ABSTRACT
Every so often, in Chile there is a discussion about the role of physicians in the care of people on hunger strike (HS). In this document, we review the ethical aspects of health care for persons in HS, aiming to provide guidelines to medical doctors who are required to attend them. First, we make an important distinction between HS and suicide, since the former is used as a protest and denunciation tool, while suicide seeks deliberately to end a life. Then we describe the three roles that the health professional can fulfill: as a treating doctor, as an expert or as an official of a prison. The respect for the autonomy and dignity of the person in HS must prevail whatever the role of the physician. Therefore, we maintain that under no circumstances, people who have autonomously decided to be in HS should be fed by force. Due to the complexity of the issue, we make special considerations about the management of minors and the non-competent persons in HS. In conclusion, we adhere to the principles that inspire the Declaration of Malta, which indicate that it would be preferable to "allow a person on hunger strike to die in dignity, rather than subjecting them to repeated interventions against their will".
Subject(s)
Humans , Fasting , Patient Rights/ethics , Ethics, Medical , Suicide , Chile , Patient Rights/legislation & jurisprudence , Delivery of Health CareABSTRACT
The present reflection refers to data obtained about the social representations of genomic research and its applications through interviews with legislators and lawyers, biomedical researchers and civilians and the review of scientific and legal literature in four Latin American countries: Argentine, Chile, Mexico and Peru. Several issues are addressed: little access to prevention and therapeutic methods, lack of equity in health benefits, commercialization of gene sequences through patents which leads to commercial exploitation of underdeveloped countries, the possibility of physical or psychological damage or genetic discrimination, the possibility of genetic modifications or abortion for eugenic reasons, the necessity of safeguarding confidentiality, risks and benefits of the use of transgenics and cloning, the necessity of legal regulation to prevent the pathway towards genetic enhancement or reproductive human cloning and of regulating access to genetic information. Using the method of content analysis of verbal behaviour to evaluate the degree of anxiety and hostility of subjects in relation to the Human Genome Project (HGP) developed by Gottschalk and Gleser, an inverse relation between levels of anxiety and level of knowledge was observed which highlights the importance of educating the population. Differences in the level of hostility towards the HGP were also found among the groups.