[Can Quality of Life Be Measured in a Health Care Setting? History, Constraints and Possibilities]. / ¿Es Posible Medir la Calidad de Vida en el Ámbito Asistencial? Historia, Límites y Posibilidades.

Quality of life concepts and scales related to health (QLRH) are beginning to be customary in clinical practice and now play an important role in bioethical discussions, particularly concerning the management of terminal patients. This paper looks at how that concept has evolved and how it relates to the health-illness binomial. We illustrate some important complexities the notion of quality of life (QL) has borne since its inception and that make applicability in the health sciences difficult and, most of all, lead to tremendous biases. In our conclusions, we argue it is necessary to improve the concept of QL by including aspects and factors related to well-being. Although not entirely quantifiable, they give coherence and meaning to the patient data health professionals normally work with.

¿Es posible medir la calidad de vida en el ámbito asistencial? Historia, límites y posibilidades / Can quality of life be measured in a health care setting? History, constraints and possibilities

Los conceptos y escalas de calidad de vida relacionada con salud (CVRS) comienzan a ser habituales en la práctica clínica, y juegan hoy un importante papel en discusiones bioéticas, especialmente en el manejo de pacientes terminales. En este artículo estudiamos la evolución que ha sufrido dicho concepto y la relación que guarda con el binomio salud-enfermedad. En este sentido, mostramos algunos importantes inconvenientes que arrastra la noción de calidad de vida (CV) desde sus orígenes y que se traducen en una difícil aplicabilidad en las ciencias de la salud y, sobre todo, que conllevan enormes sesgos. En nuestras conclusiones defendemos que es necesario mejorar el concepto de CV a partir de la inclusión de dimensiones y factores relacionados con el bienestar que, a pesar de no ser enteramente cuantificables, dotan de coherencia y sentido a los datos que, sobre el paciente, el profesional de la salud maneja habitualmente

Quality of life concepts and scales related to health (QLRH) are beginning to be customary in clinical practice and now play an important role in bioethical discussions, particularly concerning the management of terminal patients. This paper looks at how that concept has evolved and how it relates to the health-illness binomial. We illustrate some important complexities the notion of quality of life (QL) has borne since its inception and that make applicability in the health sciences difficult and, most of all, lead to tremendous biases. In our conclusions, we argue it is necessary to improve the concept of QL by including aspects and factors related to well-being. Although not entirely quantifiable, they give coherence and meaning to the patient data health professionals normally work with

Las virtudes profesionales más valoradas por pacientes en una Unidad de Cuidados Paliativos / Professional virtues rated highest by patients in a Palliative Care Unit

OBJETIVO: Conocer las virtudes profesionales más valoradas por los pacientes y su importancia respecto a las habilidades técnicas. MÉTODO: Estudio cuantitativo, tipo descriptivo, mediante el empleo de encuestas. El estudio se ha realizado en pacientes paliativos del Hospital Centro de Cuidados Laguna. RESULTADOS: Muestra de 42 pacientes. Entre las 10 prestaciones que escogió el paciente, 6 fueron virtudes del profesional sanitario. Las 5 prestaciones más valoradas fueron las siguientes: alegría (61,9%), respeto (57,1%), control del dolor (52,4%), ayuda ante la sensación del paciente de encontrarse mal (47,6%) y la sinceridad (47,3%). Con respecto a la prioridad concedida a los 10 ítems elegidos por cada paciente, las primeras posiciones las ocuparon el control del dolor (85%), la alegría (72%), la ayuda ante la sensación del paciente de encontrarse mal (67%), el respeto (58%), la asistencia ante el desánimo (54%) y la sinceridad (51%). CONCLUSIONES: Los pacientes de Cuidados Paliativos valoran las virtudes por encima de las habilidades técnicas en los profesionales que les atienden. De entre todas las virtudes, la más valorada fue la alegría, que es precisamente aquella que exige mayor compromiso existencial de entre todas. Sin embargo, para confirmar la conclusión de este estudio piloto y dado que la muestra aquí manejada es pequeña se hace necesario planear una investigación que evalúe a un mayor número de pacientes

AIM: To determine which profesional virtues are more valued by patients in a Palliative Care Unit, and their importance as regards technical skills. Method: Descriptive type of a Quantitative Study. Data was obtained by using questionnaires. Volunteers were patients of the Palliative Care Unit of Centro de Cuidados Latin'as Hospital. RESULTS: The sample consisted of 42 PATIENTS: Among the ten professional qualities chosen by them, six were virtues. The five most rated qualities were: joy (61.9%), respect (57.1%), pain control (52.4%), help when patient did not feel good (47.6%), and sincerity (47.3%). As regards the priorities in the list of ten qualities created by the patient, the first positions were taken by: pain control (85%), joy (72%), help when patient does not feel good (67%), respect (58%), help when patient feels discouraged (54%), and sincerity (51%). Conclusions Palliative patients value significantly professional virtues. Among all the virtues, joy was the most appreciated, which is precisely that which demands more commitment. However, because the sample of this study is small, a larger study is needed to confirm the conclusion

[Neurocosmetics, transhumanism and eliminative materialism: toward new ways of eugenics]. / Neurocosmética, transhumanismo y materialismo eliminativo: hacia nuevas formas de eugenesia.

In this paper I present similarities and connections between Transhumanism and Eliminative Materialism. Concretely, I study the arguments with which in both positions it is defended a merely instrumental idea of human body and, because of that, one infinitely mouldable. First, I show the social relevance of this idea and its projections in phenomena as medicalization of human condition and, especially, cosmetic psychopharmacology. Besides, I denounce that such influences are caused by illegitimate transference of authority between philosophical and scientific forums. Second, according to my analysis, these new postmodern fashions of chemical sentimentalism (related with radical changes on personal identity and human nature) drive to new eugenic forms what I name autoeugenics. Finally, I call attention to the important role of utopian speeches about the science of tomorrow and super-human civilization in a Carpe Diem society. In my conclusions, I claim that historical reasoning or warnings about what is coming are not efficient strategies to control neither new psychopharmacological habits nor passivity generated by them. Returning social confidence in the power of reason to achieve reality (and other human beings) is, in my opinion, the best way to rehabilitate a more and more devalued human action.

[Therapeutic and cosmetic psychopharmacology. Risks and limits]. / Psicofarmacología terapéutica y cosmética. Riesgos y límites.

In this paper, I analyze risks and limits of the current psychopharmacology and how both are promoting a new social interpretation of health concept. Besides, I show how such interpretation can be detected in four issues related to safety, equality, psychiatrization of human condition, and autonomy. In the conclusions, I defend, first, the obligation of physician to inform patients about the important long-term uncertainties around psychopharmacology. Second, I justify the necessity of promote more prolonged monitoring of patients treated with such kind of drugs. Third, I insist in the relevance of increasing research about drugs ' adverse effects extended over a long time. And forth, I bring up the utility of health concept to avoid the subjective stigmatization of cognitive or affective traits, to prevent potential problems of inequality and coercion, and to keep from mental disorders caused by attempts of getting psychical states supposedly optimized.