Discrimination of the Governance Principles of Science and Technology Ethics and Dissemination of Ideas / 中国医学伦理学

Ethical governance is inherent in responsible research and innovation. The Opinions on Strengthening Ethical Governance of Science and Technology puts forward five ethical principles: promoting human well-being, respecting the right to life, adhering to fairness and justice, reasonably controlling risks and maintaining openness and transparency. This paper interpreted the ideas, key points and difficulties of these five ethical principles. Three suggestions were put forward to strengthen the ethics education of science and technology: first, optimize the curriculum of science and technology ethics for related majors in colleges and universities, and help young students understand ethical principles and establish the correct ethics view of science and technology; second, colleges and universities should carry out education and training for teachers, researchers, managers and members of ethics committees, and actively explore scientific research ethics training and effect evaluation; third, the professional courses offered by college teachers should be organically integrated with the ideological and political content of the courses to play a warning role.

The Ethical Principles of Science and Technology Need Concrete Research to Guide / 中国医学伦理学

On March 20, 2022, the General Office of the CPC Central Committee and the General Office of the State Council issued The Opinions on Strengthening Ethical Governance of Science and Technology, which put forward five ethical principles of science and technology: promoting human well-being, respecting the right to life, adhering to fairness and justice, reasonably controlling risks and maintaining openness and transparency. Ethical principles require to be studied and interpreted concretely by ethical scholars, that is, first, they need to be refined in order to be truly guided; second, the principle of balance is needed to truly guide; third, it is necessary to study ethical theory in order to truly guide; fourth, it is significant to explore Chinese civilization in order to truly guide. In this way, the ethical principles of science and technology can be practically applied and guide the concrete practice of science and technology.

Ethical Issues in the Development of Smart Healthcare / 中国医学伦理学

Smart healthcare is the outcome of integration and application of the internet, Internet of things (IOT), big data analysis and artificial intelligence (AI) in the medical field. Smart healthcare has been developed rapidly in China. However, smart healthcare has both advantages and risks, thus, it faces challenges and ethical issues in practice. Technological restrictions of smart healthcare increase the risk of privacy disclosure and delayed treatment. Besides, it also induce some ethical issues.Smart healthcare turns the "justice" issue of regional equity into the population equity of medical benefits. In addition, balancing between humanities and science technology should be considered. Smart healthcare should follow the basic ethical principles and the experience of clinical medical ethics. To give full play to the advantages of smart healthcare, the ethical challenges during its development must be regulated at the legal level, and simultaneously governed through ethical norms and guidance.

Ethical Thinking on Fertility Preservation of Female Patients with Cancer / 中国医学伦理学

Fertility preservation technology provides an effective method of protecting fertility resources for young patients with malignant tumors, allowing them to offspring after their fertility is impaired. However, the development of this technology has caused many social and ethical controversies. From the perspective of ethics, this paper discussed the ethical issues faced by young female patients in the implementation of fertility preservation, including whether it is necessary to preserve fertility, the ownership of the preserved fertility resources and the fair and equitable distribution of health resources involved in its implementation process, and identifies these issues and controversies from ethical view. In order to eliminate public doubts and misunderstandings about the technology of fertility preservation, ethical principles of benefit and non-harm, informed consent, prudent application, and ethical supervision have to be followed in the process of providing fertility preservation services, so as to promote the further development and application of fertility preservation technology.

Analysis on Current Situation and Ethical Problems of Stem Cell Clinical Research in China / 中国医学伦理学

It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.

Ethics in infectious diseases: latent challenges. Part I / Ética en enfermedades infecciosas: retos latentes. Parte I

Abstract Infectious diseases socially imply individual and community medical problems. Therefore, they require actions aimed at social processes that affect the well-being of the individuals without losing sight of social groups. Faced with this panorama, we ask ourselves: is there a direct relationship between ethics and infectious diseases? To elucidate an answer, let us remember the peak period of the COVID-19 pandemic when guidelines based on ethical principles were issued to facilitate medical decisions on allocating scarce resources in periods of maximum demand. In those moments, since there was no inclusive component of society, the decisions made produced massive criticism. The reactions demonstrated the need to analyze in detail the criteria that had been considered correct. Consequently, we affirm that bioethical principles are transcendental in medical decisions and must be examined, not only for the individual but also with a view to public health. Moreover, the acquired immunodeficiency syndrome (AIDS) epidemic has lived with us for decades, and it continues to show its tragic face in the form of new cases, chronic illnesses, and deaths. Joint United Nations Programme on HIV/AIDS brings us closer to a complex reality where the fight against disease and global health are interrelated with other problems, such as the need to reduce inequality, for which human rights, gender equality, social protection, and the development of research projects, where the ethics committees in research in community processes are constituents.

Resumen Las enfermedades infecciosas implican problemas médicos individuales y comunitarios, por lo que requieren acciones dirigidas a procesos sociales que incidan en el bienestar de los individuos, sin perder de vista a los grupos sociales. Nos preguntamos: ¿existe relación directa entre la ética y las enfermedades infecciosas? Para dilucidar una respuesta, recordemos el periodo más álgido de la pandemia por COVID-19, cuando se emitieron guías fundamentadas en principios éticos para facilitar las decisiones médicas en la asignación de recursos escasos en periodos de máxima demanda. Al no haber un componente inclusivo con la sociedad, las decisiones que se tomaron produjeron críticas masivas, que demostraron la necesidad de analizar a detalle los criterios que se habían considerado correctos. En consecuencia, afirmamos que los principios bioéticos son trascendentales en las decisiones médicas y deben ser examinados, no solo frente al individuo, sino de cara a la salud pública (bien común e individualidad). Por otra parte, la epidemia del SIDA (síndrome de inmunodeficiencia adquirida) convive con nosotros desde hace décadas. ONUSIDA (Programa Conjunto de las Naciones Unidas sobre el VIH/SIDA) nos acerca una realidad compleja, como es que la lucha contra la enfermedad y por la salud global se interrelaciona con otros problemas como la necesidad de reducer la desigualdad, por los derechos humanos, la igualdad de género, la protección social y el desarrollo de proyectos de investigación, donde los comités de Ética en investigación en procesos comunitarios son constituyentes.

Challenges and principled responses to privacy protection from biometric technology in China

Biometric technology has transformed human biological characteristics into a new form of privacy, and the misuse of this technology poses challenges to protecting this new privacy. This article initially defines biometric technology and biometric characteristics, further demonstrating why biometric characteristics belong to personal privacy and how biometric technology poses challenges to its protection. Through analysis, this article argues that the essence of these challenges is the conflicts between the ethical principle of privacy protection and the ethical principle of maximizing social benefits. In order to address these challenges, it is necessary first to weigh the fundamental ethical principles. The two basic principles of privacy protection and maximizing social benefits are not mutual antagonism but hierarchy, and this hierarchy should be based on the principle of practical feasibility. That is, applying biometric technology should first meet the principle of practical feasibility and, on this premise, realize the principle of maximizing social benefits based on not infringing on the principle of privacy protection.

La tecnología biométrica ha transformado las características biológicas humanas en una nueva forma de privacidad, y el uso indebido de esta tecnología plantea desafíos a su protección. En este artículo se define inicialmente la tecnología biométrica y las características biométricas; se demuestra además por qué las características biométricas pertenecen a la privacidad personal y cómo la tecnología biométrica plantea retos para su protección. Este artículo argumenta que la esencia de estos retos es el conflicto entre el principio ético de protección de la privacidad y el de maximización de los beneficios sociales. Para abordar estos retos es necesario sopesar primero los principios éticos fundamentales. Los dos principios básicos de protección de la privacidad y maximización de los beneficios sociales no son antagónicos, sino jerárquicos, y esta jerarquía debe basarse en el principio de viabilidad práctica. Es decir, la aplicación de la tecnología biométrica debe cumplir primero el principio de viabilidad práctica y, a partir de esta premisa, realizar el principio de maximización de los beneficios sociales sobre la base de no infringir el principio de protección de la intimidad.

A tecnologia biométrica transformou as características biológicas humanas em uma nova forma de privacidade, e o mal uso dessa tecnologia apresenta desafios para proteger essa nova privacidade. Esse artigo inicialmente define tecnologia biométrica e características biométricas, demonstrando posteriormente por que características biométricas pertencem à privacidade pessoal e como tecnologia biométrica coloca desafios à sua proteção. Através de análise, esse artigo discute que a essência desses desafios é o conflito entre o princípio ético da proteção da privacidade e o princípio ético de maximizar benefícios sociais. De forma a visar esses desafios é necessário primeiro ponderar os princípios éticos fundamentais. Os dois princípios básicos de proteção da privacidade e de maximizar benefícios sociais não são mutuamente antagônicos mas hierárquicos, e essa hierarquia deve ser baseada no princípio da viabilidade prática. Isso é, aplicar tecnologia biométrica deve primeiro atender ao princípio da viabilidade prática e, nessa premissa, compreender o princípio de maximizar benefícios sociais com base em não infringir o princípio de proteção da privacidade.

Argumentación ética en la donación de riñón de donante vivo y sano La autodeterminación, voluntad y generosidad superan los riesgos

el gesto altruista del donante vivo y sano de riñón, relacionado genética o sentimentalmente, se basa en autodeterminación, voluntad y generosidad. La argumentación ética alrededor de la donación de riñón de donante vivo y sano se orienta con las éticas principialista y personalista, la dignidad humana, la corporalidad, la divisibilidad del cuerpo, el mal menor y el mal mayor. Hace parte del derecho a la información amplia y suficiente que recibe el donante sobre los riesgos y posibles complicaciones físicas y morales del procedimiento, por medio del comité de bioética y el grupo de trasplantes. Con base en la argumentación ética planteada se procedió a contestar la pregunta de esta investigación: ¿se debe dejar que una persona viva y sana sea sometida a una cirugía que le dejará mononéfrico de por vida, solo por el deseo de ayudar a otro, a pesar de que existen programas activos con donante cadavérico? El objetivo de este artículo es plantear una argumentación ética sobre la donación de riñón de donante vivo y sano que contribuya a una adecuada orientación de su decisión.

the altruistic gesture of the healthy living kidney donor, genetically or sentimentally related, is based on self-determination, willingness, and generosity. The ethical argumentation around living and healthy kidney donation is guided by principled and personalistic ethics, human dignity, corporeality, divisibility of the body, the lesser evil, and the greater evil. It is part of the right to ample and sufficient information that the donor receives about the procedure's risks and possible physical and moral complications through the bioethics committee and the transplant group. Based on the ethical argumentation raised, we proceeded to answer the question of this research: should a living and healthy person be subjected to a surgery that will leave him/her mononephric for life, just because of the desire to help another, even though there are active programs with a cadaveric donor? This article aims to provide an ethical argumentation on living and healthy donor kidney donation that will contribute to an adequate orientation of their decision.

o gesto altruísta do doador de rim vivo e saudável, relacionado genética ou sentimentalmente, está baseado na autodeterminação, vontade e generosidade. A argumentação ética ao redor da doação de rim de doador vivo e saudável é orientada pelas éticas principialista e personalista, pela dignidade humana, pela corporalidade, pela divisibilidade do corpo, pelo mal menor e pelo mal maior. Faz parte do direito à informação ampla e suficiente que o doador recebe sobre os riscos e possíveis complicações físicas e morais do procedimento, por meio do comitê de bioética e do grupo de transplantes. Com base na argumentação ética proposta, procedeu-se a contestar a seguinte pergunta de pesquisa: deve-se deixar que uma pessoa viva e saudável seja submetida a uma cirurgia que a deixará mononéfrico para sempre, somente pelo desejo de ajudar o outro, apesar de existirem programas ativos com doador cadavérico? Nesse contexto, o objetivo deste artigo é apresentar uma argumentação ética sobre a doação de rim de doador vivo e saudável que contribua para uma adequada orientação de sua decisão.

Analysis on the Ethical Principles of Traditional Chinese Medicine Health Preservation Thought from the Perspective of Healthy China: Taking Master Lyu’s Spring and Autumn Annals as an Example / 中国医学伦理学

"Healthy China 2030" states that health is a necessary requirement for all-round human development and a basic condition for economic and social development. Achieving national health and longevity is an important symbol of national prosperity and rejuvenation, and also the common aspiration of the people of all ethnic groups in China. Traditional Chinese medicine (TCM) health preservation has been fully integrated into the construction of "Healthy China", and the development of TCM health preservation culture and thought has a profound historical origin. Starting from the development of TCM health preservation culture thought and ethical principles, this paper analyzed the TCM health preservation thought contained in Master Lyu’s Spring and Autumn Annals, and further discussed and summarized the ethical principles contained in them, with a view to comprehensively and systematically promoting the development of TCM health preservation culture and providing a theoretical basis for people to use health preservation ethical principles to achieve physical fitness, disease prevention and longevity.

Current Status and Ethical Considerations of Data Collection and Application in Rare Disease Research / 中国医学伦理学

The research on rare diseases in China started relatively late, with scattered research resources and weak data foundation in epidemiology, diagnosis and treatment, and medication, which hinders its research progress. The rare disease data system is the foundation of rare disease research, and the ethical constraint on rare disease data collection is not only the protection of rare disease population, but also the need for the safety and quality of rare disease data. By analyzing and prospecting the current status of the construction of rare disease data systems, including the data of epidemiology, clinical diagnosis and treatment, drug trials, and follow-up to provide reference for the improvement of rare disease data systems. This paper explored the ethical issues to be followed in the process of rare disease data collection from the perspectives of justice, no harm, respect, sharing, and legalization, so as to improve the standardization of rare disease data collection and the understanding of data ethical review.

Ethics Considerations on Public Management of Disaster Rescue under the Context of Epidemic Prevention and Control / 中国医学伦理学

Natural disasters and epidemics are intertwined, posing a great threat to national health and property security, and hindering economic development. Faced with the complex rescue environment, the contradiction between individual interests and collective interests may escalate, causing ethical dilemmas different from those encountered in conventional medicine. In the context of COVID-19 epidemic prevention and control, how to maximize the coordination of the conflict between individual interests and collective interests, minimize the losses caused by disasters, and maintain social stability is a new topic of ethical research. Based on the ethical principles of public management, this paper explored the ethical conflicts of public management faced by emergency disaster rescue, in the view of providing ethical theoretical support for dealing with the practical difficulties of emergency public health crisis, and promoting the development and progress of disaster medical rescue work.

Ethical Disputes and Norms of Exposure Therapy / 中国医学伦理学

Exposure therapy is a kind of behavior therapy that exposes patients to certain stimulating situations to make them tolerate and adapt. Based on the ethical perspective, this paper introduced the ethical disputes in exposure therapy from three aspects that safety and tolerance, patient rights and humanistic care, as well as professional ethics and moral risks of psychotherapists. This paper also put forward three ethical norms and requirements, including earnestly implementing the principle of informed consent, adhering to the principle of no harm in the whole process, and obeying the principle of confidentiality, in order to improve the professional level of exposure therapy and protect the rights and interests of patients and psychotherapists.

Criminologia crítica e princípios éticos do Serviço Social: uma aproximação à sua interlocução / Critical criminology and Social Work ethical principles: an approach to their interlocution

Resumo: Este artigo objetiva trazer a importância da criminologia crítica como subsídio ao trabalho e à formação profissional, apresentando seus fundamentos numa análise marxista, levando em consideração a classe, a raça e o gênero, e sua possível interlocução com os princípios éticos do Serviço Social, vislumbrando uma aproximação maior com essa perspectiva na luta anticapitalista, antirracista, feminista e antipunitivista.

Abstract: This article aims to bring the importance of critical criminology as a subsidy to professional work and professional education, presenting its foundations in a Marxist analysis, taking class, race, and gender into consideration, and its possible interlocution with the ethical principles of Social Work, aiming at a greater approximation with this perspective in the anti-capitalist, anti-racist, feminist, and anti-punitivist fight.

Ethical aspects of age estimation for forensic purposes in Saudi Arabia / Aspectos éticos de la estimación de la edad para propósitos forenses en Arabia Saudita / Aspectos éticos da estimativa de idade para propósitos forenses na Arábia Saudita

Abstract: In forensic and legal contexts, an assessment of skeletal maturation is required to predict the chronological age in certain circumstances in which the chronological age is undocumented or unable to be proven. Carrying such medical examinations will always pose an ethical concern, especially in cases of assessing sexual maturity as well as examinations involving ionizing radiation. The cultural and religious barriers are also discussed concerning the ethical standards set in Saudi Arabia. Several ethical issues concerning age estimation examinations including issues related to consent forms, privacy, and radiation hazards have been documented. While ethical issues regarding radiation hazards are more likely to be overcome by introducing other imaging modalities without radiation hazards, ethics related to consent forms and privacy are still to be improved.

Resumen: En contextos forenses y legales, se requiere la evaluación de la maduración del esqueleto para predecir la edad cronológica en ciertas circunstancias en que la edad cronológica no está documentada o no es posible de probar. Realizar tales exámenes médicos siempre significa una preocupación ética, especialmente en casos de evaluación de madurez sexual así como en exámenes que involucran radiaciones ionizantes. Se discuten también las barreras culturales y religiosas relacionadas con el contexto de estándares éticos en Arabia Saudita. Entre los varios temas éticos relacionados con la estimación de la edad, se documentan temas relacionados con los formularios de consentimiento, privacidad y riesgos de radiación. Mientras que los temas éticos relacionados con riesgos de radiación pueden ser resueltos al introducir otras modalidades de examen sin radiación, los problemas éticos relacionados con los formularios de consentimiento y privacidad todavía necesitan mejorarse.

Resumo: Em contextos forenses e legais, uma avaliação de maturação esquelética é requerida para predizer a idade cronológica em certas circunstâncias nas quais a idade cronológica não é documentada ou impossível de ser provada. Conduzir tais exames médicos sempre irá suscitar uma preocupação ética, especialmente em casos para avaliar maturidade sexual bem como exames envolvendo radiação ionizante. As barreiras culturais e religiosas também são discutidas no que diz respeito a padrões éticos estabelecidos na Arábia Saudita. Diversos aspectos éticos concernentes a exames de estimativa de idade incluindo aspectos relacionados a formulários de consentimento, privacidade e risco de radiação foram documentados. Ao passo que aspectos éticos que dizem respeito a risco de radiação serem mais provavelmente superáveis pela introdução de outras modalidades de exames de imagem sem risco de radiação, a ética relacionada a formulários de consentimento e privacidade ainda estão por serem melhorados.

Reflections on Privacy Dilemma and Countermeasures in Epidemic Prevention and Control / 中国医学伦理学

Nowadays, the wide application of artificial intelligence technology and big data technology in epidemic prevention and control has played an indispensable and key role, and will continue to be used in depth. At the same time, the digitization of personal information has exacerbated ethical problems, such as the expansion of personal privacy boundary, the complexity of privacy ownership, and the imbalance of various forms of value and rights. Therefore, it is of great significance to identify, prevent and solve these privacy problems according to the needs of epidemic prevention and control and ethical principles. Starting with the application scope of big data technology in epidemic prevention and control, this paper expounded prominent problems in the four stages of privacy dilemma in epidemic prevention and control and three typical conflicts of interest, analyzed three causes of privacy problems, clarified three principles for dealing with privacy problems, comprehensively considered and put forward countermeasures to solve privacy ethics problems in epidemic prevention and control, so as to provide reference for alleviating or solving the privacy problems in epidemic prevention and control.

Ethical Analysis on a Patient with a Chronic Wound Nonunion Refused to be Hospitalized / 中国医学伦理学

This paper introduced a case of ethical conflict between the principle of benefit and the principle of respect in the formulating treatment and nursing plan for patient with chronic wound nonunion by specialist nurses, and used the "structured analysis form of clinical nursing ethics" designed by the Third Affiliated Hospital of Guangzhou Medical University to conduct ethical analysis and ethical decision-making, and solve the clinical nursing ethical problems of complex nursing cases. The practice of the case showed that under the situation of ethical conflict in making nursing treatment plan for patient, the application of structured ethical analysis of clinical nursing is helpful to improve nurses’ ethical decision-making ability and strengthen their ethical thinking. It is suggested to strengthen nurses’ ethical thinking in clinical nursing, continuously improve nurses’ ethical decision-making ability, and cultivate core nursing technology integrating science and humanities, thus to enhance nursing value.

Reflection on the Relationship between the Ethical Principles and Rules of Biomedical Science and Technology / 中国医学伦理学

Clarifying the relationship between ethical principles and rules is the key to promote the legitimate governance of scientific and technological ethics. Ethical principles and rules, as the two basic elements of science and technology ethics, are both different and related. The ethical principles are the basis and direction of the formulation of the ethical rules which are the most direct expression of following the ethical principles and an effective means to improve the effect of ethical governance. Among them, ethical standards are the general standard rules with strong universality. Based on the analysis of the relationship between the ethical principles and the ethical guidelines, this paper put forward the expression mode and reasonable application of science and technology ethical principles in the ethical rules, so as to promote the improvement of the national ethics governance system of biomedical science and technology.

Aplicación de principios éticos de la psicología en un ejercicio de formación académica sobre el diseño, validación y aplicación de un instrumento psicométrico / Application of Ethical Principles of Psychology in an Academic Training Exercise on the Design, Validation, and Application of a Psychometric Instrument / Aplicação dos princípios éticos da psicologia em um exercício de formação acadêmica sobre a elaboração, validação e aplicação de um instrumento psicométrico

La formación ética y responsable de profesionales en psicología implica reconocer que la comprensión y la aplicación de los principios éticos no solo se deben realizar en el ejercicio profesional, sino también desde el desarrollo de actividades y prácticas durante el proceso de formación académica, en diversos cursos del currículo de los programas de psicología. En Colombia se ha establecido la beneficencia, la no maleficencia, la justicia, la autonomía y la integridad como los cinco criterios de decisión más importantes que deben guiar el quehacer profesional. El presente estudio busca conocer cómo una muestra de estudiantes de psicología comprende y pone en práctica los principios éticos en el desarrollo de un ejercicio académico de diseño, aplicación y análisis de las propiedades psicométricas de un instrumento. Para ello, se realizó un estudio cualitativo con 200 estudiantes de psicología que se encontraban cursando la asignatura de Psicometría durante el segundo semestre de 2020. En algunos casos se observó desconocimiento de los principios éticos, y, por lo tanto, dificultades en su apropiación y aplicación, lo cual llevó a reflexionar sobre el aprendizaje de estos aspectos desde el macro y microcurrículo en los programas de psicología. Además, este tipo de investigaciones permite sensibilizar respecto al manejo ético de las pruebas psicológicas, tanto en su proceso de diseño como de aplicación

The ethical and responsible training of professionals in psychology implies recognizing that the understanding and application of ethical principles should not only be carried out in professional practice but also during the development of academic and practical activities in various courses of the curriculum of psychology programs. In Colombia, beneficence, non-maleficence, justice, autonomy, and integrity have been established as the five most important decision criteria that should guide professional work. The present study seeks to know how a sample of psychology students under-stands and puts into practice the ethical principles in the development of an academic exercise of the design, application, and analysis of the psychometric proper-ties of an instrument. A qualitative study was carried out with 200 psychology students who were taking the psychometry course during the second semester of 2020. In some cases, there was a lack of knowledge of ethical principles and, therefore, difficulties in their appropriation and application, which led to the reflection of these aspects' learning from the perspective of the macro- and microcurriculum in psychology programs. In addition, this type of research allows raising awareness about the ethical management of psychological tests both in their design and application

A formação ética e responsável do profissional em Psicologia implica reconhecer que a compreensão e aplicação dos princípios éticos não devem ser reali-zadas apenas na prática profissional, mas a partir do desenvolvimento de atividades acadêmicas e práticas durante o processo de formação acadêmica de toda a grade curricular dos programas de psicologia. Na Colômbia, beneficência, não maleficência, justiça, auto-nomia e integridade foram estabelecidas como os cinco critérios de decisão mais importantes que devem nortear o trabalho profissional. O presente estudo busca saber como uma amostra de estudantes de psicologia entende e coloca em prática os princípios éticos no desenvol-vimento de um exercício acadêmico de elaboração, aplicação e análise das propriedades psicométricas de um instrumento. Realiza-se um estudo qualitativo com 200 alunos de psicologia que cursavam a disciplina de psicometria durante o segundo semestre de 2020. Em alguns casos há desconhecimento dos princípios éticos e, por conseguinte, dificuldades na sua apropriação e aplicação; o que nos leva a refletir sobre a aprendizagem desses aspectos a partir dos macro e micro currículos nos programas de psicologia, além disso, esse tipo de pesquisa permite a conscientização sobre a gestão ética dos testes psicológicos tanto na sua elaboração quanto no processo de aplicação

Ethical dilemmas and principles in organ transplantation in China / Dilemas y principios éticos en el trasplante de órganos en China / Dilemas e princípios éticos no transplante de órgãos na China

Abstract In medical clinical practice, organ transplantation is mainly applied to patients with end-stage organ lesions and organ failure. However, with the development of organ transplantation, many ethical issues and controversies have arisen. From the perspective of bioethics, the article compares the relevant ethical and legal regulations of organ transplantation in various countries. Due to the complexity of the real situation, many ethical dilemmas arise in organ transplantation in China. The article analyzes and researches three aspects of organ donation, distribution, and trading, and finds that there are various ethical problems in these three aspects of organ transplantation in China, such as whether the principle of presumed consent is ethical, whether brain death is legalized, the selection and determination of transplant patients, and whether human organ trading is legalized, etc. With the help of the four principles of bioethics and the current development of organ transplantation in China, the article proposes that organ transplantation in China should follow four ethical principles: the principle of respect for life, the principle of do no harm/benefit, the principle of respect for autonomy, and the principle of justice, in order to provide a defense for the legitimacy of organ transplantation.

Resumen En la práctica clínica médica, el trasplante de órganos se aplica principalmente a los pacientes con lesiones orgánicas en fase terminal y con insuficiencia orgánica. Sin embargo, con el desarrollo del trasplante de órganos, han surgido muchas cuestiones éticas y controversias. Desde la perspectiva de la bioética, el artículo compara las normas éticas y jurídicas pertinentes del trasplante de órganos en varios países. Debido a la complejidad de la situación real, surgen muchos dilemas éticos en el trasplante de órganos en China. El artículo analiza e investiga tres aspectos de la donación, la distribución y el comercio de órganos, y constata que hay varios problemas éticos en estos tres aspectos del trasplante de órganos en China, como si el principio del consentimiento presunto es ético, si la muerte cerebral está legalizada, la selección y determinación de los pacientes de trasplante y si el comercio de órganos humanos está legalizado, etc. Con la ayuda de los cuatro principios de la bioética y el desarrollo actual del trasplante de órganos en China, el artículo propone que el trasplante de órganos en China debe seguir cuatro principios éticos: el principio de respeto a la vida, el principio de no hacer daño/beneficio, el principio de respeto a la autonomía y el principio de justicia, con el fin de proporcionar una defensa de la legitimidad del trasplante de órganos.

Resumo Na prática clínica médica, o transplante de órgãos é principalmente destinado a pacientes em estágio final de lesões e falência dos órgãos. Entretanto, com o desenvolvimento do transplante de órgãos, surgiram muitas questões e controvérsias éticas. O artigo compara, desde uma perspectiva bioética, as regulações éticas e legais relevantes sobre transplantes de órgãos em vários países. Devido à complexidade da situação real, muitos dilemas éticos surgiram no transplante de órgãos na China. O artigo analisa e investiga aspectos de doação, distribuição e comercialização de órgãos, e encontra que há vários problemas éticos nestes três aspectos do transplante de órgãos na China, tais como se o princípio do consentimento presumido é ético, se morte cerebral é legalizada, a seleção e determinação de pacientes que irão receber transplante, se a comercialização de órgãos humanos é legalizada, etc. O artigo propõe, com a ajuda de quatro princípios da bioética e o desenvolvimento atual de transplante de órgãos na China, que o transplante de órgãos na China deve seguir quatro princípios éticos: o princípio do respeito à vida, o princípio de beneficiar/não causar dano, o princípio do respeito pela autonomia e o princípio da justiça, de forma a possibilitar a defesa da legitimidade do transplante de órgãos.

Limitación del esfuerzo terapéutico al final de la vida: una mirada desde la medicina cubana contemporánea / Limitation of the Therapeutic Effort At the End of Life: A View from Contemporary Cuban Medicine

Los dilemas éticos respecto al cuidado al final de la vida son los más delicados e importantes en la práctica médica contemporánea; rebasan el campo de la bioética por sus implicaciones legales, sociales, culturales y religiosas. Independientemente de la universalidad de los postulados bioéticos, estos deben ser contextualizados atendiendo las características propias de cada nación. El panorama demográfico y epidemiológico de Cuba hace que la problemática tenga un comportamiento similar al mundo desarrollado, lo cual nos motivó a realizar un acercamiento teórico a la práctica de la limitación del esfuerzo terapéutico. Para ello partimos de los principios éticos de la nacionalidad cubana, el escenario social-demográfico, el marco legal vigente y la política de salud en el contexto de las transformaciones económicas que vive el país. Esa estrategia terapéutica no guarda relación alguna con la eutanasia y permite retirar del escenario clínico la distanasia. A la vez, constituye un punto de partida hacia los cuidados paliativos con impacto en lo económico y en el ordenamiento eficiente de los servicios de salud potencialmente beneficioso. Existe en la literatura nacional un movimiento favorable respecto a esa práctica médica; pero la principal debilidad en el país es la falta de un marco legal que condene la distanasia y reconozca la limitación del esfuerzo terapéutico como la medida que la evita(AU)

Ethical dilemmas regarding end-of-life care are the most delicate and important in contemporary medical practice; this care goes beyond the field of bioethics due to legal, social, cultural and religious implications. Regardless of the universality of bioethical postulates, they must be contextualized taking into account the characteristics of each nation. The demographic and epidemiological panorama of Cuba makes the problem behave similarly to the developed world, which motivated us to make a theoretical approach to the practice of limiting the therapeutic effort. For this purpose, we start from the ethical principles of Cuban nationality, the social-demographic scenario, the current legal framework and the health policy in the context of the economic transformations that the country is experiencing. This therapeutic strategy is not related to euthanasia and it allows dysthanasia to be removed from the clinical setting. At the same time, it constitutes a starting point towards palliative care with an economic impact and in the efficient organization of potentially beneficial health services. There is a favorable movement in the national literature regarding this medical practice; but the main weakness in the country is the lack of a legal framework that condemns dysthanasia and it recognizes the limitation of therapeutic effort as the measure that avoids it(AU)