ABSTRACT
Forced hospitalization is a common practice in psychiatry. It involves limiting the patient's freedom of movement in a clinical context without expressing informed consent, causing stress to the family and support network. Thus, forced hospitalization may cause violations, disturbances, or threats to the human rights of a vulnerable population. Considering this clinical reality, the present study seeks to analyze the current law on this subject in Chile compared to the international human rights guidelines. The analysis included a review of legal documents and referenced scientific articles. The new law No. 21,331 establishes a more demanding standard for the origin of forced internment, shortening the distance concerning the human rights guidelines regarding intellectual disability. The incoming development of the regulations mandated by the law could fill in the gaps in several situations that may arise and clarify fuzzy points. The key stakeholders' participation level will be critical in this matter.
Subject(s)
Human Rights , Humans , Chile , Human Rights/legislation & jurisprudence , Mental Disorders/therapy , Hospitalization/legislation & jurisprudence , Commitment of Mentally Ill/legislation & jurisprudence , Mental Health/legislation & jurisprudence , Informed Consent/legislation & jurisprudenceABSTRACT
Objetivo principal: Conocer los saberes sobre cuidado espiritual que ha desarrollado el personal sanitario desde la experiencia de atención en cuidado espiritual a personas mayores con cáncer, además de establecer las condiciones que favorecen este aprendizaje. Metodología: Estudio cualitativo descriptivo, con estudio de caso intrínseco. Participaron 12 trabajadores sanitarios en entrevistas semiestructuradas y grupos focales. Resultados principales: El saber práctico en cuidado espiritual tiene una finalidad centrada en el paciente y requiere del desarrollo de habilidades comunicativas. Las condiciones facilitadoras para la construcción del saber práctico tienen carácter personal, que incluye la disposición y vocación; e institucional, la diversidad de pacientes y el aprendizaje por modelamiento. Conclusión principal: Esta investigación evidencia que el saber práctico se construye con la reflexión y la acción profesional. El conocimiento práctico debe ser rescatado, valorado, explicitado y compartido para que se traduzca en un modelo de profesionalización con un mayor carácter pragmático y ético.(AU)
Objective: To know the knowledge about spiritual care that health professionals have developed from the experience of spiritual care for elderly people with cancer, in addition to establishing the conditions that favor this learning. Methods: Qualitative descriptive study, with an intrinsic case study. Twelve health workers participated in semi-structured interviews and focus groups. Results: Practical knowledge in spiritual care is patient-centered and requires the development of communication skills. The facilitating conditions for the construction of practical knowledge have a personal character, which includes disposition and vocation; and institutional, patient diversity and learning by modeling. Conclusions: This research shows that practical knowledge is built with reflection and professional action. Practical knowledge must be rescued, valued, made explicit and shared so that it translates into a professionalization model with a more pragmatic and ethical nature.(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Nursing Care , Oncology Nursing , Spirituality , Terminal Care/methods , Spiritual Therapies , Qualitative Research , Epidemiology, Descriptive , Nursing , Medical Oncology , Surveys and QuestionnairesABSTRACT
This paper analyzes the Inter-American Court of Human Rights' ruling in the case of Poblete Vilches et al. v. Chile. Poblete Vilches, a senior citizen, died in February 2001 due to septic shock and bilateral bronchopneumonia after being treated in a public hospital in Chile. The ruling held the state of Chile responsible for a number of human rights violations. The paper evaluates the interpretation of the American Convention on Human Rights as carried out by the Inter-American Court of Human Rights. It concludes that the sentence explicitly developed criteria in relation to informed consent as a derivation of the right to health and implicitly recognized, from a gerontological perspective, a manifestation of structural abuse toward older persons and their supportive environments. The gerontological gaze brings new challenges for the development of older persons' rights. The ruling is unique in the inter-American human rights system, as recognized by the court itself.
Subject(s)
Delivery of Health Care , Informed Consent , Aged , Aged, 80 and over , Chile , Humans , United StatesABSTRACT
Resumen La última década ha estudiado la faceta "espiritualidad" en el contexto de cuidados paliativos oncológicos en personas mayores desde perspectivas cuantitativas, cualitativas y mixtas. El estudio busca develar -en este contexto- el significado de espiritualidad. Se revisa literatura indexada en buscador PubMed vía Medline entre los años 2009 y 2019, con acceso on line, a texto completo, en forma anónima, en idiomas inglés-español y, análogamente, con búsqueda manual en la Revista Medicina Paliativa. Los resultados arrojan 50 artículos de pertinencia temática y cuatro categorías. Se concluye que existen desafíos relacionados con el significado de espiritualidad y calidad de vida, formación y perspectivas de investigación.
Abstract In the last decade, spirituality has been studied in oncological palliative care for the elderly from quantitative, qualitative, and mixed perspectives. The study seeks to reveal the meaning of spirituality in this context. It reviews indexed literature from the MEDLINE database through PubMed between 2009 and 2019, which was accessed online, in full text, anonymously, and in English and Spanish. Revista Medicina Paliativa was manually searched. The results include 50 subject-relevant articles and four categories. It is concluded that there are challenges related to the meaning of spirituality and quality of life, education, and research perspectives.
Resumo Na última década, a faceta "espiritualidade" tem sido estudada no contexto de cuidados paliativos oncológicos a idosos sob perspectivas quantitativa, qualitativa e mista. O estudo pretende revelar o significado de espiritualidade nesse âmbito. A literatura indexada no buscador PubMed via Medline entre 2009 e 2019 é revisada, por meio do acesso on-line dos textos completos, de forma anônima, em inglês e espanhol, além da busca manual na Revista Medicina Paliativa. Os resultados demonstram 50 artigos de pertinência temática e quatro categorias. Conclui-se que existem desafios relacionados com o significado de espiritualidade e qualidade de vida, formação e perspectivas de pesquisa.
Subject(s)
Palliative Care , Quality of Life , Aged , Spirituality , Medical OncologyABSTRACT
In Chile, more than 180 thousand people (1% of the population) have some form of dementia. The figure should increase to approximately 600,000 (3% of Chileans) by 2050. This disease poses major challenges to the society. One of them is the effective recognition of the autonomy and responsibility of the person living with this condition. This article aims to review the clinical assessment of competence, its agreement with the Chilean legal system and the challenges that the assessment of competence poses in clinical decision-making and the capacity of an individual make decisions, according to the new international obligations subscribed by Chile. It is concluded that inclusion is a pending challenge, reflected among other things, by the non-compliance with binding rules such as Article 12 of the Convention on the Rights of Persons with Disabilities, which affirms that persons with disabilities have the right to be recognized as a person everywhere, before the law.
Subject(s)
Humans , Mental Competency/legislation & jurisprudence , Persons with Mental Disabilities/legislation & jurisprudence , Decision Making , Dementia/psychology , Informed Consent/legislation & jurisprudence , Psychological Tests , Chile , Mental Competency/psychology , Persons with Mental Disabilities/psychology , Personal Autonomy , Disability Evaluation , Informed Consent/psychologyABSTRACT
Resumen La salud ocupacional cubre aspectos técnicos, médicos, sociales y jurídicos. Este artículo la analizó desde el bioderecho, específicamente los aspectos relacionados con los comportamientos de riesgo y sus factores de protección contenidos en instrumentos internacionales vinculantes, resoluciones y declaraciones emanados de la Organización Mundial de la Salud y la Organización Internacional del Trabajo, que buscan mejorar la seguridad y salud en el trabajo y medioambiente. Para ello hubo una revisión bibliográfica de documentos jurídicos y artículos científicos de referencia. El desafío es la concienciación de agentes decidores de políticas públicas y empresariales respecto de la complejidad que presenta el fenómeno del trabajo. También la implementación de buenas prácticas en los diversos sectores involucrados.
Abstract Occupational health covers technical, medical, social and legal aspects. This article analyzes it from the perspective of biodiversity, specifically aspects related to risky behavior and its protective factors that are contained in binding international instruments, resolutions and declarations issued by the World Health Organization and the International Labor Organization, which seek to improve safety and health at work and in the environment. A bibliographic review of legal documents and scientific articles of reference was conducted to that end. The challenge is to raise awareness among public and business policy-makers concerning the complexity of the phenomenon of work. The implementation of good practices in the various sectors involved is emphasized as well.
Resumo A saúde ocupacional abrange aspectos técnicos, médicos, sociais e jurídicos. Este artigo a analisou a partir do biodireito, especificamente os aspectos relacionados com os comportamentos de risco e seus fatores de proteção contidos em instrumentos internacionais vinculantes, resoluções e declarações emanadas da Organização Mundial da Saúde e da Organização Internacional do Trabalho, que procuram melhorar a segurança e a saúde no trabalho e no meio ambiente. Para isso, houve uma revisão bibliográfica de documentos jurídicos e artigos científicos de referência. O desafio é a conscientização de tomadores de decisão de políticas públicas e empresariais a respeito da complexidade que apresenta o fenômeno do trabalho. Também a implantação de boas práticas nos diversos setores envolvidos.
Subject(s)
Humans , Physicians , Awareness , World Health Organization , Health , Occupational HealthABSTRACT
In Chile, more than 180 thousand people (1% of the population) have some form of dementia. The figure should increase to approximately 600,000 (3% of Chileans) by 2050. This disease poses major challenges to the society. One of them is the effective recognition of the autonomy and responsibility of the person living with this condition. This article aims to review the clinical assessment of competence, its agreement with the Chilean legal system and the challenges that the assessment of competence poses in clinical decision-making and the capacity of an individual make decisions, according to the new international obligations subscribed by Chile. It is concluded that inclusion is a pending challenge, reflected among other things, by the non-compliance with binding rules such as Article 12 of the Convention on the Rights of Persons with Disabilities, which affirms that persons with disabilities have the right to be recognized as a person everywhere, before the law.
Subject(s)
Decision Making , Dementia/psychology , Informed Consent/legislation & jurisprudence , Mental Competency/legislation & jurisprudence , Persons with Mental Disabilities/legislation & jurisprudence , Chile , Disability Evaluation , Humans , Informed Consent/psychology , Mental Competency/psychology , Personal Autonomy , Persons with Mental Disabilities/psychology , Psychological TestsABSTRACT
Dementia is an important public health problem due to the complex challenges it poses during the progression of the disease and especially during its end-of-life stage. The aim of this article is to consider the issues that arise from the use of commonly administered therapies in patients with severe dementia. Scenarios where excessive or futile therapeutic interventions might occur are discussed. The article concludes that it is advisable to analyze the clinical criteria and ethical considerations related to the administration of those treatments in order to develop and disseminate better practice guidelines for health professionals.
Subject(s)
Dementia/therapy , Palliative Care , Alzheimer Disease/psychology , Alzheimer Disease/therapy , Dementia/psychology , Enteral Nutrition , Humans , Risk Factors , Severity of Illness Index , Terminal CareABSTRACT
Dementia is an important public health problem due to the complex challenges it poses during the progression of the disease and especially during its end-of-life stage. The aim of this article is to consider the issues that arise from the use of commonly administered therapies in patients with severe dementia. Scenarios where excessive or futile therapeutic interventions might occur are discussed. The article concludes that it is advisable to analyze the clinical criteria and ethical considerations related to the administration of those treatments in order to develop and disseminate better practice guidelines for health professionals.
Subject(s)
Humans , Palliative Care , Dementia/therapy , Terminal Care , Severity of Illness Index , Risk Factors , Enteral Nutrition , Dementia/psychology , Alzheimer Disease/psychology , Alzheimer Disease/therapyABSTRACT
El objetivo de este trabajo es discurrir sobre los orígenes, naturaleza, integración y funciones de las Comisiones Nacionales de Bioética de México e Italia, con el fin de extraer experiencia que pudiese ayudar al momento de implementar la Comisión Nacional de Bioética de Chile. La investigación es cualitativa-interpretativa, fenomenológica, descriptiva y bibliográfica. Se infiere que la Comisión Nacional Bioética de Chile, para cumplir la función encomendada, debiese considerar la experiencia de otras comisiones, en particular la de México e Italia.
The aim of this study is to reflect on the origin, nature, integration and functions of National Bioethics Commissions of Mexico and Italy, with the goal to draw helpful experience for implementing the National Bioethics Commission in Chile. The study is qualitative-interpretative, phenomenological, descriptive and bibliographical. It is inferred that the National Bioethics Commission in Chile, in order to fulfill the function entrusted, it must consider the experience of other commissions, in particular that of Mexico and Italy.
O objetivo deste trabalho é discorrer sobre as orígens, natureza, integração e funções das Comissões Nacionais de Bioética do México e da Itália, com a finalidade de obter experiência que possa ajudar na ocasião de implementar a Comissão Nacional de Bioética do Chile. A investigação é qualitativa-interpretativa, fenomenológica, descritiva e bibliográfica. Infere-se que a Comissão Nacional Bioética do Chile, para cumprir a função para a qual foi encarregada, deveria considerar a experiência de outras comissões, em particular a do México e da Itália.
Subject(s)
Advisory Committees , Bioethics , Ethics Committees , Chile , Italy , MexicoABSTRACT
El bioderecho es un neologismo que trata las reglas jurídicas de comportamiento en el contexto de cuestiones bioéticas; se ocupa también del hombre, su dignidad, vida e identidad. El presente estudio descriptivo busca atribuir significado al concepto de dignidad en dos modelos de bioderecho, que develan el estatuto jurídico reconocido por estos a los adultos mayores. Se aplica el método de análisis elaborado por Laura Palazzani³. Los resultados evidencian diferencias en el contenido del concepto de dignidad y, por ende, en el estatuto jurídico reconocido a las personas mayores.
Biolaw is a neologism that deals with the legal rules of behavior in the context of bioethical issues. It also concerns man, his dignity, life and identity. This descriptive study is intended to ascribe meaning to the concept of dignity in two models of biolaw that show the legal status they afford to the elderly. The analytical method developed by Laura Palazzani is used. The results show differences in the content of the concept of dignity and, as a result, in the legal status conferredto the elderly.
O biodireito é um neologismo que trata das regras jurídicas de comportamento no contexto de questões bioéticas; ocupa-se também do homem, sua dignidade, vida e identidade. Este estudo descritivo pretende atribuir significado ao conceito de dignidade em dois modelos de biodireito que revelam o estatuto jurídico reconhecido por estes aos idosos. Aplica-se o método de análise elaborado por Laura Palazzani. Os resultados demonstram diferenças nos conteúdos do conceito de dignidade e, consequentemente, no estatuto jurídico reconhecido às pessoas idosas.
Subject(s)
Humans , Behavior , Aged , Life , Disaster Vulnerability , RespectABSTRACT
El presente trabajo analiza algunos de los problemas que plantea en Chile el inicio de la vida del concebido por técnicas de fertilización in vitro. De allí surge la necesidad de normar la aplicación de esas técnicas con el fin de proteger la vida en cumplimiento del mandato constitucional. Es un estudio descriptivo e histórico a partir de la revisión de proyectos de ley chilenos que regulan la materia -directa o indirectamente- entre 1996 y 2013. Se concluye que es urgente regular un estatuto jurídico del concebido no nacido para una garantía integral efectiva de su vida.
The present study analyzes some of the problems encountered in Chile in the beginning of life of those conceived by in vitro fertilization. From these arises the need to norm the application of these techniques with the goal to protect life in compliance with constitutional mandate. This is a descriptive historical study grounded on the review of Chilean project laws regulating the issue -direct and indirectly- between 1996 and 2013. It is concluded that is urgent to regulate a juridical statue of the unborn conceived to guaranty the effective integrity of his/her life.
O presente trabalho analisa alguns dos problemas que apresenta no Chile o início da vida do concepto obtido por técnicas de fertilização in vitro. Dai surge a necessidade de normalizar a aplicação dessas técnicas com a finalidade de proteger a vida em cumprimento do mandato constitucional. É um estudo descritivo e histórico a partir da revisão de projetos de lei chilenos que regulam a matéria -direta ou indiretamente- entre 1996 e 2013. Conclui-se que é urgente regulamentar um estatuto jurídico do concepto não nascido para uma garantia integral efetiva de sua vida.
