Judaism.

Judaism offers a rich body of traditional beliefs and practices surrounding end-of-life, death, mourning, and the afterlife. A more detailed understanding of these topics might prove helpful to clinicians seeking guidance for how best to care for Jewish patients, to anyone supporting dying individuals, or to anyone interested in learning more about the subject. The objectives of this chapter are to examine Jewish approaches to key bioethical issues surrounding palliative care, to analyze meaning-making rituals following a loss, at a funeral, and throughout mourning, and to explore Jewish beliefs in an afterlife. Research was collected from sacred texts, legal codes, modern rabbinic responsa literature, and secondary sources. Core, guiding principles include human beings' creation "in the image of God," an obligation to save life, an obligation to mitigate pain, a prohibition against self-harm and hastening death, respect for the dead, and ritualized mourning periods ("shiva," "shloshim," and "shanah"), which feature special liturgy ("kaddish") and practices. Judaism is a religion that values thorough questioning, debate, and argumentation. It also encompasses diverse cultural and ethnic backgrounds, and various denominations. Many Jews are also unaffiliated with a movement or rarely engage with traditional law altogether. For all of these reasons, no summary can comprehensively encapsulate the wide range of opinions that exist around any given topic. That said, what follows is a detailed overview of traditional Jewish approaches to artificial nutrition/hydration, extubation, dialysis, euthanasia and more. It also outlines rituals surrounding and following death. Finally, views and beliefs of the afterlife are presented, as they often serve to imbue meaning and comfort in times of grief, uncertainty, and transition.

Perspectives, Expectations, and Concerns of European Patient Advocates on Advanced Therapy Medicinal Products.

This paper presents the results of a qualitative study based on semi-structured interviews of 10 expert patient advocates on several different issues around Advanced Therapy Medicinal Products (ATMPs). The interviews were conducted between February and May 2020 based on a guideline with a list of 8 topics that covered concerns about safety and ethics, access problems and limitations, pricing of ATMPs and educational needs for patient communities. Overall, the interviewees expressed a high degree of convergence of opinions on most of the topics and especially on the identification of the reasons for concern. Conversely, when asked about possible solutions, quite a wide range of solutions were proposed, although with many common points. However, it highlights that the debate is still in its infancy and that there are not yet consolidated positions across the whole community. A general concern emerging from all the interviews is the potential limitation of access to approved ATMPs, both due to the high prices and to the geographical concentration of treatment centers. However, patients recognize the value of a model with a limited number of specialized clinical centers administering these therapies. On the ethical side, patients do not show particular concern as long as ATMPs and the underlying technology is used to treat severe diseases. Finally, patients are asking for both more education on ATMPs as well as for a more continuous involvement of patient representatives in the whole "life-cycle" of a new ATMP, from the development phase to the authorization, from the definition of the reimbursement scheme to the collection of Real Word Data on safety and long-term efficacy of the treatment.

La bioética como faro en la instauración de la telemedicina. Tratando de evitar una medicina distante / Bioethics as a lighthouse in the establishment of telemedicine. How to avoid a distant medicine

La necesaria instauración de la telemedicina ha sido acelerada por la urgencia derivada de la crisis originada por la pandemia del SARS-CoV-2. Como todos los avances cientifico-técnicos, para evitar excesos o cursos extremos no deseables, la telemedicina también requiere un proceso de reflexión ética que acompañe su incorporación a la atención de las personas como herramienta y no como hábito. Se proponen algunas claves para la deliberación desde el objetivo esencial de la bioética que es preservar los valores, lo que hemos acordado profesionales y ciudadanos como valioso y merecedor de respeto, a pesar de las dificultades. En este caso encontrar los faros que iluminen el imprescindible cambio del formato tradicional de relación clínica, preservando sus valores esenciales, evitando el camino hacia una medicina distante, impersonal y que no responda a las necesidades de las personas. (AU)

The necessary establishment of telemedicine has been accelerated by the urgency derived from the crisis caused by the SARS-CoV-2 pandemic. Like all scientific-technical advances, to avoid excesses or undesirable extreme courses, telemedicine also requires a process of ethical reflection that accompanies its incorporation into the care of people as a tool and not as a habit. Some keys for deliberation are proposed from the essential objective of bioethics to preserve values, which professionals and citizens agree on its value and deserving of respect, despite difficulties. In the case at hand, to find the lighthouse that illuminate the essential change from the traditional clinical relationship format, preserving its essential values, avoiding the path to a distant, and impersonal medicine that does not respond to people’s needs. (AU)

Frankenstein y Caligari: ficción y bioética / Frankenstein and Caligari: fiction and bioethics

La cirugía es la rama que estudia la intervención quirúrgica en el cuerpo humano, mientras que la psiquiatría se encarga de estudiar, diagnosticar y tratar las patologías mentales del hombre. Este trabajo enfoca el antagonismo al cual remiten personajes como el Dr. Frankenstein y el Dr. Caligari, respecto a la praxis médica y científica. Aquí se muestra como la manipulación de la vida, incluso con fines científicos, puede generar problemas tanto éticos como sociales. Mary Shelley y los visionarios de Caligari, tuvieron una vida marcada por situaciones difíciles, eso no impidió que sus obras fueran de gran originalidad y despertaran curiosidad por la ciencia. Frankenstein o el moderno Prometeo (1818) y El gabinete del Dr. Caligari (1920) inician en el público (lectores o espectadores) una profunda reflexión acerca del ethos científico. (AU)

Surgery is the branch that studies surgical intervention in the human body, while psychiatry is responsible for studying, diagnosing and treating the mental pathologies of man. This work focuses on the antagonism to which characters such as Dr. Frankenstein and Dr. Caligari refer, regarding medical and scientific praxis. Here it is shown how the manipulation of life, even for scientific purposes, can generate both ethical and social problems. Mary Shelley and the visionaries of Caligari, had a life marked by difficult situations, that did not prevent their works were of great originality and aroused curiosity about science. Frankenstein or the modern Prometheus (1818) and Dr. Caligari’s cabinet (1920) begin in the public (readers or spectators) a deep reflection on the scientific ethos. (AU)

Is skin bleaching a moral wrong? An African bioethical perspective.

Focusing on black communities in Africa, in this paper, I attempt an African bioethico-aesthetic deconstruction of the falsehood in colorist definitions of beauty purveyed by the migration of non-surgical cosmetics to Africa. I provide a novel ethical evaluation of the act of skin bleaching using principles of the African ethic of communion. I argue that skin bleaching is morally wrong to the extent that it promotes disharmonious relations and false identity in the beauty industry in Africa. Drawing on scientific studies that link toxic ingredients in many skin-bleaching products to adverse health effects, I discuss the public health impact of bleaching cosmetics and other problems occasioned by their strategic expansion into African markets. I propose that there is an urgent need for a relational ethic of polycentric governance that would harmoniously regulate the production and distribution of cosmetic products across regions in order to avoid the exploitation of consumers in black African societies, while also protecting consumers' right to make informed choices through education.

Principlism and Personalism. Comparing Two Ethical Models Applied Clinically in Neonates Undergoing Extracorporeal Membrane Oxygenation Support.

Extracorporeal membrane oxygenation (ECMO) is a technology used to temporarily assist critically ill patients with acute and reversible life-threatening cardiac and/or respiratory failure. This technology can often be lifesaving but is also associated with several complications that may contribute to reduced survival. Currently, neonates supported with ECMO are complex and bear an increased risk of mortality. This means that clinicians must be particularly prepared not only to deal with complex clinical scenarios, but also ethical issues associated with ECMO. In particular, clinicians should be trained to handle unsuccessful ECMO runs with attention to high quality end of life care. Within this manuscript we will compare and contrast the application of two ethical frameworks, used in the authors' institutions (Toronto and Rome). This is intended to enhance a broader understanding of cultural differences in applied ethics which is useful to the clinician in an increasingly multicultural and diverse patient mix.

El giro epistemológico en bioética / The epistemological turn in bioethics / A virada epistemológica em bioética

El artículo aborda la discusión sobre un giro epistemológico en bioética. Como problema que orienta la discusión, se plantea cómo lograr un giro epistemológico en bioética, y como objetivo, discutir la importancia de demarcar un giro epistemológico en este campo de conocimiento práctico. El giro epistemológico implica discutir adecuadamente la interpretación del concepto bioética, exponer aspectos básicos del por qué la bioética requiere fundamentar su autonomía en cuanto a conocimiento, especificar su objeto de estudio y demarcar el procedimiento metodológico para producir y enunciar conocimientos. Por otra parte, y de forma general, discute el problema de reducir la bioética a cuatro principios, así como elevarla a un discurso academicista sin vinculación con la actividad profesional.

The following article addresses the discussion on an epistemological turn in bioethics. As the main problem that guides this discussion, it proposes how to achieve an epistemological turn in bioethics, and as objective, to discuss the importance of demarcating an epistemological turn in this field of practical knowledge. An epistemological turn implies to discuss properly the interpretation of the concept bioethics, to expose basic aspects on why bioethics require to base their autonomy as knowledge, to specify their object of study and demarcate the methodological procedure to produce and enunciate knowledge. On the other hand, and in general terms, it discusses the problem of reducing bioethics to four principles and to raise it to an academic speech as well, without any linkage to the professional activity.

O artigo aborda a discussão de uma virada epistemológica na bioética. Como problema que norteia a discussão, propõe-se como alcançar uma virada epistemológica na bioética e, como objetivo, discutir a importância da demarcação de uma virada epistemológica nesse campo de conhecimento prático. A virada epistemológica implica discutir adequadamente a interpretação do conceito bioético, expor aspectos básicos do por que a bioética requer para basear sua autonomia em termos de conhecimento, para especificar seu objeto de estudo e para demarcar o procedimento metodológico para produzir e enunciar o conhecimento. Por outro lado, e de maneira geral, ele discute o problema de reduzir a bioética a quatro princípios, bem como elevá-la a um discurso acadêmico sem qualquer conexão com a atividade profissional.

Ancillary care obligations in light of an African bioethic: from entrustment to communion.

Henry Richardson recently published the first book ever devoted to ancillary care obligations, which roughly concern what medical researchers are morally required to provide to participants beyond what safety requires. In it, Richardson notes that he is presenting the 'only fully elaborated view out there' on this topic, which he calls the 'partial-entrustment model'. In this article, I provide a new theory of ancillary care obligations, one that is grounded on ideals of communion salient in the African philosophical tradition and that is intended to rival and surpass Richardson's model, which is a function of Western considerations of autonomy. I argue that the relational approach of the former has several virtues in comparison to the basic individualism of the latter.

La dignidad humana como parámetro de interpretación en fuentes de derecho internacional de los derechos humanos y bioética ¿La definición inexistente? / Human dignity as parameter of interpretation in sources of international human rights law and bioethics. The inexistent definition?

Reflexionar sobre el concepto de dignidad humana constituye una ardua tarea para el jurista. Su abordaje filosófico resulta de gran utilidad para comprender su dimensión siendo referencia ineludible a la hora de procurar una definición del concepto. Su anclaje en materia jurídica reviste singularidades que arrojan matices complejos al momento que se hace referencia expresa al concepto mismo de la dignidad en las fuentes de Derecho Internacional de los Derechos Humanos y de la Bioética. A los efectos de abordar el tema en el plano jurídico y acotándonos al análisis normativo, se realiza una descripción sobre la inclusión de la dignidad humana en las diversas normas de Derecho Internacional de los Derechos Humanos para luego formular su entronque con el Derecho Internacional de la Bioética, disciplina que desafía los nuevos desarrollos jurídicos en el derecho comparado. Una vez constatada la forma en la cual se ha incorporado la dignidad humana en el ordenamiento jurídico de fuente internacional se realizan algunas reflexiones sobre las particularidades y carencias que ésta ofrece en materia de interpretación jurídica a la luz de las normas consagradas en las principales fuentes. El objetivo de esta reflexión radica en ofrecer a los operadores del derecho elementos que les permitan comprender las dificultades en materia interpretativa a los efectos de proyectar y asegurar la efectiva protección de los derechos humanos

To ponder on the concept of human dignity constitutes a daunting task for jurists. Its philosophical approach is extremely useful in order to understand its dimension, and it is an unavoidable reference to attempt a definition of this concept. Its fixation in the legal field presents peculiarities which shed complex nuances at the time in which explicit reference is made to the very concept of dignity within the sources of the International Law of Human Rights and Bioethics. For the purpose of approaching the subject in the legal field and bounded to a normative analysis, a description about the inclusion of human dignity in the diverse regulations on the International Law of Human Rights is drawn, in order to later formulate its junction with the International Law of Bioethics, a discipline which challenges the new legal developments in Comparative Law. Having noted, the way in which human dignity has been introduced in the legal order of international source, the article mentions some considerations regarding the peculiarities and eficiencies that it provides in the field of legal interpretation in light of the rules enshrined on the main sources. The aim of these thoughts is to provide legislators with elements that allow them to understand interpretation hardships for the purposes of the projection and assurance of the effective protection of human rights

Refletir sobre o conceito de dignidade humana constitui uma árdua tareia para o jurista. E necessária uma abordagem filosófica para compreender sua dimensão e inescusável para uma definição do mesmo. Seus fundamentos jurídicos têm aspectos singulares com nuances complexas na hora de ser referido o próprio conceito da dignidade nas fontes do Direito Internacional dos Direitos Humanos e da Bioética. Para a abordagem jurídica do assunto, e focando-nos na análise normativa, descreemos a inclusão da dignidade humana nas diferentes normas do Direito Internacional dos Direitos Humanos e depois estabelecemos a relação com a Bioética, disciplina que desafia os novos desenvolvimentos jurídicos no Direito Comparado. Após comprovada a forma de incorporação da dignidade humana na ordem jurídica de fonte internacional, refletimos sobre as particularidades e carências (deficiencias) de sua interpretação jurídica à luz das normas consagradas nas principais fontes. Esta reflexão tem por objetivo oferecer aos agentes elementos para compreender as dificuldades em matéria de interpretação para projetar e garantir a efetiva proteção dos Direitos Humanos

Revisão das técnicas de biologia molecular aplicadas no diagnóstico genético pré­implantacional e uma reflexão ética / Review of molecular biology techniques used in preimplantation genetic diagnosis and ethical reflection

O diagnóstico genético pré-implantacional (PGD) é uma ferramenta que permite a selec¸ão do embrião saudável por meio da análise gênica e cromossômica. Beneficia casais no grupo de risco, como, por exemplo, casais com histórico de aborto de repetição ou com histórico familiar de doença hereditária. Diante do avanço das metodologias empregadas no PGD, esta revisão tem como objetivo reunir as informações acerca das técnicas de biópsia, de biologia molecular e aspectos bioéticos dessa prática. Assim, foi possível agregar as informações como vantagens, desvantagens, restrições e indicações referentes ao estágio embrionário em que é retirado o material genético e as técnicas de biologia molecular usadas na análise genética. Além disso, foi possível especificar alguns questionamentos bioéticos que surgem com a prática do PGD, como, por exemplo, a possível eugenia. Concluiu-se que a análise da trofoectoderme dos embriões e da aplicação da tecnologia de NGS é promissora para o futuro do PGD, bem como a primordialidade da criação de leis que regem e completam as lacunas no sentido ético e moral dessa prática.(AU)

The preimplantation genetic diagnosis (PGD) is a tool that allows the selection of healthy embrios through gene and chromosome analysis, benefiting couples at risk. Like couples with recurrent miscarriage or family history of hereditary disease. Given the advance of the methodologies used in PGD this review aims to assemble information about the biopsy techniques, molecular biology and bioethical aspects of this practice. Therefore, it was possible collect the information like advantages, disadvantages, restrictions and indications referring to embryonic stage in which is made the removal of genetic material and molecular biology techniques used in genetic analysis. In addition, some bioethic questions that arise with the practice of PGD were verified as, for example, possible Eugenia. It was concluded that the analysis of trofoectoderme of embryos and the application of NGS technology is promising for the future of PGD, as well as the primordiality the creating laws governing and complete the gaps in the ethical and moral sense of this practice.(AU)

Iniciativas de reponsabilidad social por empresas y universidades en áreas de salud pública / Social responsibility initiatives by companies and universities in areas of public health

Se revisa en forma breve la responsabilidad social comparativa, su presencia en el país y los esfuerzos que han hecho algunas asociaciones para realizar acciones concretas de ayuda y desarrollo sostenible en el campo de la salud pública, en las que se contó con la participación de los estudiantes de medicina.

It is a brief review of corporate social responsability, its presence in the country and efforts that some associations have performed in order to carry out concrete actions of aid and sustainable development in the field of public health, with the participation of medical students.

Terapia genica: una opción de tratamiento y una controversia etica / Gene therapy: a treatment option and an ethics controversy

La terapia génica es un procedimiento innovador que esboza en su aplicación conflictos potenciales de orden médico, ético, económico y social. Puede ser definida como la transferencia de genes a células humanas específicas con el objetivo de producir un efecto terapéutico con el que se pueda corregir un defecto genético. Desde una perspectiva biológica y terapéutica aislada, la terapia génica implica consecuencias valorables estrictamente al momento de la manipulación. A pesar de la seguridad para la intervención génica, emerge una consideración ética, que si bien ha de estar presente en cualquier tipo de terapia, en la terapia génica, por su naturaleza, se hace relevante. Es posible un cambio de la selección natural y de la especie; presupuestos que han mantenido la variabilidad de nuestro material genético y han permitido la diversidad de la humanidad, la emergencia del principio de autonomía y el ejercicio de la dignidad humana a través de la libertad. Una terapia, cualquiera que sea, surge para volver al individuo a un estado saludable; debe realizarse en función del bien del hombre y no en detrimento de este o en la búsqueda irresponsable de solo su bienestar.

Gene therapy is an innovative procedure entailing in its usage potential medical, ethical, financial and social conflicts. As a therapeutic tool, it can be defined as the transfer of genes to specific human cells with the goal of producing a therapeutic effect with which a genetic defect can be corrected. There are two goals in gene therapy. Somatic cell therapy and stem cell therapy. The first aims at healing cells in non-germ line organs and tissues. Stem-cell gene therapy aims in turn to heal this cell line in order to impact on the offspring. From an isolated biological and therapeutic perspective, this tool, because of the genetic material of sex chromosomes, brings unassessed or assessable consequences strictly when handling. Despite safety for genetic interventions, ethical considerations arise, that even though always present in any type of therapy, in gene therapy it becomes particularly important because of its efficacy. It is the generation of a relaxation in natural and species selection, which have maintained the viability in our material and allowed for the genetic diversity of humanity, the emergence of the principle of autonomy and the exercise of dignity through freedom. All therapies are supposed to return the individual to a healthy state. The development of gene therapy must be based on the good for man and avoid its detriment or the irresponsible quest for their wellbeing. Therefore, in every treatment option responding to the ethical controversy, positions must be agreed upon. This is possible with a widely informed society. By being informed, it is meant the dissemination of information in a way that is understandable and that covers all areas: scientific, commercial, medical, ethical, legislative, civil and political. This is a situation that does not match our reality.

Algunos aspectos bioéticos relacionados con la atención al paciente de hansen / Some bioethics aspects related with the patient of hansen

Se realizó una revisión bibliográfica sobre la Enfermedad de Hansen; se detalla en este artículo la historia de la lepra desde su surgimiento y su arribo a Cuba. Se comenta el rechazo social que ha existido desde la época bíblica hasta Cuba en el año 1917. Se tratan temas bioéticos como: Justicia, Equidad y principales afectaciones psicológicas de estos pacientes.

A bibliographic revision about the Hansen disease was done, detailing the Leprosy`s history, from its begining until its Cuba arriving, social rejection from Biblical`s time until the Cuba in the 1917 was comment, bioethic themes like: Justice, Equity, Beneficence and main psicologicals disturbs in these patients was approached.

Algunas consideraciones bioéticas en la experimentación en animales, seres humanos y trasplantología / Some bioethical considerations concerning transplantology and experimentation with animals and human beings

Se realizó una reflexión sobre el origen y conceptualización de la Bioética. Se abordo la etica en la experimentacion con animales de laboratorio y seres humanos, asi como en dilemas que aparecen en el curso de la investigacion cientifica en ambos campos. Asimismo, son tratados aspectos que deben tenerse en cuenta en la trasplantologia. Se concluye que el incumplimiento de las normas eticas en la investigacion cientifica genera dilemas bioeticos que deben resolverse en funcion del bienestar humano y animal en contraposicion a los intereses comerciales y politicos.

The article revises some of the considerations concerning both the origin and conceptualization of Bioethics. It deals with ethical aspects related to experimentation with laboratory animals and human beings, as well as some of the dilemmas that usually come up during the course of testing. It also considers the ethical aspects of transplantology. As conclusions, it states that breaking ethical standards of scientific research provokes bioethical dilemmas, which must be solved to favor human and animal wellbeing against economical and political interests.

Breve histórico da Bioética em Santa Catarina / A brief history of Bioethic in Santa Catarina

Objetivando identificar a presença e participação daBioética em Santa Catarina foi feita uma revisão bibliográficae levantadas as principais atividades relativas àsua difusão, sob a forma de comitês de ética em pesquisa,eventos, publicações científicas, núcleos de estudose outras modalidades, com identificação das instituiçõese cidades que albergam estas iniciativas. Os resultadosdemonstram as presenças dos comitês de ética em pesquisa,tanto em seres humanos quanto em animais, comoa mais regular na discussão dos princípios e referenciaisbioéticos. Demonstra-se a escassa presença dos Comitêsde Bioética Hospitalar (Comitês de Bioética Clínica)no suporte aos pacientes, seus familiares e equipes desaúde e destaca-se a existência de uma proposta inovadorade criação de Comitês Intermunicipais de Bioéticaa serem inseridos na atenção básica à saúde para apoioaos gestores, aos profissionais da saúde e à população.É enfatizada a existência de inúmeras obras sobre ética/bioética, na forma de livros e artigos em periódicoscientíficos, ressaltando-se a Série ETHICA/Editora daUniversidade Federal de Santa Catarina e a produçãodos Núcleos de Estudos em Bioética. Com a criação, em2009, da Sociedade Brasileira de Bioética ? Regional deSanta Catarina, institucionaliza-se a presença da Bioéticaem solo catarinense, acreditando-se que a mesma possaaglutinar e alavancar novas iniciativas, atrair novasadesões e ampliar os debates sobre a Bioética, como oX Congresso Brasileiro de Bioética e o II CongressoBrasileiro de Bioética Clínica que serão realizados emFlorianópolis, em 2013. Conclui-se ser expressiva apresença da Bioética em Santa Catarina, assim como aparticipação de interessados, sobretudo dos vinculadosao meio acadêmico, e serem diversificadas as atividadesdesenvolvidas.

To identify the presence and role of bioethics in SantaCatarina, we performed a bibliographic review of themain aspects related to the spread of bioethics, such asethics committees on research, events, scientific publications,study centers and other facets of bioethics. Wealso identified the institutions and cities that house theseinitiatives. The results demonstrate the presence ofethics committees for research on human beings andanimals as the most common initiative in discussionsregarding the principles and benchmarks of bioethics.We observed the limited presence of hospital bioethicscommittees (Committees of Clinical Bioethics) in supportof patients, their relatives and teams of healthcareworkers. We highlight an innovative proposal to integrateIntermunicipal Bioethics Committees into primaryhealthcare services to support managers, health professionals,and the public. We note the existence of numerousworks on ethics and bioethics, including booksand articles in scientific journals, and we highlight theseries ETHICA, published by the Federal University ofSanta Catarina and produced by the Center for the Studyof Bioethics. With the creation of the Regional SantaCatarina Brazilian Bioethics Society in 2009, the presenceof bioethics was institutionalized in the state of SantaCatarina. We believe that this organization can unite andleverage new initiatives, attract new members, and extendthe debate on bioethics, as the X Brazilian Congresson Bioethics and the II Brazilian Congress on ClinicalBioethic that will be realized in Florianópolis (2013). Weconclude that there is a significant presence of bioethicsin Santa Catarina as well as significant involvement fromstakeholders, particularly those in the academic environment,and that activities to promote bioethics have beendeveloped in Santa Catarina.

Vulnerabilidade humana na linguagem fílmica epidemia: relação homem-natureza, conflitos, responsabilidade e poder da palavra

O texto apresenta uma reflexão crítica sobre o conceito de vulnerabilidade humana em decorrência das pretensões, dos obstáculos e das possibilidades de soluções em situações adversas à sua existência biológica, social e emocional de pessoas e populações, contidas na linguagem fílmica Epidemia, tendo por base a descrição dos múltiplos significados da vulnerabilidade humana, assim categorizados por meio das cenas-chave: abordagens diferenciadas da relação homem-natureza, modalidades de conflitos e guerras, responsabilidade institucional e não-institucional e o duplo poder da palavra.

La bioética en la medicina actual: una necesidad en la formación profesional / Bioethics in the contemporary medicine: a necessity in the professional formation

En el presente artículo los autores pretendieron evidenciar la insuficiente presencia de la bioética en la medicina actual, así como expusieron las carencias sobre el tema en el diseño del plan de estudio de la carrera de Medicina, lo que puede perjudicar el proceso de reforzamiento de valores y el ejercicio bioético valorativo en el nuevo modelo de formación profesional, para fundamentar la necesidad de esta disciplina en el currículo de la carrera.

In the current article the authors pretended to evidence the insufficient presence of the bioethics in the contemporary medicine and also exposed the lacks on the theme in the design of the medicine career curriculum, fact that may affect the process of values reinforcement and the valuing bioethical practice in the new model of professional formation, all of that to explain the necessity of this matter in the career curriculum.

Comparación de los comités de ética en países en vías de desarrollo / Comparison of the committees of ethics in countries developing in development

Entre el año 2002 y el 2007, de acuerdo con los datos de la Food and Drugs Administration (FDA), el número de investigadores fuera de Estados Unidos, que forman parte de estudios clínicos creció a una tasa de 15% anual, mientras que el número de investigadores norteamericanos disminuyo 5,5%. Actualmente más de 123 países de Asia, África, Latino América y la región del mediterráneo se encuentran involucrados en diferentes convenios de colaboración. La realización de estudios clínicos en países en desarrollo otorga no solamente beneficios para el sistema de salud relacionados con el uso de nuevas terapias, adicionalmente permite la transferencia tecnológica y aumentar la experiencia de los médicos investigadores. A pesar de estos beneficios muchas discusiones éticas se han levantado recientemente por los potenciales riesgos, como por ejemplo, la falta de estructura adecuada de los comités de ética o de lineamentos por parte de las autoridades locales. Durante los últimos años, algunas publicaciones han analizado el estado de los Comité de ética independientes (CEI) en diferentes países en desarrollo. En este trabajo compararemos los resultados de estos estudios con los obtenidos en Venezuela, para lo cual analizaremos algunos puntos claves de los comités como lo son su formación y composición, así como el entrenamiento recibido y los tiempos de aprobación.

According to FDA data, between 2002 and 2007, the total number of researchers outside the United States, as part of clinical trials grew at an annual rate of 15%, while the number of American researchers decreased by 5.5%. Currently more than 123 countries in Asia, Africa, Latin America and the Mediterranean region are involved in different cooperation agreements. The clinical studies in developing countries not only provide benefits for the health system related to the use of new therapies, they also allows the transfer of technology and increasing experience of medical researchers. Despite these benefits many ethical discussions have been raised recently about potential risks, for example, no correct ethics committees structure or lack of lineaments by local authorities. In recent years, some publications have reviewed the status of the independent ethic committees in different developing countries. In this paper we will compare the results of these studies with those from Venezuela. We will address some key points regarding the committees, such as its formation and composition, as well as training and approval times.