Estudio transversal en profesionales de la salud sobre aplicación y percepción de conocimientos bioéticos adquiridos en urgencias pediátricas / Estudio transversal en profesionales de la salud sobre aplicación y percepción de conocimientos bioéticos adquiridos en urgencias pediátricas

Introducción En comparación con ciencias clínicas básicas o aplicadas, la bioética es considerada una disciplina secundaria y subutilizada en la práctica diaria. Sin embargo, el razonamiento ético es indispensable para la calidad del cuidado. Existen pocos estudios sobre bioética en unidades de emergencia pediátrica. Nuestro objetivo fue evaluar la percepción sobre la importancia y la suficiencia del conocimiento teórico adquirido y la aplicación de los principios bioéticos en casos estandarizados. Métodos Realizamos un estudio descriptivo transversal en profesionales médicos y de enfermería que se desempeñan en unidades de emergencia pediátrica de Puerto Montt. Mediante una encuesta, evaluamos la percepción de la importancia y suficiencia del conocimiento bioético obtenido y la aplicación de los principios bioéticos en casos hipotéticos, pero probables, en la atención de urgencias pediátricas. Resultados De una población total de 50 médicos y 53 enfermeras, participaron en nuestro estudio 30 médicos (60%) y 20 enfermeras (37,7%). La mayoría reportó formación ética en pregrado (84%). Una minoría reportó formación durante la práctica (20%). Sin embargo, sólo 60% percibía tener conocimientos suficientes de bioética y 72% la consideraba importante para la práctica diaria. Además, al aplicar los principios de Beauchamp y Childress a casos clínicos estandarizados, el 82,7% no reconoció el principio de justicia y solo 50% reconoció los principios de autonomía y no maleficencia. Conclusión Aunque la mayoría de los profesionales de la salud tienen formación en bioética, el aprendizaje muchas veces se considera insuficiente y no se incorpora a la práctica diaria en las unidades de emergencia pediátrica.

Background Compared to basic or applied clinical sciences, bioethics is frequently considered as a secondary discipline and underutilized in daily practice. However, ethical reasoning is indispensable for the quality of care. There are few studies on bioethics in pediatric emergency units. Our objective was to evaluate the perception of the acquired bioethical knowledge and the application of bioethical principles in standardized cases. Methods We conducted a cross-sectional descriptive study in medical and nursing professionals working at pediatric emergency units in Puerto Montt. Through a survey, we assessed the perception of the sufficiency of the acquired bioethics knowledge and the application of bioethical principles on hypothetical, but probable cases in emergency pediatric care. Results Of a total population of 50 physicians and 53 nurses, 30 physicians (60.0%) and 20 nurses (38.7%) participated in our study. The majority reported ethics training in undergraduate education: 84%. A minority reported training during practice: 20%. However, only 60.0% perceived having sufficient knowledge of bioethics and 72.0% considered it important for daily practice. Further, when applying the principles of Beauchamp and Childress to standardized clinical cases, 82.7% did not recognize the justice principle and only 50.00% the principles of autonomy and nonmaleficence. Conclusion Although most health professionals undergo bioethics training, learning is often considered insufficient and not incorporated into daily practice at pediatric emergency units.

Knowledge, attitude, and practice of health-care ethics among doctors in Tamil Nadu – A cross-sectional study

Background: Proficiency in medical ethics is central to valuable patient care. The current medical education gives limited help in dealing with the ethical dilemmas. Objective: The objective of the study was to assess the knowledge, attitude, and practice of health-care ethics among doctors in Tamil Nadu. Materials and Methods: A questionnaire-based cross-sectional study covering all doctors on payroll (171) as on August 1, 2018, was carried out in August 2018 at Government Tiruvannamalai Medical College. A total of 165 doctors were contacted and 148 questionnaires were collected back. The pre-tested questionnaire comprised 44 questions. Approval from the Institutional Ethics Committee was obtained. SPSS version 22 was used to analyze data. Association between sociodemographic variables and attitude, practice of the doctors toward the health-care ethics was compared using Chi-square test. Results: About 87.8% of respondents were aware of the definition of health-care ethics. About 78.4% of respondents knew the duties of ethical committee. Books and journals were the source of knowledge for 66.2% of respondents. About 52% of the respondents preferred to consult their guide/head of department when they faced an ethical/legal issue. Nearly 60% were aware of existence of ethical committee. About 62.2% of the respondents had positive attitude toward health-care ethics. About 69% of the respondents had good practice of health-care ethics. Age group, sex, specialty, and duration of work experience had no significant association with attitude toward health-care ethics. Age group had significant correlation with practice while sex, specialty, and duration of work experience did not. Conclusion: Nine-tenth of respondents were aware of the definition of health-care ethics. Three-fourth was aware of duties of ethical committee. Nearly two-third of the respondents had positive attitude toward health-care ethics. More than two-third of the respondents had good practice of health-care ethics.

Bioética de la anorexia nerviosa ¿autonomía, beneficencia o responsabilidad? / Ethics in anorexia nervosa: Autonomy, beneficence or responsibility?

In patients with anorexia nervosa, ethical dilemmas will appear in case of difficult and serious medical situations. Although the principle of beneficence could be used to argue for the use of coercive medical therapies, the respect for autonomy must take precedence. The latter is a central principle of bioethics. However, the interactions between autonomy, beneficence, non-maleficence, and justice become quite complex when these patients need to be treated. Difficulties must be overcome and a balance between these considerations must be reached. This paper gives an account of ethical values relevant to moral assessment in anorexia nervosa: conviction, responsibility and care.

An Ethical Reflection on the Public Health Policy in the Post-SARS Era / 中华医学教育探索杂志

The mass epidemic of SARS in China during the spring of year 2003 reveals defects in the guidelines for Chinese public health policy. During the marketizing process of Chinese economy, our government neglected the vital importance of public health to national security, which led to insufficient investment in public health, negligence of prophylaxis and lack of effective measures to deal with emergency cases. It constitutes the underlying cause of the mass epidemic of SARS. Therefore, we must amend our public health policy and reconstruct our public health system to secure the ultimate interest of the utmost majority of our people.