Una vida para la Bioética

The article pays a tribute to Cardenal Elio Sreccia (R.I.P.) through a biographical profile and a brief sketch of the intellectual itinerary that lead him to the proposal of the model of an «ontologically founded personalist bioethics», for which he is widely known as the founder and main transmitter. His personality is described as wise and approachable, who deeply marked the lives of his collaborators and students. The relevance of his legacy is shown through its wide international diffusion and its potential to enter into a fruitful dialogue with other contemporary bioethical models.El artículo tiene como objetivo rendir un homenaje al Cardenal Elio Sgreccia (D.E.P.), a través de una semblanza y un breve recorrido del itinerario intelectual que lo llevó a proponer un modelo de «bioética personalista ontológicamente fundada», por el que hoy se le conoce como su fundador y principal difusor. Se le describe como un maestro sabio y cercano, que marcó profundamente la vida de quienes trabajaron y estudiaron con él. También se pone en evidencia la relevancia de su legado, mostrando la amplia difusión que ha tenido a nivel internacional y el potencial para entrar en diálogo con otros modelos de fundamentación de la bioética

Algunas amenazas actuales a la confidencialidad en medicina

Social, technical and legal conditions of the current practice of medicine make it necessary to insist on certain actions and circumstances that may jeopardize the confidentiality of information, offered by patients to their health providers. Therefore, some effects of the current Chilean law are analyzed in this respect, regarding access to data from the clinical record of a patient. Also, the risks of putting certain data on social networking sites are analyzed, as well as some of its effects on clinical practice. The reasons because of mandatory reporting of diseases, meaning danger to public health, is allowed, are mentioned. We also discuss the difficulties involved in managing the results of preventative health screenings and its knowledge by third parties, as well as some possible violations of personal privacy, regarding dissemination of some people health information and its further mention or figuration in mass media. We conclude that it is a must for both physicians and other health team members, to safeguard confidentiality of data to which they have had access, as well as the need to know the relevant law, in order to respect human dignity of patients, each one as a person. We address the attention to the possibility that, practicing in a different way, it could endanger the reliability of clinical records, also impairing the quality of people’s health care. (Rev Med Chile 2015; 143: 358-366) Key words: Access to Information; Confidentiality; Information Dissemination; Medical Records; Social Networkin

Respecting patient intimacy

Indexación: Web of Science; Scielo.Transparency as a general rule for all our professional acts casts doubts about the statement of the Hippocratic Oath that says "Whatever I see or hear in the lives of my patients, I will keep secret, as considering all such things to be private". Medical secrecy protects the intimacy of patients, who reveal to their physicians their most hidden secrets aiming to recover their health. Therefore, physicians should receive those secrets with reverence and care, as servers and not as their owners. The values associated with the respect for personal intimacy are the anthropological basis of medical confidentiality. A medical act is performed by definition between two equally honorable individuals. Therefore, the professional honors the trust of his patient, maintaining strict confidence of what is revealed. Therefore, medical secrecy must be strengthened rather than weakened, pursuing common wealth and dignity.http://ref.scielo.org/cf3mx

An ethical and medical perspective on the voluntary termination of pregnancy

Indexación: Web of Science; Scielo.“Voluntary termination of pregnancy” can refer to actions intended to make a delivery easier, to provide medical care to the fetus, or to protect the life or health of the mother. All of these are proper medical actions and are by definition voluntary. In other cases, the expression denotes a termination of pregnancy before the embryo or fetus is viable, leading to the death of the latter. This action is constitutive of abortion under current Chilean law. The product of conception living being, who develops in the womb during pregnancy, is an individual, both in the sense that it is different from its mother and father, and in that it is a biological individual. For these reasons, such living being constitutes another patient in itself. The free and voluntary medical action of health care professionals is geared toward disease prevention or health recovery and medical terminations of pregnancy, as distinguished from abortion, are not criminalized in our country. Therefore, the idea of legalizing abortive terminations of pregnancy so that they become “legitimate health care services” is a call to the medical community, which should engage in a debate about the meaning and consequences of an eventual mandate of the State that would be at odds with the Hippocratic tradition. A woman can feel that her health is at risk due to her pregnancy, and she certainly has the right to request medical help. Health professionals should care both at the medical and emotional level for all those who require their services, especially when such persons are undergoing situations of vulnerability and distress. When requested to perform an abortion, the physician faces dilemmas that should be addressed in line with the present state of the medical art.http://ref.scielo.org/c4ypf

Organizing health care: an ethical perspective

Indexación: Web of Science; Scielo.Health Care at population level is a complex problem. Having this in mind, the purpose of this paper is to focus on the goods that are ethically relevant in the process of caring for health at this level. We briefly analyze some of the Chilean health statistics that, although they show important improvements along the years, demonstrate that certain conditions are to be deemed as inadequate by both healthcare providers and patients. Ethics is a central component to determine how to structure and organize health care systems and how they should operate. We emphasize Human Dignity as an ethical corner stone of the Health Care System, along with other important values such as Justice and Humanization, under the scope of the Ends of Medicine, and other components such as technical competence of providers and the financing of the whole process. We conclude that as far as a health care system is organized in a way that medical practice is well ordered, primarily and fundamentally according the Ends of Medicine and the good of persons, such a health care system is ethically adequate.http://ref.scielo.org/9bt3z

Development and validation of a new artificial intelligence tool (GeneClin) for the clinical diagnosis of genetic diseases

Introduction: Advances in the field of Artificial Intelligence (AI) and Machine Learning (ML) have considerable potential to improve the diagnosis and management of rare genetic diseases, due to the human inability to memorize information on a multitude of these diseases, which AI tools could store, analyze and integrate. Objective: to develop and validate a new AI tool for the clinical diagnosis of genetic diseases. Methods: A prospective, cross-sectional, analytical, observational study was conducted at the application level, with a qualitative-quantitative approach and contributing to a technological development project. It was characterized by four stages: selection of the AI ​​tool, selection of the knowledge base, development of the virtual assistant, validation process and implementation in the clinic. Results: A total of 246 patients with genetic diseases and congenital defects were evaluated. The most predominant genetic category was monogenic genetic syndromes with 223 patients who attended the consultation (90.7%). A success rate of 84.1% was obtained and a success/no success ratio of 4.34. The highest percentage of successes was achieved in monogenic or Mendelian syndromes. There were no significant differences between successes and failures in both chromosomal aberrations and congenital defects of environmental etiology. Conclusions: Through this research, an AI virtual assistant has been validated for the clinical diagnosis of genetic diseases with a high percentage of effectiveness of 84%, which confirms its usefulness to support the clinical diagnosis of cases with genetic diseases

A reflection about the ethical implications of telemedicine

Recognizing the role of technology in the development of medicine and the impact of telecommunication advances, we reflect on the meaning and ethics of the use of Telemedicine, both in its general dimension for the use and distribution of knowledge, as well as in the delivery of health actions, scientific research, and data management. Teleconsultation is discussed in greater detail, analyzing its process and application, reviewing its possible advantages and disadvantages, from the point of view of providers and patients. We highlight the need to carry out an appropriate evaluation of each instance, from the point of view of both the patient and the professional who uses it. The importance of maintaining a doctor- patient relationship in agreement with the nature and practice of Medicine, respecting people’s dignity, is emphasized. We mention the ethical conditions that must be bore in mind for the proper use of telemedicine. We discuss the eventual influence that this practice will have on the concept and practice of medical care, while suggesting the need to legislate on the matter.Versión publicada - versión final del edito

Sedation at the End-of-life: An Interdisciplinary Approach /

The book's main contribution is its interdisciplinary approach to the issue of sedation at the end-of-life. Because it occurs at the end of life, palliative sedation raises a number of important ethical and legal questions, including whether it is a covert form of euthanasia and for what purposes it may legally be used. Many of the book chapters address the first question and almost all deal with a specific form of the second: whether palliative sedation should be used for those experiencing "existential suffering"? This raises the question of what existential suffering is, a topic that is also discussed in the book. The different chapters address these issues from the perspectives of the relevant disciplines: Palliative Medicine, Bioethics, Law and Theology. Hence, helpful accounts of the clinical and historical background for this issue are provided and the importance of drawing accurate ethical and legal distinctions is stressed throughout the whole book. So the volume represents a valuable contribution to the emerging literature on this topic and should be helpful across a broad spectrum of readers: philosophers, theologians and physicians