Ética, bioética y método clínico en el tratamiento de pacientes pediátricos aquejados de migraña / Ethics, bioethics and clinical method in the treatment of pediatric patients suffering from migraine

La migraña es una de las enfermedades que ha acompañado al hombre a lo largo de la vida. Con el objetivo de argumentar, mediante la recopilación de resultados de estudios clínicos de evidencias, la relación existente entre la ética médica y el método clínico en el tratamiento de migrañas en pacientes pediátricos, se realizó revisión de bibliografías sobre migraña, y algunos aspectos del cumplimiento de la ética médica y el método clínico, los que fueron considerados en el desarrollo de las consultas e interconsultas de Neurología del Hospital Pediátrico Universitario “William Soler”, incluyendo las consultas de Proyección Comunitaria del municipio de Boyeros, en La Habana, en los últimos 10 años. Se accedió a las bases de datos PubMed, Lilacs, Scielo y Google, se restringió la búsqueda por temática y para los últimos 10 años, así como estudios de evidencia, cuyas bases de datos se obtuvieron de las consultas y los resultados fueron publicados en revistas. Se exponen trabajos de evidencia relacionados con el tratamiento de la migraña, en los cuales se aprecia la comunión existente entre la Ética y el método clínico. Las evidencias demostradas en las publicaciones de la autora principal de este estudio sobre el tratamiento de la migraña en Pediatría, demuestran que se puede cumplir con la ética médica y el método clínico, apuntes de Hipócrates antes de nuestra era.

Migraine is a disease that has accompanied man throughout the life. With the objective of substantiating through the collection of results from clinical studies of evidence the relationship between the medical ethics and the clinical method in the treatment of migraine in pediatric patients, a literature review on migraine and on some aspects of the compliance with the medical ethics and the clinical method was made. These aspects had been considered in the medical consultation and interconsultation service of neurology in “William Soler” university pediatric hospital including the consultation service of the Community Project in Boyeros municipality in Havana in the last ten years. PubMed, Lilacs, Scielo and Goggle databases were accessed; search by topic and restricted to the last ten years was made as well as evidence-based studies whose databases were created from consultations, and the results were published in journals. Evidence papers related to the treatment of migraine were presented, in which the communion between ethics and the clinical method was reflected. The evidence shown in the publications of the main author of this study on the treatment of migraine in pediatrics prove that the medical ethics and the clinical method should be complied with, as Hippocrates said before the CE.

The Code of Medical Ethics for the Korean Academy of Child and Adolescent Psychiatry: Why Is It Important?

This article provides an overview of the developmental history and rationale of medical ethics to establish the code of ethics and professional conduct of the Korean Academy of Child and Adolescent Psychiatry (KACAP). Most medical professional organizations have their own codes of ethics and conduct because they have continuous responsibility to regulate professional activities and conducts for their members. The Ethics and Award Committee of the KACAP appointed a Task-Force to establish the code of ethics and conduct in 2012. Because bioethics has become global, the Ethics Task Force examined global standards. Global standards in medical ethics and professional conduct adopted by the World Medical Association and the World Psychiatric Association have provided the basic framework for our KACAP's code of ethics and professional conduct. The Code of Ethics of the Americal Academy of Child and Adolescent Psychiatry has provided us additional specific clarifications required for child and adolescent patients. The code of ethics and professional conduct of the KACAP will be helpful to us in ethical clinical practice and will ensure our competence in recognizing ethical violations.

Physician-patient trust as seen in medical ethics / 中华医院管理杂志

As a heteronomy,the code of medical ethics plays an important role in sustaining the trust between physicians and patients.Based on a comparative analysis of the domestic and foreign codes of medical ethics,and field survey on such trust at tertiary hospitals in Beijing,as well as medical providers’moral characteristics,this article analyzed the causes that “goodwill”is insufficient in the trust in terms of internal and external factors;and then,in respect of heteronomy as a basis,it put forward suggestions to improve code of medical ethics in order to rebuild such trust.

Autonomia da vontade do paciente X autonomia profissional do médico / Pacient's autonomy vs physician's professional autonomy

: A evolução da biotecnociência e da biotecnologia, aliada a novos preceitos jurídicos tuteladores da pessoa humana, tem repercussão direta e imediata na relação médico-paciente. Tanto é que o Código de Ética Médica, com nova roupagem, introduziu mecanismos compatíveis com relação às tutelas constitucionais e civis que abrigam o paciente, tendo como metas a realidade atual. A condição de paciente já não corresponde mais ao paternalismo e ao assistencialismo que lhe era inerente. Ao contrário, apresenta-se munida de uma nova engrenagem com o foco voltado para a autonomia da vontade, dando ao paciente a oportunidade de se manifestar a respeito da aceitação ou da recusa de determinado procedimento médico. É, na realidade, um sujeito de direito, com toda a carga jurídica compreendida na expressão. Surge, dessa forma, como corolário do principium individuationis e recebe o assentimento da própria Bioética, que erigiu a autonomia da vontade do paciente como um dos princípios basilares.

The evolution of biotechnoscience and biotechnology, together with new tutelary legal precepts of the human being, brings direct and immediate impact on the doctor-patient relationship. As matter of fact, the Code of Ethics, with a new appearance, added compatible mechanisms regarding the constitutional and civilian guidance of the patient, according to the present reality. The patient’s condition no longer corresponds to paternalism and welfarism that was relevant. However, the patient is provided with a new mechanism focused on the principle of freedom of choice, allowing them the opportunity to speak about the acceptance or rejection of a particular medical procedure. It is in fact, the subject of law, with all legal burdens properly understood. Emerges, thus, as a corollary of the principium individuationis and receives the approval of bioethics, which established the autonomy of the freedom of choice of the patients as one of the essential principles.

Enactment of Code of Medical Ethics, KMA and Its Application

In May 2001, the Code of Medical Ethics, KMA was enacted by Korean Medical Association, but is not proclaimed yet. First of all, newly elected president of KMA should promulgate this code to the all members of the KMA and the public. The code would be used as the ext of the bio-medical ethics education for medical students and physicians as well as a concrete guideline for judgment by the independent ethics committees. And this code is due to be revised according to the change of socio-medical environment.

History of medical ethics in Korea: focused on analysis of medical codes and covenants / 의사학

This article deals with the emergence of the codes of medical ethics and their change in Korean history. The modernized medical codes or covenants by the group of medical doctors has been made from the mid-twentieth century, although Korea has a long tradition of medical ethics, so called the Confucian medical ethics, Insul or Uido which were taken on very strong paternalistic characters. The history of the codes of medical ethics in contemporary Korea showed several revisions in 1961, 1965, 1979, and 1997 since the first establishment in 1955. Changes of political circumstances, the cultural level of the people, medical care system, and medical power leaded to the revisions. Throughout the revisions the codes or covenants of medical ethics in Korea has changed from simple translations of the codes by the World Medical Association and the American Medical Association to the reflexes of domestic medical situations; from the ones based on paternalistic doctor-patient relationship to more democratic ones; from the ones that only medical ethics were expressed to the ones that bioethics was expressed too.