A snapshot of cancer in Chile: analytical frameworks for developing a cancer policy

INTRODUCTION: The South American country Chile now boasts a life expectancy of over 80 years. As a consequence, Chile now faces the increasing social and economic burden of cancer and must implement political policy to deliver equitable cancer care. Hindering the development of a national cancer policy is the lack of comprehensive analysis of cancer infrastructure and economic impact. OBJECTIVES: Evaluate existing cancer policy, the extent of national investigation and the socio-economic impact of cancer to deliver guidelines for the framing of an equitable national cancer policy. METHODS: Burden, research and care-policy systems were assessed by triangulating objective system metrics -epidemiological, economic, etc. - with political and policy analysis. Analysis of the literature and governmental databases was performed. The oncology community was interviewed and surveyed. RESULTS: Chile utilizes 1% of its gross domestic product on cancer care and treatment. We estimate that the economic impact as measured in Disability Adjusted Life Years to be US$ 3.5 billion. Persistent inequalities still occur in cancer distribution and treatment. A high quality cancer research community is expanding, however, insufficient funding is directed towards disproportionally prevalent stomach, lung and gallbladder cancers. CONCLUSIONS: Chile has a rapidly ageing population wherein 40% smoke, 67% are overweight and 18% abuse alcohol, and thus the corresponding burden of cancer will have a negative impact on an affordable health care system. We conclude that the Chilean government must develop a national cancer strategy, which the authors outline herein and believe is essential to permit equitable cancer care for the country.

La cultura ética de la investigación biomédica en Venezuela / the ethical culture of the biomedical research in Venezuela

La investigación biomédica en seres humanos requiere principios bioéticos, de los cuales la autonomía es fundamental para proteger la dignidad de las personas objeto de estudio. Con la finalidad de analizar si existe cultura ética de investigación en Venezuela y si se respecta la autonomía de sujetos participantes en investigaciones biomédicas, independientemente de su competencia o incompetencia legal para otorgar su consentimiento, se realizó el presente trabajo. En él se analizan críticamente estos aspectos, de acuerdo con la cultura ética planteada por Lavery y el modelo de libertades preconizado por Sen. Asimismo, se realizó un análisis del ejercicio de la autonomía de niños y niñas y adolescentes establecido en la doctrina del menor maduro y en los instrumentos legales disponibles en el país. Se concluye que existe vulnerabilidad de la autonomía de las personas, particularmente de niños, niñas y adolescentes debido a factores que afectan el contexto humano, político y económico-social del país

The biomedical research in human beings requires of bioethics principles from which the autonomy is essential to proyect the dignity of prople which are the subject of study. The present study was carried out with the aim of analyzing if there is an ethical culture of reseach in Venezuela and if the subjects' autonomy that take part in biomedical research is respected, independently of its legal or illegal competency in order to give its consent. In this study these aspects are critically analyzed in accordance with the ethical culture expressed by Lavery and the model of liberties recommended by Sen. Likewise, an analysis of the practice of children and adolescents autonomy was carried out, established in the doctrine of the mature minor as well as in the legal instruments available in the country. It is concluded that there is a clear vulnerability of people's autonomy, especially the children and adolescents' autonomy, due to several factors that affect the human, political and socio-economical context of the country