrl":"10.30444/CB.156","url":null,"abstract":"<p><p>Twenty-five years ago, in 1998, the Italian Parliament approved to implement clinical trials in patients with advanced cancer to know the efficacy of an alternative cancer treatment that associated hormones, vitamins and, occasionally, chemotherapy proposed by Professor Luigi Di Bella. It was the answer to people demanding Public Health assume the cost of this therapy. Although parallel phase II trials in various tumors demonstrated the lack of activity, some professionals have continued to use this method since then and have published apparently promising results a few various scientific journals. This real example raises three interesting ethical scenarios. The first one is the ethics of alternative treatments proposed by medical professionals or from the academic field. In these cases, the difficulty in differentiating between hypothesis and real efficacy. This problem impacts on patients and relatives' expectations who must face a potentially fatal disease with little or no hope of a cure with traditional treatments. The second scenario is the design and good practice in the development of clinical trials, which was also the subject of debate in relation to the Di Bella method. And the last one, the ethics of scientific publications. Di Bella's followers published since 2000 12 papers with limited quality on series of patients treated with his method, the majority in a pay-per-publication journal of which Giuseppe Di Bella, son of Professor Di Bella, is included in the board of editors.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"34 112","pages":"269-278"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399690","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":"[Euthanasia: a wrong solution to an unrecognized problem?]","authors":"María Dolores Calabria Gallego","doi":"10.30444/CB.160","DOIUrl":"10.30444/CB.160","url":null,"abstract":"<p><p>Organic Law 3/2021, of March 24, regulating euthanasia, has intensified a harsh debate. A priori, it is a conflict of bioethical values and a different anthropological vision between the different parties, however, we must not forget that perhaps before considering any debate, it is necessary to correctly interpret what the patient really wants when he states that he wants to die. In our health system and in our society, there are certain traits and needs of the person that are ignored, and that urgently require attention for the patient. Discovering the meaning of one's life, considering human transcendence, finding personal order and being able to experience love are vital elements of life, which at such a critical moment as high-grade suffering or imminent death, require all the attention of the health personnel. All this can contrast sharply with the values of our society, not dedicating adequate attention to it, among other reasons, due to the effort involved in carrying out comprehensive care of this type, thus making it much easier to carry out the procedures required by law regulation of euthanasia than addressing such intimate deficiencies of the being, despite the fact that these may be the real problem of the patient, who in his dramatic experience asks for help.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"34 112","pages":"325-330"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399692","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":"[XIV International Congress of the Spanish Association of Bioethics and Medical Ethics (AEBI) held in Madrid on October 27 and 28, 2023].","authors":"","doi":"10.30444/CB.161","DOIUrl":"10.30444/CB.161","url":null,"abstract":"","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"34 112","pages":"331-374"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399695","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}
Álvaro Sanz, Francisco Barón, María Luisa Del Valle
{"title":"[Informed consent in shared processes].","authors":"Álvaro Sanz, Francisco Barón, María Luisa Del Valle","doi":"10.30444/CB.120","DOIUrl":"https://doi.org/10.30444/CB.120","url":null,"abstract":"<p><p>Nowadays, medicine tends towards specialization. But there are also more shared or interdisciplinary processes in which professionals request some type of technique or a diagnostic or therapeutic procedure that must performed by another specialist. In this scenario that involves different professionals, it is reasonable a certain debate about which of them should obtain the informed consent of the patient. The first error would be to pose this process as a confrontation between professionals who derive or delegate their own responsibilities to another. It is, on the contrary, a teamwork and not a mere delegation of duties. On the one hand, it should be the doctor who carries out the technique and, therefore, knows it best as a procedure and is an expert in the early diagnosis and management of side effects, who should inform about the procedure and its risks. And, therefore, it is his duty to obtain the appropriate informed consent. And, since everything is understood as a shared process, it would also be advisable that the physician in charge of the care and follow-up of the patient, and who has taken the initiative to request this technique, had already provided basic information, more focused on the reason for the indication, and that a pre-consent had been obtained, that is a prior elementary verbal consent of acceptance or, at least, of non-rejection. And it would be convenient to record this information in the medical record as well.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"33 108","pages":"149-156"},"PeriodicalIF":0.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40192827","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}
Rodolfo Morales Mato, Elizabeth Díaz Mederos, Javier María Lluna González
{"title":"[Bioethical aspects in the safety of cardiovascular surgery patients and their renal protection. Systematic review].","authors":"Rodolfo Morales Mato, Elizabeth Díaz Mederos, Javier María Lluna González","doi":"10.30444/CB.123","DOIUrl":"https://doi.org/10.30444/CB.123","url":null,"abstract":"<p><p>Renal dysfunction is common and can be severe in patients requiring cardiac surgery. There is currently a growing international interest in the declaration of Safe Health Units, around the safety of the surgical patient. This interest is influenced at the same time by utilitarianism and the defense of the great value of human life. The general objective was to analyze, from the bioethics of health care and the contents of surgical patient safety, acute kidney injury associated with cardiac surgery. A systematic review was carried out using the PRISMA methodology in PubMed databases with articles published in the last five years. The pathophysiology of the entity studied is complex and still poorly understood. In this period, there was a great interest in investigating acute kidney injury associated with cardiac surgery, however, no other studies were found that addressed this issue from a personalist bioethical approach. High scientific quality and methodological rigor were found in the included studies, assessed by the predominance of systematic reviews, meta-analyses, and multicenter, randomized, double-blind controlled studies. An interesting and novel field is initiated, which facilitates, from perspectives with a comprehensive and more humane assessment, decision-making on acute kidney injury associated with cardiac surgery.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"33 108","pages":"191-201"},"PeriodicalIF":0.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40192830","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":"Sex, sport and doping: conflicts for bioethical analysis.","authors":"Julio Tudela","doi":"10.30444/CB.125","DOIUrl":"https://doi.org/10.30444/CB.125","url":null,"abstract":"<p><p>It seems beyond doubt that the practice of certain sports requires gender differentiation, given the sexlinked characteristics that determine different levels of performance and skills. Moreover, there is a consensus on condemning doping practices, such as attempts to artificially alter the physical performance of athletes through the use of certain substances, because they involve tampering with the physical or mental conditions of the persons involved, as well as practices that have health risks, with consequences that can become serious and irreversible. In the case of ″trans″ athletes, their genetics, physiology, and endocrine system, responsible for typically male testosterone levels, would provide an insurmountable barrier to their eligibility in female athletic competition. However, the case of athletes diagnosed with Disorders of Sex Development does not fit into any of the above scenarios. They are biologically women and competes in the female category. They have not taken any anabolic substances that may be considered doping. We propose a bioethical evaluation of these cases.</p>","PeriodicalId":42510,"journal":{"name":"Cuadernos de Bioetica","volume":"33 108","pages":"213-217"},"PeriodicalIF":0.5,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40193841","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}