RESUMO
Background: Diseases and treatments have different presentations and impact in men and women due to sex and gender differences. This issue justifies a gender differentiated approach in clinical practice guidelines. Aim: To evaluate gender biases in the Clinical Practice Guidelines (CPG) of the Explicit Health Guarantees program (GES) in Chile. Material and Methods: GES CPGs documents published between 2005 and 2019 were reviewed. A keyword search was carried out in the CPGs, and they were classified into five groups according to their degree of incorporation of the sex / gender variables, following the methodology by Tannenbaum et al. Also, the correct use of the concepts about sex and gender was evaluated. Results: Eighty five CPGs were evaluated and 25% have specific recommendations by sex (group 1 and 2). Two percent of guides determined specific parameters by sex in diagnostic tests (group 3). Sixty one percent mention the keywords superficially or only in the section of epidemiology and risk factors, without proposing a sex differentiated management (group 4 and 5). Sixty two percent of guides have an appropriate use of concepts, 22% a wrong usage, and 17% do not refer to sex or gender. Conclusions: Gender biases are evidenced in most of the GES guidelines.
RESUMO
Euthanasia is a complex medical procedure. Even though end of life decisions are common situations in health practice, there is a lack of consensus about their terminology. In this manuscript, the main concepts about this issue are defined and delimited; including active and passive euthanasia and limitation of therapeutic effort. Then, a revision is made about the international experience on euthanasia, to then go through the Chiles history in euthanasia and the populations opinion. In Chile, euthanasia is an act that has been removed from the social dialogue and legislation. In order to have an open discussion in our population about the issue, the debate has to be opened to the citizens, accompanied by clear medical information about the procedure.
Assuntos
Humanos , Eutanásia Passiva/legislação & jurisprudência , Eutanásia Ativa/legislação & jurisprudência , Opinião Pública , ChileRESUMO
Los Observatorios de Políticas Públicas en Salud son organismos dedicados al monitoreo, seguimiento y evaluación de sistemas y políticas públicas, a través de revisión analítica de proyectos y/o estrategias establecidas a nivel nacional. En la Universidad de Chile, el Observatorio de Políticas Públicas en Salud (OPPS) se conforma el año 2011 al alero de las movilizaciones estudiantiles de la Facultad de Medicina, donde se concluye que las universidades públicas deben aportar al control social en las políticas públicas de salud, a través de la deliberación y empoderamiento ciudadano. Con este horizonte, se conforma la organización y se establecen sus objetivos y orgánica. El trabajo desarrollado hasta la fecha abarca cuatro ejes: 1) Revisión y análisis bibliográfico de políticas públicas de salud, 2) Formación en políticas y sistemas de salud, 3) Promoción del debate en torno a políticas públicas y 4) Articulación con actores del sector salud. Dada su composición estudiantil, sus principales limitantes corresponden a la ausencia de formación crítica efectiva en los currículos de las carreras de la salud, y la sobrecarga académica de los estudiantes, que en el contexto de su carácter de actividad extracurricular, dificulta el cumplimiento de los objetivos. La réplica y fortalecimiento de estas instancias requieren la participación de todos los actores de la comunidad universitaria, haciendo converger sus conocimientos, experiencias y perspectivas en torno a los temas estudiados. Además, su inclusión en la estructura institucional formalizaría el compromiso universitario con la formación estudiantil crítica, contribuyendo al debate nacional en políticas públicas.
Observatories of Public Health Policy are organizations dedicated to monitoring, tracking, and evaluating health systems and public policies through an analytical review of established national projects and strategies. At the University of Chile, the Observatory of Public Health Policy (OPPS) was created in 2011, inspired by the student's movement in the Faculty of Medicine, on the basis of the idea that public universities must contribute to the social control of Public Health Policies through deliberation and citizen empowerment. Guided by this aim, the Organization was formed, along with its objectives and organizational structure. To date, the Organization has focused on four areas: 1) Literature review and analysis of public health policies, 2) Training in Health Policy and Systems, 3) Promoting debate on public policies, and 4) Coordination with other actors in the health sector. Given its student composition, the main limitations are the lack of effective training in critical thinking at the health schools in our country, and the academic overload of the students, which in the context of its extra-curricular character, hinders the fulfillment of its objectives. Strengthening and replicating this kind of organizations requires the participation of all Stakeholders in the university community, to permit the convergence of their diverse knowledge, experiences, and perspectives on the topics studied. In addition, its inclusion in the institutional structure would formalize the University's commitment to the critical formation of future health professionals, in order to contribute to the national debate in public policy.