Clasificación Internacional de Enfermedades CIE10ES: solo sombras en su implantación / International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): only shadows in its implementation

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Should uterus transplants be publicly funded?

Since 2000, 11 human uterine transplantation procedures (UTx) have been performed across Europe and Asia. Five of these have, to date, resulted in pregnancy and four live births have now been recorded. The most significant obstacles to the availability of UTx are presently scientific and technical, relating to the safety and efficacy of the procedure itself. However, if and when such obstacles are overcome, the most likely barriers to its availability will be social and financial in nature, relating in particular to the ability and willingness of patients, insurers or the state to pay. Thus, publicly funded healthcare systems such as the UK's National Health Service (NHS) will eventually have to decide whether UTx should be funded. With this in mind, we seek to provide an answer to the question of whether there exist any compelling reasons for the state not to fund UTx. The paper proceeds as follows. It assumes, at least for the sake of argument, that UTx will become sufficiently safe and cost-effective to be a candidate for funding and then asks, given that, what objections to funding there might be. Three main arguments are considered and ultimately rejected as providing insufficient reason to withhold funding for UTx. The first two are broad in their scope and offer an opportunity to reflect on wider issues about funding for infertility treatment in general. The third is narrower in scope and could, in certain forms, apply to UTx but not other assisted reproductive technologies (ARTs). The first argument suggests that UTx should not be publicly funded because doing so would be inconsistent with governments' obligations to prevent climate change and environmental pollution. The second claims that UTx does not treat a disorder and is not medically necessary. Finally, the third asserts that funding for UTx should be denied because of the availability of alternatives such as adoption and surrogacy.

Ethics, disability and the International Classification of Functioning, Disability and Health.

This article offers preliminary reflections on the potential application of the International Classification of Functioning, Disability, and Health (ICF) to the developing literature on disability ethics. As an epidemiologic tool--an international standard language of functioning and disability--the ICF has instrumental ethical significance as its application is governed by standard bioethical concerns of informed consent, confidentiality, and respect for persons. However, the ICF also has an intrinsic ethical significance, so far untapped, arising from three conceptual features of its model of functioning and disability, namely universalism, the interactional model, and etiologic neutrality. The future of the ethical dimension of ICF is briefly explored.

Multidisciplinary research network on health and disability training on the International Classification of Functioning, Disability and Health, Ethics, and Human Rights.

This article provides a brief description of a training course in International Classification of Functioning (ICF), Disability and Health, Ethics and Human Rights done in the field of the European MURINET project. This course, in its three annual editions, was the product of a joint collaborative work among the Neurological Institute Carlo Besta, the Catholic University, and the National Council of Disability. The training program was formulated to provide knowledge and skills in the field of disability and in the use of ICF. The main result is that a new generation of European researchers was trained. Thanks to this specialized training program, they are now able to conduct and manage research on health and disability, applying the new concept of health and disability based on the ICF biopsychosocial model.