Este artículo tiene por objetivo analizar la relación y la recepción que cuatro filósofos de la generación de la democracia: Tomás Pollán, Javier Sádaba, Manuel Fraijó y Jesús Mosterín han mantenido y realizado respectivamente, con y sobre, el pensamiento español contemporáneo que les antecedió.

Background During the first weeks of March 2020 in Spain, the cases of severe respiratory failure progressively increased, generating an imbalance between the clinical needs for advanced life support (ALS) measures and the effective availability of ALS resources. To address this problem, the creation of triage committees (TC) was proposed, whose main function is to select the best candidates to receive ALS. The main objective of our study is to describe the clinical characteristics of the patients evaluated by the TC (...) of the Alcorcón Foundation University Hospital (AFUH) during the first wave of SARS CoV-2. Other objectives are to determine if there are differences between the patients considered candidates / not candidates for ALS and to analyze the functioning of the TC. Methods Retrospective observational study of all patients assessed by the AFUH TC. Results There were 19 meetings, in which 181 patients were evaluated, 65.4% male and with a mean age of 70.1 years. 31% had some degree of functional dependence, the Barthel median was 100 and Charlson 4. 58.5% were not considered a candidate for ALS at that time. The patients considered candidates to receive ALS were younger (72 vs 66; _p_ Conclusions The patients evaluated by the TC had a mean age of 70 years, high comorbidity and almost a third had some degree of functional dependence. More than half were not considered candidates for ALS at that time, these patients being older, with more comorbidity and a worse previous functional situation. TC decisions, based on objective clinical criteria, were almost always respected. Public institutions must get involved in triage procedures, which should and in our opinion must include the creation of TC in health centers. The implementation of Anticipated Decision programs (ADP) would help enable patients affected by triage decisions to participate in them. (shrink)

The COVID-19 pandemic has generated an imbalance between the clinical needs of the population and the effective availability of advanced life support (ALS) resources. Triage protocols have thus become necessary. Triage decisions in situations of scarce resources were not extraordinary in the pre-COVID-19 era; these protocols abounded in the context of organ transplantation. However, this prior experience was not considered during the COVID-19 outbreak in Spain. Lacking national guidance or public coordination, each hospital has been forced to put forth independent (...) and autonomous triage protocols, most of which were, nonetheless, based on common ethical principles and clinical criteria. However, controversial, non-clinical criteria have also been defended by Spanish scientific societies and public institutions, including setting an age cut-off value for unilaterally withholding ALS, using ‘social utility’ criteria, prioritising healthcare professionals or using ‘first come, first served’ policies. This paper describes the most common triage criteria used in the Spanish context during the COVID-19 epidemic. We will highlight our missed opportunities by comparing these criteria to those used in organ transplantation protocols. The problems posed by subjective, non-clinical criteria will also be discussed. We hope that this critical review might be of use to countries at earlier stages of the epidemic while we learn from our mistakes. (shrink)

Movies can serve valuable didactic purposes teaching clinical ethics to medical students. However, using film sequences as means to develop critical thinking is not a straightforward task. There is a significant gap in the literature regarding how to analyse the ethical content embedded in these clips systematically, in a way that facilitates the students’ transition from anecdotal reflections to abstract thinking. This article offers a pedagogical proposal to approach the ethical analysis of film sequences in a systematic fashion. This structured (...) stepwise method encourages students to identify the main ethical problem of a selected scene and to reflect on the theoretical principles involved, emphasizing the application of these norms and values in a contextually situated analysis. We believe this method in film studies both reinforces the students’ comprehension of the theoretical framework of an ethical topic, and casts light on its pertinence and limitations under the circumstances of the scene, thus proving a constructive tool to strengthen the bridge between the theoretical teaching of clinical ethics and clinical practice. (shrink)

Background No studies have been conducted in Mexico to ascertain what ethical problems doctors working at hospitals deal with. This article aims to describe the ethical conflicts most commonly identified by Mexican internists and the importance they attribute to each of these conflicts. Methods Voluntary survey to the members of the Internal Medicine Association of Mexico. Results Responses were submitted by 347 internists. Half of those face ethical conflicts almost always or frequently. The most commonplace and relevant conflicts are those (...) resulting from the clinical relationship (communication, confidentiality, informed consent, assessment of mental capacity, decisions involving incapacitated patients, and conflicts with family members), and secondly those problems related with the end of life (palliative care, withholding or withdrawing treatment, and “No CPR orders”). To resolve conflicts they seek support through protocols, Institutional Ethics Committees (IECs), and consultations with colleagues and, occasionally, with bioethics experts. Protocols and IECs are the tools most in demand among them. Conclusions 1) the most frequent and relevant conflicts are those caused by the clinical relationship, above all those due to doctor–patient communication, and secondly those due to problems which arise at the end of life; 2) though nearly all of them have doubts about how to resolve conflicts, the vast majority are satisfied with the way in which they do so; 3) to deal with conflicts, they seek support mainly in protocols, IECs, and consultation with colleagues; and 4) in order to resolve them better, what they most demand are protocols and IECs, but also bioethics consultants. (shrink)

Background Ethical conflicts generate difficulties in daily clinical activity. Which methods of ethical advice are most frequently used to resolve them among Spanish doctors has not been studied. The objective of this study is to describe what methods hospital internal medicine physicians in Spain use to resolve their ethical doubts and which they consider most useful. Design A cross-sectional observational study was conducted through a voluntary and anonymous survey and distributed through an ad hoc platform of the Spanish Society of (...) Internal Medicine. Measures We measured methods by which to resolve doubts, types of tools sought, frequency of consulting the Clinical Ethics Committees, and satisfaction with resolution of ethical issues. Results Of 261 internists surveyed, 86 per cent resolve their ethical doubts with assistance, the most frequently used method being consultation with colleagues (58.6 per cent), followed by using specific protocols or guides (11.8 per cent) and consultation with experts in bioethics (9.6 per cent). The most preferred tools are the creation of protocols (30.3 per cent) and the establishment of a consultant/expert in bioethics (27.8 per cent). Conclusions Internists in Spain usually seek assistance to resolve their ethical doubts. Consulting colleagues is the most frequently adopted method. The majority regard tools to resolve ethical conflicts as necessary, seeking above all protocols and consultants/experts in bioethics. (shrink)

The differences in clinical bioethics between the Mediterranean and Latin American cultures have not been analyzed. The objective of the study is to compare the ethical conflicts that internists in Spain, Mexico and Argentina have. Cross-sectional observational study through a survey directed at internists from Spain, Argentina and Mexico. The survey was administered to affiliated members of the National Societies of Internal Medicine across three countries via an online platform. 762 internists participated, 261 from Spain, 154 from Argentina and 347 (...) from Mexico. The main ethical conflicts that internists in Spain, Argentina and Mexico have are related (in order) to the end of life, to the clinical relationship and to the patient’s autonomy. Withholding and withdrawing life-sustaining treatment is the most frequent conflict in Spain and Argentina and the second in Mexico. Internists from Spain and Argentina identify very similar ethical conflicts. Furthermore, they consider them more frequent and difficult than in Mexico. In Argentina they are less satisfied with the way they are resolved. To explain these differences, socio-cultural factors are postulated, among others: paternalism, individualism, masculinity, organization of the health system, formal training in bioethics and assessment of death. (shrink)

un diálogo entre “Ante la Ley” de Kafka y La leyenda del santo bebedor de Roth, dos relatos cuya datación casi coinciden literalmente con el periodo de entreguerras, propicia una comparación de interpretaciones en las que participan nombres tan eximios como Benjamin, Arendt, Mann, Scholem, Adorno, Steiner, Magris... En el contexto de los años veinte y treinta del siglo XX, ambos autores plantean una pregunta por la justicia que en manos de autores como Hugo Bergmann, Frank Rosenzweig y Martin Buber (...) dio pie a un replanteamiento del judaísmo centroeuropeo, hoy casi olvidado, y a una revisión de la crisis de la modernidad europea en su conjunto. (shrink)

One of the ways of thinking God in contemporary philosophy is reflecting on violence. In fact, reflecting on violence implies always at the same time to refer to the difficulty of thinking about the co-implication of law and violence, a typical prerogative of divine action. From this perspec-tive, political theology is concerned with the status and the possibilities or impossibilities of rep-resenting violence in a given political order. Three are the classical texts in the backdrop of this reflection on the (...) hiatus between law and violence: Walter Benjamin Critique of Violence of 1921, Carl Schmitt’s Political Theology of 1922 and Derrida’s Force of Law of 1989. The article exam-ines another paradigm, that of Ernesto Laclau. The article concludes that only a non-presentable idea of God as a negative fundament allows for a non-authoritarian political idea. But this non-presentable character is only made possible by revolutionary politics. (shrink)

This essay defends that mimesis is an inherently agonistic and paradoxical human practice. The divergent views on mimesis by Plato and Aristotle, as well as by Adorno and Benjamin, are the philosophical manifestation of an agonistic tension of human mimesis that is not resolved in the exclusive truth of one of the positions, but remains as a permanent possibility to create alternative paths in history.

A sacralidade da vida humana tornou-se um problema filosófico com desdobramentos éticos e políticos. Este ensaio apresenta uma arqueologia da sacralidade a partir dos estudos de Walter Benjamin e Giorgio Agamben, estabelecendo uma comparação com o sentido da sacralidade nas polis antigas. A sacralidade aparece como figura simbólica marcada pelo paradoxo – ao mesmo tempo que protege a vida pelo direito sagrado, o direito a captura e a ameaça com a exceção. Porém, o paradoxo é insuperável, já que constitui o (...) modo de ser do humano. (shrink)

In the literature, event metonymies have been used to explain how language users produce and interpret utterances in which certain events are understood in terms of their sub-events or the overall/complex events they are a part of. This paper attempts to discuss some pragmatic effects of event metonymies which, to the best of our knowledge, have not been explored to date.The first section deals with how certain expressions based on SUB-EVENT FOR EVENT metonymies can be considered synonymous for others in (...) real communicative terms. We, therefore, show how a sound theory of synonymy could not only benefit from the incorporation of referential metonymies but also from the inclusion of SUB-EVENT FOR EVENT metonymies. The second section focuses on how EVENT FOR SUB-EVENT mappings have proven useful to achieve certain pragmatic relevance and mitigation/euphemistic contextual effects which have never been described in the literature. In order to do so, we analyzed a collection of more than 60 expressions (obtained from a study with two native speakers of English) to observe how they can qualify as event metonymies. (shrink)

El libro La indianización. Cautivos, renegados, “hommes libres” y misioneros en los confines americanos (S. XVI-XIX) es una cuidada publicación en español y francés en la que contribuyen, además de sus coordinadores, una docena de investigadores de diversas universidades y centros de investigación europeos y americanos. El germen de esta obra colectiva fue el coloquio internacional organizado por Giudicelli, Bernabéu y Havard en la Escuela de Estudios Hispano-Americanos (EEHA) de Sevilla en s...

Little has been studied on the relationship between affect and school problems related with attendance. This study aims to identify different affective profiles and to determine whether these profiles differ from each other based on the four functional conditions of school refusal behavior. Participants comprised 1,816 Spanish adolescents aged 15–18 years. The Positive and Negative Affect Schedule for Children-Short Form and the School Refusal Assessment Scale-Revised for Children were administered. Latent profile analysis revealed five affective profiles: low affective profile, self-fulfilling (...) profile, low positive affect profile, self-destructive profile, and high affective profile. The self-destructive profile revealed the highest average scores in the first three factors of the SRAS-R-C, whereas the high affective profile reached the highest average score in the fourth factor. On the contrary, the self-fulfilling profile obtained the lowest average scores in the first two factors of the SRAS-R-C, whereas the low affective profile revealed the lowest average scores in the last two factors. Findings suggest the relevance of developing more adaptative affective profiles, such as the self-fulfilling profile, which would contribute to diminishing school attendance problems. (shrink)

Since 2002, legislation in Spain has allowed for the creation and documentation of end-of-life decisionmaking. Over the intervening years, the actual implementation of such documents is very low. Through extensive analysis of the literature, this article explores the current status of the use of and attitudes toward advance directives in Spain and then proposes strategies for improvement in their implementation.

Eight focus groups were conducted in four public hospitals in Madrid to explore healthcare professionals’ perceptions of advance directives in order to improve the understanding of their lack of success among physicians and patients. A purposive sample of sixty healthcare professionals discussed ADs and reasons for their infrequent use. Three main themes were identified: perceptions about their meaning, appraisals of their use in clinical practice, and decision-making about them. Healthcare professionals perceived a lack of clarity about their definition and implementation. (...) There is insufficient awareness of their efficacy in improving the quality of clinical relationships and decision-making, and they are often perceived only as a bureaucratic procedure. Advance directives are not integrated in the clinical practice of Madrid’s healthcare specialist services because their application is exceedingly complex, because of insufficient education about them, and because of lack of procedural clarity. Consequently, healthcare professionals are not aware of how ADs could improve clinical decision-making, of when and for whom their use is appropriate, and of who has responsibility for providing ADs-related information to patients. These circumstances contribute to patients’ lack of interest in completing these documents and to physicians’ sceptical views about their usefulness. (shrink)

Background In Spain, there has been great effort by lawmakers to put Advance Directives into practice since 2002. At the same time, the field of bioethics has been on the rise, a discipline that has spurred debate on the right of patients to exercise their autonomy. Despite all this, the implementation of ADs can be said to have failed in Spain, because its prevalence is very low, there is a great lack of knowledge about them and they have very little (...) impact on clinical decisions. The purpose of this article is to analyze and discuss the main reasons for the failure of ADs in Spain. Main body The main reasons why ADs have no impact on clinical practice in Spain have been fundamentally four: the training of health professionals about the end of life and AD is lacking; there has been no public process to increase awareness about AD, and therefore people know little about them; the bureaucratic procedure to document and implement ADs is excessively complex and cumbersome, creating a significant barrier to their application; in Spain, the remnants of a paternalistic medical culture continue to exist, which causes shared decision-making to be difficult. Conclusion Due to the four reasons mentioned above, AD have not been a useful tool to help honor patients’ autonomous decisions about their future care and, therefore, they have not achieved their objective. However, despite the difficulties and problems identified, it has also been observed that health care professionals and the Spanish public have a very positive view of AD. Having identified the problems which have kept AD from being successful, strategies must be developed to help improve their implementation into the future. (shrink)

It is unknown whether hospital-based medical professionals in Spain educate patients about advance directives. The objective of this research was to determine the frequency of hospital-based physicians’ and nurses’ engagement in AD discussions in the hospital and which patient populations merit such efforts. A short question-and-answer-based survey of physicians and nurses taking care of inpatients was conducted at a university hospital in Madrid, Spain. In total, 283 surveys were collected from medical professionals, of whom 71 per cent were female, with (...) an average age of thirty-four years. Eighty-four per cent had never educated patients about ADs because of lack of perceived responsibility, time, or general knowledge of ADs. Patient populations that warranted AD discussions included those with terminal illnesses, chronic diseases, and elderly patients. Regarding degree of AD understanding in medical professionals: 57 per cent of medical professionals claimed sufficient general knowledge of ADs, 19 per cent understood particulars regarding AD document creation, and 16 per cent were aware of AD regulatory policies. Engagement in AD discussions was considered important by 83 per cent of medical professionals, with 79 per cent interested in participating in such discussions themselves. The majority of hospital physicians and nurses do not educate their patients about ADs, despite acknowledging their importance. Patient populations of highest priority included those with terminal diseases or chronic illness or who are of advanced age. (shrink)

In this article, we offer a detailed study of two important episodes in the early history of high-energy physics, namely the development of the Chew and the Nambu-Jona-Lasinio models. Our study reveals that both models resulted from the combination of an old Hamiltonian, which had been introduced by earlier researchers, and two new approximation methods developed by Chew and by Nambu and Jona-Lasinio. These new approximation methods, furthermore, were the key component behind the models’ success. We take this historical investigation (...) to support two philosophical theses about the manner in which scientific modelling operates in high-energy physics. Both of these theses run counter to a view that is commonly accepted among philosophers of science: the view that all approximations can be embedded within an equivalent idealized system, and that whatever role the former might play in scientific modelling is therefore parasitic on the much more substantial work performed by the latter. Our first thesis, which we call “Distinctness,” states that approximation methods constitute an independent category of theoretical output from idealized systems. We thus believe that approximations and idealized systems constitute two independent types of objects, both of which are essential to the practice of modelling. Our second, more radical thesis is called “Content Determination.” Our claim here is that approximation methods can in fact be essential to assigning determinate physical content to the idealized systems with which they jointly operate. As we show, this is due to the fact that quantum field theory allows for a very thin characterization of idealized systems only, making the use of approximations necessary to supply additional content. We conclude the paper with a few reflections about the manner in which our two theses can be used to articulate David Kaiser’s views on the “vanishing of scientific theory” in physics after WWII. (shrink)

El acceso equitativo a la energía y a la vivienda es una preocupación básica de la justicia social. A pesar de los numerosos vínculos entre estos dos bienes esenciales, los marcos teóricos de la justicia y la pobreza energética se han referido casi exclusivamente a la cuestión de la vivienda en términos de la eficiencia energética de los edificios residenciales. En respuesta a esta carencia conceptual, se propone la reintegración del factor vivienda en el marco de la justicia y pobreza (...) energética a lo largo de los siguientes tres ejes: dimensiones materiales y temporales; dimensiones políticas; y dimensiones éticas y legales. Como ejemplo empírico de la importancia del nexo vivienda-energía en la práctica de la justicia social, se presenta el caso de dos movimientos sociales surgidos en Barcelona que trabajan con una perspectiva conjunta de derecho a la vivienda y a la energía: la Plataforma de Afectados por la Hipoteca (PAH) y la Aliança contra la Pobresa Energètica (APE). El artículo subraya la importancia de la vivienda y la energía como fundamentos materiales de una vida digna y su naturaleza conflictiva como necesidades esenciales y bienes de mercado. (shrink)

Many recent discoveries have confirmed the importance of Orphism for ancient Greek religion, philosophy, and literature. However, its nature and role are still very controversial. The key problem of its relationship to Christianity has been discussed by ancient and modern authors from many different viewpoints, albeit too often tainted with apologetic interests and unconscious projections. This free and thorough study of the ancient sources sheds light on these questions and illuminates the complexity of the encounter between Classical culture and Jewish-Christian (...) tradition. New perspectives on the relationship between Classical and Jewish-Christian culture On the avowed subject of Orphism Author is specialist within the field. (shrink)

Las metodologías activas son unas excelentes herramientas para la mejora del desarrollo de competencias, así como del aprendizaje del alumnado. Se recogen las percepciones y el uso que 92 profesores de educación secundaria de la Comunidad Valenciana (España) manifestaron en un cuestionario tras haber realizado una formación en las mismas. Los resultados permiten constatar que, si bien se produce un aumento en el uso y una mejora en las percepciones, sigue habiendo una considerable resistencia al cambio de este colectivo de (...) profesorado. Encuentran desventajas como considerarlas muy exigentes con el tiempo y son escépticos en el aprendizaje real del alumnado. (shrink)

In March 2021, the Spanish Congress approved the law regulating euthanasia, that regulates both euthanasia and physician-assisted suicide (PAS). In this article, we analyse the Spanish law regulating euthanasia and PAS, comparing it with the rest of the European laws on euthanasia and PAS (Netherlands, Belgium and Luxembourg). Identified strengths of the Spanish law, with respect to other norms, are that it is a law with many safeguards, which broadly recognises professionals’ right to conscientious objection and the specification that it (...) makes on the prior comprehensive care of the patient, including the approach to care dependency. Regarding its shortcomings, the law does not differentiate well between euthanasia and PAS; it barely assigns a role to the healthcare team as a whole (similar to other regulations); it does not clarify the functions of the different professionals involved; it does not detail the specific composition and duration of theevaluation commission; it has not been accompanied by a prior or simultaneous regulation of palliative care; and, lastly, the period of time to implement the law is too short. (shrink)

Se pretende ofrecer una aproximación a la obra de Vicente Muñoz Delgado. Se muestran las distintas etapas en la génesis de su obra y pensamiento, así como también, los núcleos y las claves sobre las cuales se estructura.

Este artículo examina la relevancia de santo Tomás de Aquino en nuestra época, considerando tanto su contexto histórico como los elementos atemporales de su pensamiento. En la primera parte, se destacan las características sociales, políticas y culturales de la Edad Media, y se analiza cómo estos factores influyeron en la vida y obra de Tomás de Aquino. La segunda parte se centra en la actualidad de su doctrina, abordando la constitución del pensamiento humano y su relación con la verdad, así (...) como la construcción del mundo moral. Se resalta la importancia de la experiencia sensorial como base del conocimiento y la necesidad de una vida moralmente buena conforme a la razón. La obra de Tomás, presentada como un modelo de humildad intelectual y perseverancia en la búsqueda de la verdad, ofrece una filosofía que sigue siendo relevante para el entendimiento del ser humano y su realización personal. (shrink)

Las metodologías docentes han ido adaptándose a los cambios de la sociedad, partiendo de un aprendizaje en el que el alumno tiene un papel más pasivo y se limita a escuchar una clase magistral, hasta aprendizajes más activos, utilizando metodologías como active learning, flipped learning, learning by teaching, rol play, entre otras.Esta investigación analiza la percepción de los estudiantes sobre el aprendizaje obtenido con la utilización de la metodología Learning by Teaching, para ello se trabaja con una muestra de 196 (...) alumnos de Grados en Administración y Dirección de Empresas, Marketing y negocios digitales. (shrink)

Around the Council of Basel, and opposing the nominalism renewal, in the University of Salamanca a whole new movement of humanistic renewal is promoted from the field of philosophy and theology, having in Pedro Martinez de Osma one of its most significant representatives. In this paper the meaning of his work, with influences from L. Bruni and L. Valla, is shown and two of his most significant texts are rescued from that fight which confronted the humanism against the nominalism.

If Alfonso de Toledo's encyclopedia of knowledge is situated within the encyclopedic tradition, the Invencionario, 1474, is studied, highlighting the break it made with respect to the medieval order and its encyclopedias, a break which announced a new ordering of knowledge and which manifests a change of age: the transition from the Middle Ages to the Renaissance.

En este artículo se aborda la novela y el film de Georges Perec que llevan por título Un homme qui dort. Se establecen las conexiones filosóficas y literarias que la narración traza, la relación con el concepto de vida cotidiana tal como lo manejaron los Situacionistas o Henri Lefebvre, la búsqueda de la novela sin tema característica de la Modernidad y el concepto del formalismo ruso de extrañamiento como procedimiento de trascender y superar la experiencia instrumentalizada de la realidad.