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PubMed2001

[Bioethical principles: are they applied in terminal illness situations?].

Comprehensive practice of biomedical ethics principles (beneficence, non-maleficence, autonomy and justice) would guarantee appropriate assistance to patients with terminal diseases. Unfortunately today, these principles aren't put into practice in a systematic way. In order to guarantee quality care to this particular group of patients, it is necessary that all health care professionals dealing with terminal illness receive a comprehensive education in bioethics matters and that an appropriate methodology is followed in order to resolve subsequent conflicts. Furthermore, public institutions should be involved so that Palliative Care Units provide assistance to the entire population rather than select cases. If we can't provide comprehensive care, we are working against the basic bioethics principles, especially the fundamental principle of justice.

Bioethical Issues↗
PubMedDate not supplied

[Bioethics and nursing praxis].

Bioethics is a discipline that has gained great relevance in today's world Changes in health care, advances in technology and science are giving hope to life, however they are also causing ethic conflicts. Patients are at risk of loosing their own right to live or die. Healthcare professionals are meant to deliver care, but also to protect the rights and the quality of life of the patients. As more and more people have recognized the importance of bioethics, ethic committees have sprung up in many healthcare settings. Continuing education programs on ethical principles and ethical decision/making models are critical. Nurses play an important role, they bridge the gap between the needs of individual patients and the healthcare system. They have a very close contact with the patients. Nurses have the ability to recognize moral problems as actual or potential conflicts in rights, duties or principles, and to take appropriate action to resolve the ethical issue.

Bioethical Issues↗
PubMed2000

Expanded practice: the nurse as bioethics consultant.

The field of bioethics is evolving in health care. Nurses, with their clinical knowledge and expertise, are prime candidates for the role of ethics consultant. Many educational programs are available throughout the country for study in the field of bioethics. Nurses functioning in this role will find it a stimulating and challenging experience.

Ethicists↗
PubMed2001

[Bioethics and andrology].

In the present article the Author examines the relationship between Andrology and Bioethics. He takes into consideration the historical context in which the two new disciplines were born. They are practically coeval, being both come to the light about at the 60th years of XXth Century. He analyses the clinical problems of the sexuality and some diagnostic and therapeutic potentialities of the Andrology in connection with the implications of moral order. After synthetically outlining the most diffuse Bioethics' theories, and later outlining a scheme of methodological approach, he reaches the conclusions inclining for a personalist vision of the moral problems and he is wishing a theoretical and practical attitude by Andrology specialist doctor in conformity with virtues' ethics.

Andrology↗
PubMedDate not supplied

[Bioethics, deontology, and law in neonatal intensive care].

Neonatal intensive care has greatly improved the survival chances but, at the same time, it has also given rise to serious ethical problems. Different contexts influence both physicians attitude and end-of-life practices in neonatology. The clinicians can not ever follow the principles of bioethics, as they are sometimes in conflict. Also, the strategies or guidelines proposed as approaches to neonatal decision-making are difficult to practise. Probably a neonatologist makes his decision even on the basis of his interior conviction and it is well known that in Italy the debate on bioethics is the subject of confrontation between Roman Catholic and secular viewpoint, expressing two positions: the so-called sanctity and the quality of life. However, a clinician has also an obligation to follow the Code of Professional Medical Ethics which cautions against therapeutic aggressiveness; but this document has not legal status. In addition, Italian law is strongly protective of infant life and any discrimination on the basis of malformation or poor prognosis violates constitutional law; moreover, the resuscitation of a preterm infant is mandatory even when the birth is the result of induced late abortion. The author concludes emphasizing the importance, in decision making, of accepting difference as opposed to the logic of the absoluteness of normality, because many handicaps may be accepted and a society expresses its moral richness also by the solidarity reserved to its weakest sons.

Bioethics↗
PubMedDate not supplied

[Analysis of Master theses in nursing under the spotlight of bioethics].

The goal of this study is to investigate the application of ethical principles in research with people in the master's thesis of students of the Nursery Master's Course at the Federal University of Ceará (UFC). The theoretical reference were the principles of Bioethics of benevolence/maleficence, autonomy and justice, the 196/96 resolution and Coren's Resolution 240/2000. It was concluded that students have always followed some basic ethical principles; researcher's conduct has not changed after the adoption of Resolution 196/96; in spite of obligatoriness of sending research projects to Ethics and Research Council (CEP); most of the researchers did not fulfill that requirement; the principle most approached in Bioethics was autonomy with emphasis on informed consent and secrecy.

Academic Dissertations as Topic↗
PubMed2003

[Bioethics and the Hippocratic oath].

Throughout the long centuries of medical activity, the Hippocratic Oath always had a distinguished place and role within the self definition of curative practice: it contains in a condensed form those ethical principles and moral norms that determine the doctors' behavior and their relationships with their patients and colleagues. The Hippocratic Oath is not the only oath but it is surely the best known and most famous one, that contains both timeless and age dependent norms. The ceremonial taking of the Oath is still a symbol of moral commitment for doctors. The millennia long adherence to the Oath perhaps suggests a timeless stature above all changes of society, but tracing its history, it becomes apparent that, though the text remained essentially the same, the interpretation is greatly influenced by the values and norms of the given age. Even so, the Oath's deontological, normative attribute has made it possible to fulfill its morally regulating role both of level of the profession and the individual, up to the middle of the 20. century. Today, however, classic, bipolar medicine has become complex and varied. Medicine and society have both undergone changes. Bioethics has appeared and become widely accepted. All this raises the question whether the Oath is still suitable for a modern statement of the moral identity of medical practitioners. Does it still have a compulsory force beyond keeping the tradition, and can its norms still be realized in practice? Both the study of texts used for the Oath in Hungarian universities, and the international proposal for modernization--together with the arguments that followed--indicate that if the traditional oath wishes to fulfill its function in the age of modern medicine, it has to adhere to the more up-to-date principles of bioethics, that better correlate with today's expectations.

Bioethics↗
PubMedDate not supplied

[Bioethics in Latin America: legal perspective].

The jurist's work is to detect the legal guiding principles, analize them and to anticipate what kind of acceptance they will have. The legislator must be prudent if the subject studied is changeable as it happens with the norms applied in Bioethics. This detection process is more delicate if the guiding principles that have to be detected are valid for such an extensive region, as it is Latin America, where the legislation of the different countries that form it would adopt them. The two problems that will be studied here are: a) if it is advisable or not to raise some Bioethic basic principles to the constitutional level. b) which are the main principles that have been adopted by the juridical legislations of Latin America and who, in some way, guide the legal regulation.

Bioethical Issues↗
PubMed1992

[Bioethical issues and principles in cancer treatment].

Bioethics was established as a new area of interdisciplinary studies focusing on human conduct in the field of the life sciences and health care in the light of moral values and principles in the 1960's and the beginning of the 1970's. Physicians abiding by classical medical ethics based upon the Oath of Hippocrates became subject to criticism because they behaved paternalistically in relation to their patients and provided medical treatment dogmatically without adequate explanation concerning conditions and diagnoses of patients' diseases, what kinds of treatments they were to receive and the possible benefits and risks thereof, along with their prognoses. During the patients' rights' movement, law suits against paternalistic physicians increased in number and the courts tried to establish ethical and legal principles for judgments in law suits using the Ethical Code of Neurenberg (1947) as an excellent model. The legal principles established as "informed consent" include obligations of physicians to provide their patients with adequate explanation and truth-telling, and the rights of patients to autonomy, choice, self-determination, and to give consent to physicians. Besides these rights, patients also have the right to put their veto on their own rights. In such cases, truth-telling by physicians, who believe in truth-telling, such as the disclosure of the diagnosis of cancer to these patients, can legally result in infringement of the patient's rights. It is important for physicians to respect the wishes and opinions of patients based on their own values and not to insist on personal dogmatic opinions. The disclosure of cancer diagnosis to terminal patients is certainly one of the most difficult procedures in medical practice and requires profound medical experience and bioethical insight.

Bioethics↗
PubMedDate not supplied

[Embryo selection and bioethical principles].

This paper analyzes, from the point of view of the principles of Bioethics, the problems of embryonic selection with the purpose of serving as donors of future transplant for their brothers seriously ill. Analyzed the principles of Bioethics of no malice, charity, autonomy and justice in connection with the matter explained, the author defends its moral fairness and he explains the necessity of proceeding to a legal reform which permits to accommodate in the Spanish Legal Code to this kind of embryonic selection, since nowadays laws into effect prohibit this practice with the purpose discussed here.

Bioethical Issues↗
PubMed1992

The design and use of the bioethics consultation form.

The emergence of the ethics consultation as a means to resolve moral crises in clinical medicine has revealed the need for a worksheet that would facilitate intake and analysis. The author developed the "Bioethics Consultation Form" as an attempt to remedy this need. The form is arranged in an outline format and is a useful asset to ethics committee discussions and record keeping. The first section covers basic intake data concerning the patient's medical and personal information, advance directives, and values, as well as the values of the physician and family. After the intake section is completed with the above data, the ethics consultant then turns to the analysis section. This second section allows for (1) the discussion of conflicting values, (2) the identification of priorities, and (3) the elucidation of ethical norms relevant to the case. The Bioethics Consultation Form was adopted by the Patient Care Advisory committee of the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The methodology in the use of the form will be discussed. Further, the potential spectrum of consultative cases that can be analyzed using the form will be highlighted.

Bioethics↗
PubMed2006

Bioethics in Sri Lanka.

Bioethics took off slowly in Sri Lanka, but now there are ethics review committees in many medical schools and national organizations. All medical schools teach some medical ethics but there are not enough trained teachers. There are no national guidelines on research ethics. The Forum for Research and Development was formed with the aim of building a new ethical research culture. The bioethics initiative includes: awareness-raising; education activities and capacity building; advocacy; and the development of policy guidelines. We aim to raise awareness in the scientific community and the general public on ethical, legal and social principles guiding the responsible conduct of research.

Bioethics↗
PubMedDate not supplied

Bioethics, bioweapons and the microbiologist.

The analysis of behavior of man in the field of biology is carried out through bioethics, considered the science of the survival. In the microbiology, there are numerous discoveries related with pathogenic microorganisms, including those that can be used as weapons in a biological war or in an attack considered bioterrorism. The scientist involved in microbiology can participate with his knowledge in the development and improvement of bioweapons, however from the point of view of bioethics it is not acceptable that he works in an investigation related with these topics, because the defense research can evolve in offensive one. The war is an antisurvival activity, therefore it is not acceptable. In the same way, the biological weapons composed with virus, fungi or alive bacteria, or with toxins from them, neither they are morally accepted. After the terrorist attacks with anthrax in the United States in 2001, the world scientific community in the field of microbiology should show against the use of the microorganisms like bioweapons, at the time of promoting the idea that the responsible use for the microorganisms is a moral imperative for all microbiologists around the world, since the biological weapons are a threat for the human life.

Bioethics↗
PubMed2006

The role of bioethics in the international prescription drug market: economics and global justice.

In terms of health care access, bioethics has an important role to inform and shape policy issues and develop interdisciplinary ideas and interventions. The rising price of prescription drugs presents one of the most looming barriers to health care access in the world today. Including both theoretical and practical features of the pharmaceutical industry's behavior is necessary to find ethical solutions towards increasing access. Bioethics can evaluate global justice by weighing human rights theory and future innovation at the macro level, and by addressing market forces and responsibilities at the micro level. Inherent structural features of pharmaceuticals, such as its reliance on research and development, cause the industry to employ pricing strategies that seem counter-intuitive to conventional wisdom, but that result in producing a just allocation as defined by market forces. Parallel trade and drug exportation/reimportation threaten the saliency of the industry's differential pricing scheme; a case-study of a single "Euro-price" within the European Union illustrates how this will actually create harm to the most needy member states. This complex situation requires solutions weighing arguments from human rights theory with those from economic theory to arrive at the most globally just allocation of prescription drugs in the global marketplace, as well as to ensure future innovation and scientific progress. Bioethicists as well as economists need to partake urgently in this discourse for the betterment of the global injustices in the international prescription drug market.

Bioethics↗
PubMedDate not supplied

[Bioethics in Chile. Current situation and perspectives].

Some of the current issues in the field of biomedical ethics are reviewed. Taking a brief description of the structure of the Chilean medical system as a frame of reference, the article addresses questions of professional ethics that affect relationships among physicians, between physicians and the public, and between physicians and the State. Observations are offered on some of the ethical aspects of medical care, in particular the teaching of bioethics, the establishment of committees on ethics in health care and research institutions, and the future outlook for bioethics in the country. In Chile, as in other Latin American countries, the teaching of this new discipline is not widespread, but there is growing interest in its inclusion in the curricula.

Bioethics↗
PubMed1987

Bioethical review committees in perinatology.

Infant bioethical review committees have been proposed as an option to review decisions for critically ill neonates to ensure the best interests of infants. This approach has evolved out of a concern that there have been some wrong decisions made by physicians and parents in which infants have died after treatments were inappropriately withheld or withdrawn. Infant bioethics committees consisting of multidisciplinary professional and lay members will attempt to assure the best interests of infants while maintaining parental discretion concerning decision making in most cases. It is our belief that these committees not only protect the interests of infants who might have treatment inappropriately withheld but also protect the interests of infants who can no longer be benefited by medical intervention. Furthermore, by increasing discussion and deliberation of these complex moral issues, the professional staff will be better able to deal with exigent situations and to provide thoughtful decision making in difficult cases. Finally, the role of the ethics committee will be to provide ethical comfort for staff and family alike in carrying out these difficult decisions for some of the most critically ill patients in our hospitals.

Bioethics↗
PubMedDate not supplied

[Pediatric bioethics].

Today a pediatrician's credibility cannot be dissociated from his bioethical background, which in turn requires an up-to-date knowledge of infancy and childhood. Communication with the child and his family, an ethical analysis of clinical cases, an awareness of limitations, and the choice of the safest, most effective and appropriate therapies are fundamental elements of pediatric bioethics. Several specific problems such as drug testing, the continuance of therapy regardless of the cost and consequences, and assistance of very premature infants are currently the subject of study and debate.

Adolescent↗
PubMed1996

[Bioethics on DNA diagnosis].

Through the applications of medical genetic knowledges, early diagnosis, neonatal screening, prenatal diagnosis followed by selective abortion, carrier detection and genetic counselling has become more effective. Since 1960, we performed over 3,500 cases with its followup study in Kyoto, Aichi, and Fukui, according to guidelines emphasizing non-directive counselling, informed consent, autonomous decision-making and confidentiality. New bioethical problems using DNA diagnosis has been arisen on justification of presymptomatic diagnosis of trinucleotide repeat diseases, carrier detection of thalassemia as well as possibility for genetic discrimination, susceptibility and testing. We should provide knowledges of science and technology with bioethical considerations, in order to protect the human genome and right as well as biosphere, as shown in the activities of IBC, UNESCO and MURS.

Bioethics↗