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1.
An. psicol ; 36(2): 330-339, mayo 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-192070

RESUMO

En la actualidad, la corrupción constituye uno de los principales problemas psicológicos, sociales, económicos y políticos a nivel mundial. El objetivo del presente estudio es analizar las variables psicológicas asociadas a la corrupción a través de una revisión sistemática de las publicaciones entre 2008 y 2018. Tras realizar una búsqueda en las bases de datos Psycinfo, Web of Science, Scopus, Scielo y Dialnet, se encontraron 44 artículos que cumplían con los criterios de selección propuestos. Los grandes núcleos encontrados fueron la ética organizacional, creencias y valores culturales, moral y normas percibidas, y personalidad y variables relacionadas. En general, los resultados apuntan a que variables organizacionales como la percepción de la conducta de sus dirigentes o las estrategias de justificación están relacionadas con la corrupción. Valores culturales meritocráticos y materialistas también han sido ligados a la conducta corrupta, como ocurre en el caso de la percepción de un entorno corrupto y de las normas sociales. En cuanto a la personalidad, rasgos como el narcisismo y la psicopatía se encuentran íntimamente ligados a este fenómeno. Por otra parte, variables como la percepción del poder o el sexo de los participantes han recibido un sustento empírico ambiguo


Nowadays, corruption is one of the most important psychological, social, economic and political issues worldwide. The present paper aims to analyse psychological variables related to corruption through a systematic review of publications from 2008 to 2018. After carrying out a bibliographic search in scientific databases such as Psycinfo, Web of Science and Dialnet, 41 papers were found to match selection criteria. Core topics haven been organizational ethics, cultural beliefs and values, perceived norms and moral, and personality and related variables. Overall, results have shown that organizational variables such as leaders' behaviour and justification strategies are linked to corruption. Meritocratic and materialist values have also been linked to corrupt behaviour, just like perceiving a corrupt environment and social norms. In regard to personality, features such as narcissism and psychopathy are deeply connected with this phenomenon. On the other side, perception of power and gender have a mixed empirical support


Assuntos
Humanos , Corrupção/psicologia , Valores Sociais , Normas Sociais , Ética Institucional , Religião , Bases de Dados como Assunto/estatística & dados numéricos , Moral
2.
Washington; Organización Panamericana de la Salud; jun. 19, 2020. 10 p.
Não convencional em Inglês, Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1100378

RESUMO

La pandemia de COVID-19 nos enfrenta a la urgencia moral de llevar a cabo investigaciones rigurosas tan pronto como sea posible para producir evidencia sobre la seguridad y eficacia de las intervenciones para tratar o prevenir la COVID-19 (1). Sin embargo, al igual que en emergencias anteriores, caracterizadas por una alta mortalidad y la ausencia de tratamientos seguros y eficaces, las intervenciones que no han sido probadas previamente para COVID-19 se están proporcionando fuera de protocolos de investigación con seres humanos. En circunstancias ordinarias, las intervenciones se prueban primero en investigaciones que tienen como objetivo principal producir conocimiento. Existen procedimientos para garantizar que los participantes de las investigaciones estén debidamente protegidos y se reúnan datos de calidad. Una vez que se han completado los estudios necesarios y se ha comprobado que las intervenciones son seguras y eficaces, mediante procesos rigurosos dirigidos por una Autoridad Reguladora Nacional (ARN), se autorizan y pueden proporcionarse a los pacientes para tratar o prevenir enfermedades.


The COVID-19 pandemic presents us with the moral urgency to conduct rigorous research as soon as possible to produce evidence about the safety and efficacy of interventions to treat or prevent COVID-19. However, as in previous emergencies, marked by high mortality and the absence of safe and efficacious treatments, interventions that have not been previously proven for COVID-19 are being offered outside of protocols of research with human subjects. Since the safety and efficacy of these interventions have not been proven yet, their risk-benefit profile is unknown. Yet in the exceptional circumstances of the pandemic, they are being offered as an attempt to advance access to interventions that may benefit patients. As recommended by the Pan American Health Organization and the World Health Organization, unproven interventions should be offered within research protocols, and specifically within randomized controlled trials capable of assessing safety and efficacy.


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/epidemiologia , Pandemias/prevenção & controle , Betacoronavirus , Organização Pan-Americana da Saúde , Ética Institucional , Assistência ao Paciente/normas
3.
Can J Cardiol ; 36(8): 1313-1316, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32505633

RESUMO

The COVID-19 pandemic has raised ethical questions for the cardiovascular leader and practitioner. Attention has been redirected from a system that focuses on individual patient benefit toward one that focuses on protecting society as a whole. Challenging resource allocation questions highlight the need for a clearly articulated ethics framework that integrates principled decision making into how different cardiovascular care services are prioritized. A practical application of the principles of harm minimisation, fairness, proportionality, respect, reciprocity, flexibility, and procedural justice is provided, and a model for prioritisation of the restoration of cardiovascular services is outlined. The prioritisation model may be used to determine how and when cardiovascular services should be continued or restored. There should be a focus on an iterative and responsive approach to broader health care system needs, such as other disease groups and local outbreaks.


Assuntos
Serviço Hospitalar de Cardiologia , Doenças Cardiovasculares , Infecções por Coronavirus , Ética Institucional , Controle de Infecções/métodos , Pandemias , Administração dos Cuidados ao Paciente , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Canadá/epidemiologia , Serviço Hospitalar de Cardiologia/organização & administração , Serviço Hospitalar de Cardiologia/tendências , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Modelos Organizacionais , Inovação Organizacional , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/ética , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
4.
Dig Dis Sci ; 65(8): 2161-2163, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32519138

RESUMO

Many GI training programs have needed to adjust to the serious disruption to the training and education of fellows worldwide due to the COVID-19 pandemic. A silent problem that has arisen within programs is the issue of burnout among their trainees. Burnout is common among gastroenterologists, especially in fellows (Keswani et al. in Gastroenterology 147(1):11-14, 2014. https://doi.org/10.1053/j.gastro.2014.05.023 , Am J Gastroenterol 106(10):1734-1740, 2011. https://doi.org/10.1038/ajg.2011.148 ), with negative consequences to patient care and the safety of the trainees if not effectively dealt with. In this article, the author describes several additional factors potentially contributing to the intensifying burnout of the fellows in their home institution during this pandemic. Moreover, he describes specific practical interventions that the hospital and program have taken in order to address these factors.


Assuntos
Esgotamento Psicológico , Infecções por Coronavirus/epidemiologia , Educação , Gastroenterologia/educação , Internato e Residência , Pneumonia Viral/epidemiologia , Betacoronavirus , Esgotamento Psicológico/etiologia , Esgotamento Psicológico/prevenção & controle , Educação/ética , Educação/organização & administração , Educação/tendências , Ética Institucional , Bolsas de Estudo/métodos , Gastroenterologistas/psicologia , Humanos , Internato e Residência/métodos , Internato e Residência/organização & administração , Internato e Residência/tendências , Pandemias
5.
Washington; Organización Panamericana de la Salud; abr. 8, 2020. 1 p.
Não convencional em Inglês, Espanhol | LILACS | ID: biblio-1096783

RESUMO

La pandemia de COVID-19 conlleva la obligación de los gobiernos de destinar la mayor cantidad de recursos posibles para atender las necesidades de salud. Sin embargo, es posible que enfrentemos situaciones en las que los recursos disponibles (como ventiladores o camas de cuidados intensivos) no sean suficientes para atender todas las necesidades de la población. Ese escenario es moralmente trágico puesto que sabemos que debemos dar el tratamiento necesario a todas las personas afectadas. Ante ese escenario, debemos proceder de manera ética: Dado que no podemos hacer todo lo que debemos hacer, ¿cuál es la manera más ética de proceder? Actuar con responsabilidad obliga a las autoridades sanitarias a establecer criterios para las decisiones de priorización que pudieran ser necesarias en este escenario.


The COVID-19 pandemic faces governments with the obligation of allocating the greatest possible amount of resources to meet health care needs. However, we may encounter situations in which available resources (such as ventilators or ICU beds) are not sufficient to meet all the needs of the population. This is a morally tragic scenario because we know we should provide treatment to all who need it. In this scenario, we must proceed ethically: since we cannot do everything that we should do, what is the most ethical path of action? Responsible action calls for health authorities to establish criteria for the priority-setting decisions that may be necessary in this scenario.


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Sistemas de Saúde/organização & administração , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/epidemiologia , Ética Institucional , Pandemias/prevenção & controle , Betacoronavirus
7.
PLoS One ; 15(1): e0226920, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31990925

RESUMO

This paper aims to explore whether entrepreneurial ethics can improve entrepreneurial performance in new ventures. The dynamic impact of entrepreneurial ethics on entrepreneurial performance (survival and sustainable growth) is investigated from an institutional perspective, and the moderating role of firm visibility between them is explored. From different regions of China, 296 valid questionnaires are obtained and analyzed. We find that entrepreneurial ethics is adverse to the survival of new ventures but conducive to their sustainable growth of new ventures. We also find that high firm visibility can help entrepreneurial ethics be more effective in improving entrepreneurial performance. This study provides a new insight to explain the theoretical controversy of entrepreneurial ethics and provides guidance for the establishment of the internal ethical structures of new ventures. Suggestions for government and industry regulators on the management of entrepreneurial ethics are also provided.


Assuntos
Contrato de Risco/ética , Ética Institucional , China , Humanos , Inquéritos e Questionários
8.
London; Nuffield Council on Bioethics; ene. 2020. 16 p.
Não convencional em Espanhol | Coleciona SUS | ID: biblio-1116477

RESUMO

Este documento describe los principales temas, hallazgos y recomendaciones del informe del Consejo Nuffield sobre Bioética Investigaciones en emergencias sanitarias globales: cuestiones éticas (publicado en enero de 2020). El informe sigue una investigación en profundidad de dos años realizada por un grupo de trabajo internacional, que se benefició de la evidencia y la experiencia compartida por muchos colaboradores de todo el mundo (ver el mapa a continuación para conocer las ubicaciones de los colaboradores). Las contribuciones se realizaron a través de las respuestas a una convocatoria abierta para evidencia, la participación en mesas redondas y reuniones individuales, la crítica de los primeros borradores del informe y la participación en talleres y eventos internacionales.


Assuntos
Surtos de Doenças/prevenção & controle , Temas Bioéticos , Populações Vulneráveis , Ética Institucional , Vigilância Sanitária de Serviços de Saúde , Sistemas de Saúde/organização & administração
9.
Buenos Aires; Ministerio de Salud; 2020.
Não convencional em Espanhol | LILACS | ID: biblio-1116482

RESUMO

Ante la pandemia de COVID-19 la primera obligación es responder a las necesidades de atención de salud de las personas y comunidades afectadas. Al mismo tiempo, resulta un deber realizar investigaciones que generen evidencia para mantener, promover y mejorar la atención de la salud, la toma de decisiones y la definición de políticas en salud para el tratamiento y mitigación de la pandemia. La conducción de investigación durante la emergencia sanitaria conlleva mayores desafíos que los habituales. Demanda generar conocimiento rápidamente para dar respuesta a la pandemia, asegurar la validez científica de las investigaciones, respetar los principios éticos en su realización y mantener la confianza de la comunidad. Esta tarea requiere de la colaboración y solidaridad de la comunidad científica, investigadores, patrocinadores, comités evaluadores, personal de salud, autoridades sanitarias y la sociedad, para encontrar el mejor modo de evitar retrasos en la realización de las investigaciones. En este contexto, los comités de ética en investigación (CEI) deberían formular procedimientos para una evaluación ética rigurosa de las investigaciones en seres humanos que, a su vez, aseguren la existencia de mecanismos rápidos y flexibles para dar una respuesta eficiente a los tiempos y necesidades de una emergencia sanitaria. Estas recomendaciones buscan orientar a los CEI en el desarrollo de procedimientos operativos para una evaluación acelerada de proyectos de investigación relacionados con el COVID-19.


Assuntos
Pneumonia Viral/prevenção & controle , Pessoal de Saúde/ética , Infecções por Coronavirus/prevenção & controle , Ética Institucional , Pandemias/prevenção & controle , Betacoronavirus , Experimentação Humana/ética , Serviços Médicos de Emergência/ética , Políticas Públicas de Saúde , Atenção à Saúde
10.
Cien Saude Colet ; 25(1): 251-259, 2020 Jan.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31859873

RESUMO

The article aims to reinforce the importance of organizational ethics for health organizations. As a first step, organizational ethics is differentiated from other areas of applied ethics, which are mobilized by health-related ethical issues. Then, the objects of study and intervention that characterize it are presented. Finally, the article focuses on some core elements of a particularly rich and relevant organizational ethical approach.


Assuntos
Assistência à Saúde/ética , Ética Institucional , Brasil
11.
J Law Health ; 33(1): 79-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31841618

RESUMO

Alfie Evans was a terminally ill British child whose parents, clinging to hope, were desperately trying to save his life. Hospital authorities disagreed and petitioned the court to enjoin the parents from removing him and taking him elsewhere for treatment. The court stepped in and compelled the hospital to discontinue life support and claimed that further treatment was not in the child's best interest. This note discusses the heartbreaking stories of Alfie and two other children whose parents' medical decisions on their behalf were overridden by the court. It argues that courts should never decide that death is in a child's best interest and compel parents to withdraw life support from their children. Such a decision is outside the scope of the judiciary. Furthermore, it argues that even in those instances when the court may or must intervene, a new framework is necessary because the current framework used by the court to determine the best interest of the child ignores fundamental realities of child psychology. Too often, as a result of the court's mistaken framework, the court illegitimately trespasses into the parental domain. By adopting a new framework, the court will intervene only when actual abuse or neglect is suspected. In all other cases, judicial restraint will be practiced and the court will show greater deference to the parents' wishes.


Assuntos
Tomada de Decisões , Dissidências e Disputas , Função Jurisdicional , Pais , Adolescente , Adulto , Terapias Complementares/ética , Terapias Complementares/legislação & jurisprudência , Ética Institucional , Ética Médica , Feminino , Humanos , Identificação Psicológica , Lactente , Cuidados para Prolongar a Vida/ética , Cuidados para Prolongar a Vida/legislação & jurisprudência , Masculino , Obrigações Morais , Autonomia Pessoal , Autonomia Profissional
13.
BMC Health Serv Res ; 19(1): 879, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752958

RESUMO

BACKGROUND: Seclusion is an invasive clinical intervention used in inpatient psychiatric wards as a continuation of milieu therapy with vast behavioural implications that raise many ethical challenges. Seclusion is in Norway defined as an intervention used to contain the patient, accompanied by staff, in a single room, a separate unit, or an area inside the ward. Isolation is defined as the short-term confinement of a patient behind a locked or closed door with no staff present. Few studies examine how staff experiences the ethical challenges they encounter during seclusion. By making these challenges explicit and reflecting upon them, we may be able to provide better care to patients. The aim of this study is to examine how clinical staff in psychiatric inpatient wards describes and assess the ethical challenges of seclusion. METHODS: This study was based on 149 detailed written descriptions of episodes of seclusion from 57 psychiatric wards. A descriptive and exploratory approach was used. Data were analysed using qualitative content analysis. RESULTS: The main finding is that the relationship between treatment and control during seclusion presents several ethical challenges. This is reflected in the balance between the staff's sincere desire to provide good treatment and the patients' behaviour that makes control necessary. Particularly, the findings show how taking control of the patient can be ethically challenging and burdensome and that working under such conditions may result in psychosocial strain on the staff. The findings are discussed according to four core ethical principles: autonomy, beneficence, non-maleficence, and justice. CONCLUSION: Ethical challenges seem to be at the core of the seclusion practice. Systematic ethical reflections are one way to process the ethical challenges that staff encounters. More knowledge is needed concerning the ethical dimensions of seclusion and alternatives to seclusion, including what ethical consequences the psychosocial stress of working with seclusion have for staff.


Assuntos
Atitude do Pessoal de Saúde , Ética Institucional , Transtornos Mentais/terapia , Isolamento de Pacientes/ética , Recursos Humanos em Hospital , Unidade Hospitalar de Psiquiatria/ética , Adulto , Feminino , Humanos , Pacientes Internados , Masculino , Noruega , Pesquisa Qualitativa
14.
BMC Med Ethics ; 20(1): 75, 2019 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651308

RESUMO

BACKGROUND: An ethics reflection group (ERG) is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark. METHODS: This is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis of significance. RESULTS: A recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG. CONCLUSION: This study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives.


Assuntos
Comitês de Ética Clínica/organização & administração , Ética Institucional , Departamentos Hospitalares/ética , Departamentos Hospitalares/organização & administração , Antropologia Cultural , Atitude do Pessoal de Saúde , Dinamarca , Humanos , Entrevistas como Assunto , Princípios Morais , Paternalismo/ética , Autonomia Pessoal , Papel Profissional/psicologia , Unidade Hospitalar de Psiquiatria/ética , Unidade Hospitalar de Psiquiatria/organização & administração , Pesquisa Qualitativa , Estudos Retrospectivos
15.
Rev Panam Salud Publica ; 43, july 2019https://doi.org/10.26633/RPSP.2019.61.
Artigo em Inglês | PAHO-IRIS | ID: phr-51105

RESUMO

[ABSTRACT]. Objectives. To document the underlying science of how the Pan American Health Organization (PAHO) adapted the Hanlon method, which prioritizes disease control programs, to its wider range of program areas and used it to implement the PAHO Strategic Plan 2014 – 2019. Methods. In 2014, PAHO established a Strategic Plan Advisory Group (SPAG) with representatives from 12 Member States to work closely with the PAHO Technical Team to adapt the Hanlon method to disease and non-disease control programs. Three meetings were held in 2015 – 2016 during which SPAG reviewed existing priority-setting methods, assessed the original Hanlon method and subsequent revisions, and developed the adapted method. This project was initiated by Member States, facilitated by PAHO, and conducted jointly in transparent and horizontal technical cooperation. Results. From the original Hanlon equation, the PAHO-adapted method maintains components A (size of problem), B (seriousness of problem), and C (effectiveness of intervention), drops component D (PEARL – Propriety, Economics, Acceptability, Resources, and Legality), and adds component E (inequity) and F (institutional positioning). The PEARL score was dropped because it serves a purpose for pre-screening process, but not in the priority-setting process for PAHO. Conclusions. The PAHO-adapted Hanlon method provides a refined approach for prioritizing public health programs that include disease and non-disease control areas. The method may be useful for the World Health Organization and country governments with similar needs.


[RESUMEN]. Objetivos. Documentar los fundamentos científicos a través de los cuales la Organización Panamericana de la Salud (OPS) adaptó el método de Hanlon, que sirve para asignar prioridades a los programas de control de enfermedades, para aplicarlo al conjunto de áreas programáticas y ejecutar el Plan Estratégico de la OPS 2014-2019. Métodos. En el 2014, la OPS creó un Grupo Asesor sobre el Plan Estratégico integrado por representantes de 12 Estados Miembros cuya misión era colaborar estrechamente con el equipo técnico de la OPS para adaptar el método de Hanlon para su aplicación a los programas de control de enfermedades y otras áreas programáticas. Se celebraron tres reuniones entre el 2015 y el 2016, en las cuales el Grupo Asesor examinó los métodos existentes de establecimiento de prioridades, evaluó el método de Hanlon original y sus revisiones, y elaboró el método adaptado. Este proyecto fue iniciado por los Estados Miembros, facilitado por la OPS y llevado a cabo conjuntamente mediante una cooperación técnica transparente y horizontal. Resultados. El método adaptado por la OPS mantiene los componentes A (magnitud del problema), B (gravedad del problema) y C (eficacia de la intervención) de la ecuación de Hanlon original, prescinde del componente D (resumido en la sigla PEARL, en inglés: pertinencia, factibilidad económica, aceptabilidad, disponibilidad de recursos y legalidad), e incorpora los componentes E (inequidad) y F (posicionamiento institucional). La puntuación PEARL no fue incluida porque solo cumple una función en el proceso de preselección, no durante el proceso de establecimiento de prioridades en el que estaba trabajando la OPS. Conclusiones. El método de Hanlon adaptado por la OPS proporciona un enfoque más preciso para la asignación de prioridades a los programas de salud pública relativos al control de enfermedades y a otras áreas programáticas. El método podría resultar útil para la Organización Mundial de la Salud y para aquellos gobiernos nacionales con necesidades similares.


[RESUMO]. Objetivos. Documentar o processo de base científica empregado pela Organização Pan-Americana da Saúde (OPAS) para adaptar o método de Hanlon, que define a priorização de programas para controle de doenças, às diversas áreas programáticas da OPAS e descrever como esta metodologia foi usada para implementar o Plano Estratégico da OPAS 2014-2019. Métodos. Em 2014, a OPAS formou um grupo consultivo sobre o Plano Estratégico, composto por representantes de 12 Estados Membros, para colaborar estreitamente com a Equipe Técnica da OPAS na adaptação da metodologia de Hanlon aos programas para controle de doenças e não doenças. Foram realizadas três reuniões em 2015–2016 em que se examinaram os métodos existentes para definição de prioridades, avaliaram-se o método de Hanlon original e versões revisadas posteriores e elaborou-se uma metodologia adaptada. Este projeto foi de iniciativa dos Estados Membros, com o auxílio da OPAS, conduzido conjuntamente com cooperação técnica transparente e equiparada. Resultados. Partindo da equação original de Hanlon, a metodologia adaptado pela OPAS mantém os componentes A (magnitude do problema), B (gravidade do problema) e C (eficácia da intervenção), elimina o componente D (PEARL – pertinência, viabilidade econômica, aceitação, recursos e legalidade) e acrescenta os componentes E (iniquidade) e F (posicionamento institucional). A pontuação do componente PEARL foi excluída porque serve à finalidade de pré-seleção, não ao processo de definição de prioridades para a OPAS. Conclusões. O método de Hanlon adaptado pela OPAS oferece um enfoque aprimorado para definir as prioridades programáticas em saúde pública que abrangem áreas de controle de doenças e não doenças. A metodologia pode ser útil à Organização Mundial da Saúde e aos governos de países com necessidades semelhantes.


Assuntos
Prioridades em Saúde , Tomada de Decisões , Ética Institucional , Planejamento Estratégico , Organização Pan-Americana da Saúde , Prioridades em Saúde , Tomada de Decisões Gerenciais , Planejamento Estratégico , Organização Pan-Americana da Saúde , Prioridades em Saúde , Tomada de Decisões Gerenciais , Planejamento Estratégico , Organização Pan-Americana da Saúde
17.
J Clin Ethics ; 30(1): 35-45, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30896442

RESUMO

In this article, we first review the development of clinical ethics in pediatrics in the United States. We report that, over the last 40 years, most children's hospitals have ethics committees but that those committees are rarely consulted. We speculate that the reasons for the paucity of ethics consults might be because ethical dilemmas are aired in other venues. The role of the ethics consultant, then, might be to shape the institutional climate and create safe spaces for the discussion of difficult and sometimes contentious issues. Finally, we report how pediatric clinical ethics has evolved differently in a number of other countries around the world.


Assuntos
Ética Clínica , Pediatria , Criança , Eticistas , Comissão de Ética , Comitês de Ética Clínica , Ética Institucional , Humanos , Internacionalidade , Pediatria/ética , Estados Unidos
18.
Rev. clín. esp. (Ed. impr.) ; 219(2): 90-95, mar. 2019.
Artigo em Espanhol | IBECS | ID: ibc-185705

RESUMO

Los objetivos de gestión, en ocasiones, plantean importantes conflictos de valor, hasta el momento poco estudiados. En el presente artículo se analiza qué cuestiones éticas plantean los objetivos operativos de gestión a los médicos que trabajan en hospitales españoles. Estas cuestiones son las siguientes: 1) en el sistema actual se prima la cantidad sobre la calidad, lo que supone una perspectiva de gestión predominantemente economicista; 2) se trata de un sistema jerarquizado, en el que apenas hay participación y en el que los clínicos carecen de capacidad decisoria y 3) los objetivos se centran en actividades desfasadas respecto a la realidad del sistema sanitario actual, por lo que deben ser actualizados considerando, por ejemplo, la cronicidad o la continuidad asistencial. Al analizar estas cuestiones, se realiza una propuesta de elaboración de los objetivos de gestión basada en 3 aspectos: priorizar la calidad asistencial (lo que finalmente repercute en una gestión eficiente), elaborar los objetivos de forma participativa y mixta (con objetivos colectivos e individuales) y diseñar nuevos objetivos acordes con la realidad del actual sistema sanitario. No es complicado poner en práctica esta propuesta, ya que la meta final de los clínicos y de la gerencia es la de proporcionar una asistencia sanitaria óptima


Management objectives at times create significant value conflicts that have so far been seldom studied. This article analyses the ethical issues created by the operational objectives of management for physicians who work in Spanish hospitals. These issues are as follows: 1) the current system places quantity above quality, which represents a predominantly economist management perspective; 2) the system is hierarchical, lacks participation and deprives clinicians of decision-making authority; 3) the objectives are focused on outdated activities in terms of the current reality of the healthcare system and should therefore be updated considering, for example, chronicity and the continuity of care. After analysing these issues, we created a proposal for developing management objectives based on prioritising quality care (which ultimately results in efficient management), developing objectives in a participatory and mixed manner (with group and individual objectives) and designing new objectives in keeping with the current reality of the healthcare system. Putting this proposal into practice is not complicated because the final goal of clinicians and management is to provide optimal health care


Assuntos
Humanos , Ética Institucional , Administração Hospitalar/ética , Objetivos Organizacionais , Dissidências e Disputas , Organizações de Assistência Responsáveis/organização & administração
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