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1.
Edumecentro ; 12(1): 222-237, ene.-mar. 2020.
Artículo en Español | LILACS | ID: biblio-1090008

RESUMEN

RESUMEN Introducción: la responsabilidad médica se inserta en las llamadas responsabilidades de profesionales; para fijar sus contornos es necesario precisar la naturaleza jurídica de la relación médico-paciente y la responsabilidad civil por los daños causados en el ejercicio de la actividad médica. Objetivo: determinar la naturaleza de la relación médico-paciente para precisar el criterio de imputación de responsabilidad y la extensión de los daños resarcibles. Métodos: se realizó una revisión doctrinal de importantes juristas cubanos y españoles, análisis de la legislación y jurisprudencia comparada y valoración de la legislación cubana. La búsqueda fue realizada en textos originales con vinculación directa a la temática. Desarrollo: la relación médico-paciente es, cualquiera que sea su causa, una relación jurídica a la que el Derecho le confiere tutela. Su naturaleza jurídica tiene su base en la obligación de medios que surge entre los sujetos; en tal sentido resulta importante la ubicación de la responsabilidad médica como responsabilidad profesional y el análisis de los daños causados, así como el criterio de imputación dominante. Los daños causados por la actuación negligente del personal médico pueden ser de índole patrimonial o moral; ambos deben ser reparados e indemnizados según las normas vigentes. Conclusiones: el criterio de imputación predominante en la responsabilidad civil del médico debe ser el subjetivo, valorando siempre su pericia y destreza en el ejercicio de su profesión; asunto este poco tratado en los currículos de las carreras, por lo que esta revisión se une a otras destinadas a desarrollar una cultura jurídica entre estudiantes y profesionales de la salud.


ABSTRACT Background: medical liability is inserted in the so-called responsibilities of professionals; to determine its framework it is necessary to specify the legal nature of the doctor-patient relationship and the civil responsibility for the damages caused in the exercise of the medical activity. Objectives: to determine the nature of the doctor-patient relationship to specify the criterion of imputation of responsibility and the extent of compensable damages. Methods: a doctrinal review of important Cuban and Spanish jurists, analysis of comparative legislation and jurisprudence and valuation of Cuban legislation was carried out. The search was carried out in original texts with direct link to the subject. Development: the doctor-patient relationship is, whatever its cause, a legal relationship to which the law confers guardianship. Its legal nature is based on the obligation of means that arises among the subjects; in this sense it is important the location of medical responsibility as professional responsibility and the analysis of the damages caused, as well as the dominant imputation criteria. The damages caused by the negligent action of the medical personnel can be of patrimonial or moral nature; both must be repaired and compensated according to current regulations. Conclusions: the predominant imputation criterion in the physician's civil responsibility must be the subjective one, always assessing his expertise and skill in the exercise of his profession; this issue is not much discussed in the curricula of the careers, so this review joins others aimed at developing a legal culture among students and health professionals.


Asunto(s)
Relaciones Médico-Paciente , Derechos Civiles , Derecho Penal , Educación Médica
2.
Ciênc. Saúde Colet ; 25(1): 37-46, jan. 2020. graf
Artículo en Portugués | LILACS | ID: biblio-1055766

RESUMEN

Resumo O artigo refletiu sobre a formação em Enfermagem no Brasil a partir da regulamentação do Sistema Único de Saúde numa perspectiva histórica comparada dos processos evolutivos das escolas anglo-americana e francesa, influenciadoras do ensino de Enfermagem no Brasil, bem como o aspecto orientador da formação em Enfermagem para o Sistema Único de Saúde. Neste sentido, são desenvolvidas inciativas de formação em Enfermagem, orientadas pelas Diretrizes Curriculares Nacionais, com vistas a propiciar vivências significativas no cotidiano do Sistema Único de Saúde, assim como o movimento transformador da Educação Permanente em Saúde no contexto do mundo do trabalho. Dessa maneira, a superação dos desafios da formação precisa considerar a trajetória social, política e cultural da profissão, de modo a possibilitar mudanças que impactam nos projetos pedagógicos, na oferta de cursos, nas metodologias de ensino-aprendizagem e no cotidiano do trabalho.


Abstract The paper reflected on the Brazilian Nursing education from the regulation of Unified Health System in a comparative historical perspective of the evolutionary processes of the Anglo-American and French schools, influencing Brazilian nursing education, as well as the guiding aspect of nursing education for the Unified Health System. Thus, nursing training initiatives guided by the National Curriculum Guidelines are developed to provide meaningful experiences in the Unified Health System's daily routine, as well as the transforming movement of Permanent Health Education in the context of the world of work. Therefore, overcoming training challenges must consider the social, political, and cultural path of the profession in order to allow changes that affect pedagogical projects, course offerings, teaching-learning methodologies, and daily work.


Asunto(s)
Atención a la Salud/organización & administración , Educación en Enfermería/organización & administración , Brasil , Guías como Asunto , Curriculum , Atención a la Salud/legislación & jurisprudencia
3.
J Lesbian Stud ; 24(3): 199-213, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31621537

RESUMEN

Minnie Bruce Pratt (1946-) and Mab Segrest (1949-) are white middle-class lesbians that both came of age during the classical phase of the Civil Rights Movement in rural Alabama. Today, they are considered influential figures in feminist and lesbian, gay, bisexual, transgender, and queer (LGBTQ) literary movements and recognized as important activists in late twentieth-century feminist, LGBTQ, and anti-racist political struggles. Examining Pratt's Rebellion: Essays, 1980-1991 (1991) and Segrest's Memoir of a Race Traitor (1994), I argue that both texts deconstruct the sociopolitical dynamics and ideologies that inform the inculcation of white middle-class southern womanhood specifically and hegemonic white southern culture generally through performing a form of anti-racist praxis that I call geospatial critique. This term addresses how Pratt and Segrest mine spaces that they occupy for histories of struggle, paying specific attention to how white settler-colonialism and chattel slavery produced particular epistemologies of race, class, gender, and sexuality that continue to influence social identities and practices in the present. Initially developed during Pratt and Segrest's collaboration on Feminary, a lesbian-feminist journal located in Durham, North Carolina, between 1978 and 1982, geospatial critique, I suggest, is a direct response to or a way of undoing the racial training that was part of the production of whiteness in the south from the turn to the first half of the twentieth century.


Asunto(s)
Feminismo/historia , Literatura , Racismo/historia , Minorías Sexuales y de Género/historia , Autoria , Derechos Civiles/historia , Historia del Siglo XX , Humanos , Minorías Sexuales y de Género/legislación & jurisprudencia
4.
Cien Saude Colet ; 25(1): 37-46, 2020 Jan.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31859853

RESUMEN

The paper reflected on the Brazilian Nursing education from the regulation of Unified Health System in a comparative historical perspective of the evolutionary processes of the Anglo-American and French schools, influencing Brazilian nursing education, as well as the guiding aspect of nursing education for the Unified Health System. Thus, nursing training initiatives guided by the National Curriculum Guidelines are developed to provide meaningful experiences in the Unified Health System's daily routine, as well as the transforming movement of Permanent Health Education in the context of the world of work. Therefore, overcoming training challenges must consider the social, political, and cultural path of the profession in order to allow changes that affect pedagogical projects, course offerings, teaching-learning methodologies, and daily work.


Asunto(s)
Atención a la Salud/organización & administración , Educación en Enfermería/organización & administración , Brasil , Curriculum , Atención a la Salud/legislación & jurisprudencia , Guías como Asunto
5.
Saúde debate ; 43(spe5): 44-57, Dez. 2019.
Artículo en Portugués | LILACS, Coleciona SUS, CONASS | ID: biblio-1101961

RESUMEN

RESUMO Na perspectiva da análise comparada de Sistemas de Saúde (SS), este artigo analisa o SS brasileiro visando identificar estratégias promissoras para seu desenvolvimento. Metodologicamente, baseados em estudos sobre a sua formação/situação e nos seus principais componentes assistenciais e de financiamento, discutem-se suas aproximações e distanciamentos dos três tipos principais de SS: 1- baseados nos serviços nacionais universais (beveridgeanos); 2- baseados em seguros sociais obrigatórios (bismarckianos); 3- baseados em seguros privados voluntários (smithianos). O SS brasileiro é misto/segmentado, com muitos aspectos beveridgeanos, especialmente na Atenção Primária à Saúde (APS) (municipalizada e heterogênea), e smithianos (setor privado, cuidado especializado e hospitalar - insuficientes no SUS); e pouco similar aos bismarckianos. Nos seus aspectos smithianos e bismarckianos, é muito intensa a vigência da lei dos cuidados inversos, com financiamento público do setor privado para o quartil mais rico da população. Para maior racionalidade, equidade e universalidade, há que se investir nos aspectos beveridgeanos do SS brasileiro, o que não vem ocorrendo: reduzir gastos tributários em saúde, expandir e qualificar a APS via Estratégia Saúde da Família (ESF) e o cuidado especializado e hospitalar, regionalizar sua gestão, reduzindo desigualdades, e aumentar o poder de coordenação da ESF, ampliando/modificando os Núcleos de Apoio à Saúde da Família.


ABSTRACT In light of comparative analysis of Health Systems (HS), this article aims to discuss the Brazilian HS in order to identify promising strategies for its development. Methodologically, based on studies about its formation/situation and on its main components of assistance and of funding, the approximation and distancing from the three main types of HS are discussed: 1- those based on universal national services (Beveridgeans); 2- those based on compulsory social insurance (Bismarckian); 3- those based on voluntary private insurance (Smithians). The Brazilian HS is mixed/segmented and includes both Beveridgean aspects, especially Primary Health Care (PHC) (municipalized and heterogeneous), and Smithians elements, such as private sector, specialized and hospital care. But it is little similar to the Bismarckian HS. In its Smithian and Bismarckian aspects, the law of reverse care is more evident, with public funding from the private sector to the wealthiest quartile of the population. For greater rationality, efficiency, equity, and universality, it is necessary to invest in the Beveridgean aspects of the Brazilian HS, which does not yet occur. This means reducing health tax expenditures, expanding and qualifying both PHC, through Family Health Strategy (FHS) and specialized and hospital care, as well as regionalizing its management, reducing inequalities and increasing the coordinating role of the FHS, by expanding or modifying the Family Health Support Center.


Asunto(s)
Sistema Único de Salud/organización & administración , Sistemas de Salud/economía , Estrategia de Salud Familiar , Gasto Público en Salud/políticas , Política de Salud/legislación & jurisprudencia , Seguro de Salud/organización & administración , Brasil
6.
Rev Esp Salud Publica ; 932019 Jun 24.
Artículo en Español | MEDLINE | ID: mdl-31258153

RESUMEN

In this paper the current regulations on cadaveric preservation practices required for the transfer of corpses in the different Autonomous Communities -Reglamentos de Policía Sanitaria Mortuoria- and national legislation are compared. The criteria taken into account have been: a) which sanitary practices are included in the regulations, b) which ones can be carried out in corpses posing a health risk, c) when they are compulsory to be carried out, d) when they can be carried out after death, and e) what professionals can carry them out and/or take responsibility for them. At the time of finishing the paper, a new mortuary regulation is being passed in Andalusia, as well as a decree from the Ministry of Health on technical and sanitary requirements concerning international transfer of corpses and human remains.


Asunto(s)
Cadáver , Embalsamiento/legislación & jurisprudencia , Regulación Gubernamental , Prácticas Mortuorias/legislación & jurisprudencia , Conservación de Tejido , Embalsamiento/métodos , Embalsamiento/normas , Humanos , Prácticas Mortuorias/métodos , España , Conservación de Tejido/métodos , Conservación de Tejido/normas
7.
Rev. esp. salud pública ; 93: 0-0, 2019. tab
Artículo en Español | IBECS | ID: ibc-189456

RESUMEN

Se comparan las normativas vigentes sobre prácticas sanitarias de conservación cadavérica requeridas para el traslado de cadáveres, en las diferentes Comunidades autónomas y la legislación estatal. Los criterios tenidos en cuenta han sido: qué prácticas sanitarias se incluyen en la normativa, cuáles pueden llevarse a cabo en cadáveres de riesgo sanitario, cuándo se requiere su realización, en qué momento tras el fallecimiento pueden realizarse y qué profesionales las pueden llevarlas a cabo y/o responsabilizarse de las mismas. En el momento de finalizar el artículo se está tramitando la publicación del nuevo decreto de sanidad mortuoria de Andalucía, así mismo se está elaborando, por parte del Ministerio de Sanidad, Consumo y Bienestar Social, un Real Decreto sobre "Condiciones técnico sanitarias básicas en materia de traslado internacional de cadáveres, restos humanos y restos cadavéricos"


In this paper the current regulations on cadaveric preservation practices required for the transfer of corpses in the different Autonomous Communities -Reglamentos de Policía Sanitaria Mortuoria- and national legislation are compared. The criteria taken into account have been: a) which sanitary practices are included in the regulations, b) which ones can be carried out in corpses posing a health risk, c) when they are compulsory to be carried out, d) when they can be carried out after death, and e) what professionals can carry them out and/or take responsibility for them. At the time of finishing the paper, a new mortuary regulation is being passed in Andalusia, as well as a decree from the Ministry of Health on technical and sanitary requirements concerning international transfer of corpses and human remains


Asunto(s)
Humanos , Cadáver , Embalsamiento/legislación & jurisprudencia , Regulación Gubernamental , Prácticas Mortuorias/legislación & jurisprudencia , Conservación de Tejido/métodos , Conservación de Tejido/normas , Embalsamiento/métodos , Embalsamiento/normas , Prácticas Mortuorias/métodos , España
8.
Perspect Biol Med ; 61(3): 450-464, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30293981

RESUMEN

The origins and aspirations of institutional review boards (IRBs), the American oversight system for research with human subjects, are well known, and their failures have been documented and disputed for decades. Contention about IRBs is often ideological and unsatisfying, but their shortcomings are real. A new wave of attention to the promise and problems of this oversight system has coincided with the years-long effort to update the federal "Common Rule." Three very different recent books-Rebecca Dresser's Silent Partners, Robert Klitzman's Ethics Police, and Carl Schneider's The Censor's Hand-draw from a wealth of experiential, empirical, and rhetorical resources to triangulate this long-standing set of concerns and tensions at individual, institutional, and system levels. Schneider's volume exemplifies anti-government critiques of the regulation of science; Klitzman's catalogues IRB members' reflections on the ambiguities inherent in their regulatory role; and, by far the most interestingly, Dresser examines the potential contributions of experienced research subjects to the oversight process. Taken together, these books can help refocus the IRB wars on the ever-challenging relationships among goals, uncertainties, and practicalities, and move us toward understanding and addressing those relationships in their current (and rapidly changing) scientific and societal context. Some real progress might even result.


Asunto(s)
Comités de Ética en Investigación , Experimentación Humana/ética , Experimentación Humana/legislación & jurisprudencia , Humanos , Literatura , Estados Unidos
9.
Hist. ciênc. saúde-Manguinhos ; 25(1): 13-31, jan.-mar. 2018. graf
Artículo en Español | LILACS | ID: biblio-892587

RESUMEN

Resumen Las masivas olas de migrantes chinos que llegaron a California y Lima en la segunda mitad del siglo XIX jugaron un rol clave en la expansión de la medicina china en ambos contextos. Desde fines de la década de 1860, los herbolarios expandieron su sistema de sanación más allá de su comunidad étnica, transformando la medicina china en una de las prácticas de sanación más adoptada por la población local. Desde una perspectiva comparada, este artículo examina las divergentes trayectorias de los sanadores chinos en Perú y EEUU, así como los factores sociales y políticos que determinaron la adaptación de este conocimiento médico, foráneo, en su nuevo entorno.


Abstract The massive waves of Chinese migrants arriving in California and Lima in the second half of the nineteenth century played a crucial role in expanding Chinese medicine in both settings. From the late 1860s on, herbalists expanded their healing system beyond their ethnic community, transforming Chinese medicine into one of the healing practices most widely adopted by the local population. This article uses a comparative approach to examine the diverging trajectories of Chinese healers in Peru and the USA, as well as the social and political factors that determined how this foreign medical knowledge adapted to its new environments.


Asunto(s)
Humanos , Historia del Siglo XIX , Historia del Siglo XX , Medicina de Hierbas/historia , Emigrantes e Inmigrantes/historia , Medicina China Tradicional/historia , Perú , Médicos/historia , Fiebre Amarilla/historia , Fiebre Amarilla/terapia , China/etnología , California , Publicidad/historia , Medicina de Hierbas/legislación & jurisprudencia , Disentimientos y Disputas/historia , Migración Humana/historia
10.
Rev. esp. salud pública ; 92: 0-0, 2018. ilus, graf
Artículo en Español | IBECS | ID: ibc-177583

RESUMEN

Fundamentos: Tras el retorno de España a la democracia y la asunción regional de competencias gubernamentales, se iniciaron actuaciones de mejora de la estadística de causas de muerte. El objetivo de este trabajo fue describir la evolución de las actividades de mejora de la calidad en la estadística de mortalidad en la región de Murcia de 1998 a 2011. Métodos: Estudio epidemiológico descriptivo de todos los documentos de defunción procesados por el registro de mortalidad de Murcia. Dentro de este estudio se incluyen el uso de indicadores relativos a la calidad de la cumplimentación de documentos por médicos y juzgados, la recuperación de información sobre las causas y circunstancias de la muerte, y el impacto en la estadística de las causas mal definidas, inespecíficas y poco específicas. Resultados: Durante el periodo de estudio, la notificación médica sin secuencia temporal en el certificado de defunción ha disminuido del 46% inicial al 21% final (p<0,001). La recuperación de información de las fuentes resultó exitosa en el 93% de los casos en 2001 comparada con el 38% al principio del periodo (p<0,001). Las tasas regionales de las causas mal definidas y poco específicas descendieron más que las nacionales, y se situaron en el último año con un diferencial de 10,3 (p<0,001) y 2,8 puntos (p=0,001), respectivamente. Conclusiones: La certificación médica de la defunción mejoró en forma e idoneidad. La recuperación reglada de las causas y circunstancias de la muerte corrigió la información médica y judicial. La región de Murcia presentó menores tasas ajustadas por causas poco específicas y entidades mal definidas que el promedio nacional


Background: After the return of democracy to Spain and the assumption of governmental powers by the regional areas, measures were taken to improve cause-of-death statistics. The objective of this study was to describe the evolution of the activities undertaken to improve the quality of mortality statistics in the region of Murcia from 1998 to 2011. Methods: A descriptive epidemiological study of all the death documentation processed by the mortality registry in Murcia. Relative quality indicators were used to evaluate the fulfilment of documentation by doctors and court staff. This was backed up by information recovery regarding the causes and circumstances of death, and evaluating the impact on the mortality statistics of ill-defined, unspecific and less specific causes. Results: During the study-period, lack of temporal sequence on the medical death certificate reduced from an initial 46% to a final 21% (p<0.001). Retrieval of information from the various sources was successful in 93% of cases in 2001 compared with 38% at the start of the period (p<0.001). Regional rates of ill-defined and less specific causes have reduced more than the national Spanish rates, with a difference of 10.3 (p<0.001) and 2.8 points (p=0.001), respectively. Conclusions: Medical certification of death has improved both form and suitability. The regulated recovery of the causes and circumstances of death corrected medical and judicial information. Murcia presented lower age-adjusted death rates of less specific and ill-defined causes than the national average


Asunto(s)
Humanos , Certificado de Defunción/legislación & jurisprudencia , Causas de Muerte , Registros Médicos/normas , Medicina Legal/tendencias , Mejoramiento de la Calidad/estadística & datos numéricos , Mortalidad/tendencias , Registros Médicos/legislación & jurisprudencia , Clasificación Internacional de Enfermedades/normas , Almacenamiento y Recuperación de la Información/tendencias
11.
Pers. bioet ; 21(2): 243-258, jul.-dic. 2017.
Artículo en Español | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-955259

RESUMEN

Resumen El profesional de la salud no puede perder de vista que la precariedad es una circunstancia profundamente humana que exige respeto incondicionado del enfermo moribundo. El presente estudio descriptivo es una reflexión biojurídica respecto de la muerte digna en los casos de enfermedades que conllevan largos procesos de deterioro y sufrimiento físico y psíquico. Se tomará en cuenta la legislación comparada y la jurisprudencia más emblemática, a la luz de los derechos fundamentales implicados. Se concluye que es legítimo respetar la voluntad del paciente respecto de su proceso de muerte mientras no se vulnere la dignidad que le es propia: cualquier conducta que lo conduzca a la muerte o se la provoque de manera deliberada no puede permitirse.


Abstract Healthcare professionals cannot lose sight of the fact that precariousness is a deeply human circumstance that demands unconditional respect for the dying patient. This descriptive study is a bio-legislation reflection about dignified death in cases of diseases entailing long processes of deterioration and physical and psychological suffering. Comparative legislation and the most emblematic jurisprudence will be considered, in light of the fundamental rights involved. It is concluded that it is legitimate to respect the patient's wishes regarding his or her dying process, so long as their dignity is not violated: any conduct that leads them to death or which deliberately causes it cannot be allowed.


Resumo O profissional da saúde não pode perder de vista que a precariedade é uma circunstância profundamente humana que exige respeito incondicional ao doente moribundo. O presente estudo descritivo é uma reflexão biojurídica com respeito à morte digna nos casos de doenças que implicam longos processos de deterioração e sofrimento físico e psíquico. A legislação comparada e a jurisprudência mais emblemática serão levadas em consideração à luz dos direitos fundamentais implicados. Conclui-se que é legítimo respeitar a vontade do paciente com respeito a seu processo de morte uma vez que a dignidade que lhe cabe não seja ferida: qualquer conduta que o conduza à morte ou a provoque de maneira deliberada não pode ser permitida.


Asunto(s)
Humanos , Pacientes , Derecho a Morir , Eutanasia , Personeidad , Muerte
12.
Int J Law Psychiatry ; 54: 26-35, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28962684

RESUMEN

BACKGROUND: Good mental health legislation is essential for ensuring high quality mental health care and protecting human rights. Many countries are attempting to bring mental health legislation in line with the UN - Convention on the Rights of Persons with Disability (UN-CRPD). The UN-CRPD requires policy-makers to rethink the 'medical model' of mental illness and existing laws. It also challenges WHO guidelines on drafting mental health law, described in the WHO Resource Book on Mental Health, Human Rights and Legislation (WHO-RB). AIMS: This study examines the relationship between the UN-CRPD and the WHO-RB. METHODS: It compares the documents, highlighting similarities and identifying areas of disagreement. The WHO-RB contains a checklist of human rights standards it recommends are met at national level. This study analyses each component on this checklist and identifies the relevant sections in the UN-CRPD that pertain to each. RESULTS: Both the UN-CRPD and WHO-RB address more than just acute exacerbations of illness, providing guidelines on, inter alia, treatment, education, occupation and housing. They are patient-centred and strongly influenced by social rights. The UN-CRPD, however, gives just superficial consideration to the management of acute illness, forensic and risk issues, and does little to identify the role of family and carers. CONCLUSION: The UN-CRPD has evolved from disability research and strong advocacy organisations. Careful consideration is needed to enable it to address the specific needs encountered in mental illness. Both the UN-CRPD and WHO-RB highlight common tensions that must be resolved by clinicians, and provide some guidance for stakeholders who commonly need to observe one principle at the expense of another.


Asunto(s)
Personas con Discapacidad , Política de Salud , Derechos Humanos , Trastornos Mentales , Naciones Unidas , Personas con Discapacidad/legislación & jurisprudencia , Guías como Asunto , Derechos Humanos/legislación & jurisprudencia , Humanos , Internacionalidad , Literatura , Trastornos Mentales/terapia , Salud Mental , Organización Mundial de la Salud
13.
Rev. bioét. (Impr.) ; 25(2): 371-381, maio-ago. 2017. tab
Artículo en Portugués | LILACS | ID: biblio-897687

RESUMEN

Resumo Este estudo teve como objetivo avaliar, à luz da bioética, a frequência e as características dos pareceres-consultas do Conselho Regional de Medicina do Estado de São Paulo atinentes à relação médico-paciente. A amostra baseou-se nos pareceres-consultas publicados no site do conselho regional relativos aos descritores "relação médico-paciente", "bioética", "bioéticas", "bioético", "bioéticos" e "ética médica". Foram encontrados 5.012, sendo 2.717 (54,2%) relativos ao descritor "ética médica", 111 (2,21%) aos descritores "bioética", "bioéticas", "bioético", "bioéticos" e 163 (3,25%) ao descritor "relação médico-paciente". Conclui-se que a frequência dos relacionados à bioética e à relação médico-paciente é pequena quando comparada aos relacionados à ética médica, e que há predomínio de aspectos deontológicos e administrativos nos pareceres-consultas centrados na relação médico-paciente quando comparados aos aspectos bioéticos. Além disso, os pareceres-consultas e publicações desse conselho regional influenciaram resoluções do Conselho Federal de Medicina e a atualização do Código de Ética Médica.


Abstract This study aimed to evaluate, in the context of bioethics, the frequency and characteristics of the opinion-consultations of the Conselho Regional de Medicina (Regional Medicine Council) of the state of São Paulo concerning the doctor-patient relationship. The sample was based on the opinion-consultations published on the Regional Council website relating to the descriptors "doctor-patient relationship", "bioethics - bioethic - bioethical" and "medical ethics". The total number of opinion-consultations identified was 5,012, of which 2,717 (54.2%) were related to the descriptor "medical ethics", 111 (2.21%) were related to the descriptors "bioethics - bioethic - bioethical" and 163 (3.25%) were related to the descriptor "doctor-patient relationship". It was concluded that the frequency of opinion-consultations related to bioethics and the doctor-patient relationship is relatively small when compared to thenumber of opinion-consultations related to medical ethics, and that there is a predominance of deontological and administrative aspects in the opinion-consultations focused on the doctor-patient relationship, in comparison with bioethic aspects. In addition, the opinion-consultations and publications of this Regional Council influenced Conselho Federal de Medicina (Federal Council of Medicine) resolutions and the updating of the Code of Medical Ethics.


Resumen Este estudio tuvo como objetivo evaluar, a la luz de la Bioética, la frecuencia y las características de los dictámenes- consultas del Conselho Regional de Medicina (Consejo Regional de Medicina) del Estado de São Paulo atinentes a la relación médico-paciente. La muestra se basó en los dictámenes-consultas publicados en el sitio del Consejo Regional relativos a los descriptores "relación médico-paciente", "bioética", "bioéticas", "bioético", "bioéticos" y "ética médica". Se encontraron 5.012 dictámenes-consultas, siendo 2.717 (54,2%) relativos al descriptor "ética médica", 111 (2,21%) relativos a los descriptores "bioética-bioéticas-bioético-bioéticos" y 163 (3,25%) relativos al descriptor "relación médico-paciente". Se concluye que la frecuencia de dictámenes-consultas relacionados con la bioética y con la relación médico-paciente es relativamente pequeña cuando se la compara con los relativos a la Ética Médica, y que existe un predominio de aspectos deontológicos y administrativos en los dictámenes-consultas centrados en la relación médico-paciente en comparación con los aspectos bioéticos. Por otra parte, los dictámenes-consultas y las publicaciones de este Consejo Regional tuvieron influencia en las resoluciones del Conselho Federal de Medicina (Consejo Federal de Medicina) y en la actualización del Código de Ética Médica.


Asunto(s)
Humanos , Masculino , Femenino , Relaciones Médico-Paciente , Bioética , Legislación , Ética Médica
14.
J Interpers Violence ; 32(6): 967-978, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-30145959

RESUMEN

As a result of his assignment to the Federal Bureau of Investigation (FBI) Behavioral Science Unit, the author consulted on and has firsthand knowledge of most of the cases discussed in Cheit's book. He came to believe that there is a middle ground. Some of what victims allege may be true and accurate, some may be misperceived or distorted, some may be symbolic, and some may be contaminated or false. The problem and challenge, however, is to determine which is which. He basically agrees with much of what Cheit sets forth about seeds of truth in many allegations. He has concerns about some confusing and inconsistent definitions. What was and is referred to by many as the backlash can be confused with what Cheit refers to in his book as the witch-hunt narrative. Many professionals, including possibly Cheit, do not seem fully aware of the wide diversity of ways in which children are sexually victimized. The author believes that any delayed reporting and minimization of recent cases involving the Catholic priests and Penn Sate have more to do with inaccurate stereotypes perpetuated by child abuse idealists than some witch-hunt narrative. From a law enforcement perspective, more benefit would have come had Cheit's extensive research focused more on documenting how allegations became so bizarre and inaccurate and less on the alleged far-ranging harm caused by the witch-hunt narrative. In the author's opinion, it is that process and not the witch-hunt narrative that caused most of the long-term damage discussed.


Asunto(s)
Abuso Sexual Infantil/legislación & jurisprudencia , Ciencias Forenses/métodos , Entrevistas como Asunto/métodos , Aplicación de la Ley , Literatura , Narración , Niño , Abuso Sexual Infantil/diagnóstico , Preescolar , Femenino , Humanos , Masculino
15.
J Interpers Violence ; 32(6): 784-804, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-30145960

RESUMEN

This article provides an overview of The Witch-Hunt Narrative, focusing on the challenges of gathering information from young children, such as those involved in sexual abuse allegations in day care. The article summarizes the research methodology of The Witch-Hunt Narrative, which involves a series of case studies. The article articulates Cheit's hypothesis, which is that the witch-hunt narrative originated in two key publications, a series of articles by two journalists, Tom Charlier and Shirley Dowling, and the book, Satan's Silence: Ritual Abuse and the Making of a Modern-Day Witch-Hunt, by Debbie Nathan and Michael Snedeker, and notes his disputes with the evidence from these two publications. Cheit deals in depth with three hotly contested day care center cases: the McMartin Pre-School case in Manhattan Beach, California, the Wee Care Day Nursery case in Maplewood, New Jersey, and the Country Walk Babysitting Service case in Dade County, Florida. The article summarizes Cheit's research and conclusions related to these three cases and also notes how forensic interview practices used in these cases would not be supported today. The article concludes with noting that despite the impressive progress in forensic interviewing of children when sexual abuse is alleged, methods for gathering information from young children remain inadequate. Moreover, there are no easy answers to the reasons for the rise and fall of allegations of sexual abuse in day care and of allegations of ritual abuse.


Asunto(s)
Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/legislación & jurisprudencia , Guarderías Infantiles/legislación & jurisprudencia , Psicología Forense/métodos , Entrevistas como Asunto/métodos , Literatura , Niño , Preescolar , Revelación/legislación & jurisprudencia , Femenino , Humanos , Masculino , Narración
16.
J Interpers Violence ; 32(6): 853-874, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-30145965

RESUMEN

From an evidentiary point of view, the project Ross Cheit seeks to accomplish in his book, The Witch-Hunt Narrative: Politics, Psychology, and the Sexual Abuse of Children, is remarkably complex. I examine the methodology that underlies Cheit's scholarship to assess the strength of his claims. Cheit's work has a strong methodological core in which he asserts the existence of a "Witch-Hunt Narrative" (WHN), public perception that there are "hundreds" of legal cases involving innocent adults wrongly criminally pursued for child sexual abuse. He identifies three foundational cases in this WHN, McMartin, Michaels, and Fuster, along with dozens of others, which he distills from published lists. Using broadly collected archival and other data, Cheit investigates the veracity of this WHN. He concludes there is insufficient evidence to substantiate the witch-hunt claim. Methodologically, Cheit's research veers into more problematic territory when he seeks to extend his WHN claims beyond this central core and extend it to the academy, particularly the research of several prominent academics, including psychologists Stephen J. Ceci and Maggie Bruck. I examine these claims and argue Cheit has not paid sufficient attention to the methods and methodology upon which he bases his claims. I conclude by noting the complexity of evaluating evidence produced and utilized in, and across, disciplinary boundaries, including journalism, law, and the academy. Nonetheless, Cheit's scholarship raises a plethora of important questions and possibilities for future research.


Asunto(s)
Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/legislación & jurisprudencia , Guarderías Infantiles/legislación & jurisprudencia , Literatura , Narración , Adulto , Niño , Humanos
17.
J Interpers Violence ; 32(6): 897-925, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-30145966

RESUMEN

We comment on The Witch-Hunt Narrative ( TWHN) by Cheit. As its first hypothesis, TWHN argues that most of the famous ritual child abuse cases of the 1980s and 1990s were not really witch-hunts at all. In response, we criticize the TWHN definition of a witch-hunt as overly narrow and idiosyncratic. Based on the scholarly literature, we propose 10 criteria for identifying a witch-hunt. We rate four well-known ritual child abuse cases with these criteria and show they were classic witch-hunts. As its second hypothesis, TWHN argues that most defendants in child ritual abuse cases were guilty or probably guilty. In response, we point out many instances in which TWHN has omitted or mischaracterized important facts or ignored relevant scientific information running contrary to its hypotheses. We conclude that TWHN is often factually inaccurate and tends to make strong assertions without integrating relevant scholarly and scientific information. Scholars should approach the book with caution.


Asunto(s)
Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/legislación & jurisprudencia , Guarderías Infantiles/legislación & jurisprudencia , Psicología Forense/métodos , Entrevistas como Asunto/métodos , Literatura , Narración , Niño , Humanos , Reproducibilidad de los Resultados
18.
J Interpers Violence ; 32(6): 956-966, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-30145967

RESUMEN

Responding to Ross E. Cheit's Witch-Hunt Narrative, this article is a commentary chronicling the emergence of child sexual abuse as a social issue in Los Angeles County in the 1980s. Based on the responses to child sexual abuse in Los Angeles County as experienced by one social worker during the McMartin years, it discusses the impact of the McMartin case on the identification and intervention in child sexual abuse cases and tracks the evolution and changes that took place in the 1980s and 1990s in Southern California. It offers some insight into a rationale for the denial of child sexual abuse which continues to this day.


Asunto(s)
Actitud del Personal de Salud , Abuso Sexual Infantil/legislación & jurisprudencia , Guarderías Infantiles/legislación & jurisprudencia , Narración , Trabajadores Sociales/psicología , California , Niño , Abuso Sexual Infantil/diagnóstico , Preescolar , Femenino , Humanos , Literatura
19.
J Interpers Violence ; 32(6): 805-825, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-30145968

RESUMEN

Ross Cheit's book The Witch-Hunt Narrative highlights the difficulties of prosecuting child sexual abuse. Drawing examples from a single case, Alex A., we examine the ways in which false acquittals of sexual abuse are likely to occur. First, prosecutors tend to question children in ways that undermine their productivity and credibility. Second, prosecutors have difficulty in explaining to juries the dynamics of sexual abuse and disclosure, making children's acquiescence to abuse and their failure to disclose when abuse first occurs incredible. Third, attorneys undermine children's credibility by pushing them to provide difficult to estimate temporal and numerical information. A post-script to the Alex A. case illustrates the costs of wrongful acquittals.


Asunto(s)
Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/legislación & jurisprudencia , Revelación/legislación & jurisprudencia , Rol Judicial , Niño , Guarderías Infantiles , Preescolar , Femenino , Humanos , Entrevistas como Asunto , Literatura , Masculino , Narración
20.
Rev. Esc. Enferm. USP ; 50(4): 635-641, July-Aug. 2016. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: lil-794940

RESUMEN

Abstract OBJECTIVES To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. METHODS Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). RESULTS The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). CONCLUSION The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation.


Resumen OBJETIVOS Verificar el impacto de la promoción del autocuidado en la carga laboral de enfermería y asociarla con las variables: edad, género, clasificación socioeconómica, escolaridad, estado civil y número de hijos de los cuidadores. MÉTODO Estudio prospectivo, en el que participaron 31 niños y sus respectivos cuidadores. Los participantes fueron evaluados en dos momentos, 1ª y 2ª hospitalización, en cuanto a la carga laboral de enfermería medida por medio del Nursing Activities Score (NAS). RESULTADOS El promedio NAS en la 1ª hospitalización fue del 60,9% y, en la 2ª, fue del 41,6%, es decir, 14,6 y 9,9 horas de enfermería, respectivamente. La carga de trabajo de enfermería el primer día de hospitalización fue mayor cuando comparada con el último día, tanto en la 1ª (p<;0,001) como en la 2ª hospitalización (p<;0,001), y mayor el primero (p<;0,001) y último día (p=0,025) en la 1ª hospitalización. En la 1ª hospitalización fue aún mayor cuando comparada con la 2ª hospitalización (p<;0,001), y los ítems NAS referentes a la capacitación del autocuidado la influenciaron (p<;0,001). CONCLUSIÓN La carga laboral de enfermería referente a la promoción del autocuidado correspondió a 14,6 horas y fue superior a lo determinado por la legislación existente.


Resumo OBJETIVOS Verificar o impacto da promoção do autocuidado na carga de trabalho de enfermagem e associá-la às variáveis: idade, gênero, classificação socioeconômica, escolaridade, estado civil e número de filhos dos cuidadores. MÉTODO Estudo prospectivo, onde participaram 31 crianças e seus respectivos cuidadores. Os participantes foram avaliados em dois momentos, 1ª e 2ª internação, quanto à carga de trabalho de enfermagem mensurada por meio do Nursing Activities Score (NAS). RESULTADOS A média NAS na 1ª internação foi de 60,9%, e na 2ª internação foi de 41,6%, ou seja, 14,6 e 9,9 horas de enfermagem, respectivamente. A carga de trabalho de enfermagem no primeiro dia de internação foi maior quando comparada ao último dia, tanto na 1ª (p<0,001) como na 2ª internação (p<0,001), e maior no primeiro (p<0,001) e último dia (p=0,025) na 1ª internação. Ainda, na 1ª internação, foi maior quando comparada à 2ª internação (p<0,001), e os itens NAS referentes à capacitação do autocuidado a influenciaram (p<0,001). CONCLUSÃO A carga de trabalho de enfermagem referente à promoção do autocuidado correspondeu a 14,6 horas e foi superior ao determinado pela legislação existente.


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Adulto Joven , Síndrome de Pierre Robin/enfermería , Autocuidado , Enfermería , Carga de Trabajo , Cuidadores , Estudios Prospectivos
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