The use of placebo is crucial in the development of clinical research with a drug. It is a fundamental step in the application of the experimental method, which allows statistical efficiency as well as clarity in the interpretation of the results, However, the discussion is not closed since some authors consider it an unethical procedure that should be prohibited.
The prevailing thesis justifies the use of placebo only under a strict ethical evaluation that minimizes risks and determines that patients will not suffer serious harm.
The Hippocratic Oath: Paradigm of Medical Ethics.
In the posthippocratic era, it´s necessary to adapt the hypocritical principles to the contemporary world.
World Congress on Bioethics 2020 (6/19-6/21 at the University of Pennsylvania). International Association of Bioethics. Philadelphia, Pennsylvania, (USA)
Three Abstracts from Professor Roberto M. Cataldi Amatriain accepted for the World Congress.
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.
The XIIth Congress of Bioethics in Puerto Rico
This congress is organized by the Federation of Latin American and Caribbean Bioethics Institutions (FELAIBE) and the program issues of clinical bioethics are addressed.
Ten years ago (2009) it was held in Mendoza (Argentina), in Notti Hospital, the VII Latin American and Caribbean Congress of Bioethics (FELAIBE). In the photo from left to right the doctors: Alberto Bochatey, Marta Fracapani, Fernando lolas Stepke, José Alberto Mainetti, Roberto Cataldi Amatriain and Carlos A. Barclay.
Neurosciences: Ethical and juridical reflections
Dr. Christian Byk, magistrat, Secrétaire général de l’Association internationale droit, éthique et science, Président du Comité intergouvernemental de bioéthique de l’UNESCO
The french ethicist Doctor Christian Byk (centre), author of the article, between Doctores Cataldi Amatriain y Florentino Sanguinetti, in the Fundación Internacional Cataldi Amatriain (Buenos Aires), 2018.
José Alberto Mainetti. Doctor of Medicine and Doctor of Philosophy, National University of La Plata (UNLP). Professor of Medical Humanities (UNLP). President of honor of the Argentine Academy of Ethics in Medicine
Dr. José Alberto Mainetti (left), with the doctors Cataldi Amatriain y Detrich von Engelhardt (Germany). Round Table at the Argentine Medical Association.
Bioethics: at the current technological and innovative crossroads
The technological imperative or ¿ Is technology always equal to progress?
The digital gap
The technological gap
The cultural gap
“The true instrument of progress lies in the moral factor”
Giuseppe Mazzini (1805 – 1872)
“No one can use the word progress without a defined creed and an iron moral code…”
Gilbert Keith Chesterton (874 – 1936)