[Bioethics in catastrophe situations such as earthquakes]. / Después de un terremoto: bioética en situaciones de catástrofe.

A catastrophe of the magnitude of the earthquake and tsunami that hit Chile not long ago, forces us to raise some questions that we will try to answer from a philosophical, ethical and responsibility viewpoints. An analysis of the basic principles of bioethics is also justified. A natural catastrophe is not, by itself, moral or immoral, fair or unfair. However, its consequences could certainly be regarded as such, depending on whether they could have been prevented or mitigated. We will identify those individuals, who have the ethical responsibility to attend the victims and the ethical principles that must guide the tasks of healthcare and psychological support teams. The minimal indispensable actions to obtain an adequate social and legal protection of vulnerable people, must be defined according to international guidelines. These reflections are intended to improve the responsibility of the State and all the community, to efficiently prevent and repair the material and psychological consequences of such a catastrophe.

Deber ético de promover la autonomía y competencia del paciente psiquiátrico: [revisión] / Ethical duty to promote the autonomy and competence of the psychiatric patient: [review]

Artículo de revisión teórica sobre el deber ético de promover la autonomía y la competencia del paciente, como fin fundamental en la actuación del profesional psiquiatra. Más allá del respeto por la autonomía, su interpretación legal, las decisiones sobre la competencia del paciente y la subrogación en sus familiares, está la promoción de su autonomía –dentro de lo posible en cada caso- como parte del respeto por su dignidad personal. El autor parte del análisis del concepto de autonomía y su papel en la bioética, y su aplicación en el caso de las enfermedades psiquiátricas, siguiendo el modelo de “intención ética” de Ricoeur, para articularla con la beneficencia y la justicia. Concluye que es deber ético primordial de los profesionales, en el ámbito de la psiquiatría, promover la mayor participación posible del paciente en las decisiones que se tomen sobre su salud, así como mejorar su competencia mediante el tratamiento y mediante la educación en salud.

Theoretical review article on the ethical duty to promote the patient’s autonomy and competence, as a fundamental aim in the professional psychiatrist’s performance. Beyond the respect for the autonomy, his legal interpretation, the decisions on the patient’s competence and the subrogation on his relatives, is the promotion of his autonomy – as long as it is possible in each case – as part of the respect for his personal dignity. The author starts analyzing the concept of autonomy and its role in bioethics, and its application in the case of psychiatric diseases, following Ricoeur’s “ethical intention” model, for articulating it with that of charity and justice. He concludes that it is the professionals’ vital ethical duty, in the field of psychiatry, to promote the patient’s participation in the decisions to be made on his health, as well as to improve his competence through the treatment and health education.