Bioética Clínica

Juramento Hipocrático: paradigma de la ética médica

La tradición de este juramento presupone una concepción mística, heredada del pitagorismo, secretista y también autoritaria, que difiere de manera sustancial de la tradición de los “derechos fundamentales de la persona” que ha configurado el ideario del mundo actual.

En la era posthipocrática, es necesario adaptar los  principios hipocráticos al mundo contemporáneo.

Los colegios médicos necesitan redefinir algunos aspectos deontológicos según los cambios que han originado la ciencia y la técnica, como también las mutaciones de la sociedad y las nuevas legislaciones.

 

Congreso Mundial de Bioética 2020 (del 19 al 21 de junio en la Universidad de Pensilvania). Asociación Internacional de Bioética. Filadelfia, Pensilvania (USA).

Tres abstracs del Prof. Dr. Roberto M. Cataldi Amatriain que fueron aceptados por el Congreso.

Vulnerabilities, Environment and Medicine

The polysemy of the adjective, its nuances and approaches allude to the biological and/or biographical fragility or weakness of an individual or social group (populations at risk). Vulnerability legitimizes itself in bioethical discourse. The relationship between the health of the population and the health of the environment reveals vulnerabilities, conflicts of interest and moral dilemmas in the face of decision-making. In the collective imagination appear  the fragilities of the poor and indigent populations (high vulnerability). But there are environmental vulnerabilities that do not respect social classes or economic power. The medicine has had a reductionist vision and neglected the vulnerability of the environment and its impact on human beings. In the clinical and epidemiological field it is linked to other vulnerabilities (anthropological, group, generic, ethnic, cultural, socioeconomic) and we postulate as an approach a model of porous borders. Interdisciplinarity and integration are essential in this bioethical reflection. Preserve the health of the planet and of all beings living on it. The ethics and the law against harmful transgressions and abusive paternalism that use human beings in research protocols in the name of scientific and technological progress. Alternatives are needed to satisfy human interests and the growth of the planet, in the context of environmental constraints (control of pollution, soil degradation). Model of growth with equity. Bioethics should be a bridge between anthropology and sociology, between medicine and politics, between psychology and law. Bioethics as anticipatory awareness, that considers feelings (really with more weight than reasoning in the construction of the human) and that brings us closer to solidarity.

Medical assistance and inclusion policies

The health of the population in the social context, its structure and dynamics, the development achieved and the various factors vital before the State. With economic growth, new demands arise, consolidated rights tend to improve and rights expand. Inequality depends on external factors (family, cradle, social class), but also on merits, the economic power achieved and how each feels (stigmatization). The consequences should not be confused with the causes. Inequality arises in different areas of life, such as access to education, good food, well-paid work, own housing, etc., ending up in health care and disease. Start by tackling the humanly unacceptable inequalities that collide with dignity, freedom and autonomy in a given cultural context. A system without privileges of any kind, with equal opportunities for all, what is needed to include all those excluded for decent health care. The health problems and illness are verified from clinical medicine or individual to health public or collective. Attempts are often made overcome the difficulties of the moment, but no attempt is made to change the structure of the problem. Mentalities did not change overnight and morality was not imposed by decree. Public health is consolidated through public institutions, with the aim of promoting, protecting and restoring health. An inclusive, fair, equitable and efficient health system was needed. The political sphere is different from the ethical sphere, however they may coincide. It is necessary to resort to the ethical imagination and political will. An equitable and efficient health system

The health business and its tangles with the market

With the rising cost of health services, rising prices of medical technology and drugs, large sections of the population are excluded from such assistance. Many Governments have formulated policies to provide basic assistance to low-income, uninsured populations and also to indigent populations. With the argument of how costly medical research is, these costs are shifted to the medical act and often disproportionately. Large companies lobby governments and have an excessive influence on the formulation of public health policies, reveal a continuing urge to reduce costs and disproportionately increase shareholder profits. Daily media reports on complaints about healthcare providers and also pharmaceutical industry companies in their actions, not only with regard to the cost of medicines but also to irregularities in research protocols with vulnerable humans. Factors contributing to the current malaise of the population in relation to medical care. ¿What can bioethics do to help solve this problem? The good intentions do not reach, the harmful facts go ahead  constituting the evidence, and the intentions are to the facts as the Bioethics is to the Law. In everyday life, ethical awareness and ethical principles are often too weak to guarantee ethical behavior. While the relationship between ethics and law is complex, legal sanctions are needed to ensure ethical practice. The law can correct abuses and transgressions that violate justice, because at this point in time it would be illusory to believe that the ethical attitude will descend from the heavens on those actors who have a abusive attitude and for whom their particular interests are above the Common Good.

 

El congreso es organizado por la Federación Latinoamericana y del Caribe de Instituciones de Bioética (FELAIBE) y en el programa siempre se abordan temas de bioética clínica, en esta oportunidad: ¿Marihuana medicinal?; Investigación médica; Directrices anticipadas o testamento vital;  Neuroética; Institucionalización de la Bioética en escenarios clínicos, etc.

La iniciativa de la fundación de FELAIBE fue tomada en Caracas en junio de 1991, entre las siguientes instituciones:  Federación Panamericana de Facultades y Escuelas de Medicina (FEPAFEM), con sede en Caracas (Venezuela), representada por su Director Ejecutivo, Dr. Pablo Pulido. El Centro de Bioética de la Fundación Dr. José María Mainetti, con sede en Manuel B. Gonnet, Provincia de Buenos Aires (Argentina), representada por su Director Ejecutivo, Dr. José Alberto Mainetti y el Centro de Ética Médica de la Asociación Colombiana de Facultades de Medicina (ASCOFAME), representado por su fundador y Director Alfonso Llano Escobar, S.J. con sede en Santafé de Bogotá (Colombia).

Hace 10 años (2009) se hacía en Mendoza (Argentina), en el Hospital Notti,  el VII Congreso Latinoamericano y del Caribe de Bioética (FELAIBE). En la foto de izquierda a derecha los doctores: Alberto Bochatey, Marta Fracapani, Fernando Lolas Stepke, José Alberto Mainetti, Roberto Cataldi Amatriain y Carlos A. Barclay.

 

Les NEUROSCIENCES : Réflexion éthique et juridique

Christian Byk, magistrado. Secretario general de la Asociación internacional de derecho, ética y ciencia, Presidente del Comité Intergubernamental de Bioética de la UNESCO. Miembro Correspondiente Extranjero de la Academia Argentina de Ética en Medicina.

El bioeticista francés Doctor Christian Byk (centro), autor del artículo, entre los Doctores Cataldi Amatriain y Florentino Sanguinetti, en la Fundación Internacional Cataldi Amatriain (Buenos Aires), 2018.

El texto cuya versión original está en francés, fue traducido al español para incorporarlo como capítulo al Libro de la Academia Argentina de Ética en Medicina, Bioética: conflictos & dilemas, de próxima aparición.

Dr. José Alberto Mainetti. Doctor en Medicina y Doctor en Filosofía por la Universidad Nacionalo de La Plata (UNLP). Profesor de Humanidades Médicas de la UNLP. Presidente de Honor de la Academia Argentina de Ética en Medicina.

 

 

 

 

 

 

 

 

 

 

 

Dr. José Alberto Mainetti (izquierda), con los Dres. Cataldi Amatriain y Detrich von Engelhardt (Alemania).

Mesa redonda en la Asociación Médica Argentina.

 

 

La Bioética en la encrucijada cultural e innovadora actual

 

El Imperativo tecnológico o ¿Tecnología siempre es igual a progreso? 

La brecha digital

La brecha tecnológica

La brecha cultural

“El verdadero instrumento del progreso radica en el factor moral”

Giuseppe Mazzini (1805 – 1872)

 

Nadie puede usar la palabra progreso si no tiene un credo definido y un férreo código moral…”

Gilbert Keith Chesterton (874 – 1936)

 

Fritz Jahr (1927): “BioEthics: A Review of the Ethical Relationships of Humans to Animals and Plants”


Van Rensselaer Potter (1071): “Bioethics: Bridge to the Future”

 

 

 

 

 

 

 

 

 

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