Climate change and the surgeon: what is the problem? Why is it so hard? What can be done?

We know very well what causes climate change, and in general terms, what the dangers are. This is a new kind of environmental problem, it is not like taking lead out of petrol, and it is important to understand why responding to climate change is so challenging. But that is no reason to give up: in fact there are many opportunities to intervene, including actions that can be taken by surgeons and other health professionals.

Uso y publicidad del diagnóstico genético para dietas personalizadas en nutrición: comentario a la sentencia 317/2018 del Tribunal Superior de Justicia del País Vasco / Use and advertising of genetic diagnosis for personalised diets in nutrition: commentary on judgement 317/2018 of the High Court of Justice of the Basque Country

El presente trabajo comenta la sentencia 317/2018 del Tribunal Superior de Justicia del País Vasco, que desestima la solicitud de un farmacéutico diplomado en Nutrición de publicitar un asesoramiento nutricional individualizado mediante la realización de un test nutrigenético. El fallo del Tribunal y las alegaciones tanto del solicitante como del Departamento de Salud del Gobierno Vasco dan paso a un debate sobre cuál es la utilidad real de este método para la personalización de dietas, novedad hoy día de fácil acceso a la población general, y si ésta es suficientemente autónoma cuando toma la decisión de usarla. Finalmente analizamos a qué nivel debe enmarcarse el empleo de esta prueba

The present work comments sentence 317/2018 of the Superior Court of Justice of the Basque Country, which dismisses the request of a pharmacist qualified in Nutrition to publicize an individualized nutritional advice by performing a nutrigenetic test. The ruling of the Court and the allegations of both the applicant and the Health Department of the Basque Government give way to a debate on what is the real use of this method for personalizing diets, a novelty nowadays easily accessible to the general population, and if it is sufficiently autonomous when it makes the decision to use it. Finally, we analyze at what level the use of this test should be framed

[The complexity of obesity--some ethical perspectives]. / Zum themenkomplex adipositas--einige ethische perspektiven.

The clinically oriented debate in the context of obesity is often blurred when in comes to morality, professional ethos and societal values. Surgeons, for example, might bring different normative approaches to the operation rooms than psychiatrists to their therapeutic sessions. These values often remain unspoken, but might change the medical conveyor belt of the patients affected. In this text, we want to focus on this so called "implicit normativity" of different stake holders. In addition, we question the concept of "illness" as obesity can be labelled as an illness and/or symptom - depending on the eyes of the observer. From a more societal perspective, any effort of prevention also comes with normative strings attached. Thus we plea for a stronger awareness of one's own values related to obesity, either in a clinical, personal or societal setting.

The bioethical experiences of student dietitians on their final clinical placement.

BACKGROUND: Dietetic students are exposed to bioethical dilemmas on clinical placements; however, the nature of these situations has not been investigated. The present study aimed to analyse students' reports of incidents and their associated personal development plans (PDP) to assess the type of ethical incidents faced and how they cope with them. METHODS: Final-year dietetic students were recruited via an announcement in class. The students' PDPs were analysed using thematic analysis to identify the type of ethical issues faced and how they felt about them. The 500-word PDPs were submitted after the final placement. RESULTS: Thirteen (13/26) students identified 'ethics' as a learning need and most of these incidents were related to enteral feeding (10/13). Ethical issues identified related to nonmaleficence; best interest; consent and capacity; truth telling and integrity; autonomy and substituted decision-making; futile treatment; beneficence and confidentially. The themes for how the students coped included being unsure; lack of confidence or knowledge with ethics and/or with communication; lack of experience; unease/concern about shared decision-making; and their own role in the situation. CONCLUSIONS: Student dietitians are exposed to a wide range of complex ethical clinical situations, with those related to enteral feeding being the most common. Students felt unsure of what to do and lacked confidence, which resulted in unease and concern; however, students appeared to have some ethical sensitivity. Communication problems with the multidisciplinary team or families were a common theme. Clinical educators need to support students in these situations and act as role models.

Planteamientos éticos en la indicación y retirada del soporte nutricional / No disponible

No disponible