Quality of Life Reach in Medical Care Alcance da qualidade de vida no atendimento médico The term quality of life has increasingly widespread use in biomedical practice, especially in end-of-life situations. Experience shows that the expression is often used with very different —and sometimes conflicting— scopes. The present article presents the results of a literature review that show diverse positions, while delimitating the subject. The analysis compares the terms “quality of life,” “human dignity,” and “value of human life.” Para citar (...) este artículo / To reference this article / Para citar este artigo Páez G, López-Gabeiras MP, Moreno-D’Anna M. Alcance de la “calidad de vida” en atención médica. Pers Bioet. 2020;24:14-27. DOI: https://doi.org/10.5294/pebi.2020.24.1.2 Recibido: 06/11/2019 Aceptado: 04/03/2020 Publicado: 07/05/2020. (shrink)

Este estudio tiene como objetivo identificar la tipología y los patrones de los mensajes desinformativos relacionados con la salud y la nutrición que se difundieron durante la primera etapa de la pandemia COVID-19 (marzo-noviembre de 2020). Para ello, se realizó un estudio cuantitativo exploratorio con dos tipos de datos. Los primeros provienen del estudio de 95 documentos (artículos científicos) hallados en la base de datos SCOPUS a través de búsquedas booleanas con los términos desinformación, engaño, salud y nutrición. A estos (...) documentos se les aplicó un formulario de registro, indicando los siguientes ítems: a) el tema del artículo (salud o nutrición); b) el tipo de mensaje erróneo (desinformación o engaño); c) el país en el que se realizó el estudio; d) el tipo de participantes (público general, jóvenes, ancianos, profesionales de la salud, estudiantes universitarios); y e) el tipo de canal de información estudiado (Twitter, Facebook, YouTube, Instagram, periódicos impresos, periódicos digitales, plataformas web, televisión, entre otros). Por otro lado, se seleccionaron 95 ingredientes o alimentos que fueron diseminados vía WhatsApp en diferentes bulos en español durante el primer mes de confinamiento (marzo-abril de 2020). Se aplicó un formulario para evaluar el contenido de los engaños, identificando: a) el tipo de sustancia o alimento (fruta, verdura, legumbre, nuez, hierba, entre otros); y b) las fuentes de información a las que se refirió el engaño (autoridades sanitarias, público general, organismos médicos, entre otros). Finalmente, los resultados de ambos estudios cuantitativos concluyeron que el patrón internacional de difusión de bulos fue principalmente sobre la salud en general, y que la desinformación sobre nutrición fue minoritaria, y en el 91% de los casos estuvo relacionada con la ingesta de frutas y verduras, afirmando que podrían prevenir o curar la COVID-19, sin ninguna evidencia científica. (shrink)

Je rappelle ici l’une des plus constantes préoccupations de la pensée de Jean-Luc Nancy : celle du destin d’un Occident qui, au moment même où il paraît accomplir son élargissement au monde entier, est amené à faire, de plus en plus, le constat de son propre effacement, de son déclin, ou de sa finitude. Je le fais tout en déplaçant quelque peu le point de vue d’où le problème se pose « normalement » car, comme c’est arrivé maintes fois dans (...) mes échanges avec Nancy lui-même, j’y fais jouer mon écart, ou mon arrabal hispanique. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

Pointing to similarities between challenges encountered in today's neural coding and twentieth-century behaviorism, we draw attention to lessons learned from resolving the latter. In particular, Perceptual Control Theory posits behavior as a closed-loop control process with immediate and teleological causes. With two examples, we illustrate how these ideas may also address challenges facing current neural coding paradigms.

It is shown that both covariant harmonic oscillator formalism and quantum field theory are based on common physical principles which include Poincaré covariance, Heisenberg's space-momentum uncertainty relation, and Dirac's “C-number” time-energy uncertainty relation. It is shown in particular that the oscillator wave functions are derivable from the physical principles which are used in the derivation of the Klein-Nishina formula.

Prior studies provide consistent evidence of deficits for psychopaths in processing verbal emotional material but are inconsistent regarding nonverbal emotional material. To examine whether psychopaths exhibit general versus specific deficits in nonverbal emotional processing, 34 psychopaths and 33 nonpsychopaths identified with Hare's (R. D. Hare, 1991) Psychopathy Checklist-Revised were asked to complete a facial affect recognition test. Slides of prototypic facial expressions were presented. Three hypotheses regarding hemispheric lateralization anomalies in psychopaths were also tested (right-hemisphere dysfunction, reduced lateralization, and reversed (...) lateralization). Psychopaths were less accurate than nonpsychopaths at classifying facial affect under conditions promoting reliance on right-hemisphere resources and displayed a specific deficit in classifying disgust. These findings demonstrate that psychopaths exhibit specific deficits in nonverbal emotional processing. (shrink)

We present the true stages machinery and illustrate its applications to descriptive set theory. We use this machinery to provide new proofs of the Hausdorff–Kuratowski and Wadge theorems on the structure of $\mathbf {\Delta }^0_\xi $, Louveau and Saint Raymond’s separation theorem, and Louveau’s separation theorem.

Background and objectives Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. Design A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee—whether the (...) doctor referred and whether the doctor disclosed their objection to the abortion. Participants and setting 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Measurement Physicians indicated their approval for the vignette doctor's decision. Main results Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. Conclusion OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor–patient relationship. (shrink)

Justifying his proposal for “health savings accounts,” which would allow individuals to set aside tax-free dollars against future healthcare needs, President Bush has said that “Health savings accounts all aim at empowering people to make decisions for themselves.” Who could disagree with such a sentiment? Although bioethicists may be among those who express skepticism that personal health savings accounts will be part of the needed “fix” of our healthcare financing system, self determination has long been part of their mantra. Indeed, (...) the field of bioethics played an important role in advancing this idea in the medical world when physician paternalism was regnant. Has its popularity caused it to become so vapid as to be ripe for misuse? (shrink)

Aceptar que los Dissoì Lógoi fueron escritos a mitad del siglo V a.n.e., tal como propuso Santo Mazzarino, permite dejar de considerarlos un mero apéndice a los sofistas. Propongo un nuevo análisis de su estructura y considerar que los fragmentos 8 y 9 recogen la tesis criticada por el autor; no, como habitualmente son considerados, la tesis defendida por él. Se restituye así el aroma de las discusiones filosóficas antes de que Platón las sometiera a su criba.

Aunque los caminos filosóficos de George Santayana y de Edmund Husserl transcurrieron por distintos recorridos, resulta sorprendente el momento en que, tras los pasos del escepticismo cartesiano en busca de la evidencia, ambos parecen encontrarse en torno al descubrimiento de la esencia. En este artículo se comparan las dos obras donde se establece ese diálogo durante los años veinte del pasado siglo: Scepticism and Animal Faith, de Santayana, y Cartesianische Meditationen, de Husserl.

Although the neoconservative movement has come to dominate American conservatism, this movement has its origins in the old Marxist Left. Communists in their younger days, as the founders of neoconservatism, inverted Marxist doctrine by arguing that moral values and not economic forces were the primary movers of history. Yet the neoconservative critique of biotechnology still borrows heavily from Karl Marx and owes more to the German philosopher Martin Heidegger than to the Scottish philosopher and political economist Adam Smith. Loath to (...) identify these sources - or perhaps unaware of them - neoconservatives do not acknowledge these intellectual underpinnings or their implications. Thus, in the final analysis, their critique is incoherent and even internally inconsistent. By not acknowledging and embracing their intellectual roots, neoconservatives are left with a deeply ambivalent and often confused view of biotechnology and the society that gives rise to it. (shrink)

When classes of structures are not first-order definable, we might still try to find a nice description. There are two common ways for doing this. One is to expand the language, leading to notions of pseudo-elementary classes, and the other is to allow infinite conjuncts and disjuncts. In this paper we examine the intersection. Namely, we address the question: Which classes of structures are both pseudo-elementary and ${\mathcal {L}}_{\omega _1, \omega }$ -elementary? We find that these are exactly the classes (...) that can be defined by an infinitary formula that has no infinitary disjunctions. (shrink)

El fragmento, inédito en español, pertenece al capítulo IX de La razón en el sentido común, libro primero de La vida de la razón, 5 vols. (1905-1906) del filósofo hispano-norteamericano Jorge/George Santayana (Madrid, 1862-Roma, 1953). Santayana aborda aquí la relación entre mente y cerebro desde un naturalismo materialista, que ha asumido por completo la revolución intelectual darwinista, y mostrando ser un fino analista de la experiencia de la acción consciente.

Western society today is less unified by a set of core values than ever before. Undoubtedly, the concept of moral consensus is a difficult one in a liberal, democratic and pluralistic society. But it is imperative to avoid a rigid majoritarianism where sensitive personal values are at stake, as in bioethics. Bioethics has become an influential part of public and professional discussions of health care. It has helped frame issues of moral values and medicine as part of a more general (...) effort to find consensus about some of the most perplexing questions of our time. But why is it thought that a moral consensus is important or that it deserves respect? How does moral consensus acquire legitimacy in a society that includes diverse value systems? How is moral consensus possible and how do small groups help create or distort consensus processes? Written by a medical school professor trained in philosophy, this timely work tackles these questions from philosophical, historical, and social scientific standpoints. It begins by describing the traditional ambivalence about consensus in Western culture as well as the uncertain relationship in modernity between consensus and expertise. After outlining the current bioethical consensus, the book gives philosophical and political analyses of the idea of consensus, then assesses the role of consensus in national ethics commissions and in the ethics committee movement. Moreno constructs an original, naturalistic philosophy of moral consensus, referred to as "bioethical naturalism", and then applies sociology and social psychology to actual consensus processes. The book concludes with an account of bioethics as a consensus-oriented social reform movement. This insightful volume will be essential reading for bioethicists, philosophers, physicians, members of ethics committees, and all those concerned with ethical and social issues in health care. (shrink)

Timely and provocative essays on bioethical questions brought to the forefront by the bioterrorist threat.

La alternativa entre Sócrates y Cristo planteada por Santayana le permite cerrar su sistema filosófico con una propuesta de vida espiritual que oscila entre la filantropía y la caridad en consonancia con una filosofía que hace compatible a Demócrito y Platón, la desilusión y la regeneración. El ¿testamento espiritual¿ de Santayana es la respuesta a la pregunta ¿¿Qué lealtad íntima, qué religión última, sería la apropiada a un espíritu completamente libre y desilusionado?¿. El presente artículo se centra, por tanto, en (...) la obra del último Santayana buscando la clave de bóveda de su sistema filosófico. (shrink)