ABSTRACT
Resumen El objetivo de este trabajo fue explicar por qué murieron más mujeres en el sismo del 19 de septiembre de 2017 en la Ciudad de México. La metodología fue mixta, cuantitativa con datos epidemiológicos y estadísticos, y cualitativa con una revisión hemerográfica sobre la influencia del género en la mortalidad derivada de los sismos. Los resultados indican para la parte cuantitativa que la diferencia en las defunciones entre las mujeres respecto de las presentadas entre los hombres no puede atribuirse ni a cuestiones de distribución poblacional ni al azar. Los resultados indican para la parte cualitativa que hay muchos datos que indican que el género es un determinante social importante para explicar por qué es más frecuente que mueran más mujeres que hombres tras un sismo. Se recomienda entonces que deben considerarse estos datos de manera responsable para mejorar las acciones de prevención y de intervención a futuro.
Abstract This paper aimed to explain why more women died in the earthquake of September 19, 2017, in Mexico City. We adopted a mixed quantitative-qualitative method, with epidemiological and statistical data and a hemerographic review about the influence of gender on earthquake-derived mortality. In the quantitative part, the results show that the difference in deaths among women compared to those among men cannot be attributed to population distribution or randomization issues. In the qualitative part, the results show that many data are evidencing that gender is an essential social determinant that can explain why more women die than men after an earthquake. Therefore, we recommend that these data be considered responsibly to improve future prevention and intervention actions.
Subject(s)
Humans , Male , Female , Disasters , Earthquakes , Mexico/epidemiologyABSTRACT
Este trabajo busca cómo articular el psicoanálisis y la bioética. Para ello, se revisa cuáles marcos podrían ser adecuados, optando por la transdisciplina. Para una aproximación transdisciplinaria se requiere romper con algunos puntos de la ortodoxia de cada una de las disciplinas que intentan relacionarse, así como el requerimiento de un eje transdisciplinar que no se restrinja a reunir unas visiones de un modo reductible, ni sometible, ni complementario (en el sentido de agregable), sino que las reorganice en un nuevo nivel epistemológico, distinto. El trabajo propone que los puntos de ruptura de la ortodoxia de la relación entre psicoanálisis y bioética podrían ser la realidad tecnocientífica contemporánea y el papel del psicoanalista en un comité de ética. Finalmente, se propone que un posible eje transdisciplinario entre psicoanálisis y bioética puede ser la deliberación, metodología propuesta para la bioética (en cuanto ética de la responsabilidad) por Diego Gracia Guillén.
This paper seeks how to articulate psychoanalysis and bioethics. To do this, it is reviewed what might be an appropriate framework, choosing transdiscipline. For a transdisciplinary approach it is proposed that is required to break some orthodoxy points of each of the disciplines that try to relate, and also the requirement of a transdisciplinary axis that is not restricted to gather some insights in a reducible or bringing under, complimentary (in the sense of mere aggregation), but that reorganize into a new epistemological level, a different one. The paper proposesthat breakpoints of orthodoxy of the relationship between psychoanalysis and bioethics could be the actual contemporary technoscience, and the role of the psychoanalyst in an ethics committee. Finally, it is proposed that a possible transdisciplinary axis between psychoanalysis and bioethics can be deliberation, a proposed methodology for bioethics (understanding it as an ethics of responsibility) done by Diego Gracia Guillén.
Este artigo procura como articular a psicanálise e a bioética. Para fazer isso, se revê quais enquadramentos poderiam ser adequados, optando pela transdisciplina. Para uma abordagem transdisciplinar é necessário quebrar alguns pontos da ortodoxia de cada uma das disciplinas que tentam se relacionar, bem como a exigência de um eixo transdisciplinar que não se restringe a reunir visões de uma forma redutível, nem passíveis nem complementares (no sentido de agradável), mas que sejam reorganizadas num novo nível epistemológico, diferente. O documento sugere que os pontos de quebra da ortodoxia da relação entre psicanálise e bioética podem ser a realidade tecnociência contemporânea e o papel do psicanalista em um comité de ética. Finalmente, propõe-se que um possível eixo transdisciplinar entre a psicanálise e a bioética pode ser a deliberação, metodologia proposta para a bioética (como ética da responsabilidade) por Diego Gracia Guillén.
Subject(s)
Humans , Bioethics , Consensus , Ethics Committees , Interdisciplinary Communication , Interdisciplinary ResearchABSTRACT
Una idea fundamental para sostener conceptos éticos fundamentales, tales como el de autonomía, responsabilidad etc., lo es la "libertad". La aporía determinismo/libertad ha estado presente en la filosofía desde el mundo antiguo. Sin embargo, tras el desarrollo de las neurociencias, se ha planteado que la libertad es una mera ilusión y que los seres humanos estamos determinados neurobiológicamente en nuestro actuar. Este trabajo presenta los trabajos pioneros de Benjamín Libet sobre este tema (una aproximación que utilizó electroencefalografía y electromiografía), a la vez que realiza una crítica sobre las interpretaciones del propio Libet...
A fundamental idea to sustain basic ethical concepts such as autonomy, responsibility, etc., is "liberty". The determinism/freedom aporia has been present in philosophical tradition since ancient world. However, after the development of neuroscience, it has been argued that freedom is merely an illusion and human beings are neurobiologically determined in our actions. This paper presents the pioneering work of Benjamin Libet on this subject (an approach that used electroencephalography and electromyography), also a critique on Libet interpretations of his results...
Uma ideia fundamental para sustentar conceitos éticos fundamentais, tais como autonomia, responsabilidade, etc., é a "liberdade". A aporia determinismo/liberdade tem sido presente na filosofia desde o mundo antigo. No entanto, após o desenvolvimento da neurociência, tem-se argumentado que a liberdade é uma mera ilusão e que nós seres humanos estamos neurobiologicamente determinados em nossas ações. Este artigo apresenta os estudos pioneiros de Benjamin Libet sobre este assunto (una abordagem que utilizou eletroencefalografia e eletroneuromiografia), enquanto realiza uma crítica sobre as interpretações do próprio Libet...
Subject(s)
Humans , Male , Female , Bioethics , Conscience , Freedom , Memory , Neurosciences , Personal Autonomy , Philosophy , LearningABSTRACT
El trabajo aborda aspectos sociales y legales de la fecundación in vitro, entendidos como un marco general para poder aplicar las técnicas de reproducción humana asistida en general. Para el caso de los aspectos sociales, se revisan dos temas fundamentales: el parentesco y la familia. Respecto a las cuestiones legales, dado que prácticamente hay un vacío general con relación a los elementos regulatorios, se hacen algunas puntualizaciones sobre un marco general para el contexto actual. En el tema del parentesco, se retoman estudios clásicos, etnografías hechas sobre la infertilidad y sobre las nuevas tecnologías en reproducción humana. El tema se liga con el de la familia, donde se tratan los cambios que han surgido en el mundo contemporáneo tras la modificación en las nociones sobre lo que es el parentesco. Una conclusión general es que todo lo humano es producto de una construcción, de modo que los criterios que se han tenido para construir conceptos como "parentesco" o "familia" han cambiado sustancialmente desde la llegada de las técnicas de reproducción asistida. Siendo esto así, habrá que buscar la mejor manera de regular la aplicación de estas técnicas, pudiendo ser una orientada por principios.
The work deals with social and legal aspects of IVF, understood as a general framework to apply the techniques of assisted human reproduction in general. Regarding the social aspects, two fundamental issues are reviewed, kinship and family. Regarding the legal issues, since there is practically no legal regulation, some remarks on a general framework for the current context are made. On the issue of kinship, classical studies are taken up, ethnographies made on infertility and on new technologies in human reproduction. Kinship is linked with the family, where the changes that have emerged in the modern world following the shift in notions about what is kinship are discussed. A general conclusion is that everything is a product of human construction so that the former criteria to build concepts such as kinship or family have changed substantially since the advent of assisted reproductive techniques. This being so, we must find the best way to regulate the application of these techniques, and maybe the best would be a legal framework oriented by principles.
ABSTRACT
El desarrollo de la Bioética en Latinoamérica ha enfrentado un problema que la Filosofía afrontó hacia mediados del siglo XX: la originalidad de pensamiento. En el trabajo se recuerdan la visión pesimista de Salazar Bondy y la optimista de Zea respecto a la filosofía, como marco antecedente para presentar posturas contemporáneas optimistas y pesimistas en relación con una "Bioética latinoamericana". Se destacan paralelismos entre filósofos pesimistas y bioeticistas pesimistas a través de metáforas como el trasplante de ideas. Posteriormente se hace un recorrido sobre los estudios sociales de la ciencia y algunas extensiones que podrían hacerse hacia la Filosofía y la Bioética. Se finaliza considerando que no hay una propuesta "autóctona" de "Bioética latinoamericana", y que lo que realmente puede elaborarse es una "Bioética en Latinoamérica"...
Development of bioethics in Latin America has faced a problem that philosophy faced previously by the middle of the twentieth century: originality of thought. This paper recalls the pessimistic view of Salazar Bondy and optimistic one of Zea about philosophy, as a historical framework to show optimistic and pessimistic contemporary views regarding a "Latin American bioethics". The paper highlights parallels between pessimistic philosophers and pessimistic bioethicists through metaphors like ideas transplantation. Subsequently, the paper traces a path on social studies of science and some extensions that could be made into philosophy and bioethics. It ends by considering that there is not a "native" proposal of "Latin American bioethics," and that it can really be developed as "bioethics in Latin America."...
O desenvolvimento da bioética na América Latina enfrentou um problema com o qual se deparou a filosofia em meados do século XX: a originalidade de pensamento. No trabalho é lembrada a visão pessimista de Salazar Bondy e a otimista de Zea a respeito da filosofia, como marco antecedente para a apresentação de posturas contemporâneas otimistas e pessimistas em relação a uma "bioética latino-americana". São destacados paralelismos entre filósofos pessimistas e bioeticistas pessimistas através de metáforas como o transplante de idéias. Posteriormente é feito um percurso nos estudos sociais da ciência e sobre algumas extensões que poderiam ser feitas à filosofia e à bioética. Finaliza considerando que não há uma proposta "autóctone" de "bioética latino-americana", e o que realmente pode ser feito é uma "bioética na América Latina"...
Subject(s)
Humans , Bioethics , Ethics , Ethics, ProfessionalABSTRACT
Para plantear posibles retos de la bioética en la medicina del siglo XXI es necesario considerar que existieron algunos retos en el pasado (en el origen de esa nueva disciplina llamada bioética); que los retos se han ido modificando con el avance científico, biomédico y humanístico; considerando que los retos que pueden plantearse para el futuro serán, de diferentes maneras, resultado de este devenir histórico. Se plantean como grandes retos: los problemas no resueltos de justicia, equidad y pobreza; los retos que plantea la introducción de nuevas tecnologías con el paradigma de la nanomedicina y los retos que plantea el avance de las neurociencias con el paradigma de la neuroética.
In order to propose possible challenges of bioethics in the twenty-first century medicine, it is necessary to consider that there were some past challenges (at the origin of this new discipline called bioethics), that the challenges have been modified with scientific, biomedical and humanistic breakthroughs, considering at the same time that challenges that may arise in the future will be, in different ways, a result of this historical evolution. The major challenges would be in the future: the unsolved problems of justice, equity and poverty; the challenges posed by the introduction of new technologies with the nanomedicine paradigm; and finally, the challenges driven by breakthroughs in neurosciences with the neuroethics paradigm.
Subject(s)
Humans , Bioethics , Ethics, Medical , Bioethics/trends , ForecastingABSTRACT
En este artículo se intenta mostrar la importancia de incluir la literatura en la enseñanza de la medicina en general y de las humanidades médicas en particular. Se muestra la relevancia del escritor médico y del no médico, pudiendo ser paciente a la vez, y se justifica la inclusión de este tipo de enseñanza. Se sugieren cuatro pasos para la creación de un curso: selección de textos, establecer el contenido temático, delimitar el momento de su inclusión dentro del currículo y tomar como estrategias metodológicas el distanciamiento y otras, desde perspectivas analíticas hasta sintéticas.
This article emphasizes on the importance of including literature as a subject in the medical curriculum and particularly in the teaching of medical humanities. It underlines the importance of the physician-writer and the non-physician writer, who may become patients at the same time, justifying why to include this subject in teaching medicine. Finally, the article suggests four steps to create a course in this field: text selection, definition of the content, time of inclusion within the curriculum, and distancing as a methodological strategy.
Subject(s)
Education, Medical , Humanities , LiteratureABSTRACT
Los estudios empíricos sobre donación de embriones realizados en paísesdesarrollados indican que lo más probable sería el descarte de los embriones, y en caso de donarlos sería mayormente con fines de investigación, y eventualmentecon fines asistenciales. En Hispanoamérica, prácticamente no existen estudios sobre las opiniones de los participantes en técnicas de reproducción humana asistida (TRHA) complejas, respecto de las posibilidades de la disposición de losembriones sobrantes en dichas técnicas. Además, tampoco hay marcos legislativos contra los cuales se pueda contrastar opiniones o preferencias de los pacientes.Trabajos realizados en Ecuador, Chile y Perú son antecedentes directos y base para la realización de un estudio latinoamericano. Existe una necesidad de llevar a cabo un estudio descriptivo acerca de si las parejas latinoamericanas donarían sus embriones o no, que beneficiaria a varias áreas (práctica clínica, investigación, bioética, bioderecho, etc.).
Empirical studies regarding embryo donation in developed countries show that the most probable action would be to discard surplus embryos and, if they would donate them, the preferred option would be for research, and eventually to other couples. There are not enough studies in Hispanic America about the opinions of those who have participated in assisted reproductive technologies (ART) regarding embryo disposition of surplus embryos. Moreover, thereare scarce specific laws regulating ART in order to contrast peopleÆs opinion. Works performed in Ecuador, Chile and Peru are also preceding works and basis to design a Latin American Study on embryo donation. It is necessary to perform a descriptive study on Latin American couples opinions regarding embryo donation, which would benefit several areas (clinical practice, research,bioethics, biolaw, etc.).
Subject(s)
Humans , Bioethics , Gift Giving , Embryonic Structures , Reproductive Techniques , Latin AmericaABSTRACT
La presencia de un hombre transexual embarazado en los medios de comunicación ha hecho repensar al acceso de personas transexuales a la reproducción asistida. La discusión bioética en torno a un caso así debe centrarse en el mejor interés para el menor. Este trabajo inicia con la historia de un hombre transexual legalmente casado con una mujer en el estado de Oregon, Estados Unidos; continúa con un breve repaso de la transexualidad y las características específicas de este caso, con consideraciones especiales en torno a la fertilidad de las personas transexuales. Posteriormente se hacen algunas reflexiones sobre la maternidad y la paternidad, para sugerir algunas consideraciones bioéticas en este novedoso caso.
The presence of a transsexual pregnant male in the mass media has made people reassess if transsexuals should have access to assisted reproduction. The bioethical discussion should focus on the future child best interests. This article describes the story of this transsexual man, legally married to a woman in the state of Oregon in the United States. A brief overview of transsexuality and the specific characteristics of this case, with special considerations towards fertility in transsexual people is included. We suggest reflections on what constitutes motherhood and fatherhood and bioethical considerations brought forth by this groundbreaking event.
Subject(s)
Humans , Male , Female , Bioethical Issues , Fathers , Mothers , Transsexualism , Reproductive Techniques, AssistedABSTRACT
Con el marco del 125 aniversario del nacimiento de Franz Kafka, se realiza un resumen de su biografía y se comenta su situación de paciente afectado por la tuberculosis. Se esboza un comentario del Kafka escritor y a qué podría referirse lo kafkiano; finalmente, se propone un comentario acerca de la ética que puede expresarse en un relato titulado Un médico rural. La forma de interpretarlo debe envolver la noción de responsabilidad, concepto que aparece en lo teológico, pasa a lo jurídico y se instala en lo ético. Kafka lo expresa en su literatura.
Within the framework of the 125 anniversary of the birth of Franz Kafka we discuss his work as a patient affected by tuberculosis. This essay outlines a review of Kafka as a writer and explains the meaning of the term [quot ]Kafkaesque[quot ]. We put forward a commentary on the ethics expressed in a short story entitled A country doctor. An interpretation of Kafka must involve the notion of responsibility, a theological concept that is then followed by the legal context. Finally, Kafka embraces an ethical approach expressed in his work.
Subject(s)
History, 19th Century , History, 20th Century , Literature/history , Medicine in Literature , Czech Republic , EthicsABSTRACT
Objetivo: Explorar opiniones de pacientes que han acudido a técnicas de reproducción asistida (TRA) complejas, respecto a la donación de gametos y embriones, así como las razones para hacerlo o no. Diseño: Estudiotransversal de bioética descriptiva, con metodología cualitativa etnográfica, mediante entrevista semiestructurada, aplicando análisis del discurso al texto resultante. Lugar: Clínica privada, en Lima, Perú. Participantes: Veinte mujeres y 12 hombres, quienes habían acudido por lo menos a una TRA compleja. Intervenciones: Entrevista semiestructurada, aplicando análisis del discurso al texto resultante. Principales medidas de resultados: Opinión sobre donación de gametos y embriones. Resultados: Respecto a la donación de embriones, 11 de los hombres los donarían con fines de terapia de fertilidad, 6 con fines de investigación y solamente uno rechazó ambas posibilidades de donación. Las 20 mujeres entrevistadas, por su parte, los donarían para terapia de fertilidad y 8 de ellas con fines de investigación. Los participantes que han aceptado gametos donados, no necesariamente piensan que donarían los propios en caso de poder hacerlo. Conclusiones: La donación de gametos es más comentada y generalmente aceptada; la donación de embriones es un tema menos discutido y más conflictivo, tanto para donar como para aceptar. La criopreservación es un tema complejo, comentado pero también conflictivo, cuya aceptación o no, así como el destino de los embriones probablemente criopreservados, depende de las concepciones que se tiene respecto al origen de la vida, la ética personal, entre otros. Se puede plantear una hipótesis, a ser verificada en estudios cuantitativos, de que la donación de embriones podría efectuarse, principalmente, para terapia de fertilidad y excepcionalmente con fines de investigación.
Objective: To explore patients undergoing complex assisted reproductive technologiesÆ (ART) opinions on both gamete and embryo donation, as well as the reasons to do it or not. Design: Cross-sectional study of descriptive bioethics, with ethnographic qualitative methodology using a semi-structured interview, applying speech analysis to the resulting written transcript. Setting: Private medical institution, in Lima, Peru. Participants: Twenty women and 12 men who had had at least one complex ART. Interventions: Semi-structured interview, applying speech analysis to the resulting written transcript. Main outcome measures: Opinion on both gamete and embryo donation. Results: Regarding embryo donation, 11 men would donate their embryos for infertility treatment, 6 for research purposes, and only one rejected both possibilities. On the other hand, all 20 women would donate embryos for infertility treatment and only 8 for research purposes. Participants who accepted gamete donations did not necessarily think they would donate their own gametes. Conclusions: Results suggest gamete donation is more commented and generally accepted; embryo donation, either to donate or to accept donation, is a more conflicting and less discussed subject. Cryopreservation is a complex subject, commented but also conflicting, whose acceptance or not as well as the probable cryopreserved embryos destiny depend on participants beliefs on life origin, personal ethics, etc. Hypothesis resulting from this study to be verified in future quantitative researches is that embryo donation could take place mainly for infertility treatment and exceptionally for research.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Cryopreservation , Germ Cells , Embryo Disposition , Fertilization in Vitro , Sperm Injections, Intracytoplasmic , Reproductive Techniques, Assisted , PeruABSTRACT
Este artículo revisa la vivisección en animales no humanos y su actual justificación desde el punto de vista bioético. Se inicia con una breve revisión histórica sobre la vivisección animal hasta el recrudecimiento de la polémica sobre ésta en el siglo XX. Reflexiona sobre la ética de la relación entre seres humanos y animales y de la experimentación con animales, y concluye que hoy podría ser justificable una vivisección animal sólo en situaciones verdaderamente excepcionales, de lo contrario no se estaría obrando conforme a la ética.
Subject(s)
Animals , Vivisection , Bioethics , Animal Experimentation , EthicsABSTRACT
La bioética cubre temas clásicos del inicio al final de la vida humana. Al inicio de la vida humana, los problemas parten del mismo punto: el estatus del embrión humano.Existen numerosos e interesantes trabajos que abordan problemas alrededor de este tema, tales como la reproducción asistida, la recolección y manejo de gametos y embriones en el laboratorio, la investigación en células embrionarias, fuentes de células troncales (o células madre), la anticoncepción de emergencia, la interrupción voluntaria del embarazo, etc. Todos ellos se apoyan en conceptos filosóficos que pueden estar implícitos o explícitos. Las posturas filosóficas en torno al estatus del embrión humano se pueden dividir en dos: el personalismo y el gradualismo. El personalismo considera que el embrión es persona desde la fecundación. El gradualismo considera que es persona en un momento posterior a la fecundación. En este trabajo se aborda la definición de las palabras estatus y embrión, se resumen criterios para considerar a partir de que momento un ser humano es una persona, se presenta el gradualismo como una alternativa actual frente al personalismo y se enfatiza en la postura gradualista propuesta por Alonso Bedate sobre el estatus del embrión humano, sugiriendo que el gradualismo tiene sus fundamentos metafísicos en la biología moderna.
Bioethics debates topics regarding the beginning and ending of human life. The beginning of human life includes when a human embryo reaches full human status. There are multiple and interesting issues surrounding human embryo status. These include assisted reproduction, seeking and management of human gametes and embryos at specialized laboratories, embryonic and stem cell research, emergency contraception, voluntary interruption of pregnancy, etc. They are based on implicit or explicit philosophical concepts. Philosophical positions about human embryo status could be summarized in two postures: personalism and gradualism. Personalism considers that human embryos reach the status of persons from the moment of fertilization. On the other hand, gradualism considers human embryos become persons at a later time after fertilization. The present work discusses the definitions of [quot ]status[quot ] and [quot ]embryo[quot ], summarizes criteria to consider a human being as a person, presents gradualism as an alternate posture to personalism, and finally emphasizes Alonso Bedate's gradualist position about human embryo status, suggesting that gradualism has its metaphysical foundation in modern biology.
Subject(s)
Humans , Beginning of Human Life , Embryo, Mammalian , Personhood , Human RightsABSTRACT
Se realizó un estudio bibliohemerográfico de tipo monográfico con el fin de revisar el vivenciar de la sexualidad en parejas con problemas de fertilidad a partir del modelo de la sexualidad humana de Rubio Aurioles, Se describen los cuatro holones (reproductividad, erotismo, vínculos afectivos y género) en parejas con problemas de fertilidad, haciendo referencia a las investigaciones clínicas que se han hecho respecto a la sexualidad en este grupo de parejas, aunado a algunas reflexiones teóricas.
A monographic type, bibliographic and hemerographic study on the sexuality in couples with fertility problems is presented. The study is based on the Rubio Aurioles' model of human sexuality, and the four holones (reproductivity, eroticism, affective bonds, gender) in couples with fertility problems are described. A review of clinical studies on the prevailing sexuality in this kind of couples and some theoretical reflections are also presented.
Subject(s)
Humans , Male , Female , Infertility , Sexuality , Infertility/psychologyABSTRACT
resumen está disponible en el texto completo
Abstract: An article published recently explored the kinds of anxiety displayed by couples that have been treated with assisted fertilization techniques, IVF (in vitro fertilization) and ICSI (intracytoplasmic sperm injection) towards the hypothetical embryo donation for research. The study shows that the more frequent kinds of anxiety, in agreement with the methodology of Gottschalk et al, are guilt anxiety and separation anxiety. This work intends to give a reflection as an essay on the probable relationship present between gender and these kinds of anxiety. Reproductive medicine. Basic definitions The different clinical presentations of infertility and sterility have given origin to their study in a novel area called reproductive medicine. Reproductive medicine is in charge of the prevention, diagnosis and opportune treatment of the problems of human fertility. A reproductive problem is that one present in the couple who does not obtain a spontaneous pregnancy. Sterility is the inability of the man or the woman to conceive. Primary sterility is acknowledged when the couple, after a year of sexual relations without use of contraceptive method and with deliberate search of descendants, has not become pregnant. Secondary sterility occurs when the couple, after conceiving, does not obtain a new gestation after trying for two or more years. On the other hand, infertility is the inability to produce a living child. Therefore, primary infertility is suffered by the couple who has a gestation without a suitable ending (abortion, repeated loss of gestation, etc.), and the secondary infertility occurs when after a childbirth with at least one child being born alive, they cannot attain a new gestation upon maturity. After a complete medical evaluation, the treatment plan could include simple techniques of assisted fertilization (like the intrauterine insemination) or complex techniques of assisted fertilization (like IVF and ICSI). IVF technique begins with the ovarian hyperstimulation with exogenous hormones, in a controlled way, and the transvaginal ovular capture guided by ultrasound; then, every ovum with a high quality is incubated with sperm treated previously in the gamete laboratory by an embryologist. After the gamete meeting, a culture of the zygote is done to be able to visualize the cellular division and thus to demonstrate its fertilization. Later the transference to the uterus is made. The pregnancy probability increases with the number of transferred embryos: 9% with one, 18% with two, 29% with three and 32% with four. The rest of produced embryos is cryopreserved. The success of the technique, understood like «baby in house¼, cannot exceed 40%, basically because the knowledge of the molecular mechanisms that regulate the implantation of the human embryo is still very limited. ICSI technique consists in the same steps that the IVF, but differs in the way of fertilization, which is done here by a direct injection of a sperm into the cytoplasm of an ovum. The use of these new techniques as tools to the service of human reproduction have undertaken the analysis and the debate in this kind of treatments, with special emphasis on the psycho-logical, social and ethical aspects. This is so because now appears the possibility (unthinkable before), of 5 relatives as parents: the genetic mother (the ovum producer), the biological mother (who held the pregnagcy), the social mother (who will take care of the product in postpartum), the genetic father (sperm producer), and the social father (who will take care of the product in postpartum). Anxiety in reproductive medicine The emotional and psychological aspects have been, in general, little studied and understood in the population of the couples that have fertility problems. Usually it is accepted that the reproductive problems have repercussions in the psychological sphere, but still it is discussed that the psychological factor is a cause of fertility problems. At the beginning of this type of studies, it could have suggested that women with a traditional feminine roll are more anxious than men, but they would not show levels of depression nor of sexual or marital dissatisfaction. Nevertheless, the taller will depend largely on the conceptions that settle down around the relation between masculinity and paternity, femininity and maternity. Gender perspective Gender perspective makes reference to the academic, illustrated and scientific conception that synthesizes the theory, the liberating philosophy and the policy, created by the women in the femnist culture. Gender perspective allows to analyze and to understand the characteristics that define women and men in a specific way, as well as their similarities and differences. This gender perspective analyzes the vital possibilities of women and of men: the sense of their lives, their expectations and opportunities, the complex and diverse social relations, that occur between both genders, as well as the institutional and daily conflicts that they must face and the ways in which they do it. The feminist gender analysis is detractive of the patriarchal order, it contains specific criticism of the injurious, destructive, oppressive and alienated aspects that are present due to the generic organization based on the inequality, injustice, and political hierarchy sustained by people based on gender. The category of captivity for the feminine gender and of dominion for the masculine gender cannot escape to the scope of the reproductive medicine and to the theoretical possibility which is becoming more and more real, of using human embryos for research. Guilt anxiety Guilt anxiety can be associated independently with the disapproving vision of Christianity in the West, in respect to the reproductive medicine in general and to the donation of embryos in particular, wether its aim is reproductive or not. It would be possible to locate a first instance of patriarchal dominion through the Church and the exerted control over sexuality and reproductivity in the Family, and a second one of patriarchal dominion when the previous one not being enough, it uses reproductive medicine like a dominion agent on the feminine captivity, that is, the "motherspouse" captivity. Separation anxiety It is possible to consider what the series of procedures involved arouses in a so technified reproductive medicine: the solitude sensation that can experience a human body when self perceived by itself like a biological body; like another object more of the technological and science to the service of the human reproduction. Solitude, isolation, loss of what has been gained or isolation from what it is about to be gained through the technique (the non had son until the moment to go to receive diagnosis). If one considers the embryo like a being of equal ontological value that an adult, these will be a greater anxiety of separation when donating embryos. Final considerations Reproductive medicine has too many matters not sufficiently explored. Other sciences should make new theoretical constructions, besides psychology (which should study empirically and theoretically if the anxiety is the same when people is thinking about embryo donation, and when they are donating the embryos). For example, anthropology must review and (eventually) redefine some concepts as family, incest and others. Law must create new norms about gamete and embryo donation, and contribute with the legal definitions of "father", "mother", "son"; maybe even make laws regarding the legal disposition of cryopre-served embryos, etc. Finally, real world is too complicated as are our mental maps and schemes.
ABSTRACT
Introducción: La donación de embriones presenta características especiales en el marco latinoamericano, donde no existe la constante de los países desarrollados de tener embriones criopreservados sobrantes. Además, la religiosidad cristiana occidental es un poco mayor. La necesidad de regular desde lo ético y lo jurídico la práctica de la donación de embriones sugiere que se pueden tomar en cuenta las opiniones de los involucrados: los pacientes, los profesionales de la salud, y la sociedad. El objetivo de este estudio es explorar la esfera de los pacientes mediante la búsqueda de tipos de ansiedad frente a la donación hipotética de embriones para investigación. Material y métodos: Con un diseño descriptivo y transversal se realizó una entrevista semiestructurada, individual y grabada, a 32 pacientes en una clínica privada en Lima, Perú, que habían acudido a técnicas complejas de fecundación asistida (FIV e ICSI); al transcrito de la entrevista se le aplicó la escala de ansiedad del método de análisis de la conducta verbal de Gottschalk et al., identificándose el tipo de ansiedad predominante en cada entrevistado. Resultados: Los tipos de ansiedad más comunes frente a la donación de embriones para investigación en este grupo de participantes fueron la ansiedad por sentimiento de culpa, la ansiedad por separación y la ansiedad por vergüenza. Divididos por género, los tipos de ansiedad más comunes para el género masculino fueron la ansiedad por culpa, vergüenza y separación; para el femenino, la ansiedad por culpa, separación y vergüenza.
INTRODUCTION: Embryo donation displays special characteristics within the Latin American context, where spare cryopreserved embryos are not currently available as is the case of industrialized countries. The Catholic church also plays a significant role. The need to regulate ethically and legally the practice of embryo donation suggests that we need to take into account the opinions from the main key players: patients, health professionals, and society. The objective of this study is to explore the patients perceptions vis a vis potential embryo donation for research purposes. MATERIALS AND METHODS: A descriptive, cross-sectional design included a tape recorded semi-structured interview administered to 32 patients attending a private clinic in Lima, Peru. Participants had undergone complex techniques of assisted fertilization (FIV and ICSI). The verbal Gottschalk analytical method was used to identify predominant anxiety manifestations in the interviews. RESULTS: The most common types of anxiety associated with embryo donation for research in this group of participants were guilt, separation anxiety and shame. Divided by gender, the more common types of anxiety reported by men were guilt, shame and separation anxiety. Women reported guilt, separation anxiety and shame.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Anxiety/classification , Anxiety/epidemiology , Tissue Donors/psychology , Embryo Research , Reproductive Techniques, Assisted , Cross-Sectional Studies , PeruABSTRACT
Más de 300 mujeres muertas... la historia está llena de injusticias. En ocasiones, las víctimas, sus descendientesu organizaciones han reclamado por la injusticia realizada. Este trabajo intenta ser un reclamo por la injusticia vivida por más de 300 mujeres, muchas de ellas víctimas de violación y homicidio, en Ciudad Juárez, Chihuahua, México. En la década pasada (1993-2003) más de 300 mujeres han desaparecido; muchas se han encontrado posteriormente violadas, mutiladas y asesinadas. Recordando el principialismo, el énfasis se hace en una reflexión posmodernista de la bioética, el género, el poder y la injusticia. Se hace un análisis de la violencia como un problema de salud pública, con un énfasis especial en la salud sexual y la violencia en contra del género femenino. Se comenta la relación entreviolación y homicidio contra mujeres. Finalmente, un comentario sobre el escalofriante caso de "las muertas de Juárez". Analizando los datos epidemiológicos sobre violación y homicidio en México, es particularmente importante recalcar que los casos de Juárez no son utópicos, son realmente diferentes.