ABSTRACT
This paper undertakes an analysis of the scientific criteria used in the diagnosis of death and underscores the importance of intellectual rigor in the definition of medical concepts, particularly regarding such a critical issue as the diagnosis of death. Under the cardiorespiratory criterion, death is defined as "the irreversible cessation of the functioning of an organism as a whole", and the tests used to confirm this criterion (negative life-signs) are sensitive and specific. In this case, cadaverous phenomena appear immediately following the diagnosis of death. On the other hand, doubts have arisen concerning the theoretical and the inner consistency of the criterion of brain death, since it does not satisfy the definition of "the irreversible cessation of the functioning of an organism as a whole", nor the requirement of "total and irreversible cessation of all functions of the entire brain, including the brain stem". There is evidence to the effect that the tests used to confirm this criterion are not specific enough. It is clear that brain death marks the beginning of a process that eventually ends in death, though death does not occur at that moment. From an ethical point of view, the conflict arises between the need to provide an unequivocal diagnosis of death and the possibility of saving a life through organ transplantation. The sensitive issue of brain death calls for a more thorough and in-depth discussion among physicians and the community at large.
Subject(s)
Death , Postmortem Changes , Brain Death/diagnosis , Ethics, Medical , Humans , Organ Transplantation , RespirationABSTRACT
It is not clear if medical records belong to the physician, the institution or the patient. There is a bill being discussed in the Chilean Congress that establishes that "the patient, personally or through a representative, has the right to access and review his medical record. In case of death, this right may be exerted by his inheritors". In this article we postulate that this bill infringes a number of legal norms in force and universally accepted ethical principles. We distinguish between patient's advocacy to be informed and their free access to medical records. The main ethical principles violated are those of beneficence and non maleficence.
Subject(s)
Confidentiality/legislation & jurisprudence , Patient Access to Records/legislation & jurisprudence , Chile , HumansABSTRACT
Professional colleges lost the ethical control of their members in 1980, when a free market economical model was implemented in Chile. Courts of justice have failed to accomplish this task. To recover such control, the Chilean Medical Association would need to modify its internal organization, separating its functions as a union from those required to control professional ethics. The health reform that is being set forth in the country, proposes a "new instance" for the control of professional ethics, within the Health Services and forming part of the Health Care Authority.
