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1.
Rev Chilena Infectol ; 37(1): 64-68, 2020 Feb.
Artículo en Español | MEDLINE | ID: mdl-32730402

RESUMEN

We remember Lazaro Spallanzani (1729-1799) mainly for his controversy with Needham over spontaneous generation, but he was a man of multiple scientific activities in the fields of biology, mineralogy, physics, mathematics and… volcanology! Called "the biologist of biologists", he developed a series of investigations about reproduction of amphibian, in one of them -Experiences in service to the history of the generation of animals and plants- we have found horrific experiments with frogs, including severe and useless mutilation of males, in order to interrupt its copulation with females, acts he describes as "barbaric", and we estimate inadmissible in the ecclesiastic man he was, even in an epoch in which animals were considered "anima vili" (something without value). A brief review of the use of animals in laboratories shows significant advances in the ethical regulations for this practice, but we believe that these achievements are not enough.


Asunto(s)
Bienestar del Animal , Laboratorios , Bienestar del Animal/historia , Bienestar del Animal/normas , Animales , Animales de Laboratorio , Femenino , Historia del Siglo XVIII , Laboratorios/ética , Masculino , Reproducción/fisiología , Ciencia/ética , Ciencia/historia
3.
Anat Sci Educ ; 12(4): 349-359, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30739388

RESUMEN

Medical schools are increasingly integrating professionalism training into their gross anatomy courses, teaching ethical behavior and humanistic attitudes through the dissection experience. However, many schools continue to take a traditional, technical approach to anatomical education while teaching professionalism in separate courses. This interview-based study explored how students viewed the body donor and the professional lessons they learned through dissection at one such medical school. All students oscillated involuntarily between seeing the cadaver as a specimen for learning and seeing the cadaver as a person, with some students intentionally cultivating one of these ways of seeing over the other. These views shaped students' emotional and moral responses to the experiences of dissection. The "specimen" view facilitated a technical, detached approach to dissection, while the "person" view made students engage emotionally. Further, students who intentionally cultivated a "specimen" view generally felt less moral distress about dissection than students who intentionally cultivated a "person" view. The concept of respect gave students permission to perform dissections, but "person-minded" students developed more complex rules around what constituted respectful behavior. Both groups of students connected the gross anatomy experience to their professional development, but in different ways. "Specimen-minded" students intentionally objectified the body to learn the emotional control physicians need, while "person-minded" students humanized the body donor to promote the emotional engagement required of physicians. These findings support efforts to integrate professionalism teaching into gross anatomy courses, particularly content, addressing the balance between professional detachment and concern.


Asunto(s)
Anatomía/educación , Educación de Pregrado en Medicina/ética , Emociones , Profesionalismo/ética , Estudiantes de Medicina/psicología , Anatomía/ética , Curriculum , Educación de Pregrado en Medicina/métodos , Femenino , Humanismo , Humanos , Laboratorios/ética , Masculino , Profesionalismo/educación , Investigación Cualitativa , Facultades de Medicina/ética
4.
Anat Sci Educ ; 12(4): 360-369, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30586224

RESUMEN

Use of unclaimed bodies for anatomy teaching in undergraduate medical education continues, but is ethically controversial. The purposes of this study were to estimate the proportion of United States (US) medical schools using unclaimed bodies in first-year anatomy laboratories, to determine whether schools inform students of this use, and to explore anatomy course leaders' attitudes toward unclaimed body use. Anatomy course leaders from 146 US medical schools that had independent preclinical programs including anatomy were surveyed. Survey results were analyzed with descriptive statistics and statistical tests of association. Free text responses were analyzed using a thematic editing style of qualitative content analysis. Of 89 responses (response rate, 61.0%), 11 schools (12.4%) reported possible use of unclaimed bodies. Course leaders from these schools reported greater comfort with using unclaimed bodies compared to leaders from other schools (P < 0.01). Although most course leaders (49/76, or 64.5%) believed it was important or very important to inform students about use of unclaimed bodies, respondents from schools where unclaimed bodies could be used were more neutral (P < 0.01). Qualitative findings revealed deep disagreement and contradictory views about how unclaimed body use relates to ethical principles of respect for persons and justice. Continued use of unclaimed bodies, varying levels of comfort with their use, and disagreement about the practices' underlying morality suggest a need for greater ethical reflection about the permissibility of unclaimed body use in clinical anatomy and for educational interventions that teach students about its history, ethics, and contemporary practice.


Asunto(s)
Anatomía/educación , Disección/ética , Educación de Pregrado en Medicina/métodos , Docentes/psicología , Obtención de Tejidos y Órganos/ética , Anatomía/ética , Cadáver , Educación de Pregrado en Medicina/ética , Docentes/estadística & datos numéricos , Humanos , Laboratorios/ética , Laboratorios/organización & administración , Facultades de Medicina/ética , Facultades de Medicina/organización & administración , Encuestas y Cuestionarios/estadística & datos numéricos , Obtención de Tejidos y Órganos/métodos , Estados Unidos
5.
Nature ; 563(7729): 35, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30382212
6.
Exp Anim ; 66(4): 313-320, 2017 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-28592716

RESUMEN

Live animals are used in surgical skills training in wet lab, which has undeniable effectiveness for the development of future surgeons. However, where such training is provided, animal welfare is a major consideration. Increasingly, institutions that offer wet-lab training are incorporating animal ethics and welfare-related content into their training courses, but the effectiveness of such animal ethics education has yet to be evaluated quantitatively. We investigated whether the animal ethics content of a training course affected trainees by measuring increase in ethical awareness using visual analog scale questionnaires before and after training. Our results demonstrated a significant and positive increase in awareness of animal ethics (significance level of 5%; 0.0380≤P≤0.0016).


Asunto(s)
Experimentación Animal/ética , Bienestar del Animal/ética , Concienciación , Educación de Postgrado en Medicina , Cirugía General/educación , Internado y Residencia , Laboratorios/ética , Médicos/psicología , Adulto , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Escala Visual Analógica
7.
Genet Med ; 19(5): 575-582, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-27811861

RESUMEN

PURPOSE: While the diagnostic success of genomic sequencing expands, the complexity of this testing should not be overlooked. Numerous laboratory processes are required to support the identification, interpretation, and reporting of clinically significant variants. This study aimed to examine the workflow and reporting procedures among US laboratories to highlight shared practices and identify areas in need of standardization. METHODS: Surveys and follow-up interviews were conducted with laboratories offering exome and/or genome sequencing to support a research program or for routine clinical services. The 73-item survey elicited multiple choice and free-text responses that were later clarified with phone interviews. RESULTS: Twenty-one laboratories participated. Practices highly concordant across all groups included consent documentation, multiperson case review, and enabling patient opt-out of incidental or secondary findings analysis. Noted divergence included use of phenotypic data to inform case analysis and interpretation and reporting of case-specific quality metrics and methods. Few laboratory policies detailed procedures for data reanalysis, data sharing, or patient access to data. CONCLUSION: This study provides an overview of practices and policies of experienced exome and genome sequencing laboratories. The results enable broader consideration of which practices are becoming standard approaches, where divergence remains, and areas of development in best practice guidelines that may be helpful.Genet Med advance online publication 03 Novemeber 2016.


Asunto(s)
Pruebas Genéticas/métodos , Laboratorios/normas , Análisis de Secuencia de ADN/métodos , Revelación , Pruebas Genéticas/normas , Humanos , Hallazgos Incidentales , Difusión de la Información , Laboratorios/ética , Guías de Práctica Clínica como Asunto , Informe de Investigación , Tamaño de la Muestra , Análisis de Secuencia de ADN/normas , Encuestas y Cuestionarios
8.
Arch Pathol Lab Med ; 140(2): 171-80, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26910222

RESUMEN

CONTEXT: Emerging pathogens have affected, and will continue to affect, the health care system in diverse ways. Clinical laboratories face ethical challenges in responding to emerging pathogens. We use the 2014-2015 outbreak of Ebola virus disease as a model to explore some of the ethical issues in laboratory medicine related to emerging infectious disease. OBJECTIVE: To describe the major ethical concerns raised in the clinical laboratory environment by emerging infections. DATA SOURCES: We assessed current guidelines and practices in the Ebola outbreak in developed-world clinical laboratories, reviewed risk assessment practices and the role of the clinical laboratory in providing care for patients with potential or confirmed Ebola, and reviewed the relevant literature on duty to provide care in the laboratory context. CONCLUSIONS: Clinical laboratories in developed countries have to rely more on expert guidelines and theoretical risk assessments than on practice in less-developed areas. Risk minimization for clinical laboratory workers is essential but may conflict with the laboratory's duty to provide standard of care. Patients can be put at risk not only from loss of laboratory services from restriction of testing but also from impairment of laboratory services in cases of spills or accidents. Significant discrepancies in guidelines from professional and governmental sources exacerbate the difficulty and confusion inherent in dealing with a dynamic, emerging infectious disease crisis. The duty to provide care for laboratory workers is ill-defined. Balancing risks to patients and laboratory workers and benefits to patients presents challenges to laboratory professionals at all levels.


Asunto(s)
Enfermedades Transmisibles Emergentes , Fiebre Hemorrágica Ebola , Laboratorios/ética , Técnicos Medios en Salud , Guías como Asunto , Humanos , Exposición Profesional/ética , Exposición Profesional/prevención & control , Medición de Riesgo
9.
Sci Eng Ethics ; 22(6): 1707-1716, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-26676032

RESUMEN

The global biomedical research enterprise is driving substantial advances in medicine and healthcare. Yet it appears that the enterprise is rather wasteful, falling short of its true innovative potential. Suggested reasons are manifold and involve various stakeholders, such that there is no single remedy. In the present paper, I will argue that laboratories are the basic working units of the biomedical research enterprise and an important site of action for corrective intervention. Keeping laboratories relatively small will enable better training and mentoring of individual scientists, which in turn will yield better performance of the scientific workforce. The key premise of this argument is that people are at the heart of the successes and failures of biomedical research, yet the human dimension of science has been unduly neglected in practice. Renewed focus on the importance of laboratories and their constituent scientists is one promising approach to reducing waste and increasing efficiency within the biomedical research enterprise.


Asunto(s)
Investigación Biomédica/ética , Investigación Biomédica/normas , Laboratorios/ética , Laboratorios/normas , Administración de Residuos/normas , Investigación Biomédica/educación , Investigación Biomédica/tendencias , Humanos , Laboratorios/tendencias , Mentores , Administración de Residuos/ética
10.
Med Sci (Paris) ; 31(4): 447-9, 2015 Apr.
Artículo en Francés | MEDLINE | ID: mdl-25958764

RESUMEN

The announcement of several deals between the DTC genetics firm 23 and Me and Genentech, Pfizer and other corporations reveals the real business model of the company: selling access to sets of characterized patients for targeted drug development. This may be a useful strategy, but it raises a number of questions concerning the privacy of the company's customers and also of adequate compensation when they become valuable currency.


Asunto(s)
Pruebas Genéticas/economía , Laboratorios/economía , Investigación Biomédica/tendencias , California , Comercio , Revelación/ética , Ética en Investigación , Pruebas Genéticas/ética , Humanos , Consentimiento Informado/legislación & jurisprudencia , Laboratorios/ética
11.
J Opioid Manag ; 11(1): 82-8, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25750169

RESUMEN

In 2012, Duke University initiated a research project, funded by an unrestricted research grant from Millennium Laboratories, a drug testing company. The project focused on assessing the frequency and nature of questionable, unethical, and illegal business practices in the clinical drug testing industry and assessing the potential for establishing a business code of ethics. Laboratory leaders, clinicians, industry attorneys, ethicists, and consultants participated in the survey, were interviewed, and attended two face-to-face meetings to discuss a way forward. The study demonstrated broad acknowledgment of variations in the legal and regulatory environment, resulting in inconsistent enforcement of industry practices. Study participants expressed agreement that overtly illegal practices sometimes exist, particularly when laboratory representatives and clinicians discuss reimbursement, extent of testing, and potential business incentives with medical practitioners. Most respondents reported directly observing probable violations involving marketing materials, contracts, or, in the case of some individuals, directly soliciting people with offers of clinical supplies and other "freebies." While many study respondents were skeptical that voluntary standards alone would eliminate questionable business practices, most viewed ethics codes and credentialing as an important first step that could potentially mitigate uneven enforcement, while improving quality of care and facilitating preferred payment options for credentialed parties. Many were willing to participate in future discussions and industry-wide initiatives to improve the environment.


Asunto(s)
Monitoreo de Drogas/ética , Laboratorios/ética , Cumplimiento de la Medicación , Detección de Abuso de Sustancias/ética , Trastornos Relacionados con Sustancias/diagnóstico , Acreditación , Certificación , Comercio/ética , Conflicto de Intereses , Monitoreo de Drogas/normas , Fraude/ética , Fraude/prevención & control , Regulación Gubernamental , Adhesión a Directriz , Guías como Asunto , Encuestas de Atención de la Salud , Humanos , Laboratorios/legislación & jurisprudencia , Laboratorios/normas , Comercialización de los Servicios de Salud/ética , North Carolina , Valor Predictivo de las Pruebas , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Reproducibilidad de los Resultados , Detección de Abuso de Sustancias/normas , Trastornos Relacionados con Sustancias/prevención & control , Encuestas y Cuestionarios
12.
Sci Eng Ethics ; 21(1): 51-73, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24510311

RESUMEN

Responsibility within life science research is a highly scrutinised field. Increasingly, scientists are presented with a range of duties and expectations regarding their conduct within the research setting. In many cases, these duties are presented deontologically, forgoing extensive discussion on how these are practically implemented into the minutiae of daily research practices. This de-contextualized duty has proven problematic when it comes to practical issues of compliance, however it is not often considered as a fundamental aspect of building ethics discourse. This paper examines this issue in detail, particularly focusing on how differences in the contrasts between the ideal and real physical research environments cause conceptual problems for scientists and retard ethical engagement. Such issues are particularly pertinent in low- and middle-income countries. This paper combines theoretical and empirical analyses using the concept of "dual-use" as a focalizing topic. The data show that the research environment acts as an intimate component in the interpretation and implementation of ethical actions.


Asunto(s)
Disciplinas de las Ciencias Biológicas/ética , Ética en Investigación , Laboratorios/ética , Responsabilidad Social , Investigación de Doble Uso , Humanos
16.
Prenat Diagn ; 33(7): 656-61, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23613322

RESUMEN

OBJECTIVE: The goal of this study is to provide an ethical framework for clinicians and companies providing noninvasive prenatal testing using cell-free fetal DNA or whole fetal cells. METHOD: In collaboration with a National Institutes of Health-supported research ethics consultation committee together with feedback from an interdisciplinary group of clinicians, members of industry, legal experts, and genetic counselors, we developed a set of best practices for the provision of noninvasive prenatal genetic testing. RESULTS: Principal recommendations include the amendment of current informed consent procedures to include attention to the noninvasive nature of new testing and the potential for a broader range of results earlier in the pregnancy. We strongly recommend that tests should only be provided through licensed medical providers and not directly to consumers. CONCLUSION: Prenatal tests, including new methods using cell-free fetal DNA, are not currently regulated by government agencies, and limited professional guidance is available. In the absence of regulation, companies and clinicians should cooperate to adopt responsible best ethical practices in the provision of these tests.


Asunto(s)
Pruebas Genéticas/ética , Diagnóstico Prenatal/ética , ADN/sangre , Femenino , Feto/química , Feto/citología , Pruebas Genéticas/métodos , Personal de Salud/ética , Humanos , Consentimiento Informado , Laboratorios/ética , National Institutes of Health (U.S.) , Guías de Práctica Clínica como Asunto , Embarazo , Diagnóstico Prenatal/métodos , Estados Unidos
17.
Correo Cient Méd Holguín ; 17(1)ene.-mar. 2013.
Artículo en Español | CUMED | ID: cum-55825

RESUMEN

En 2002, la Organización Mundial de la Salud efectuó su 55 Asamblea, en el centro de sus análisis estuvo la incidencia de eventos adversos que ponían en peligro la calidad de la atención de salud. Por ser una causa importante y evitable de sufrimiento humano con múltiples consecuencias, instó a sus estados miembros a prestar la mayor atención posible al problema de la seguridad del paciente(AU)...


Asunto(s)
Humanos , Niño , Laboratorios/ética , Ética , Personal de Laboratorio Clínico
19.
J Nepal Health Res Counc ; 10(1): 37-40, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22929635

RESUMEN

BACKGROUND: The status of basic, general and specialist workforces in pathology services in Nepal needs to be defined and explored for better pathology services. The objective of the study was to find out the status of laboratory medicine professionals (pathology workforces) and the regulation of ethics and limitations of the different level of workforces. METHODS: A cross-sectional descriptive study was conducted by observing and taking interview with the head of the clinical private institutions from August 2008 to January 2009. A total of 373 private pathology laboratories and the workforces working over there were included in the study. RESULTS: The workforces heading private pathology services showed that 153 (41%) of laboratories were headed by laboratory assistant, 79 (21%) by laboratory technician, 90 (24%) by (medical technologist) pathology officer, 30 (8%) by histocytopathologist and 21 (6%) by non pathology professionals. Officer level Pathology workforce (eligible to work independently) was 113 (30%) whereas 260 (70%) of laboratories had no such workforces. Intermediate level Pathology workforce (eligible to work dependently and for some investigation independently) was 34% (127/373) where as 66% (246/373) of laboratories were lacking such workforces. Specialist level (MD/M. Sc) workforces in histocytopathology, clinical microbiology and cytopatholgy & hematology were 43 (11%), 10 (3%) and 3 (1%) respectively. CONCLUSIONS: The workforces heading the private laboratories were not according to the norms of good laboratory practices. The workforces had crossed their limitations and ethical barrier in performing pathological investigations which did not abide by the rules and regulations made by respective councils of Nepal by pathology workforces. There was intervention of non medical/clinical workforce in laboratory services especially in microbiology and biochemistry.


Asunto(s)
Laboratorios , Patología Clínica , Estudios Transversales , Humanos , Laboratorios/ética , Laboratorios/normas , Nepal , Patología Clínica/ética , Patología Clínica/normas , Investigación Cualitativa , Especialización , Recursos Humanos
20.
Eur J Hum Genet ; 20(9): 911-6, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22453292

RESUMEN

The arrival of new genetic technologies that allow efficient examination of the whole human genome (microarray, next-generation sequencing) will impact upon both laboratories (cytogenetic and molecular genetics in the first instance) and clinical/medical genetic services. The interpretation of analytical results in terms of their clinical relevance and the predicted health status poses a challenge to both laboratory and clinical geneticists, due to the wealth and complexity of the information obtained. There is a need to discuss how to best restructure the genetic services logistically and to determine the clinical utility of genetic testing so that patients can receive appropriate advice and genetic testing. To weigh up the questions and challenges of the new genetic technologies, the European Society of Human Genetics (ESHG) held a series of workshops on 10 June 2010 in Gothenburg. This was part of an ESHG satellite symposium on the 'Changing landscape of genetic testing', co-organized by the ESHG Genetic Services Quality and Public and Professional Policy Committees. The audience consisted of a mix of geneticists, ethicists, social scientists and lawyers. In this paper, we summarize the discussions during the workshops and present some of the identified ways forward to improve and adapt the genetic services so that patients receive accurate and relevant information. This paper covers ethics, clinical utility, primary care, genetic services and the blurring boundaries between healthcare and research.


Asunto(s)
Investigación Biomédica/tendencias , Pruebas Genéticas/tendencias , Investigación Biomédica/ética , Investigación Biomédica/legislación & jurisprudencia , Investigación Biomédica/métodos , Prestación de Atención de Salud/ética , Pruebas Genéticas/ética , Pruebas Genéticas/legislación & jurisprudencia , Pruebas Genéticas/métodos , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Laboratorios/ética , Guías de Práctica Clínica como Asunto
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