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Nurs Ethics ; 28(1): 82-90, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33472524


The conduct of nurse managers, and health service managers more widely, has been subject to scrutiny and critique because of high-profile organisational failures in healthcare. This raises concerns about the practice of nursing management and the use of codes of professional and managerial conduct. Some responses to such failures seem to assume that codes of conduct will ensure or at least increase the likelihood that ethical management will be practised. Codes of conduct are general principles and rules of normative standards, including ethical standards, and guides for action of agents in particular roles. Nurse managers seem to stride two roles. Contra some accounts of the roles of a professional (nurse) and that of a manager, it is claimed that there is no intrinsic incompatibility of the roles though there is always the possibility that it could become so and likewise for codes of conduct. Codes of conduct can be used to support nurse managers in making practical decisions via an 'outside in' approach with an emphasis on the use of principles and an 'inside out' approach with an emphasis on the agent's character. It is claimed that both approaches are necessary, especially as guides to ethical action. However, neither is sufficient for action because judgement and choice will always be required (principles always underdetermine action) as will a conducive environment that positively influences good judgement by being supportive of the basic principles and values of healthcare institutions. The response to the Covid-19 pandemic has created a unique set of circumstances in which the practical judgement, including ethical judgement, of nurse managers at all levels is being tested. However, the pandemic could be a turning point because staff and institutions (temporarily) freed from managerialism have demonstrated excellent practice supportive of ethical and other practical decision making. Organisations need to learn from this post pandemic.

/enfermería , Códigos de Ética , Liderazgo , Cultura Organizacional , Ética en Enfermería , Humanos , Pandemias
BMC Med Ethics ; 22(1): 6, 2021 01 25.
Artículo en Inglés | MEDLINE | ID: mdl-33494754


BACKGROUND: Critical public health measures implemented to mitigate the spread of the novel coronavirus disease (COVID-19) pandemic have disrupted health research worldwide, including HIV prevention research. While general guidance has been issued for the responsible conduct of research in these challenging circumstances, the contours of the dueling COVID-19 and HIV/AIDS pandemics raise some critical ethical issues for HIV prevention research. In this paper, we use the recently updated HIV Prevention Trials Network (HPTN) Ethics Guidance Document (EGD) to situate and analyze key ethical challenges related to the conduct of HIV prevention research during the COVID-19 pandemic as well as identify potential areas for refinement of the guidance document based on this unprecedented state of affairs. MAIN BODY: Necessary actions taken for HIV prevention research studies due to the COVID-19 pandemic involve an array of ethical issues including those related to: (1) risk mitigation; (2) behavior change; (3) compounding vulnerability; (4) community engagement; (5) trial reopening; and 6) shifting research priorities. CONCLUSIONS: In the context of the dueling HIV and COVID-19 global pandemics, research teams and sponsors must be nimble in responding to the rapidly changing environment by being sensitive to the associated ethical issues. The HTPN EGD provides a rich set of tools to help identify, analyze and address many of these issues. At the same time, future refinements of the HPTN EGD and other research ethics guidance could be strengthened by providing explicit advice regarding the ethical issues associated with disrupted research and the reopening of studies. In addition, additional consideration should be given to appropriately balancing domains of risk (e.g., physical versus social), addressing the vulnerability of research staff and community partners, and responding to un-anticipatable ancillary care needs of participants and communities. Appropriately addressing these issues will necessitate conceptual work, which would benefit from the careful documentation of the actual ethical issues encountered in research, the strategies implemented to overcome them, and their success in doing so. Throughout all of these efforts, it is critical to remember that the HIV pandemic not be forgotten in the rush to deal with the COVID-19 pandemic.

Investigación Biomédica/ética , Códigos de Ética , Ética , Infecciones por VIH/prevención & control , Pandemias , /epidemiología , Ética en Investigación , Salud Global , Servicios de Salud , Investigación sobre Servicios de Salud/ética , Humanos , Salud Pública , Investigadores , Características de la Residencia , Riesgo
Am J Bioeth ; 21(1): 4-13, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33373555


Statements of the core ethical and professional responsibilities of medical professionals are incomplete in ways that threaten fundamental goals of medicine. First, in the absence of explicit guidance for responding to cases in which there is significant uncertainty or disagreement about the relative therapeutic, prophylactic or diagnostic merits of available interventions they perpetuate self-defeating practices. Second, without addressing the role of advertising in shaping patient and community preferences they risk creating moral loopholes that bypass and undermine professional duties of fidelity, honesty and transparency. In both cases, these flaws are exacerbated by an individualism that ignores the critical role of health systems in managing and reducing uncertainty and conflict over best practices, and in communicating with and shaping the expectations of the public. These points are illustrated with examples from the response to COVID-19 and suggestions for reform are proposed.

Códigos de Ética , Ética Médica , Humanos , Principios Morales
Am J Bioeth ; 21(1): 31-33, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33373577
Nursing (Säo Paulo) ; 23(271): 5041-5054, dez.2020.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1147030


Com a recente atualização do Código de Ética dos Profissionais de Enfermagem, essa tornou-se conhecida apenas por parte dos profissionais. Objetivo: avaliar o conhecimento dos enfermeiros sobre o Código de Ética dos Profissionais de Enfermagem. Método: Trata-se de um estudo observacional, descritivo e transversal, com dados coletados no período de setembro a outubro de 2018, por meio de um questionário online, via Plataforma Google Forms®. Participaram da pesquisa 217 enfermeiros, sendo 190 (87,46%) do sexo feminino e 27 (12,44%) do sexo masculino. Resultado: Em relação aos direitos, os participantes obtiveram respostas semelhantes, considerando a alternativa mais coerente. Quanto aos deveres e proibições, apresentaram grande diversidade e discordância entre as alternativas escolhidas, demonstrando dúvida ou equívoco por parte dos participantes. Conclusão: Foi possível observar que o conhecimento dos enfermeiros acerca do Código de Ética Profissional de Enfermagem é limitado em relação aos deveres e proibições da profissão.(AU)

With the recent update of the Nursing Professionals Code of Ethics, this became known only by professionals. Objective: to evaluate nurses' knowledge of the Nursing Professionals Code of Ethics. Method: This is an observational, descriptive and cross-sectional study, with data collected from September to October 2018, through an online questionnaire, via the Google Forms® Platform. 217 nurses participated in the research, 190 (87.46%) female and 27 (12.44%) male. Result: Regarding rights, the participants obtained similar responses, considering the most coherent alternative. As for duties and prohibitions, they showed great diversity and disagreement between the alternatives chosen, showing doubt or misunderstanding on the part of the participants. Conclusion: It was possible to observe that the nurses' knowledge about the Nursing Professional Code of Ethics is limited in relation to the duties and prohibitions of the profession.(AU)

Con la reciente actualización del Código de Ética de los Profesionales de Enfermería, esto solo se dio a conocer por los profesionales. Objetivo: evaluar el conocimiento de los enfermeros sobre el Código de Ética para Profesionales de Enfermería. Método: Se trata de un estudio observacional, descriptivo y transversal, con datos recolectados de septiembre a octubre de 2018, a través de un cuestionario en línea, vía Google Forms® Platform. En la investigación participaron 217 enfermeras, 190 (87,46%) mujeres y 27 (12,44%) hombres. Resultado: En cuanto a derechos, los participantes obtuvieron respuestas similares, considerando la alternativa más coherente. En cuanto a deberes y prohibiciones, mostraron gran diversidad y desacuerdo entre las alternativas elegidas, mostrando dudas o incomprensiones por parte de los participantes. Conclusión: se pudo observar que el conocimiento de las enfermeras sobre el Código de Ética Profesional de Enfermería es limitado en relación a los deberes y prohibiciones de la profesión.(AU)

Humanos , Códigos de Ética , Ética en Enfermería , Ética Profesional , Conocimiento , Rol de la Enfermera , Enfermeras y Enfermeros
Rev. bioét. derecho ; (50): 439-452, nov. 2020.
Artículo en Español | IBECS | ID: ibc-191367


La regulación de la publicidad en algunos ámbitos de lo sanitario proporciona, más allá del nivel concreto de eficacia en su aplicación, naturalmente mutable y coyuntural, un marco coherente de protección que no se constata en otros campos. Este trabajo analiza la aplicabilidad de los criterios legales y jurisprudenciales de uno de ellos (el de publicidad de medicamentos) como complemento para la actuación frente a prácticas gravemente dañosas del interés público y de los derechos de los consumidores en otros como el de la publicidad de bebidas alcohólicas o de alimentos malsanos, muy necesitados de criterios jurídicos fundados con los que actuar para atajar la desprotección del consumidor y defender la salud pública

The regulation of advertising in some areas of health provides, beyond the specific level of effectiveness in its application, naturally mutable and conjunctural, a coherent framework of protection that is not found in other fields. This paper analyzes the applicability of legal and jurisprudential criteria of one of these areas (advertising of medicinal products) as a complement to action against practices that are seriously harmful to public interest and to consumer rights in other areas, such as the advertising of alcoholic beverages or unhealthy food, which are in great need of well-founded legal criteria with which to act to take action to tackle consumer protection and defend public health

La regulació de la publicitat en alguns àmbits del sanitari proporciona, més enllà del nivell concret d'eficàcia en la seva aplicació, naturalment mutable I conjuntural, un marc coherent de protecció que no es constata en altres camps. Aquest treball analitza l'aplicabilitat dels criteris legals I jurisprudencials d'un d'ells (el de publicitat de medicaments) com a complement per a l'actuació enfront de pràctiques greument danyoses de l'interès públic I dels drets dels consumidors en uns altres com el de la publicitat de begudes alcohòliques o d'aliments malsans, molt necessitats de criteris jurídics fundats amb els quals actuar per a atallar la desprotecció del consumidor I defensar la salut pública

Humanos , Control de la Publicidad de Productos , Códigos de Ética , Acceso a la Información/ética , Bebidas Alcohólicas
J Med Ethics ; 46(11): 732-735, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32958693


A recent update to the Geneva Declaration's 'Physician Pledge' involves the ethical requirement of physicians to share medical knowledge for the benefit of patients and healthcare. With the spread of COVID-19, pockets exist in every country with different viral expressions. In the Chareidi ('ultra-orthodox') religious community, for example, rates of COVID-19 transmission and dissemination are above average compared with other communities within the same countries. While viral spread in densely populated communities is common during pandemics, several reasons have been suggested to explain the blatant flouting of public health regulations. It is easy to fault the Chareidi population for their proliferation of COVID-19, partly due to their avoidance of social media and internet aversion. However, the question remains: who is to blame for their community crisis? The ethical argument suggests that from a public health perspective, the physician needs to reach out and share medical knowledge with the community. The public's best interests are critical in a pandemic and should supersede any considerations of cultural differences. By all indications, therefore, the physician has an ethical obligation to promote population healthcare and share medical knowledge based on ethical concepts of beneficence, non-maleficence, utilitarian ethics as well as social, procedural and distributive justice. This includes the ethical duty to reduce health disparities and convey the message that individual responsibility for health has repercussions within the context of broader social accountability. Creative channels are clearly demanded for this ethical challenge, including measured medical paternalism with appropriate cultural sensitivity in physician community outreach.

Educación en Salud/ética , Obligaciones Morales , Pandemias/ética , Médicos/ética , Rol Profesional , Responsabilidad Social , Acceso a la Información , Beneficencia , Betacoronavirus , Códigos de Ética , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Competencia Cultural , Cultura , Teoría Ética , Equidad en Salud , Promoción de la Salud/ética , Humanos , Internet , Pandemias/prevención & control , Paternalismo , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/virología , Salud Pública/ética , Religión , Justicia Social
Rev Med Chil ; 148(3): 399-403, 2020 Mar.
Artículo en Español | MEDLINE | ID: mdl-32730386


The code of ethics of the Medical College of Chile was modified in December 2019. The amendment was mainly to article 8, which refers to the doctor's duty to care for the pregnant woman and the child she is carrying. The change maintains this duty, but allows doctors to perform abortions, introducing three considerations that act as new principles or values for the medical profession: the plurality of values existing in society, the autonomy of women and what is established by law. This paper is a reflection on codes of ethics, their relationship with values, and with legislation. Also it shows the consequences that this modification represents for the principles governing medical activity, the status of medical specialties, the commitment of doctors to their patients and the validity of the code of ethics.

Códigos de Ética , Aborto Inducido , Chile , Ética Médica , Femenino , Humanos , Médicos , Embarazo
BMC Med Ethics ; 21(1): 60, 2020 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-32664908


BACKGROUND: As the COVID-19 (coronavirus) pandemic develops, healthcare professionals are looking for support with, and guidance to inform, the difficult decisions they face. In the (current) absence of an authoritative national steer in England, professional bodies and local organisations have been developing and disseminating their own ethical guidance. Questions inevitably arise, some of which are particularly pressing during the pandemic, as events are unfolding quickly and the field is becoming crowded. My central question here is: which professional ethical guidance should the professional follow? MAIN BODY: Adopting a working definition of "professional ethical guidance", I offer three domains for a healthcare professional to consider, and some associated questions to ask, when determining whether - in relation to any guidance document - they should "bin it or pin it". First, the professional should consider the source of the guidance: is the issuing body authoritative or, if not, at least sufficiently influential that its guidance should be followed? Second, the professional should consider the applicability of the guidance, ascertaining whether the guidance is available and, if so, whether it is pertinent. Pertinence has various dimensions, including whether the guidance applies to this professional, this patient and/or this setting, whether it is up-to-date, and whether the guidance addresses the situation the professional is facing. Third, the professional should consider the methodology and methods by which the guidance was produced. Although the substantive quality of the guidance is important, so too are the methods by which it was produced. Here, the professional should ask whether the guidance is sufficiently inclusive - in terms of who has prepared it and who contributed to its development - and whether it was rigorously developed, and thus utilised appropriate processes, principles and evidence. CONCLUSION: Asking and answering such questions may be challenging, particularly during a pandemic. Furthermore, guidance will not do all the work: professionals will still need to exercise their judgment in deciding what is best in the individual case, whether or not this concerns COVID-19. But such judgments can and should be informed (and constrained) by guidance, and hopefully these preliminary observations will provide some useful pointers for time-pressed professionals.

Infecciones por Coronavirus , Ética Médica , Personal de Salud/ética , Pandemias , Neumonía Viral , Guías de Práctica Clínica como Asunto , Betacoronavirus , Códigos de Ética , Investigación sobre Servicios de Salud , Humanos , Pandemias/ética
Goiânia; SES-GO; 10 jul. 2020. 1-7 p.
No convencional en Portugués | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1116448


No Brasil, em diversos municípios de diferentes estados, no período da pandemia de Infecção por Coronavírus, até a publicação deste material, tem sido relatada a distribuição dos chamados "KIT-COVID", que se tratam de kits de medicamentos para serem usados como profilaxia ao contágio e/ou aos primeiros sintomas da infecção pelo novo Coronavírus (SARS-CoV-2). Os kits tem composição variável, sendo que os medicamentos incluídos com mais frequência são: cloroquina ou hidroxicloroquina, ivermectina, azitromicina, prednisona (ou outro corticosteroide). Além da variação de combinação de medicamentos que compõem o "KIT-COVID", também é variável a posologia e as orientações de uso. Alerta que, o uso de qualquer medicamento fora de sua indicação aprovada (off-label) deve ser uma decisão individual do médico, analisando caso a caso e compartilhando os possíveis benefícios e riscos com o paciente, e que é vedado ao médico a publicidade sobre tal conduta, de acordo com Código de Ética Médica, capítulo de Publicidade Médica: "Art. 113. Divulgar, fora do meio científico, processo de tratamento ou descoberta cujo valor ainda não esteja expressamente reconhecido cientificamente por órgão competente"

In Brazil, in several municipalities of different states, in the period of the Coronavirus Infection pandemic, until the publication of this material, the distribution of the so-called "KIT-COVID" has been reported, which are drug kits to be used as prophylaxis contagion and / or the first symptoms of infection with the new Coronavirus (SARS-CoV-2). The kits have a variable composition, and the drugs most frequently included are: chloroquine or hydroxychloroquine, ivermectin, azithromycin, prednisone (or another corticosteroid). In addition to the variation in the combination of drugs that make up the "KIT-COVID", the dosage and directions for use are also variable. Warns that the use of any medication outside its approved indication (off-label) must be an individual decision of the doctor, analyzing case by case and sharing the possible benefits and risks with the patient, and that the doctor is prohibited from advertising about such conduct, according to the Medical Ethics Code, Medical Advertising chapter: "Art. 113. Disclose, outside the scientific environment, a treatment or discovery process whose value is not yet expressly recognized scientifically by a competent body "

Humanos , Terapéutica , Conducta , Ivermectina , Brasil/epidemiología , Prednisona , Preparaciones Farmacéuticas , Cloroquina , Infecciones por Coronavirus/epidemiología , Azitromicina , Combinación de Medicamentos , Pandemias , Hidroxicloroquina , Posología , Morbilidad , Transmisión de Enfermedad Infecciosa , Publicidad , Alertas , Códigos de Ética , Distribución de Productos
Rev. bioét. (Impr.) ; 28(2): 307-318, abr.-jun. 2020. graf
Artículo en Portugués | LILACS | ID: biblio-1137089


Resumo Trata-se de estudo observacional, do tipo transversal, realizado entre agosto e outubro de 2018 para avaliar o conhecimento sobre ética médica de 601 estudantes de medicina de uma universidade privada de Salvador/BA. Os dados foram coletados por meio de questionário de múltipla escolha com simulação de sete casos envolvendo conflitos éticos. Os participantes, em sua maioria, eram jovens do sexo feminino, e uma parcela já tinha formação acadêmica prévia. A maior parte dos alunos afirmou já ter lido o Código de Ética Médica e considerar sua linguagem de fácil entendimento. Exceto por pequenas variações, o conhecimento demonstrou-se progressivo ao longo dos semestres, com evolução no aprendizado após cumprimento do componente curricular dedicado à ética médica e melhor desempenho no último semestre da graduação.

Abstract This is a cross-sectional, observational study conducted between August and October 2018, to survey knowledge of medical ethics among 601 medical college students of a private university in the city of Salvador, Bahia, Brazil. Were collected the data through a multiple-choice questionnaire with a simulation of seven cases involving ethical conflicts. The participants were mostly young females, and part of them had a previous academic degree. Most students reported having read the code of medical ethics and considered its language easy to understand. Except for some slight variations, knowledge of medical ethics proved to be progressive over the semesters, and the best performance was in the last semester of the program.

Resumen Se trata de un estudio observacional transversal, realizado entre agosto y octubre de 2018 para evaluar los conocimientos sobre ética médica de 601 estudiantes de medicina de una universidad privada de Salvador, Bahia, Brasil. Los datos se reunieron mediante un cuestionario de opción múltiple presentando simulaciones de siete casos de conflictos éticos. La mayoría de los participantes eran mujeres jóvenes, y un grupo tenía formación académica previa. La mayoría de los estudiantes declararon que ya habían leído el Código de Ética Médica y que consideraban que su lenguaje es fácil de entender. Salvo pequeñas variaciones, los conocimientos demostraron ser progresivos a lo largo de los semestres, con una evolución en el aprendizaje después de cumplir los requisitos educativos dedicados a la ética médica y un mejor rendimiento en el último semestre de la graduación.

Estudiantes de Medicina , Códigos de Ética , Evaluación Educacional , Ética Médica
Am Psychol ; 75(5): 644-654, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32437180


Psychologists are in a position to respond to the COVID-19 pandemic through research, practice, education, and advocacy. However, concerns exist about the ethical implications associated with transitioning from face-to-face to online or virtual formats as necessitated by stay-at-home orders designed to enforce the social distancing required to flatten the curve of new COVID-19 cases. The purpose of this article is to review potential ethical issues and to provide guidance to psychologists for ethical conduct in the midst of the current crisis and its aftermath. In addition to contextualizing relevant ethical considerations according to the principles and standards of the current American Psychological Association's ethics code, vignettes are presented to exemplify the ethical dilemmas psychologists in various roles may face when responding to COVID-19 and to offer suggestions and resources for resolving potential conflicts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Códigos de Ética , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Psicología/ética , Telemedicina/ética , Betacoronavirus , Competencia Clínica , Confidencialidad/ética , Documentación/ética , Ética en Investigación , Guías como Asunto , Humanos , Consentimiento Informado/ética , Edición/ética , Investigación , Sociedades Científicas
Plast Reconstr Surg ; 145(5): 988e-996e, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32332557


LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Identify the key social media platforms to use. 2. Recall the primary components of the code of conduct when using social media. 3. Recognize how to build a social media presence and brand. 4. Summarize the primary applications of social media in plastic surgery. SUMMARY: Social media are a growing new tool that has emerged in recent years, with numerous applications that have allowed for an effective means to rapidly disseminate information. Plastic surgeons must gain an understanding of the technology to both grow their practices and the specialty as a whole in an ethical and responsible way. The different platforms available; code of conduct; how to build a social media presence; and the main applications of advertising, education, and research, as based on evidence-based recommendations, are presented.

Comunicación , Medios de Comunicación Sociales , Cirujanos/psicología , Cirugía Plástica/métodos , Códigos de Ética , Humanos , Comercialización de los Servicios de Salud/ética , Comercialización de los Servicios de Salud/métodos , Educación del Paciente como Asunto , Selección de Paciente , Proyectos de Investigación , Cirujanos/economía , Cirujanos/ética , Cirugía Plástica/economía , Cirugía Plástica/ética , Cirugía Plástica/tendencias