ABSTRACT
The debate on legalization of physician-assisted death (PAD) has focused on its purely individual aspects, leaving aside equally relevant social dimensions such as a progressive expansion of PAD's causes, strains and changes in the doctor-patient relationship, and unreported PADs. The aim of this work was to explore these aspects through an analysis of the experience of Belgium and the Netherlands, countries where PAD is legal since 2002. The results, obtained through a systematic review of the literature, indicate that in both countries, the acceptance of the concept of "psychological suffering" allowed PAD to be performed in psychiatric patients, in persons with dementia and in older people with geriatric conditions. The acceptance to perform a PAD has a significant emotional burden for the physician who must assume the role of executor of the patient's will, which is aggravated by pressures from patients and their relatives. Moreover, more than 30% of PADs are not reported. All this information was obtained from physicians not willing to incriminate themselves, after the commission of the PADs, therefore hampering the monitoring of law abiding. These results reveal the existence of a social impact of PAD decriminalization that deserves greater consideration and further studies.
Subject(s)
Humans , Attitude to Death , Right to Die/ethics , Ethics, Medical , Euthanasia/ethics , Christianity , PhilosophyABSTRACT
Se estudiaron aspectos metodológicos y la validación del método de dilución con deuterio, el cual ha sido propuesto para medir la ingesta de leche materna. Una experiencia realizada en niños de 2 a 3 meses de edad, con estado nutricional normal, indicó que el equilibrio isotópico se alcanza de 6 a 8 horas después de administrar inicialmente una solución de deuterio al 16.5%. Las mediciones de líquido ingerido, efectuadas en el grupo de niños en período de recuperación de desnutrición marásmica, permitieron comparar los resultados de la dilución isotópica con el registro directo de leche administrada con biberón. Esta comparación reveló una buena correlación entre los valores respectivos al estimar el agua corporal total con la fórmula de Friis-Hansen. Los resultados sugieren que la técnica de dilución con deuterio es una valiosa alternativa frente a los métodos habituales que se utilizan para medir la ingesta de leche humana