ABSTRACT
El presente artículo tiene como propósito establecer la participación que pueden tener los menores de edad en la toma de decisiones en la práctica sanitaria, según su desarrollo moral y el marco normativo venezolano. En los procedimientos se realizó la revisión bibliográfica, desde los clásicos hasta lo más reciente sobre el tema y se aplicó un método analítico. Se concluyó: que es fundamental una deliberación participativa con el menor, incluyéndolo en un proceso serio, honesto y sincero que exige escuchar al niño antes de los 12 años y solicitar su asentimiento de 12 a 17 años; los niños y adolescentes, pueden llegar a tomar decisiones con la adecuada ayuda por parte de familiares, equipo de salud, y otros expertos, que los apoyen en el desarrollo de una comprensión de los problemas y en la demostración de su capacidad de decisión, promoviendo el desarrollo de su independencia y responsabilidad; los profesionales de la salud requieren de formación ética y psicológica, para lograr una verdadera relación de ayuda en función del bienestar superior para con sus pacientes menores de edad y sus familiares
This paper aims to establish the participation that may have minors in decision-making in health care practice, according to their moral and legal framework in Venezuela. The procedures conducted the literature review, from the classics to the latest on the subject and applied an analytical nematode. It concluded that participatory deliberation is essential to the child, including it in a serious process, honest and sincere that requires listening to the child before age 12 and apply for consent from 12 to 17 years, children and adolescents, may reach appropriate decisions with help from family, health team and other experts to support them in developing an understanding of the problems and to demonstrate the ability of decision, promoting the development of independence and responsibility, health professionals require ethical and psychological training to achieve a real relationship based aid to higher welfare with their minor patients and their families
Subject(s)
Humans , Bioethics , Enacted Statutes , Informed Consent By Minors , Moral Development , Decision Making/ethicsABSTRACT
Contrariamente às expectativas de erradicação das doenças infecciosas, constata-se a emergência, mundial, de doenças desconhecidas para a ciência ou consideradas erradicadas ou sob o controle dos serviços de vigilância epidemiológica. Neste artigo, pretende-se caracterizar o debate sobre as doenças infecciosas emergentes e analisar o conceito difundido pelas publicações dos Centros de Controle e Prevenção de Doenças (CDC) dos Estados Unidos e pelas contribuições das ciências humanas. A revisão da literatura nacional e internacional sobre a temática aponta as ambiguidades na definição das categorias "doença nova" e "doença emergente" e as diferenças entre o conceito de doenças infecciosas emergentes e o estudo da emergência das doenças. Enquanto o primeiro inclui o estudo de infecções específicas e foca a análise no organismo, no paciente e na população humana, o segundo, menos trabalhado, envolve as dimensões epistemológicas do conhecimento médico e da ecologia das doenças infecciosas emergentes, no nível sistêmico (no ecossistema e populações de parasitos e hospedeiros, quaisquer que sejam as espécies, e no comportamento sociocultural), e demanda a integração de várias disciplinas acadêmicas.
Contrary to expectations concerning the eradication of infectious diseases, it has been emerged, diseases worldwide that were unknown to science or considered to be eradicated or under control by epidemiological surveillance services. In this paper we outline the emergent infectious diseases debate and analyze the concept spread through publications from the Centers for Disease Control and Prevention (CDC) of the United States and through human science point of view. The review of national and international literature suggests some ambiguities in the definition of the categories "new disease" and "emerging disease" and the differences between the concept of emerging infectious diseases and the study of the emergence of diseases. Whilst the first concept includes the study of specific infections and focuses the analysis on the organism affected, on the patient and on the human population; the second concept - less studied - encompasses the study of the epistemological dimensions of medical knowledge and the ecology of emerging infectious diseases. This concept focuses on the systemic level - on the ecosystem and populations of parasites and hosts (whatever the species) and on the socio-cultural behavior - and demands the integration of various academic disciplines.
Subject(s)
Humans , Communicable Diseases, Emerging , Communicable Diseases, Emerging/epidemiologyABSTRACT
Objetivo comprender las características del acceso al Sistema General de Seguridad Social en Salud (SGSSS), desde la perspectiva de los médicos, enfermeras, administradores y usuarios. Metodología: bajo la teoría fundada se presenta un estudio realizado en seis ciudades de Colombia: Barranquilla, Bucaramanga, Bogotá, Leticia, Medellín y Pasto, para la cual se realizaron entrevistas en profundidad a profesionales de la salud vinculados en la prestación de servicios y grupos focales con usuarios de los servicios. Resultados: los hallazgos señalan que el aseguramiento se convirtió en un fin en sí mismo y estar afiliado al SGSSS no garantiza el acceso efectivo a los servicios. El predominio del mercado, la rentabilidad financiera de las aseguradoras, impone mecanismos de contención de costos por encima del derecho de la salud. Hay limitaciones desde las normas, los planes de beneficios que generan barreras administrativas, geográficas, económicas y culturales desde los diferentes actores involucrados en la cadena de las decisiones. Adicionalmente, se visualizan carencias éticas individuales e institucionales, el clientelismo y la corrupción en el manejo de los recursos, que sumados a la pobreza y dispersión geográfica de algunas comunidades, hacen que se limite aún más el acceso a los servicios de salud.
Objective: To understand the characteristics of access to the General System of Social Security in health (SGSS), from the perspective of doctors, nurses, administrators and users. Results: The findings indicate that insurance has become an end in itself, and being affiliated that insurance has become an end in itself, and being affiliated to SGSSS does not guarantee effective access to services. The dominance of the market, the financial profitability of insures, imposed cost-containment mechanisms over the right to health. There are limitations from the rules, benefit plans that create geographical, economic and cultural barriers from the various actors involved in the chain of decisions. Additionally, display individual and institutional ethical shortcomings, clienteles and corruption in the management of resources, coupled with poverty and geographical dispersion of communities, mean that further limiting access to health services.