Encuesta nacional sobre cambios en las políticas de comunicación, visitas y cuidados al final de la vida en las unidades de cuidados intensivos durante las diferentes olas de la pandemia de COVID-19 (estudio COVIFAUCI) / National survey on changes in visitation, communication and end-of-life care policies in intensive care units through the different COVID-19 pandemic's waves (COVIFAUCI study)

Introducción La pandemia derivada de la infección por SARS-CoV-2 propició cambios en los cuidados tanto a familiares como a pacientes de cuidados intensivos durante las diferentes olas de incidencia del virus. La línea de humanización seguida por la mayoría de los hospitales se vio gravemente afectada por las restricciones aplicadas. Como objetivo, planteamos conocer las modificaciones experimentadas durante las diferentes olas de la pandemia por SARS-CoV-2 en España respecto a la política de visitas a los pacientes en UCI, el acompañamiento al final de la vida, y el uso de las nuevas tecnologías de la comunicación entre familiares, pacientes y profesionales. Métodos Estudio descriptivo transversal multicéntrico mediante encuesta a las UCI españolas desde febrero a abril de 2022. Se realizaron métodos de análisis estadísticos a los resultados según lo apropiado. El estudio fue avalado por la Sociedad Española de Enfermería Intensiva y Unidades Coronarias. Resultados Respondieron un 29% de las unidades contactadas. Los minutos de visita diarios de los familiares se redujeron drásticamente de 135 (87,5-255) a 45 (25-60) en el 21,2% de las unidades que permitían su acceso, mejorando levemente con el paso de las olas. En el caso de duelo, la permisividad fue mayor, aumentando el uso de las nuevas tecnologías para la comunicación paciente-familia en el caso del 96,5% de las unidades. Conclusiones Las familias de los pacientes ingresados en UCI durante las diferentes olas de la pandemia por COVID-19 han experimentado restricciones en las visitas y cambio de la presencialidad por técnicas virtuales de comunicación. Los tiempos de acceso se redujeron a niveles mínimos durante la primera ola, recuperándose con el avance de la pandemia pero sin llegar nunca a los niveles iniciales... (AU)

Introduction The pandemic derived from the SARS-CoV-2 infection led to changes in care for both relatives and intensive care patients during the different waves of incidence of the virus. The line of humanization followed by the majority of the hospitals was seriously affected by the restrictions applied. As an objective, we propose to know the modifications suffered during the different waves of the SARS-CoV-2 pandemic in Spain regarding the policy of visits to patients in the ICU, monitoring at the end of life, and the use of new technologies of communication between family members, patients and professionals. Methods Multicenter cross-sectional descriptive study through a survey of Spanish ICUs from February to April 2022. Statistical analysis methods were performed on the results as appropriate. The study was endorsed by the Spanish Society of Intensive Nursing and Coronary Units. Results Twenty-nine percent of the units contacted responded. The daily visiting minutes of relatives dropped drastically from 135 (87.5-255) to 45 (25-60) in the 21.2% of units that allowed their access, improving slightly with the passing of the waves. In the case of bereavement, the permissiveness was greater, increasing the use of new technologies for patient-family communication in the case of 96.5% of the units. Conclusions The family of patients admitted to the ICU during the different waves of the COVID-19 pandemic have suffered restrictions on visits and a change from face-to-face to virtual communication techniques. Access times were reduced to minimum levels during the first wave, recovering with the advance of the pandemic but never reaching initial levels. Despite the implemented solutions and virtual communication, efforts should be directed towards improving the protocols for the humanization of healthcare that allow caring for families and patients whatever the healthcare context. (AU)

Encuesta nacional sobre cambios en las políticas de comunicación, visitas y cuidados al final de la vida en las unidades de cuidados intensivos durante las diferentes olas de la pandemia de COVID-19 (estudio COVIFAUCI) / National survey on changes in visitation, communication and end-of-life care policies in intensive care units through the different COVID-19 pandemic's waves (COVIFAUCI study)

Introducción La pandemia derivada de la infección por SARS-CoV-2 propició cambios en los cuidados tanto a familiares como a pacientes de cuidados intensivos durante las diferentes olas de incidencia del virus. La línea de humanización seguida por la mayoría de los hospitales se vio gravemente afectada por las restricciones aplicadas. Como objetivo, planteamos conocer las modificaciones experimentadas durante las diferentes olas de la pandemia por SARS-CoV-2 en España respecto a la política de visitas a los pacientes en UCI, el acompañamiento al final de la vida, y el uso de las nuevas tecnologías de la comunicación entre familiares, pacientes y profesionales. Métodos Estudio descriptivo transversal multicéntrico mediante encuesta a las UCI españolas desde febrero a abril de 2022. Se realizaron métodos de análisis estadísticos a los resultados según lo apropiado. El estudio fue avalado por la Sociedad Española de Enfermería Intensiva y Unidades Coronarias. Resultados Respondieron un 29% de las unidades contactadas. Los minutos de visita diarios de los familiares se redujeron drásticamente de 135 (87,5-255) a 45 (25-60) en el 21,2% de las unidades que permitían su acceso, mejorando levemente con el paso de las olas. En el caso de duelo, la permisividad fue mayor, aumentando el uso de las nuevas tecnologías para la comunicación paciente-familia en el caso del 96,5% de las unidades. Conclusiones Las familias de los pacientes ingresados en UCI durante las diferentes olas de la pandemia por COVID-19 han experimentado restricciones en las visitas y cambio de la presencialidad por técnicas virtuales de comunicación. Los tiempos de acceso se redujeron a niveles mínimos durante la primera ola, recuperándose con el avance de la pandemia pero sin llegar nunca a los niveles iniciales... (AU)

Introduction The pandemic derived from the SARS-CoV-2 infection led to changes in care for both relatives and intensive care patients during the different waves of incidence of the virus. The line of humanization followed by the majority of the hospitals was seriously affected by the restrictions applied. As an objective, we propose to know the modifications suffered during the different waves of the SARS-CoV-2 pandemic in Spain regarding the policy of visits to patients in the ICU, monitoring at the end of life, and the use of new technologies of communication between family members, patients and professionals. Methods Multicenter cross-sectional descriptive study through a survey of Spanish ICUs from February to April 2022. Statistical analysis methods were performed on the results as appropriate. The study was endorsed by the Spanish Society of Intensive Nursing and Coronary Units. Results Twenty-nine percent of the units contacted responded. The daily visiting minutes of relatives dropped drastically from 135 (87.5-255) to 45 (25-60) in the 21.2% of units that allowed their access, improving slightly with the passing of the waves. In the case of bereavement, the permissiveness was greater, increasing the use of new technologies for patient-family communication in the case of 96.5% of the units. Conclusions The family of patients admitted to the ICU during the different waves of the COVID-19 pandemic have suffered restrictions on visits and a change from face-to-face to virtual communication techniques. Access times were reduced to minimum levels during the first wave, recovering with the advance of the pandemic but never reaching initial levels. Despite the implemented solutions and virtual communication, efforts should be directed towards improving the protocols for the humanization of healthcare that allow caring for families and patients whatever the healthcare context. (AU)

Vacinas e desinformação: uma análise de conteúdo sobre fake newsapuradas por plataformas de debunkingem redes sociais / Vaccines and disinformation: a content analysis on fake news verified by debunking platforms on social networks / Vacunas y desinformación: un análisis de contenidos sobre fake news verificadas por las plataformas de debunking en las redes sociales

O impacto das fake news chegou à área da saúde e a desconfiança em relação às vacinas trouxe de volta doenças até então erradicadas. Mas como os discursos antivacinasão construídos nas redes sociais? Neste trabalho, 80fake news com foco nas vacinas foram coletadas de sites brasileiros que realizam debunking, uma estratégia de detecção e desmascaramento de desinformação e fake news. A partir da aplicação de um protocolo analítico, mapeamos as principais características presentes na elaboração dessas publicações. A análise de conteúdo revelou que o Facebook e o WhatsApp são as redes preferidas para esse tipo de compartilhamento. Cerca de 59% dos conteúdos são totalmente falsos e a maioria dos discursos destaca possíveis riscos das vacinas como estratégias de convencimento. As fontes mais referenciadas são supostamente médicos e cientistas, para criar confiabilidade. O levantamento aponta ainda que 60% das publicações apresentaram erros gramaticais e ortográficos na elaboração dos textos

The impact of fake news reached the health area and distrust in relation to vaccines brought back diseases that had been eradicated. But how are these anti-vaccine discourses constructed in social medias? In this paper, 80 fake news stories focusing on vaccines were collected through Brazilian websites that perform debunking, a strategy for detecting and unmasking misinformation and fake news. From the application of an analytical protocol, the main characteristics present in the elaboration of these publications were mapped. Content analysis revealed that Facebook and WhatsApp are the preferred medias for this type of sharing. About 59% of the contents are totally false and most of the speeches highlight the risks of vaccines as a convincing strategy. The most referenced sources are supposedly doctors and scientists to create re-liability. The survey also points out that 60% of publications have grammatical and spelling errors in the preparation of texts

El impacto de las fake news llegó al área de la salud y la desconfianza en las vacunas trajo de vuelta enfermedades erradicadas. Pero, ¿cómo se construyen los discursos antivacunas en las redes sociales? En este trabajo, se recopilaron 80 noticias falsas centradas en vacunas a través de sitios web brasileños que realizan debunking, una estrategia para detectar y desenmascarar información errónea y noticias falsas. A partir de la aplicación de un protocolo analítico, mapeamos las principales características presentes en la elaboración de estas publicaciones. El análisis de contenido reveló que Facebook y WhatsApp son las redes preferidas para este tipo de intercambio. Alrededor del 59% del contenido es completamente falso y la mayoría destaca los posibles riesgos de las vacunas como estrategias convincentes. Las fuentes más referenciadas son supuestamente médicos y científicos para crear confiabilidad. La encuesta señala que el 60% de las publicaciones tenían errores gramaticales y ortográficos

Aspectos éticos relacionados ao processo de comunicação efetiva durante pandemia COVID-19: revisão integrativa / Ethical aspects related to the effective communication process during pandemic COVID-19: integrative review

Objetivo: Investigar a produção de literatura sobre a comunicação da equipe de saúde com pacientes e familiares durante a pandemia da COVID-19. Método: Trata-se de uma revisão integrativa realizada nas bases de dados BVS, PubMed e Scopus, utilizando os descritores em ciências da saúde (DeCS): Coronavirus, Bioética e Comunicação. Resultados: Obtiveram-se 139 artigos, sendo selecionados 6 artigos para análise dessa revisão. Os achados mais comuns foram: os desafios no processo de comunicação, principalmente entre populações mais vulneráveis, como a oncologia, cuidados paliativos e pacientes de unidades de terapia intensiva; na outra ponta estratégias que visam mitigar esse agravante, como métodos alternativos de comunicação, que inclue um componente de vídeo. Conclusão: A comunicação efetiva ficou comprometida durante a pandemia da COVID-19, sendo necessário a criação de protocolos com base em parâmetros éticos e bioéticos conforme os valores de cada sociedade.(AU)

Objective: Investigate the production of literature on the communication of the health team with patients and families during the COVID-19 pandemic. Method: This is an integrative review carried out in the VHL, PubMed and Scopus databases, using the health science descriptors (DeCS): Coronavirus, Bioethics and Communication. Results: 139 articles were obtained, with 6 articles selected for analysis of this review. The most common findings were: challenges in the communication process, especially among the most vulnerable populations, such as oncology, palliative care and intensive care unit patients; at the other end, strategies aimed at mitigating this problem, such as alternative methods of communication, which include a video component. Conclusion: Effective communication was compromised during the COVID-19 pandemic, requiring the creation of protocols based on ethical and bioethical parameters according to the values of each society.(AU)

Objetivo: Investigar la producción de literatura sobre la comunicación del equipo de salud con pacientes y familiares durante la pandemia COVID-19. Método: Se trata de una revisión integradora realizada en las bases de datos BVS, PubMed y Scopus, utilizando los descriptores de ciencias de la salud (DeCS): Coronavirus, Bioética y Comunicación. Resultados: Se obtuvieron 139 artículos, con 6 artículos seleccionados para el análisis de esta revisión. Los hallazgos más comunes fueron: desafíos en el proceso de comunicación, especialmente entre las poblaciones más vulnerables, como pacientes de oncología, cuidados paliativos y unidad de cuidados intensivos; en el otro extremo, estrategias destinadas a mitigar este problema, como los métodos alternativos de comunicación, que incluyen un componente de video. Conclusión: La comunicación efectiva se vio comprometida durante la pandemia de COVID-19, requiriendo la creación de protocolos basados en parámetros éticos y bioéticos acordes a los valores de cada sociedad.(AU)

Misinformation and public opinion of science and health: Approaches, findings, and future directions.

A summary of the public opinion research on misinformation in the realm of science/health reveals inconsistencies in how the term has been defined and operationalized. A diverse set of methodologies have been employed to study the phenomenon, with virtually all such work identifying misinformation as a cause for concern. While studies completely eliminating misinformation impacts on public opinion are rare, choices around the packaging and delivery of correcting information have shown promise for lessening misinformation effects. Despite a growing number of studies on the topic, there remain many gaps in the literature and opportunities for future studies.

Misinformation in and about science.

Humans learn about the world by collectively acquiring information, filtering it, and sharing what we know. Misinformation undermines this process. The repercussions are extensive. Without reliable and accurate sources of information, we cannot hope to halt climate change, make reasoned democratic decisions, or control a global pandemic. Most analyses of misinformation focus on popular and social media, but the scientific enterprise faces a parallel set of problems-from hype and hyperbole to publication bias and citation misdirection, predatory publishing, and filter bubbles. In this perspective, we highlight these parallels and discuss future research directions and interventions.

The narrative truth about scientific misinformation.

Science and storytelling mean different things when they speak of truth. This difference leads some to blame storytelling for presenting a distorted view of science and contributing to misinformation. Yet others celebrate storytelling as a way to engage audiences and share accurate scientific information. This review disentangles the complexities of how storytelling intersects with scientific misinformation. Storytelling is the act of sharing a narrative, and science and narrative represent two distinct ways of constructing reality. Where science searches for broad patterns that capture general truths about the world, narratives search for connections through human experience that assign meaning and value to reality. I explore how these contrasting conceptions of truth manifest across different contexts to either promote or counter scientific misinformation. I also identify gaps in the literature and identify promising future areas of research. Even with their differences, the underlying purpose of both science and narrative seeks to make sense of the world and find our place within it. While narrative can indeed lead to scientific misinformation, narrative can also help science counter misinformation by providing meaning to reality that incorporates accurate science knowledge into human experience.

Ethical Issues in COVID-19 Communication to Mitigate the Pandemic: Dilemmas and Practical Implications.

Communication plays a critical role in all stages of a pandemic. From the moment it is officially declared governments and public health organizations aim to inform the public about the risk from the disease and to encourage people to adopt mitigation practices. The purpose of this article is to call attention to the multiple types and the complexity of ethical challenges in COVID-19 communication. Different types of ethical issues in COVID-19 communication are presented in four main sections. The first deals with ethical issues in informing the public about the risk of the pandemic and dilemmas regarding communicating uncertainty, using threats and scare tactics, and framing the pandemic as a war. The second concerns unintended consequences that relate to increasing inequities, stigmatization, ageism, and delaying medical care. The third raises ethical issues in communicating about specific mitigation practices: contact tracing, wearing face masks, spatial (also referred to as social) distancing, and handwashing or sanitizing. The fourth concerns appealing to positive social values associated with solidarity and personal responsibility, and ethical challenges when using these appeals. The article concludes with a list of practical implications and the importance of identifying ethical concerns, which necessitate interdisciplinary knowledge, cross-disciplinary collaborations, public discourse and advocacy.

Aspectos éticos y legales ante la conspiración de silencio según los profesionales sanitarios / Ethical and legal aspects in the conspiracy of silence according to health professionals

OBJETIVOS: Conocer los discursos de los profesionales sanitarios sobre el marco normativo ético y legal en el contexto del pacto de silencio, como origen del fenómeno y sus consecuencias: participación en la toma de decisiones, obstinación terapéutica, limitación o adecuación del esfuerzo terapéutico y sedación paliativa. Estudio cualitativo descriptivo, enfoque fenomenológico. EMPLAZAMIENTO Y PARTICIPANTES: profesionales de enfermería y medicina de atención primaria, hospital y urgencias de Sevilla. MÉTODO: Entrevistas semiestructuradas. Áreas exploradas: comunicación inicial sobre diagnóstico, pronóstico y situación de últimos días, opinión sobre el pacto de silencio, consecuencias en el afrontamiento de la muerte y la participación en la toma de decisiones. Análisis de contenido interpretativo. RESULTADOS: Información a la familia de forma preferente, la mayoría desconocen los principios éticos al final de la vida, se confunde intimidad, autonomía y confidencialidad, si la conspiración de silencio está presente la mantienen. La autonomía está anulada, se aplica la beneficencia y la no maleficencia desde el punto de vista del profesional, se cita falta de justicia respecto a la comunicación e información según razones sociales. La participación del paciente en toma de decisiones imposible en este contexto; se sobreactúa para evitar la muerte cayendo en la obstinación terapéutica. No se suele practicar la adecuación del esfuerzo terapéutico y el rechazo del tratamiento es imposible. Aparece la eutanasia como categoría emergente, se confunde con la sedación paliativa. CONCLUSIONES: Desconocimiento del marco normativo ético y legal al final de la vida como causa del pacto de silencio, teniendo como consecuencias la falta de participación en la toma de decisiones, obstinación terapéutica y no aplicación de limitación del esfuerzo terapéutico

OBJETIVE: to collect the discourses of health professionals about the ethical and legal regulatory framework in the context of the pact of silence as origin of the phenomenon, and its consequences: participation in decision making, therapeutic obstinacy, limitation or adjustment of therapeutic efforts, and palliative sedation. A qualitative, descriptive study using a phenomenological approach. PLACE AND PARTICIPANTS: nurses and physicians in primary care, palliative care, hospital care, and emergency care in Seville. METHODS: Semi-structured interviews. Explored areas: breaking bad news regarding diagnosis, prognosis, and end of life; opinions about the conspiracy of silence, consequences for coping with death, and participation in decision making. Interpretive content analysis. RESULTS: Families are preferentially informed; most are unaware of ethical principles at the end of life; intimacy, autonomy, and confidentiality are mixed up terms; when present, the conspiracy of silence is maintained. Autonomy is overridden, beneficence and nonmaleficence are applied from the professional's perspective, lack of justice is mentioned regarding communication and information according to social reasons. Patient participation in decision making is impossible in this setting; overreacting occurs to avoid death, leading to therapeutic obstinacy. Therapeutic effort adjustment is not practiced and treatment refusal is impossible. Euthanasia appears as an emergent category, and is confused with palliative sedation. CONCLUSION: Ignorance of the ethical and legal regulatory framework for end-of-life care, as a cause of the pact of silence. Consequences include absence of patient participation in decision making, therapeutic obstinacy, and failure to implement therapeutic effort limitations

COVID-19: carrera mundial por una vacuna

Estudio regional sobre alcohol, drogas y lesiones viales en salas de emergencia: Primeros hallazgos.

Conspiración de silencio: diferencias en la información al anciano frente al paciente joven / Conspiracy of silence: differences in the information provided to older versus younger patients

No disponible

Seguridad del Paciente en Medicina Intensiva. Aspectos bioéticos / Patient Safety in Intensive Care Medicine. Bioethical aspects / Seguretat del Pacient en Medicina Intensiva. Aspectes bioètics

La Seguridad del Paciente se ha convertido en un reto y en una prioridad de todos los sistemas sanitarios. Se ha implantado políticas internacionales con el objetivo de reducir el número de incidentes relacionados con Seguridad del Paciente. Todavía son muchos los pacientes que sufren daños derivados de la atención sanitaria. Además, su impacto se extiende no solo a los familiares y allegados, sino también a los propios profesionales, a las instituciones sanitarias y todo ello con un coste económico y emocional con importantes consecuencias para todos los implicados. La mayoría de estudios realizados han ido dirigidos a conocer la epidemiología de los eventos adversos, a conocer sus causas y sus consecuencias. Se han promovido numerosas prácticas seguras con el objetivo de reducir los riesgos relacionados con la atención sanitaria. Recientemente han cobrado mayor relevancia aspectos relacionados con la actuación posterior a un evento adverso (EA). La gestión del riesgo implica entre otras acciones, la identificación, notificación y el análisis de los EA que señalen los fallos latentes en el sistema y la causa raíz con el objetivo último de establecer acciones de mejora y evitar su recurrencia. De forma paulatina estas estrategias se han ido incorporando en las políticas institucionales y mejorando con ello la cultura de seguridad. Pero todavía existen partes del proceso, que en nuestro ámbito se encuentran en su etapa más inicial, tales como el proceso de información sobre los EA a los pacientes y sus familiares y el soporte a los profesionales tras verse implicados en un EA. Todo ello debe construirse en un marco de confianza y credibilidad

Patient Safety has become a challenge and a priority of all healthcare systems. International policies have been implemented with the aim of reducing the number of incidents related to Patient Safety. There are still many patients who suffer damages derived from health care. In addition, its impact extends not only to family members and relatives, but also to the professionals themselves, to health institutions and all of this at an economic and emotional cost with important consequences for all those involved. Most studies have been directed to know the epidemiology of adverse events (AE), to know their causes and their consequences. Numerous safe practices have been promoted with the aim of reducing the risks related to health care. Recently, aspects related to post-AE performance have become more relevant. Risk management involves, among other actions, the identification, notification and analysis of the AE that point out latent failures in the system and the root cause with the ultimate goal of establishing improvement actions and avoiding their recurrence. Gradually these strategies have been incorporated into institutional policies and thereby improving the safety culture. But there are still parts of the process, which in our area are in their most initial stage, such as the process of informing about AE to patients and their families and the supoort to professionlas after being involved in an AE. All this must be built in a framework of trust and credibility

La seguretat del pacient s'ha convertit en un repte i en una prioritat de tots els sistemes sanitaris. S'han implantat polítiques internacionals amb l'objectiu de reduir el nombre d'incidents relacionats amb la seguretat del pacient. Encara són molts els pacients que sofreixen danys derivats de l'atenció sanitària. A més, el seu impacte s'estén no només als familiars i afins, sinó també als propis professionals, a les institucions sanitàries i tot això amb un cost econòmic i emocional amb importants conseqüències per a tots els implicats. La majoria d'estudis realitzats han anat dirigits a conèixer l'epidemiologia dels esdeveniments adversos, a conèixer les seves causes i les seves conseqüències. S'han promogut nombroses pràctiques segures amb l'objectiu de reduir els riscos relacionats amb l'atenció sanitària. Recentment han cobrat major rellevància els aspectes relacionats amb l'actuació posterior a un EA (esdeveniment advers). La gestió del risc implica entre altres accions, la identificació, notificació i l'anàlisi dels EA que assenyalin les fallades latents en el sistema i la causa arrel de les mateixes amb l'objectiu últim d'establir accions de millora i evitar-ne la recurrència. De forma gradual, aquestes estratègies s'han anat incorporant en les polítiques institucionals millorant amb això la cultura de seguretat. Però encara existeixen parts del procés, que en el nostre àmbit es troben en la seva etapa més inicial, tals com el procés d'informació sobre els EA als pacients i els seus familiars i el suport als professionals després de veure's implicats en un EA. Tot això ha de construir-se en un marc de confiança i credibilitat

La conspiración del silencio: estrategias de comunicación efectiva en los cuidados enfermeros / The Conspiracy of Silence: Effective Communication Strategies in Nursing Care

Ocultar información al paciente para omitir el diagnóstico o pronóstico de enfermedad es un fenómeno presente que se produce por diferentes situaciones, siendo la más destacable la expresa petición de la familia, lo cual puede derivar en consecuencias negativas para todos los actores del proceso: paciente, familia y profesionales. En estas circunstancias tan complejas no queda claro el rol de las enfermeras respecto al proceso de comunicar malas noticias o al uso de estrategias de comunicación empleadas. A partir de un caso en el que una paciente de edad avanzada diagnosticada de mieloma múltiple cuyo diagnóstico y pronóstico conocía la familia, pero los cuales ella desconocía, se planteó la necesidad de describir las estrategias de comunicación que pueden ayudar a los profesionales en situaciones similares. Es necesario fomentar un aprendizaje didáctico y práctico, con estrategias de comunicación claras, dentro de un marco de colaboración entre el equipo multidisciplinar donde queden delimitados los roles de los miembros que lo integran

Hiding information from the patient in order to omit their disease diagnosis or prognosis is a current phenomenon; this is caused by different situations, and the express request by relatives stands out among these. This can lead to negative consequences for all those involved in the process: the patient, the family and the professionals. In these highly complex circumstances, the role of nurses is not clear in terms of communicating bad news or using the adequate communication strategies. The case of an advanced-age female patient diagnosed with multiple myeloma, with diagnosis and prognosis known by the family but unknown to her, was the basis for considering the need to describe the communication strategies that might be helpful for professionals in similar situations. It is necessary to encourage educational and practical learning, with clear communication strategies, within a frame of collaboration between the multidisciplinary team, clearly determining the roles of the members involved

Clinicians' Perspectives on the Duty to Inform Patients About Medical Aid-in-Dying.

Background: As of 2019, ten jurisdictions in the United States have authorized physicians to prescribe a lethal dose of medication to a terminally ill patient for the purpose of hastening death. Relatively little bioethics scholarship has addressed the question of whether physicians have an obligation to inform qualifying patients about aid-in-dying (AID) in permissive jurisdictions and little is known about providers' actual communication practices with respect to this issue. Methods: One hundred and forty-four in-depth, semi-structured interviews were conducted and analyzed using an inductive analytic approach as part of the Vermont Study on Aid-in-Dying. Results: Seventeen respondents, 14 physicians and 3 nurse practitioners, met the inclusion criteria for this sub-study. Eleven respondents indicated that they at least sometimes inform patients about AID. Respondents described multiple factors that influence whether or not they might initiate discussions of AID, including the importance of informing patients of their options for end-of-life care, worries about undue influence, and worries about the potential effects on the patient-provider relationship. For those providers who do initiate discussion of AID at least some of the time, attention to the particulars of each individual patient's situation and the context of the discussion appear to play a role in shaping communication about AID. Conclusions: While initiating a clinical discussion of AID is undoubtedly challenging, our study provides compelling descriptive evidence that some medical providers who support AID do not unilaterally follow the conventional bioethics wisdom holding that they ought to wait for patients to introduce the topic of AID. Future research should investigate how to approach these discussions so as to minimize ethical worries about undue influence or potential negative consequences.

La ética en la comunicación del diagnóstico de síndrome de Down / Ethics in the communication of down syndrome diagnosis

La comunicación del diagnóstico de síndrome de Down tiene serias implicaciones éticas ya que la finalidad del mismo puede ser eugenésica o terapéutica. El objetivo de este artículo es, por un lado, resaltar el papel fundamental que desempeñan los profesionales sanitarios en la comunicación del diagnóstico y la posterior decisión de la madre. Por otra parte, se exponen las recomendaciones sobre la manera de comunicar un diagnóstico. Por último, se analiza el estado de la cuestión en España, para lo que se exponen los resultados de un estudio descriptivo transversal con una muestra de 352 madres en la que expresan, mediante una encuesta, sus experiencias personales sobre como han recibido la noticia. La conclusión a la que se llega es que la comunicación del diagnóstico de síndrome de Down se puede mejorar en muchos aspectos

Down Syndrome diagnosis communication has got serious ethical implications, since the aim thereof can be either eugenic or therapeutic. The purpose of this paper is, on the one hand, to highlight the fundamental role which sanitary professionals play in diagnosis communication and the subsequent decision of the mother. On the other, recommendations on the way to communicate a diagnosis are set out. Finally, in order to analize the state of play in Spain the results of a cross-sectional descriptive study with a sample of 352 mothers are exposed. In this study the mothers express, by means of a survey, their personal experiences of how they have received the news. It is concluded that the communication of Down syndrome diagnosis can be improved in many aspects

[Ethics in health communication.] / Etica della comunicazione in ambito biomedico.

Health communication must be based on open and multi-dimensional dialogue involving all stakeholders: public and private institutions, health professionals, industries, associations and, above all, citizens. Currently, communication suffers many problems related to bad research (unethical research, falsification of data, conflict of interest, incomplete reporting, spin and plagiarism) and to the limits of an academic system that does rewards quantity more than quality. A turnaround is needed, based on five major changes: establishing rules that can actually be followed; improve the quality of scientific information; accept and encourage open confrontation; allow citizens to be able to express and assert their needs; transform uncertainty from limit to value. The "Liberati's principles" must be reaffirmed: an honest communication must make the results of the research accessible to those who have to make decisions that affect their health; researchers must engage in studies that promise benefits to citizens and are not just useful to one's career or industry; before opening up new research fronts it is necessary to exhaust the potential of research already started; the definition of research priorities must be a transparent and shared process; the best evidence is the most relevant for citizens and patients. These principles and all ethical issues related should be part of educational programs for all health operators and researchers.

La comunicación del error médico. Consecuencias éticas y médico-legales / Medical errors communication. Ethical and medicolegal issues

No disponible