Promoting professionalism through humanities-based transformation.

INTRODUCTION: In the last two decades, academic medical centers in the United States have faced a new challenge, dealing with breaches of medical professionalism in their staff, house staff, and medical students. Medical education settings have largely directed their professionalism efforts toward responding reactively to negative outliers. DISCUSSION: This paper contends that the warrant of medical education mandates a transformative path forward. While negative behavior must be responded to meaningfully, so, too, must positive role models of professional behavior be publicly lauded for their consequential culture change in their institutions, and promoted as positive role models. Further, the promotion of medical professionalism must be part of this culture by proactively engaging all learners and health care providers with medical ethics and humanities-based knowledge, critical thinking skills, and role modeling. CONCLUSION: Professionalism programs should be vested with the authority to implement an affirmative educational program intended to nurture and promote medical professionalism in each medical student, resident, fellow, and attending and utilize methods to that end employing both virtue and care ethics.

Medical professionalism is the foundational concept grounded upon scientific- and humanities-based knowledge and skills, directed toward the promotion of patient benefit with the rejection of self-interest, delivered with excellence in comportment, and the adherence to a covenant of trust with society.Medical educators who solely emphasize the detection and punishment of negative outliers are missing essential elements in promoting medical professionalism.Medical professionalism should be comprehensively addressed through a systematic addressing of teaching fundamental knowledge, skills, and virtue, promote excellence in role modeling and mentorship, and the redress of those lacking insight in their professional conduct.

Aristotelian Practical Wisdom (Phronesis) as the Key to Professional Ethics in Teaching.

This article is about a virtue ethical approach to the professional ethics of teaching, centred around the ideal of phronesis (practical wisdom) in an Aristotelian sense. It is grounded empirically in extensive research conducted at the Jubilee Centre for Character and Virtues into teachers and other UK professionals, and it is grounded theoretically in recent efforts to revive an Aristotelian concept of phronesis as excellence in ethical decision-making. The article argues for the need for a virtue-based approach to professional practice, based on time-honoured Aristotelian assumptions and culminating in a conceptually viable construct of phronesis as a psycho-moral integrator and adjudicator. After setting some of the historical background in Sect. 1, Sect. 2 charts the most relevant empirical findings. Section 3 introduces a call for phronesis as a guide to virtue-based professional ethics: its role, nature, and methods of instruction. Section 4 adds some caveats and concerns about if and how phronesis can be cultivated as part of teacher training. Finally, Sect. 5 offers some concluding remarks about the novelty and radicality of the approach on offer in this article.

Mandevillian vices.

Bernard Mandeville argued that traits that have traditionally been seen as detrimental or reprehensible, such as greed, ambition, vanity, and the willingness to deceive, can produce significant social goods. He went so far as to suggest that a society composed of individuals who embody these vices would, under certain constraints, be better off than one composed only of those who embody the virtues of self-restraint. In the twentieth century, Mandeville's insights were taken up in economics by John Maynard Keynes, among others. More recently, philosophers have drawn analogies to Mandeville's ideas in the domains of epistemology and morality, arguing that traits that are typically understood as epistemic or moral vices (e.g. closed-mindedness, vindictiveness) can lead to beneficial outcomes for the groups in which individuals cooperate, deliberate, and decide, for instance by propitiously dividing the cognitive labor involved in critical inquiry and introducing transient diversity. We argue that mandevillian virtues have a negative counterpart, mandevillian vices, which are traits that are beneficial to or admirable in their individual possessor, but are or can be systematically detrimental to the group to which that individual belongs. Whilst virtue ethics and epistemology prescribe character traits that are good for every moral and epistemic agent, and ideally across all situations, mandevillian virtues show that group dynamics can complicate this picture. In this paper, we provide a unifying explanation of the main mechanism responsible for mandevillian traits in general and motivate the case for the opposite of mandevillian virtues, namely mandevillian vices.

Virtue ethics and the unsettled ethical questions in controlled human infection studies.

Controlled human infection studies (CHIs) involve the intentional infection of human subjects for a scientific aim. Though some past challenge trials have involved serious ethical abuses, in the last few decades, CHIs have had a strong track record of safety. Despite increased attention to the ethics of CHIs during the COVID-19 pandemic, CHIs remain controversial, and there has been no in-depth treatment of CHIs through the lens of virtue ethics. In this article, we argue that virtue theory can be helpful for addressing CHIs that present a constellation of controversial, unresolved, and/or under-regulated ethical issues. We begin with some brief background on virtue ethics. We then substantiate our claim that some CHIs raise a constellation of ethical issues that are unresolved in the ethics literature and/or lack adequate regulatory guidance by demonstrating that CHIs can present indeterminate social value, risks to third parties, limitations on the right to withdraw from research, and questions about the upper limit of allowable risk. We argue that the presence of a virtuous investigator, with virtues such as prudence, compassion, and integrity, is especially important when these unresolved research ethics issues arise, which is the case for certain types of controlled human infection studies. We use the historical example of Walter Reed and the Yellow Fever Commission to illustrate this claim, and we also highlight some contemporary examples. We end by sketching some practical implications of our view, such as ensuring that investigators with experience running CHIs are involved in novel CHI models.

Virtue marketing: Trends in health-, eco-, and cause-oriented claims on the packaging of new alcohol products in Australia between 2013 and 2023.

OBJECTIVE: Some claims on alcohol labels highlight virtuous aspects of brands or products, including in health-, eco-, and cause-oriented domains (including charity partnerships, or ethical or humanitarian certifications). This virtue marketing may create a 'halo' whereby consumers generalise from specific attributes to a more favourable overall appraisal of the product, brand, or even alcohol or the alcohol industry in general. This study aims to describe the prevalence of and trends over time in virtue marketing on the packaging of new alcohol (including lower and zero alcohol) products on the Australian market. METHOD: Records of N=4,024 new alcohol products released in Australia between 2013 and 2023 were extracted from Mintel Global New Products Database. Health-, eco-, and cause-oriented claims on packaging were summarised across product types and time, and co-occurrence between claims was assessed. RESULTS: Virtue marketing appeared on 36.5% of new alcohol products, of which health-oriented claims were most common (32.5%), followed by eco- (6.3%) and cause-oriented claims (2.0%). The prevalence of each claim category and virtue marketing overall significantly increased over time (each p<.001) and varied by product type. New alcohol products displayed as many as eight different types of claims and all claims tended to co-occur with at least two others. CONCLUSIONS: Virtue marketing is prevalent on new alcohol products in Australia and has recently increased. While product packaging can provide useful consumer information, health-, eco-, and cause-oriented claims may exploit consumers' motivation to make healthy, sustainable, and socially responsible choices despite alcohol being detrimental in these areas.

Sacrifice as a Part of Medical Education: A Reflection on the COVID-19 Pandemic.

The COVID-19 pandemic demanded significant sacrifices from medical learners. We examine the meaning of sacrifice and frame it as a "side effect" of being dedicated to the good of the patient. We contend that sacrifice has played a central role in medicine, even before the pandemic, for professionals and learners alike. We identify three limits to the role of sacrifice in medical education and practice to separate healthy from harmful experiences of sacrifice. Developing an understanding of sacrifice in medical education and practice can help trainees and clinicians know when to marshal resilient responses to healthy sacrifices and reject harmful sacrifices encountered. Maintaining this balance requires a broader reflection on the nature of medical schools and their ability to support virtuous professional identity formation.

Virtuous Collective Attention.

How can a collective pay attention virtuously? Imagine a group of scientists. It matters what topics they pay attention to, that is, which topics they draw to the foreground and take to be relevant, and which they leave in the background. It also matters which aspects of an investigated phenomenon they foreground, and which aspects they leave unnoticed in the background. If we want to understand not only how individuals pay attention of this kind virtuously, but also collectives, we first need a framework to understand virtuous collective agency. A result of this article will be that virtuous collective action depends on the collective being institutionalized. At the same time, we have to think of the constituents of the collective in terms of practical identities (as opposed to individuals). This is what enables us to understand how a collective can acquire the stability required for virtue, and how we don't end up with a summative account of group virtue, respectively. It will be argued that collectives only have the required stability in their actions when their commitments are habitualized in the form of institutionalized procedures. An Aristotelian understanding of virtue distinguishes between commitment, inclination, and action. Only when a subject's inclination is fully lined up with her commitment, do we arrive at the required stability (of character) for virtuous action. In the case of individuals, to build up an appropriate inclination consists in an inscribing of the commitment into the feelings and body of the subject. If a commitment is fully 'embodied' in this sense, it has formed the individual's inclination accordingly. How can one make sense of this in the case of collective subjects? This article tries to show that for collectives, the embodiment of commitment (the forming of the fitting inclinations) consists in creating policies, procedures, and rules that stabilize the acting according to the commitment, irrespective of the motivation of each individual involved in the collective. Hence, embodiment of commitment, in the case of collectives, is institutionalization. The article then explores what this requirement of institutionalization means for collective attention. The illustration will draw on a distinction between focused and open-minded attention. It will be shown that for either case - focused and open-minded - in order for a collective to pay attention virtuously, it needs to have its commitments institutionalized.

Teaching epistemic integrity to promote reliable scientific communication.

In an age of mass communication, citizens need to learn how to detect and transmit reliable scientific information. This need is exacerbated by the transmission of news through social media, where any individual has the potential to reach thousands of other users. In this article, we argue that fighting the uncontrolled transmission of unreliable information requires improved training in broad epistemic integrity. This subcategory of research integrity is relevant to students in all disciplines, and is often overlooked in integrity courses, in contrast to topics such as fraud, plagiarism, collaboration and respect for study subjects. Teaching epistemic integrity involves training epistemic skills (such as metacognitive competences, capacity to use helpful heuristics, basic statistical and methodological principles) and values (such as love of truth, intellectual humility, epistemic responsibility). We argue that this topic should be addressed in secondary school, and later constitute a fundamental component of any university curriculum.

Perceptions of COVID-19 patients in the use of bioethical principles and the physician-patient relationship: a qualitative approach.

BACKGROUND: The COVID-19 pandemic has influenced the approach to the health-disease system, raising the question about the principles of bioethics present in physician-patient relations. The principles while widely accepted may not be sufficient for a comprehensive ethical analysis. Therefore, the aim of this study was to explore the perception of these principles and the physician-patient relationship during a hospital stay through a qualitative approach. METHOD: Sixteen semi-structured interviews took place to know the patients' perception during their 2020 hospitalization for COVID-19. The data was analyzed through the constant comparison method, creating categories and comparing them. In the end, seven categories were established and were grouped in three: bioethical principles (dignity, charity, vulnerability, autonomy), doctor-patient relationship (participant commitment, informed consent, health staff-patient relationship) and the experience of the disease (illness, the role of the family). RESULTS: The research found that most patients described a positive experience, with the feeling of having been well cared for with no sense of discrimination or injustice done. The majority also reported that their autonomy was respected in the treatment decisions. The evaluation of these attitudes is an area of opportunity, especially when the patients' vulnerability is at risk. CONCLUSIONS: The ethics of virtue offers a better reflection of how human beings manifest themselves by emphasizing the development of virtuous character and behaviors that allow them to realize their values in life. Authorized by the Research Ethics Committee with registration: DI/18/105-B/3/308.

Enhancing the moral courage of nurses: A modified Delphi study.

BACKGROUND: The urgency of ensuring adequate moral courage in clinical nursing practice is evident. However, currently, there are few formal intervention plans targeted at enhancing the moral courage of nurses. AIM: To develop a training program for improving the moral courage of nurses using the modified Delphi method. RESEARCH DESIGN: A modified Delphi study. PARTICIPANTS AND RESEARCH CONTEXT: From November to December 2022, a literature review and expert group discussion were conducted to develop a preliminary training plan framework. From January to March 2023, a two-round Delphi survey was performed, and a consensus was reached regarding the plan through online questionnaires. Descriptive statistics were used to analyze the data. ETHICAL CONSIDERATIONS: This study was approved by the institutional ethics committee (No. 138, 30 August 2021). All participants provided written informed consent. RESULTS: Consensus was reached on eight themes and 33 items to strengthen the moral courage training program for nurses. CONCLUSIONS: Guided by a unified goal of moral education, a multi-level and acceptable intervention plan was designed to enhance the moral courage of nurses.

Emotion regulation from a virtue perspective.

BACKGROUND: The ability to regulate one's emotional state is an important predictor of several behaviors such as reframing a challenging situation to reduce anger or anxiety, concealing visible signs of sadness or fear, or focusing on reasons to feel happy or calm. This capacity is referred to as emotion regulation. Deficits in this ability can adversely affect one's adaptive coping, thus are associated with a variety of other psychopathological symptoms, including but not limited to depression, borderline personality disorder, substance use disorders, eating disorders, and somatoform disorders. METHODS: The present study examined emotion regulation in relation to the virtue-based psychosocial adaptation model (V-PAM). 595 participants were clustered based on their Difficulties in Emotion Regulation Scale (DERS) score, producing two clusters (i.e., high functioning vs. low functioning). Then, emotion regulation group membership was discriminated by using five V-PAM virtue constructs, including courage, integrity, practical wisdom, committed action, and emotional transcendence. RESULTS: Results show that five virtues contribute to differentiating group membership. Practical wisdom was the strongest contributor, followed by integrity, emotional transcendence, committed action, and courage. Predictive discriminant analysis was conducted and 71% of cases were correctly classified. A discussion of the relationship between emotion regulation and virtues was elaborated. CONCLUSION: The concept of virtue holds significant importance in the comprehension of an individual's capacity to regulate their emotions, meriting future study.

Objectivity, honesty, and integrity: How American scientists talked about their virtues, 1945-2000.

What kind of people make good scientists? What personal qualities do scholars say their peers should exhibit? And how do they express these expectations? This article explores these issues by mapping the kinds of virtues discussed by American scientists between 1945 and 2000. Our wide-ranging comparative analysis maps scientific virtue talk across three distinct disciplines - physics, psychology, and history - and across sources that typify those disciplines' scientific ethos - introductory textbooks, book reviews, and codes of ethics. We find that, when inducting students into a discipline, evaluating peers, or codifying their professional standards, postwar American scientists routinely named virtues like carefulness, objectivity, and honesty. They applied such virtues not only directly to scholars' characters, minds, and attitudes (thereby equating virtues with personal qualities), but also to their methods, modes of reasoning, and working habits (in the form of what we call virtue-qualifiers). Strikingly, we find that physicists, psychologists, and historians drew upon largely similar repertoires of virtue. For all of them, scientific work required carefulness, thoroughness, and accuracy. Not all virtues, however, were equally important in all disciplines (notably objectivity), nor did each ethos-forming genre place equal emphasis on the directly personal nature of such virtues. All in all, our research establishes an extended framework for understanding the ways virtues remained present in postwar American scientific discourse writ large.

Clinician Moral Distress: Toward an Ethics of Agent-Regret.

Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well-understood in terms of what Bernard Williams calls "agent-regret." We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience.

The consciousness of virtue: uncovering the gaps between educational specialists and the general public in their understanding of virtue in Japan.

Virtue is a normative concept that constitutes social and moral codes. The notion of virtue can be identified in both the West and the East. Since this concept was revived in academia in the 20th century after a long sinking into oblivion, contemporary professional researchers, but not the general public, may be familiar with this notion. We conducted a survey on the attitudes of educational specialists and the general public regarding the notion of virtue in Japan. Our study found that, in contrast to educational specialists, the general public were not so familiar with the notion; both had a positive image of virtue and a poor understanding of the Confucian notions of virtue; both retain Buddhist values under the term of virtue, but educational specialists tended to associate ancient Greek and Western elements with the notion of virtue. Educational specialists emphasized active, intellectual virtues, such as practical wisdom, whereas the general public emphasized passive, emotional virtues, such as gratitude. Our study showed that, the notion of virtue was understood in different ways between educational specialists and the general public in Japan. This finding has several social implications, such as academic integrity and educational policy.

Ética e cuidado humanizado em Saúde Mental: percepções dos profissionais de enfermagem / Ethics and humanizing health care in mental health: from nursing professionals' perspective

Estudo exploratório, descritivo de abordagem qualitativa, que teve por objetivo compreender como os profissionais que atuam no campo da saúde mental percebem a ética e o cuidado humanizado na sua prática profissional, a partir do referencial da Ética das Virtudes (EV), conforme a proposta de Pellegrino e Thomasma (1993). Foram entrevistados 21 profissionais da equipe de enfermagem, entre eles auxiliares e técnicos de enfermagem e enfermeiros de um hospital psiquiátrico situado no interior do estado de São Paulo. As entrevistas foram gravadas em mídia digital, com o consentimento dos participantes e posteriormente transcritas, os dados foram analisados através do método de Análise de Conteúdo de Bardin (2016) emergiram as categorias 8.2.1 Significados atribuídos a ética; 8.2.2 Percepções sobre situações que envolvam ética na oferta do cuidado; 8.2.3 Significados atribuídos a cuidado humanizado; 8.2.4 Percepções sobre situações que envolvam cuidado humanizado. Dessas categorias despontaram 10 subcategorias, dentre essas destacaram-se 8.2.1.1 Sigilo Profissional, que para o grupo pesquisado é associado ao termo " ética" e associado ao respeito e a confiança na relação profissional-paciente; 8.2.1.3 Hábitos e virtudes e 8.2.2.2 Virtudes subcategorias estas onde os profissionais trouxeram práticas éticas alicerçadas em virtudes; 8.2.2.1 Violência, onde foram expressadas situações que caracterizam o cuidado como não ético; 8.2.3.2 Empatia entendida pelos entrevistados como um fator afetivo essencial na prática do cuidado humanizado e a subcategoria 8.2.4.1 Vínculo que também está relacionado com a empatia, a percepção dos profissionais é que este laço deve ser construído com base na confiança. Foi evidenciado que o termo " ética" foi eminentemente associado a situações negativas enquanto o termo "cuidado humanizado", está relacionado majoritariamente a situações positivas

Exploratory research, employing qualitative descriptive approach, aimed to understand how mental health professionals perceive ethics and humanizing health care in their practice, based on The Virtues in Medical Practice proposed by Pellegrino and Thomasma (1993). 21 nursing professionals (including nurses and nursing assistants) from a psychiatric hospital in the state of São Paulo were interviewed. The interviews were consentingly recorded in electronic devices and transcribed. The Bardin's Content Analysis method (2016) were applied to the data and the following categories emerged 8.2.1 Meanings attributed to ethics; 8.2.2 Perceptions of situations involving ethics in the provision of care; 8.2.3 Meanings attributed to humanizing health care, and 8.2.4 Perceptions of situations involving humanizing health care. 10 subcategories came out from these categories, bringing attention to 8.2.1.1 Professional Secrecy, which is associated with ethics, respect and trust in the professional-patient relationship, according to the group studied; 8.2.1.3 Habits and virtues; 8.2.2.2 Subcategories of virtues where the professionals mentioned ethical practices based on virtues; 8.2.2.1 Violence, where situations were characterized as unethical care; 8.2.3.2 Empathy as an essential affective factor to humanizing health care, according to the interviewees, and 8.2.4.1 Connection also associated with empathy, which from the professionals' perspective, must be based on trust. It was found that the term "ethics" is usually associated with negative situations while the term "humanizing health care" is mostly associated with positive ones

Comunicação de más notícias em saúde: contribuições à discussão bioética através de uma nova ética das virtudes

Este trabalho compreende uma pesquisa teórica através de revisão bibliográfica narrativa. O objeto desta pesquisa foi a comunicação de más notícias em saúde, no âmbito da relação médico-paciente. Utilizando o instrumental teórico disponível no campo da Bioética, procurou-se responder à questão teórica acerca das contribuições possíveis de uma nova teoria ética baseada nas virtudes de caráter do agente moral para a discussão sobre comunicação de más notícias em saúde, e também para a própria Bioética. A teoria ética das virtudes da filósofa neozelandesa Christine Swanton, fundamentada a partir de conceitos importantes da filosofia de Nietzsche, mostrou-se útil quando aplicada ao debate ético na relação médico-paciente. Também foi possível utilizar esta formulação teórica na ponderação sobre a situação de comunicação de más notícias em saúde, a partir da articulação com um caso clínico discutido no âmbito da bioética. Por fim, a Ética das Virtudes Pluralista de Swanton demonstrou ser capaz de oferecer contribuições aos debates éticos no campo da Bioética, ratificando nossa hipótese inicial.

This work comprises a theoretical research through narrative bibliographic review. The object of this research was breaking bad news in health care, within the scope of the doctor-patient relationship. Using the theoretical tools available in the field of Bioethics, we sought to answer the theoretical question about the possible contributions of a new ethical theory based on the moral agent's character virtues to the discussion about breaking bad news in health care, and also to the own Bioethics. The ethical theory of virtues of the New Zealand philosopher Christine Swanton, grounded on important concepts of Nietzsche's philosophy, has proved useful when applied to the ethical debate in the doctor-patient relationship. It was also possible to use this theoretical formulation in the weighting on the situation of breaking of bad news in health care, based on the articulation with a clinical case discussed within bioethics scope. Finally, Swanton's Pluralistic Virtue Ethics proved to be able to offer contributions to ethical debates in the field of Bioethics, ratifying our initial hypothesis.

Virtudes y fortalezas del carácter en población adulta de Buenos Aires. Un estudio con un enfoque mixto émico/ético / Virtues and character strengths in Buenos Aires adult population. A study with a mixed emic/etic approach

El presente estudio tiene como objetivo establecer la validez cultural de la clasificación VIA (24 fortalezas en 6 virtudes) mediante la utilización de un enfoque mixto (ético/émico). Se intentó determinar si la clasificación VIA resultaba relevante culturalmente para poder capturar las respuestas de personas legas en ocasión de describir las características positivas de personajes protípicos admirados en un formato de respuesta libre (free listing). Participaron del estudio una muestra de 378 personas adultas de población general no consultante argentina, varones y mujeres. Los resultados señalan que las fortalezas más frecuentes fueron la integridad, la persistencia, la bondad y el amor, lo que da lugar a dos perfiles diferenciados de personajes prototípicos de características positivas. No se encontraron diferencias según sexo y edad. Los resultados sugieren que la clasificación VIA debe ser ajustada en función de las variables culturales.

The purpose of the present study is to establish the cultural validity of the Values in Action (VIA) classification through the use of 24 character strengths contained in 6 virtues, by implementing a combined emic-etic approach. A group of 378 male and female Argentinian adults participated from this research. The aim was to determine if the VIA classification was culturally relevant to portray the answers of the participants involved. Results indicate that the most frequent strengths listed by the participants were integrity, persistency, kindness and love. No differences regarding age and gender were found. The results also suggest that the VIA classification needs to be adjusted according to cultural variables.

METODOLOGÍA PARA EL ANÁLISIS DE CASOS CLÍNICOS EN LOS COMITÉS DE BIOÉTICA: ENFOQUES Y PROPUESTAS DE APOYO / METHODOLOGY FOR ANALYZING CLINICAL CASES IN BIOETHICS COMMITTEES: APPROACHES AND PROPOSED SUPPORT / METODOLOGIA PARA A ANÁLISE DE CASOS CLÍNICOS NOS COMITÊS DE BIOÉTICA: ENFOQUES E PROPOSTA DE APOIO

El presente trabajo examina y evalúa los modelos y las metodologías más importantes para la resolución de casos clínicos: 1) el principialismo, 2) el deontologismo, 3) el consecuencialismo, 4) la casuística, 5) la ética de la virtud y 6) la ética centrada en la persona (o ética "personalista"). Se sopesan las fortalezas y debilidades de cada una y se propone, además, un instrumento que facilite este tipo de análisis. Como grupo, se opta por una metodología que articula tres modelos: el enfoque de la virtud, el enfoque centrado en la persona y estos dos en armonía con una ética centrada en los principios. Las razones para esta opción integral están basadas, fundamentalmente, en el reconocimiento de la supremacía de la dignidad de la persona humana y de que las situaciones clínicas complejas requieren de una mirada integral tanto de la persona como de la práctica clínica. Esta última requiere de virtudes, principios éticos y del reconocimiento del ser humano como un ser dotado de dignidad intrínseca y, a su vez, como fundamento de la ética y de la práctica clínica.

This paper examines and evaluates the models and the most important methods for solving clinical cases; namely, 1) principlism, 2) deontologism, 3) consequentialism, 4) casuistry, 5) virtue ethics and 6) ethics centered on the person (or "personalist" ethics). The strengths and weaknesses of each are weighed and an instrument is proposed to facilitate this type of analysis. As a group, the preference is for a methodology that articulates three models: the virtue approach, the person-centered approach, and these two in harmony with an ethics centered on principles. The reasons for this comprehensive option are based primarily on recognition of the primacy of the dignity of the human person and on acknowledgement that complex clinical situations require a comprehensive view of both the person and clinical practice. The latter requires virtues, ethical principles and recognition of the human person as being endowed with inherent dignity and, in turn, as the foundation of ethics and clinical practice.

Este trabalho examina e avalia os modelos e as metodologias mais importantes para a resolução de casos clínicos: 1) o principialismo; 2) a deontologia; 3) o consequencialismo; 4) a casuística; 5) a ética da virtude e 6) a ética centralizada na pessoa (ou ética "personalista"). Consideram-se as fortalezas e as debilidades de cada uma e propõe-se, além disso, um instrumento que facilite esse tipo de análise. Como grupo, opta-se por uma metodologia que articula três modelos: o enfoque da virtude, o enfoque centralizado na pessoa e esses dois em harmonia com uma ética focada nos princípios. As razões para essa opção integral estão baseadas, fundamentalmente, no reconhecimento da supremacia da dignidade da pessoa humana e de que as situações clínicas complexas requerem de um olhar integral tanto da pessoa quanto da prática clínica. Esta última exige virtudes, princípios éticos e reconhecimento do ser humano como um ser dotado de dignidade intrínseca e, por sua vez, como fundamento da ética e da prática clínica.

Metodología para la deliberación en el modelo bioético personalista con fundamentación en la virtud

Se plantea una metodología para la solución de casos en el modelo bioético personalista ontológico con fundamentación en la virtud con el objetivo de dar claridad al procedimiento en el momento del juicio ético y poder dar las recomendaciones y la decisión final en cada situación. Esta metodología debe ser tenida en cuenta por los Comités que deliberan en la experimentación con animales para tener juicios claros y acordes con el modelo bioético que se ha planteado. El científico que experimenta con animales debe tener en cuenta que los actos que el ejecuta sobre sus experimentos deben estar mediados por acciones virtuosas que de una manera u otra engrandecerán sus prácticas y sus obras para el bien del planeta incluyendo el bienestar del propio hombre; se debe ser cuidadoso en el trato con los animales, y la bioética personalista con fundamentación en la virtud ha de caminar de la mano con los actos excelentes, que de por sí engrandecerán el comportamiento del hombre colocándolo a su altura humana.

A methodology to solve cases under the ontological personalist bioethics model based on virtue is proposed in this paper, aiming to clarify the procedure at the moment of the ethical judgment and allow the provision of recommendations and the final choice for every situation. This methodology should be taken into account by the committees that deliberate in experiments with animals, in order to have clear judgments within the bioethical model proposed. Scientists who perform experiments with animals must be aware of the fact that the acts performed in such experiments must be mediated by virtuous actions which, one way or another, will extoll thir work and practices for the good of the planet, including mankind's wellbeing. Animals must be treated carefully and personalistic bioethics based on virtue must advance along with excellent deeds, thus extolling the behavior of men to an actually human position.

Propõe-se uma metodologia para a solução de casos no modelo bioético personalista ontológico com fundamentação na virtude com o objetivo de dar clareza ao procedimento no momento do juízo ético e poder dar as recomendações e a decisão final em cada situação. Esta metodologia deve ser tida em conta pelos Comitês que deliberam na experimentação com animais para ter juízos claros e conformes com o modelo bioético que se propôs. O cientista que experimenta com animais deve ter em conta que os atos que o executa sobre seus experimentos devem estar mediados por ações virtuosas que de uma maneira ou outra engrandecerão suas práticas e suas obras para o bem do planeta incluindo o bem-estar do próprio homem; deve-se ser cuidadoso no trato com os animais, e a bioética personalista com fundamentação na virtude tem de caminhar da mão com os atos excelentes, que de por si engrandecerão o comportamento do homem colocando-o a sua altura humana.