Ética, bioética y método clínico en el tratamiento de pacientes pediátricos aquejados de migraña / Ethics, bioethics and clinical method in the treatment of pediatric patients suffering from migraine

La migraña es una de las enfermedades que ha acompañado al hombre a lo largo de la vida. Con el objetivo de argumentar, mediante la recopilación de resultados de estudios clínicos de evidencias, la relación existente entre la ética médica y el método clínico en el tratamiento de migrañas en pacientes pediátricos, se realizó revisión de bibliografías sobre migraña, y algunos aspectos del cumplimiento de la ética médica y el método clínico, los que fueron considerados en el desarrollo de las consultas e interconsultas de Neurología del Hospital Pediátrico Universitario “William Soler”, incluyendo las consultas de Proyección Comunitaria del municipio de Boyeros, en La Habana, en los últimos 10 años. Se accedió a las bases de datos PubMed, Lilacs, Scielo y Google, se restringió la búsqueda por temática y para los últimos 10 años, así como estudios de evidencia, cuyas bases de datos se obtuvieron de las consultas y los resultados fueron publicados en revistas. Se exponen trabajos de evidencia relacionados con el tratamiento de la migraña, en los cuales se aprecia la comunión existente entre la Ética y el método clínico. Las evidencias demostradas en las publicaciones de la autora principal de este estudio sobre el tratamiento de la migraña en Pediatría, demuestran que se puede cumplir con la ética médica y el método clínico, apuntes de Hipócrates antes de nuestra era.

Migraine is a disease that has accompanied man throughout the life. With the objective of substantiating through the collection of results from clinical studies of evidence the relationship between the medical ethics and the clinical method in the treatment of migraine in pediatric patients, a literature review on migraine and on some aspects of the compliance with the medical ethics and the clinical method was made. These aspects had been considered in the medical consultation and interconsultation service of neurology in “William Soler” university pediatric hospital including the consultation service of the Community Project in Boyeros municipality in Havana in the last ten years. PubMed, Lilacs, Scielo and Goggle databases were accessed; search by topic and restricted to the last ten years was made as well as evidence-based studies whose databases were created from consultations, and the results were published in journals. Evidence papers related to the treatment of migraine were presented, in which the communion between ethics and the clinical method was reflected. The evidence shown in the publications of the main author of this study on the treatment of migraine in pediatrics prove that the medical ethics and the clinical method should be complied with, as Hippocrates said before the CE.

Ética, Bioética y método clínico en el tratamiento de pacientes pediátricos aquejados de migraña / Ethics, Bioethics and clinical method in the treatment of pediatric patients suffering from migraine

La migraña es una de las enfermedades que ha acompañado al hombre a lo largo de la vida. Con el objetivo de argumentar, mediante la recopilación de resultados de estudios clínicos de evidencias, la relación existente entre la ética médica y el método clínico en el tratamiento de migrañas en pacientes pediátricos, se realizó revisión de bibliografías sobre migraña, y algunos aspectos del cumplimiento de la ética médica y el método clínico, los que fueron considerados en el desarrollo de las consultas e interconsultas de Neurología del Hospital Pediátrico Universitario William Soler , incluyendo las consultas de Proyección Comunitaria del municipio de Boyeros, en La Habana, en los últimos 10 años. Se accedió a las bases de datos PubMed, Lilacs, Scielo y Google, se restringió la búsqueda por temática y para los últimos 10 años, así como estudios de evidencia, cuyas bases de datos se obtuvieron de las consultas y los resultados fueron publicados en revistas. Se exponen trabajos de evidencia relacionados con el tratamiento de la migraña, en los cuales se aprecia la comunión existente entre la Ética y el método clínico. Las evidencias demostradas en las publicaciones de la autora principal de este estudio sobre el tratamiento de la migraña en Pediatría, demuestran que se puede cumplir con la ética médica y el método clínico, apuntes de Hipócrates antes de nuestra era(AU)

Migraine is a disease that has accompanied man throughout the life. With the objective of substantiating through the collection of results from clinical studies of evidence the relationship between the medical ethics and the clinical method in the treatment of migraine in pediatric patients, a literature review on migraine and on some aspects of the compliance with the medical ethics and the clinical method was made. These aspects had been considered in the medical consultation and interconsultation service of neurology in William Soler university pediatric hospital including the consultation service of the Community Project in Boyeros municipality in Havana in the last ten years. PubMed, Lilacs, Scielo and Goggle databases were accessed; search by topic and restricted to the last ten years was made as well as evidence-based studies whose databases were created from consultations, and the results were published in journals. Evidence papers related to the treatment of migraine were presented, in which the communion between ethics and the clinical method was reflected. The evidence shown in the publications of the main author of this study on the treatment of migraine in pediatrics prove that the medical ethics and the clinical method should be complied with, as Hippocrates said before the CE(AU)

[Teaching Bioethics to Students of Medicine with Problem-Based Learning (PBL)]. / Enseñar Bioética a Estudiantes de Medicina Mediante el Aprendizaje Basado en Problemas (ABP).

We present the experience of the introduction of the subject of bioethics in a medical school in order to give to the 73 students of 5th degree skills to handle ethical conflicts in their practice. The main teaching method used was problem-based learning (PBL). Skills objectives are described. The course was structured with a theoretical seminar (2 hours of duration), a workshop (2 hours of duration), 4 cases of PBL (24 hours of duration in total) and a role playing workshop (2 hours of duration). The seminar was aimed at the acquisition of theoretical knowledge. The PBL cases provided critical appraisal, obtaining knowledge, and application. The Role Playing set out for the practical demonstration of skills acquired in a simulated environment. A continuous assessment of students was performed throughout their practice on the PBL cases (40% of the final score) and also a final evaluation of the course was carried out via exam (60% of the final score). Students completed a course and faculty evaluation anonymously, which came out with positive results (median score of 8.5/10).

Documento Cosce sobre el uso de animales en investigación científica / Cosce Document about the use of animals in scientific research

No disponible

Biochemistry in an undergraduate writing-intensive first-year program: Seminar courses in drugs and bioethics.

The College of the Holy Cross offers a universal first-year program called Montserrat, in which first-year students participate in a living-learning experience anchored by a yearlong seminar course. The seminar courses are part of a thematic cluster of four to eight courses; students in the cluster live together in a common dormitory and participate in shared co-curricular events designed to engage the entire cluster in intellectual discourse related to the theme. A two-semester seminar within the "Natural World" cluster was offered using biochemical principles as the underlying content. In the first semester, students were introduced to drug design, activity and abuse via student presentations and guided readings on ethnobotany, drug laws, drug use in religion, and prescription drug costs. In the second semester, students discussed primary readings in ethics followed by case study analyses of assisted reproduction technologies, informed consent, genetic privacy, performance enhancing drugs and genetically modified organisms. Student learning outcomes were evaluated via rubrics and a College-facilitated survey.

Aportes desde la bioética para la incluision de niños y niñas con necesidades educativas especiales en la escuela común a través de musicoterapia / Contributions from bioethics for the inclusion of children with special educational needs in mainstream schools through music therapy

La tesis reflexiona sobre los aportes de la musicoterapia en la inclusión de niños y niñas con necesidades educativas especiales (NEE) en la escolaridad común. Tomando como punto de partida su reconocimiento como sujetos éticos, históricos, políticos, culturales e integrantes de una comunidad - y no solo como personas a la que hay que rehabilitar - este estudio documental y exploratorio integra fuentes bibliográficas y categorías pertenecientes a los campos de la bioética, la educación y la musicoterapia. La exploración de las potencialidades de la musicoterapia dentro del sistema educativo formal promueve reflexiones éticas y nuevos interrogantes sobre los límites y posibilidades de la acción escolar vinculando los principios bioéticos con el pleno ejercicio de los derechos consagrados en la Ley Nacional de Educación. Dentro de un marco de justicia distributiva, se presenta la musicoterapia como un recurso que puede optimizar los procesos de inclusión de personas con NEE pasando del cumplimiento del principio de la no maleficencia al de la beneficencia. A la luz de categorías provenientes del campo educativo, como la noción de educabilidad vinculada a la atención de la diversidad y el uso pleno de los derechos, se revisan los paradigmas que subyacen en los procesos de inclusión/exclusión de NEE. Luego de ofrecer un esquema conceptual referencial y operativo para incorporar la musicoterapia al ámbito educativo, se presenta el Caso Matías, un relato sistemático que permite integrar las particularidades y propiedades de la Musicoterapia y sus aspectos convergentes con la Bioética, en sentido inductivo y deductivo

ABSTRACT: This thesis shows how music therapy helps in the inclusion of boys and girls with special needs in the educational area, we have to recognize them as ethic, historical, political and cultural human been which integrates a community and not just see them as people who we need to rehabilitate. This documental study integrates the bioethics, education and music therapy resources. The exploration of how the music therapy has the potential to get into the formal educational system, and propose new question about limits and possibilities to get into the school vinculating the bioethics principles knowing the existence of the rights which are in the National Education Law. The musical therapy is a resource inside the distributive justice, can be used as an inclusive process for people with special educational needs, using the fulfillment of the non maleficence to the beneficence. With the categories of the educational area like educability notion, bonding to the attention of diversity and the use of rights, we check the paradigms that are in the process of inclusion/exclusion. After offering a conceptual, referential and operative scheme to incorporate the musical therapy to the educational system we present Matia’s case, a systematic report which help us to integrate the properties and particularities of the musical therapy convergent with the bioethics, in a sense of induction and deduction

Revisión integrativa sobre las cuestiones bioéticas relacionadas con el anciano: aspectos relevantes para la enfermería / Integrative Review on bioethical issues related to the elderly: aspects relevant to nursing

Objetivo: Analizar la producción científica sobre la bioética centrada en los ancianos en aspectos relevantes para la enfermería en el período 2007 a 2011. Método: Revisión integradora con período de recolección de datos 14/09/11 al 08/12/11, realizada la búsqueda en las bases de datos de las Bibliotecas Virtuales: LILACS, Scielo y PubMed desde 2007 a 2011. Resultados: 36 artículos seleccionados destacaron los dilemas éticos y autonomía en el 13,8% de los artículos; 11,1% respecto a la necesidad de trasplante de órganos; 2,8% tratan de la formación médica en relación a las cuestiones de bioética de los ancianos; 8,3 % la disponibilidad de albergues para ancianos abandonados; 5,5% citan la disponibilidad de tecnologías asistenciales; 5,5% hablan del papel de la familia con los ancianos; 11,1% el consentimiento informado en la toma de decisiones éticas; 5,5% se refiere a cuidados paliativos para los ancianos; 17% habla de la Bioética intervencionista para el cuidado al anciano buscando la credibilidad de sus derechos, y el 2,8% refieren las conductas éticas de los cuidados a los ancianos. Conclusión: La responsabilidad social de las políticas de salud, la asignación de recursos y el desempeño de los profesionales de la salud debe reflejarse a la la luz de la bioética y no olvidar que la producción de estas intervenciones y las soluciones a los conflictos morales de los ancianos pueden tener consecuencias para la población en su conjunto(AU)

Objective: To analyze the scientific production on Bioethics focused on the elderly in aspects relevant for nursing in the period 2007 to 2011. Method: an integrative review with data collection period 14/09/11 to 08/12/11 conducted the search in the databases of Virtual Libraries: LILACS, Scielo and Pubmed from 2007 to 2011. Results: 36 articles selected and highlighted the ethical dilemmas of autonomy in articles 13,8%; 11,1% concerning the need for organ transplantation; 2,8% deal with medical training in relation to bioethical issues of the elderly; 8,3 % availability of shelters for abandoned elderly; 5,5% cite the availability of assistive technologies; 5,5% for the family's role with the elderly people, 11,1% out of the elderly informed consent in ethical decision-making; 5,5% referred to hospice care to the elderly; 17% for Bioethics intervention aimed at elderly care hospital seeking the credibility of their rights, and 2,8% refer to the ethical standards of care to the elderly. Conclusion: The social responsibility of health policies, resource allocation and performance of health professionals needs to be reflected in the light of bioethics and not forgetting to consider that the production of these interventions and solutions to moral conflicts involving the elderly may have consequences for the population as a whole(AU)

Bioethics education of nursing curriculum in Korea: a national study.

The aim of this study is to examine the current profile of bioethics education in the nursing curriculum as perceived by nursing students and faculty in Korea. A convenience sampling method was used for recruiting 1223 undergraduate nursing students and 140 nursing faculty in Korea. Experience of Bioethics Education, Quality of Bioethics Education, and Demand for Bioethics Education Scales were developed. The Experience of Bioethics Education Scale showed that the nursing curriculum in Korea does not provide adequate bioethics education. The Quality of Bioethics Education Scale revealed that the topics of human nature and human rights were relatively well taught compared to other topics. The Demand for Bioethics Education Scale determined that the majority of the participants believed that bioethics education should be a major requirement in the nursing curriculum. The findings of this study suggest that bioethics should be systemically incorporated into nursing courses, clinical practice during the program, and during continuing education.

Ethics education in chiropractic colleges: a North American survey.

OBJECTIVE: The purposes of this study were to survey Council on Chiropractic Education-accredited chiropractic colleges in North America and to describe curricular details on the teaching of bioethics. METHODS: A custom-designed survey was sent to chiropractic colleges. Total number of contact hours, whether the ethics was a stand-alone course or integrated elsewhere, type of instructor, and if there was a required or recommended course text were queried. RESULTS: Of 19 surveys sent by mail, 15 surveys were returned. The average time in ethics instruction was 18.7 hours including lecture format, small group tutorial, and self-study. Chiropractic ethics education includes 8 areas of content (boundaries, law and jurisprudence, professionalism, basic ethic tenets/principles, ethical codes of conduct, prevention of financial and of sexual abuse, and resolving an ethical dilemma). Some colleges include content taught to students under the domain of law and jurisprudence. CONCLUSION: The results of this survey indicate that there are opportunities to further develop the educational ethics program at Council on Chiropractic Education-accredited colleges. All colleges currently offer bioethics teaching. An expanded role for this content is recommended so as to offer optimal benefit for students and practitioners.

Development of integrative bioethics in the Mediterranean area of South-East Europe.

With regards to its origin, foundation and development, bioethics is a relatively new discipline, scientific and theoretical field, where different and even contradicting definition models and methodological patterns of its formation and application meet. In some philosophical orientations, bioethics is considered to be a sub-discipline of applied ethics as a traditional philosophical discipline. Yet in biomedical and other sciences, bioethics is designated as a specialist scientific discipline, or a sort of a new medical ethics. The concept of integrative bioethics as an interdisciplinary scholarly and pluriperspectivistic area goes beyond such one-sided determinations, both philosophical and scientistic, and intends to integrate the philosophical approach to bioethics with its particular scientific contents, as well as different cultural dimensions and perspectives. This concept of integrative bioethics has gradually developed at philosophical and interdisciplinary conferences and institutions on the "bioethical islands" of the Croatian Mediterranean. In this paper, the author follows the formation, development and prospects of integrative bioethics in the wider region of the Mediterranean and Southeast Europe.

Los derechos humanos y los cuidados paliativos: autoevaluación sobre la formación en cuidados paliativos en un grupo de residentes de medicina / Human rights and palliative care: self-assessment training in palliative care in a group of medical residents

La demanda social por los aspectos paliativos de la Medicina se ha incrementado notablemente en los últimos años debido, entre otros factores, al envejecimiento de la población y al aumento de los enfermos con cáncer y otras enfermedades crónicas con mal pronóstico de vida. Todo paciente con enfermedad terminal tiene el derecho a una asistencia integral, que le posibilite calidad de vida y una muerte digna. El discurso médico que enfoca sólo lo patológico se ve reflejado en la práctica médica en el corte entre la enfermedad y el hombre que la padece. La relación médico-paciente con enfermedad avanzada no puede reducirse al control de síntomas físicos, sino que demanda una atención integral, abarcativa de los aspectos bio-psico-sociales y espirituales. Hay estudios que señalan que los médicos recién egresados no están preparados suficientemente para asistir a estos pacientes. El ejercicio de la profesión en sí, no los capacita para enfrentar el sufrimiento y la muerte. Uno de los retos actuales de la Medicina es mejorar la atención de los enfermos incurables en su fase avanzada. A tal fin, las Facultades de Medicina, entre otras, deberían incorporar en sus planes de estudio, conocimientos, estrategias y habilidades que capaciten a estudiantes y residentes en el manejo óptimo de los síntomas, brindando información adecuada, proporcionando soporte emocional y trabajando en equipo interdisciplinario. El objetivo de este trabajo es determinar que proporción de un grupo de residentes de Medicina, han tenido formación en Cuidados Paliativos durante los estudios de pre y post-grado y cómo valoran esa formación.

The social demand for the palliative aspects of Medicine has increased significantly in the last years, among other reasons, as a result of an ageing population and an increase in cancer patients as well as other chronic diseases with poor life prognosis. Every terminally ill patient is entitled to an overall assistance that grants them a better quality of life and a dignified death. The physician’s speech, which only focuses on the pathological, is reflected on the medical practice in the breach between the illness and the person suffering it. The relationship doctor-patient with advanced disease cannot be confined to controlling physical symptoms only, it also calls for an overall, holistic assistance that contemplates bio-psycho-social and spiritual aspects. Current research stresses the fact that recent graduate doctors are not sufficiently trained to assist these patients. The profession as such does not prepare them to cope with suffering and death. One of the present challenges of Medicine is to improve the assistance to the terminally ill in their advanced stages. For that reason, the Medical Schools among others, should include knowledge, strategies and skills in their curricula with a view to training students and residents to deal with symptoms, to deliver information, to provide emotional support and to work as an interdisciplinary team in the best possible way.

La enseñanza de la Bioética en el pregrado: reflexiones sobre un problema inconcluso / The teaching of the Bioética in the pregrado: meditate on an unconcluded problem

Enseñar bioética en el pregrado es un problema no resuelto en nuestras Universidades Médicas; en el presente artículo se reflexiona sobre este interesante tema. El autor defiende que el especialista que va a enseñar bioética ha de tener una doble vocación: de una parte debe estar familiarizado con el estado actual de los conocimientos científicos, de otra debe hundir las raíces de su formación humanista en el ámbito de la filosofía moral, de manera que pueda juzgar, con suficiente conocimiento de juicio, los hechos que en la praxis clínica se le presentan. Se propone además, enseñar bioética como una disciplina propia desde el ciclo básico y lograr que esos conocimientos se integren en el actuar diario de cada estudiante, para que llegue a ser un profesional integral, colmado de virtudes en cada una de sus actuaciones(AU)

The role of psychosomatic-medicine psychiatrists in bioethics: a survey study of members of the academy of psychosomatic medicine.

The Bioethics Subcommittee of The Academy of Psychosomatic Medicine developed a survey to assess the involvement of psychosomatic-medicine psychiatrists in bioethics and the extent of their participation on bioethics committees and in the teaching of bioethics. Of 599 Academy members surveyed, 122 (20.4%) responded. The majority of respondents reported that the management of bioethical dilemmas had a significant impact on their work in psychosomatic medicine. Many respondents were involved in teaching bioethics and in serving on ethics committees. The majority of respondents reported psychiatry-resident involvement on ethics committees. Bioethics work is an integral part of the fabric of psychosomatic medicine.

A medical humanities special study module on principles of medical theory and practice at the Charité, Humboldt University, Berlin, Germany.

The authors are members of a committee in charge of a special study module (SSM) entitled Principles of Medical Theory and Practice in a problem-based and integrated reformed curriculum track at the Charité, the medical school and university hospital of the Humboldt University, Berlin, Germany. The SSM contextualizes medicine by highlighting the societal contexts of the doctor-patient relationship and the medical profession. Integrating the humanities into medical education helps students develop an awareness of the strengths and limitations of modern medicine, develop their own personalities and sense of social responsibility, and generally broaden their outlook. Teachers in the SSM seminars are from different disciplines, such as the history of medicine, bioethics, sociology, anthropology, and complementary medicine. Once a week, one or two teachers meet with as many as 21 students per group for a 90-minute course. Twelve courses constitute a seminar. Students are required to participate in four seminars during five years of studies. They can choose different topics from a set range. Although this SSM has been largely successful, some problems have occurred. Results from the course evaluations and experiences show that the seminars differ from one another in many ways. Financial restraints and the departmental structure of the faculty have influenced implementation of the SSM. However, the SSM is a new concept and is continuously reviewed and renewed. Future plans will be to specify outcomes, continue to discuss reasonable seminar topics, establish continuous support and training for teachers, and motivate students to become actively involved in the seminar discussions.

Cloning, stem cells, and the current national debate: incorporating ethics into a large introductory biology course.

Discussing the ethical issues involved in topics such as cloning and stem cell research in a large introductory biology course is often difficult. Teachers may be wary of presenting material biased by personal beliefs, and students often feel inhibited speaking about moral issues in a large group. Yet, to ignore what is happening "out there" beyond the textbooks and lab work is to do a disservice to students. This essay describes a semester-long project in which upperclass students presented some of the most complex and controversial ideas imaginable to introductory students by staging a mock debate and acting as members of the then newly appointed President's Council on Bioethics. Because the upperclass students were presenting the ideas of real people who play an important role in shaping national policy, no student's personal beliefs were put on the line, and many ideas were articulated. The introductory audience could accept or reject what they were hearing and learn information important for making up their own minds on these issues. This project is presented as an example of how current events can be used to put basic cell biology into context and of how exciting it can be when students teach students.

An annotated bibliography for ethics training in consultation-liaison psychiatry.

The expanding field of bioethics has created a need in psychiatry for rapid access to the complex bioethics literature. This is especially true in consultation-liaison work. An annotated bibliography was created by a task force of the Academy of Psychosomatic Medicine charged with exploring how psychiatrists function on bioethics committees. The bibliography is organized into headings that reflect how bioethical problems came to the attention of psychiatrists. Introductory references allow the reader an overview of the history of bioethics and a selection of useful textbooks. References are provided explaining how ethical principles are used. References are also organized by areas of medical work frequently visited by consultation-liaison psychiatrists.