Acta Bioethica https://revistas.uchile.cl/index.php/AB <p>Acta Bioethica is a biannual publication by the Interdisciplinary Center for Studies in Bioethics of the University of Chile (ISSN 0717-5906, press edition, y 1726-569-X, electronic edition), which publishes in three languages: Spanish, English and Portuguese.</p> <p>Indexed in Science Citation Index (SCI), Scopus, Lilacs, SciELO y Latindex, and in database from several Institutions; it constitutes a pluralistic source of perspectives and an important tribune which accepts the contributions of authors compromised with the interdisciplinary study of ethical determinants and consequences of techno scientific research.</p> <p>The journal edits a main topic per issue, with articles asked by an invited editor (specialist in the topic chosen), and it also includes a section of articles not solicited of various nature (interfaces), reviews of recent bioethical publications and other significant documents for the inter discipline. It also counts with an International Advisory Committee and a system of arbitration of manuscripts based on peer review.</p> <p>The journal is published on HTML and PDF format in SciELO (Scientific Electronic Library Online) and in PDF in the web site for journals of the University of Chile.</p> Universidad de Chile. Centro Interdisciplinario de Estudios en Bioética en-US Acta Bioethica 0717-5906 <p>Acta Bioethica&nbsp;is edited by the Interdisciplinary Center for Bioethical Studies of the University of Chile and published under a Creative Commons Attribution Share Alike 4.0 International license.Intellectual property::The submission and evaluation of the manuscripts received implies that the author (s) declare that they are original and exclusive owners of the author's economic and moral rights over the article, in accordance with the provisions of Law 17.336 on Intellectual Property (Chile) In case of having used outside works in the creation of the article, in whole or in part, they declare that they have the respective authorizations or licenses of use of their respective owners or that their use is expressly protected by law.The author expressly releases from any subsequent responsibility to the Interdisciplinary Center of Studies in Bioethics of the University of Chile, for any legal, regulatory or contractual infraction that eventually commits or has committed in relation to the work, being obliged to repair any damage that results from the Infringement of these or other rights.The author authorizes the Interdisciplinary Center of Studies in Bioethics of the University of Chile, in order that, by itself or through third parties expressly authorized by it, exercise the rights that are specified below, with respect to the article sent:Publication, edition, reproduction, adaptation, distribution and sale of reproduced copies, including making available to the public online by electronic or digital means, of the article, in Castilian language, in any known territory, And for all types of printed edition in paper and electronic or digital, by its inclusion in the journal Acta Bioethica or another publication that publishes the Center.This authorization is conferred on a non-exclusive, free, indefinite, perpetual and non-revocable basis, as long as the corresponding rights subsist and release the Interdisciplinary Center for Bioethical Studies of the University of Chile from any payment or remuneration for the exercise of Rights.The authors retain their copyright on their works, being able to reuse them as they decide.</p> Marcel Proust and in search of lost time: ethics of human existence and the world of medicine recovered https://revistas.uchile.cl/index.php/AB/article/view/67275 1. Marcel Proust´s In Search of Lost Time recounts the fiction of the “author's” project-of-existence to become an artist. 2. The world of medicine is the area in which the fragility of man is expressed as being-referred-to-death. 3. The deceptive feeling of the power of good health intoxicates medicine, physicians, patients, relatives, treatments — irreverent depreciation toward the perishable. 4. The medical treatment of the agony of the “author's” grandmother shows the central elements of the doctor-patient relationship in medicine at the beginning of the 20th century: cognitive, affective, operational, ethical, and social. 5. The “author” of the novel is not Marcel Proust and, although it is a fiction, it encourages today´s medical world to reflect on its fundamental bioethical foundations. Gustavo Figueroa Copyright (c) 2022 Gustavo Figueroa 2022-06-01 2022-06-01 28 1 Ethical foundations that sustain the Mapuche and nature relationship. Contributions for intercultural health https://revistas.uchile.cl/index.php/AB/article/view/67276 Environmental pollution is a big problem that affects the earth. The Mapuche territory is no exception, given that the extractivist model violates sacred spaces, exploits natural resources, and pollutes, affecting the Mapuche's ways of life and health. The objective was proposed: reflect on the relevance of the ethical foundations that sustain the Mapuche and nature relationship as contributions to intercultural health. It is appreciated that the ethical foundations: “Az-mapu”, “küme mogen” and “ixofil mogen”, have a fundamental role in ethical behavior regarding the relationship between the Mapuche and nature, where respect, love, care, empathy and reciprocity of the Mapuche towards nature, himself and with other people, allows him to be in harmony and balance from the physical and spiritual. In this sense, it is relevant to consider these ethical foundations to improve the health service, from an intercultural perspective, considering complementarity based on dialogue, in order to provide a humanizing, diverse and, therefore, quality health to move towards a good to be more full of subjects belonging to different cultures. Juan Beltrán-Véliz Julio Tereucán Angulo Ana María Alarcón José Luis Gálvez-Nieto Maura Klenner Loebel Copyright (c) 2022 Juan Beltrán-Véliz, Julio Tereucán Angulo, Ana María Alarcón, José Luis Gálvez-Nieto, Maura Klenner Loebel 2022-06-01 2022-06-01 28 1 Empty interculturality: the right to intercultural health of indigenous peoples and migrants in Chile https://revistas.uchile.cl/index.php/AB/article/view/67278 This work analyzes the development of the intercultural perspective in the protection and guarantee of the right to health in indigenous peoples and migrant population in Chile from the legal point of view. It reviews the prevalent practices and experiences in the field of public health in Chile, to establish the shape and scope of interculturality in the protection of the right to health, and the way in which it contributes to interculturality. The intercultural perspective on access to justice in Chile is weak, formal, these are incipient initiatives in the case of indigenous peoples while in the case of migrants, they hardly address language barriers. Liliana Galdámez Zelada Salvador Millaleo Hernández Copyright (c) 2022 Liliana Galdámez Zelada, Salvador Millaleo Hernández 2022-06-01 2022-06-01 28 1 Xenophobia and medicine (profession of a doctor): can the two coexist in the 21st century? https://revistas.uchile.cl/index.php/AB/article/view/67296 This study was conducted to reveal how physicians view the access of refugees, who have difficulties in accessing health services and who may experience various health rights violations, to health services and to discuss the case in terms of medical ethics and deontology. Xenophobia, which is one of the main causes of discrimination in health, needs to be evaluated. In this context, quantitative research methods were used to measure the xenophobia levels of physicians working in Eskişehir province. Stratified sampling method was used to evaluate the views of the physicians. The study data were collected through the Xenophobia Scale developed by Kees Van Der Veer et al. and a questionnaire created by the researchers. The age distribution of the physicians in the study was 38,069±10,337. The distribution of the scores obtained from the xenophobia scale was found to be high (56.20±11.54). Of the physicians in the study, 34.3% stated that they would not want to provide health services for refugees if they were given the right to choose. They mainly thought that health services should not be provided free of charge for refugees and should be provided in separate places, refugees affected the access of the citizens of the Turkish Republic to health services negatively, the number of children should be limited, refugees would increase violence in health and public health problems, and that there should be an interpreter in health institutions. “Refugees do not deserve discrimination in health services” in terms of medical ethics. “Physicians should reach a common consensus against all kinds of discrimination while carrying out their profession.” When xenophobia shows its effect in the field of health, it turns into a phenomenon that damages human dignity, causes all kinds of inequality, and moves medicine away from its deontology. Cem Hakan Basaran Omur Sayligil Copyright (c) 2022 Cem Hakan Basaran, Omur Sayligil 2022-06-01 2022-06-01 28 1 Evaluation of Psychiatrist’s Communication with Psychosis Patients https://revistas.uchile.cl/index.php/AB/article/view/67297 Evaluation of the physician-patient relationship is very important in determining priorities in medical practice and medicine. For this purpose, in this study the psychiatrist’s communication with psychotic patients as a sensitive group was evaluated. A questionnaire was administered to 210 patients in a psychiatric clinic of Inonu University Hospital in Turkey to determine how the examination is performed in the facility for outpatients in the psychosis unit. According to the study conducted, it was observed that the evaluation score of the psychiatrist's communication with psychotic patients increased positively with increasing consultation duration. Our work is particularly noteworthy because it deals with a sensitive area, such as a group of psychiatric patients. The scores were obtained based on data from the evaluation of the questionnaires, which showed that the communication between the psychiatrist and the psychotic patient was conducted in a sensitive and careful manner, and without ethical problems. Mehmet Karatas Sukru Kartalci Engin Burak Selcuk Hakan Yetis Turgay Karatas Harika Gozukara Copyright (c) 2022 Mehmet Karatas, Sukru Kartalci, Engin Burak Selcuk, Hakan Yetis, Turgay Karatas, Harika Gozukara 2022-06-01 2022-06-01 28 1 Confidentiality and help-seeking behavior for adolescents mental health problems https://revistas.uchile.cl/index.php/AB/article/view/67298 Prevention and early detection of mental health problems in the adolescent population is essential to reduce the possibility of developing more serious disorders. Likewise, seeking help for these problems and timely access to mental health care in this group is necessary. However, it has been found that adolescents tend not to seek professional help when they present symptoms of emotional disorders and, when they do seek help, they do so from informal sources. Various barriers, at the individual, structural, social, and health professional-patient relationship levels, can hinder help-seeking behavior in adolescents. Among these is young people's concern about confidentiality. This article presents and analyzes evidence on the role of confidentiality in help-seeking behavior for mental health problems in adolescents, presenting an analysis from a bioethical perspective and pointing out some of its implications in the approach to youth mental health services. Cecilia Olivari Pablo Méndez-Bustos Rodrigo Núñez Ignacia Sepúlveda-Ramírez Copyright (c) 2022 Cecilia Olivari, Pablo Méndez-Bustos, Rodrigo Núñez, Ignacia Sepúlveda-Ramírez 2022-06-01 2022-06-01 28 1 Brazilian law of inclusion: an applied analysis of the correlation of bioethical principles https://revistas.uchile.cl/index.php/AB/article/view/67299 Objective: The present study aims to analyse whether bioethical principles are present in the Brazilian Law of Inclusion of the Disabled Person. Methods: The study is based on a textual analysis of Law No. 13.146, of July 6, 2015 (Brazilian Law of Inclusion) using a content analysis technique regarding the bioethical principles of beneficence, nonmaleficence, justice and autonomy. A qualitative analysis was conducted based on the concepts of these bioethical principles and their expression in the articles laid down in the Statute of the Disabled Person. Results: The obtained results demonstrate that the primary articles of the Brazilian Law of Inclusion correlate with the aforementioned bioethical principles according to the conceptualisation of each principle. Conclusion: The articles of the Brazilian Law of Inclusion, published on July 6, 2015, under the provisions of the Federal Constitution of 1988 and the Convention on the Rights of Persons with Disabilities, demonstrate a correlation with the stated bioethical principles. Rosylane Nascimento das Mercês Rocha Josierton Cruz Bezerra Francisco Cortes Fernandes Mónica Correia Rui Nunes Copyright (c) 2022 Rosylane Nascimento das Mercês Rocha, Josierton Cruz Bezerra, Francisco Cortes Fernandes, Mónica Correia, Rui Nunes 2022-06-01 2022-06-01 28 1 Repercussions in Spanish deontology in light of the rise of low cost dental clinics https://revistas.uchile.cl/index.php/AB/article/view/67300 The change in deontological health care model in Spain has led to the proliferation of huge dental franquises or low cost dental clinics. This type of settings generally engages customers by aggressive advertising campaigns, establishing financing with banks and reducing the agreed initial budget. In the last years, the Ethical and Deontological Commission of the Official College of Dentists and Stomatologists of Aragon has noticed a significant increase of claims by patients attending this type of clinics. One of the most striking cases has been the closing of iDental, which led thousands of patients without finishing dental treatment. This study pretends updating the deontological repercussions that these clinics have in the Autonomous Community of Aragon. Alejandro Carlos de la Parte-Serna Copyright (c) 2022 Alejandro Carlos de la Parte-Serna 2022-06-01 2022-06-01 28 1 Testamentum tempore pestis Civil law and bioethics faced with the testament in cases of epidemics https://revistas.uchile.cl/index.php/AB/article/view/67301 The confinement due to the Covid pandemic affected the granting of wills, which are so necessary in the health crisis when people need to decide the fate of their property and other individual acts at the risk of life. The solemnity of the will impedes the exercise of testamentary rights of patients, even healthy people. Facilitating the right to testament in times of plague has a bioethical content since life, health, self-determination and the right to decide the destiny of property are at stake. The will in times of pandemic, supported by ICTs, is a solution that should be made feasible with the help of digitization and technology in order to allow the exercise of the rights of last will in isolation by contagion. Enrique Varsi Rospigliosi Copyright (c) 2022 Enrique Varsi Rospigliosi 2022-06-01 2022-06-01 28 1 Is it possible to force people to be vaccinated? Nudge against coronavirus https://revistas.uchile.cl/index.php/AB/article/view/67302 We all know that the world is facing a terrible pandemic. Science, with effort and promptness, has been able to develop various vaccines against Covid-19, generating great expectations. However, mass vaccination processes have not advanced at the required speed due to various factors; one of the main ones is the resistance of many people to get vaccinated, for different reasons. Faced with this situation, it has oscillated between carrying out advertising campaigns to proposals for forced imposition. An alternative to go beyond the merely lyrical and coercive is to generate forms of motivation for those people to voluntarily decide to be vaccinated through various measures, direct and indirect, appealing to "Nudge" -or the "little push theory" - in order to promote the best protection of individual and collective health, the subject of this article, based on the bibliographic review on the matter and various experiences in the fight against coronavirus. Ronald Cárdenas Krenz Copyright (c) 2022 Ronald Cárdenas Krenz 2022-06-01 2022-06-01 28 1 A Theoretical Framework for Ethical Decision-Making During Public Health Emergencies https://revistas.uchile.cl/index.php/AB/article/view/67303 The new theoretical ethical framework is a general frame or tool for ethical agents, developed to guide ethical reasoning during public health emergency preparedness and response. The TEF is based on the assumption that no existing ethical discourse in medical ethics alone is sufficient to address ethical issues of a PHE. The solutions suggested by existing approaches are limited in practicability and effectiveness, because they cannot address root problems and interplay among ethical problems. The reason for this insufficiency rests on the argument that ethical problems of PHEs have causal and reciprocal relationships, and any ethical decision-making framework should provide a wide enough perspective to consider relevant ethical norms and theories to suggest practical, implementable, coherent solutions compatible with the communal values and cultural norms. The TEF we suggest for PHEs embraces a holistic and integrated ethical perspective that enables us to comprehend that ethical problems that arise in various settings caused by PHE phenomena are in relationship with each other instead of addressing them as a standalone problem. The TEF provides decision-makers to achieve a coherent web of considered judgements compatible with ethical values and principles in various settings. This type of conceptualization offers a wide perspective to see causal and relational relationships among problems and produce outcomes that would not be possible by eclectic approaches. Perihan Elif Ekmekci Morenike Oluwatoyin Folayan Copyright (c) 2022 Perihan Elif Ekmekci, Morenike Oluwatoyin Folayan 2022-06-01 2022-06-01 28 1 Ethical Aspects of Age estimation for Forensic purposes in Saudi Arabia https://revistas.uchile.cl/index.php/AB/article/view/67304 In forensic and legal contexts, an assessment of skeletal maturation is required to predict the chronological age in certain circumstances in which the chronological age is undocumented or unable to be proven. Carrying such medical examinations will always pose an ethical concern, especially in cases of assessing sexual maturity as well as examinations involving ionizing radiation. The cultural and religious barriers are also discussed concerning the ethical standards set in Saudi Arabia. Several ethical issues concerning age estimation examinations including issues related to consent forms, privacy, and radiation hazards have been documented. While ethical issues regarding radiation hazards are more likely to be overcome by introducing other imaging modalities without radiation hazards, ethics related to consent forms and privacy are still to be improved. Khalaf Alshamrani Copyright (c) 2022 Khalaf Alshamrani 2022-06-01 2022-06-01 28 1 Obtaining Informed consent: psychiatric nurses’ knowledge and practice at Federal Neuro-Psychiatric Hospital Enugu, Nigeria https://revistas.uchile.cl/index.php/AB/article/view/67309 Background: Within a psychiatric care setting, informed consent is the voluntary acceptance of a plan for medical care by a competent patient after full disclosure of the care plan, its risks, benefits, and alternative approaches. This implies that the patient must have full information about any treatment options and must be competent to make the needed decisions. Objective: To assess psychiatric nurses’ knowledge and practices of obtaining informed consent. Research Method: The study used a quantitative, descriptive cross-sectional survey design. Data were collected from a random sample of 99 nurses selected from a total of 131 nurses of different professional cadres working in the hospital, by means of a structured questionnaire constructed by the researchers. Data were analyzed using descriptive statistics. Results: Respondents’ score on Knowledge of Informed Consent was above average (15.06 ± 2.671 out of a possible total score of 25). Likewise, their score on the disclosure of full information to psychiatric patients before treatment was well above average (6.01 ± 2.198 out of a maximum possible score of 8). However, respondents’ score on the practice of obtaining Informed Consent was below average (2.41 ± 0.940 out of a maximum possible score of 5). Conclusion: Though a majority of the participants indicated good knowledge of informed consent, there was no corresponding correct practice of obtaining informed consent from patients in the hospital. Chinwe S. F. Ezeruigbo Easter Osuchukwu Michael O. Elom Chinelo Vincent Nneka Ubochi Peace Iheanacho Copyright (c) 2022 Chinwe S. F. Ezeruigbo, Easter Osuchuchu, Michael O. Elom, Chinelo Vincent, Nneka Ubochi, Peace Iheanacho 2022-06-02 2022-06-02 28 1 Individuals living with cancer in turkey and the COVID-19 pandemic https://revistas.uchile.cl/index.php/AB/article/view/67311 The aim of this study is to determine the problems faced by individuals living with cancer (ILCs) in accessing health services during the COVID-19 pandemic in Turkey. This qualitative study’s sample consisted of 18 volunteer interviewees from 10 cancer-related patient associations in Turkey. Research data were collected by semi-structured interview method. Data collection and analysis were carried out simultaneously. In the sessions where all researchers participated together, the data were coded with a common view, and main and sub-themes were determined. In the analysis of the data the inductive thematic analysis method was applied. Information was gathered under two main themes: compliance with the measures taken and access to health services. Lack of information about nutrition, physical activity, psychological problems, caused by the lockdown and social distance measures taken within the scope of the pandemic should be accepted as problems within the scope of the right of individuals to access health, and additional programs should be prepared to minimize these. Cancer types should be considered in delaying diagnosis, treatment, and controls related to cancer, so that patients are not harmed at least or at all. It is important to ensure that patients do not hesitate to attend diagnosis, treatment, and controls with the anxiety of being infected with COVID-19, both in transportation to health facilities and in terms of preventing transmission in health facilities. Gürkan Sert Serap Torun Mehmet Karatas Yakup Gozderesi Selda Okuyaz Sibel Oner Yalcın Gulay Yıldırım Sadık Nazik Copyright (c) 2022 Gürkan Sert, Serap Torun, Mehmet Karatas, Yakup Gozderesi, Selda Okuyaz, Sibel Oner Yalcın, Gulay Yıldırım, Sadık Nazik 2022-06-01 2022-06-01 28 1 Are we ready for pig-to-human clinical xenotransplantation trials? https://revistas.uchile.cl/index.php/AB/article/view/67314 The invention and widely use of organ allotransplantation provides effective treatment of some originally fetal diseases such as liver/kidney failure and has saved million of lives around the globe. However, the scarcity of human organs has caused many patients, who could have been treated, to die while waiting for suitable organs around the world. Pig-to human xenotransplantation provides a potential solution to solve this tough problem. Pig organs have been considered as major sources of xenotransplantation because of the sufficient number of donors, the sizes of organs, and physiologically structural similarities. However, xenotransplantation also has some problems, such as the possibility of spreading animal diseases to human, the interspecies immunological barrier, organs of animal origin challenging human nature, and potential informed consent issues. This article will discuss these potential issues and to see whether it is the suitable time to conduct clinical xenotransplantation trials in humans. Laichun Zhang Lijun Ling Copyright (c) 2022 Laichun Zhang, Lijun Ling 2022-06-01 2022-06-01 28 1 Integridad científica, integridad decisional, integridad social https://revistas.uchile.cl/index.php/AB/article/view/67274 Fernando Lolas Stepke Copyright (c) 2022 Fernando Lolas Stepke 2022-06-01 2022-06-01 28 1 La privacidad como derecho humano: contribuciones para la promoción de una nueva agenda bioética https://revistas.uchile.cl/index.php/AB/article/view/67321 Luis Guillermo Blanco Copyright (c) 2022 Luis Guillermo Blanco 2022-06-01 2022-06-01 28 1 Die Schmerzen https://revistas.uchile.cl/index.php/AB/article/view/67322 Fernando Lolas Stepke Copyright (c) 2022 Fernando Lolas Stepke 2022-06-01 2022-06-01 28 1 Allgemeine Klinische Medizin. Ärztliches Handeln im Dialog als Grundlage einer modernen Heilkunde https://revistas.uchile.cl/index.php/AB/article/view/67323 Fernando Lolas Stepke Copyright (c) 2022 Fernando Lolas Stepke 2022-06-01 2022-06-01 28 1 De vidas ajenas https://revistas.uchile.cl/index.php/AB/article/view/67324 Fernando Lolas Stepke Copyright (c) 2022 Fernando Lolas Stepke 2022-06-01 2022-06-01 28 1 The Global Forum on Research Ethics and Integrity https://revistas.uchile.cl/index.php/AB/article/view/67317 David R. Curry Francis P. Crawley Barbara E. Bierer Copyright (c) 2022 David R. Curry, Francis P. Crawley, Barbara E. Bierer 2022-06-01 2022-06-01 28 1 III Jornada de Capacitación en Ética de la Investigación https://revistas.uchile.cl/index.php/AB/article/view/67320 Natalia Chahin Inostroza Copyright (c) 2022 Natalia Chahin Inostroza 2022-06-01 2022-06-01 28 1