Propuesta de un marco deontológico para los biólogos españoles / Proposal of a deontological framework for spanish biologists

La Deontología es el conjunto de deberes y obligaciones en que se concreta el obrar correcto en una profesión determinada. Los Códigos deontológicos (CD), además de respetar el marco legal en que se insertan, deben ir más allá de las leyes en tanto son un reflejo del compromiso ético propio de cada profesión; compro-miso con unos principios deontológicos, que contribuye, además, a configurar su identidad. Con este trabajo se pretende aportar, a partir de la bibliografía y de la normativa legal y deontológica vigente, una propuesta que sirva de guía para la elaboración de un Código Deontológico para el Biólogo (CDB), inexistente, a fecha de hoy, en España, tomando como base la revisión de los Códigos deontológicos de otras profesiones afines a la Biología. Con ese fin, se ha procedido a realizar una revisión sistemática y comparativa de los códigos deontológicos de otras profesiones sanitarias, de las pautas éticas emanadas de sociedades científicas (sobre todo, del área anglosajona) y de la normativa aplicable a esas profesiones. El resultado se materializa en una propuesta de los apartados más importantes que, a nuestro juicio, debe contener dicho Código

Deontology is the set of duties and obligations in which the correct act is specified in the exercise of a profession. The Deontological Codes (CD), in addition to respecting the legal framework in which they are inserted, must go beyond the laws insofar as they are a reflection of the ethical commitment of each profession; commitment to deontological principles, which also helps to shape your identity. The aim of this project is to provide, based on the bibliography and current legal and deontological regulations, a proposal to serve as a guide for the accomplishment of Ethic Codes for Biologists (CDB), which currently does not exist in Spain, taking as a basis the revision of the ethics codes of other professions related to Biology. Under this purpose, a systematic and comparative review has been carried out of other health professions ethics codes, of the ethical guidelines emanating from scientific societies (above all, from the Anglo-Saxon area) and of the regulations applicable to those professions. The result is the proposal of the most impor-tant sections that we believe this Code should contain

Is There Gender Bias on the American Board of Surgery General Surgery Certifying Examination?

BACKGROUND: When oral examinations are administered, examiner subjectivity may possibly affect ratings, particularly when examiner severity is influenced by examinee characteristics (e.g., gender) that are independent of examinee ability. This study explored whether the ratings of the general surgery oral certifying examination (CE) of the American Board of Surgery and likelihood of passing the CE were influenced by the gender of examinees or examiners. MATERIALS AND METHODS: Data collected from examinees who attempted the general surgery CE in the 2016-2017 academic year were analyzed. There were 1341 examinees (61% male) and 216 examiners (82% male). Factorial analysis of variance and logistic regression analyses were used to evaluate the effect of examinee and examiner gender on CE ratings and likelihood of passing the CE. RESULTS: Examinees received similar ratings and had similar likelihood of passing the CE regardless of examinee or examiner genders and different combinations of examiner gender pairs (all P values > 0.05). CONCLUSIONS: These results indicate that CE ratings of examinees are not influenced by examinee or examiner gender. There was no evidence of examiner bias due to gender on the CE.

Discovering overtreatment: second-opinion dilemma.

An experienced vascular surgeon, Dr Al Wright, specializing in venous disease, often sees self-referred patients seeking second opinions primarily for ablation therapy and is deeply disturbed at what he finds. Some patients have no reflux on ultrasound examination and, thus, no treatment is indicated. Others were told they need a ludicrous three to seven ablations in each leg where only one or at most two are needed. Several advertise their services in the media. Dr Wright asked esteemed colleagues from the American Venous Forum what they recommended and they suggested sending a copy of his consultation to the first consultant with the goal of shaming him. He also notified the state medical board 2 years ago about one egregious repeat offender, without action. What should he do? A. Do as suggested, send your consult along with a harsh letter. B. Do nothing. It is none of your business. C. Notify the state medical board, again. D. Notify the insurance companies and regulators. E. There is no good venue to deal with the problem.

More than a list of values and desired behaviors: a foundational understanding of medical professionalism.

The term "professionalism" has been used in a variety of ways. In 2012, the American Board of Medical Specialties (ABMS) Standing Committee on Ethics and Professionalism undertook to develop an operational definition of professionalism that would speak to the variety of certification and maintenance-of-certification activities undertaken by ABMS and its 24 member boards. In the course of this work, the authors reviewed prior definitions of professions and professionalism and found them to be largely descriptive, or built around lists of proposed professional attributes, values, and behaviors. The authors argue that while making lists of desirable professional characteristics is necessary and useful for teaching and assessment, it is not, by itself, sufficient either to fully define professionalism or to capture its social functions. Thus, the authors sought to extend earlier work by articulating a definition that explains professionalism as the motivating force for an occupational group to come together and create, publicly profess, and develop reliable mechanisms to enforce shared promises-all with the purpose of ensuring that practitioners are worthy of patients' and the public's trust.Using this framework, the authors argue that medical professionalism is a normative belief system about how best to organize and deliver health care. Believing in professionalism means accepting the premise that health professionals must come together to continually define, debate, declare, distribute, and enforce the shared competency standards and ethical values that govern their work. The authors identify three key implications of this new definition for individual clinicians and their professional organizations.

La reacción de los practicantes en Medicina y Cirugía frente a la creación del título de Enfermera en 1915 / The reaction of Practicantes in Medicine and Surgery to the creation of a Nursing qualification in 1915

El objetivo de este trabajo es conocer los argumentos que justificaron que el Gobierno promulgase la Real Orden de 7 de mayo de 1915, que creaba oficialmente los estudios y el título de Enfermera en España, y por qué y cómo reaccionaron los practicantes en Medicina y Cirugía a esa Real Orden. Dicha norma legalizó el ejercicio asistencial de las enfermeras y se reconoció así a una profesión sanitaria alternativa a la de Practicante, lo cual fue justificado por el Gobierno con tres argumentos: que lo aconsejaron los médicos, la escasa formación básica y profesional de parte de los practicantes y que la profesión enfermera surgía como una nueva vía para que la mujer española tuviese más oportunidades de formarse e incorporarse al mercado laboral. Los practicantes acogieron dicha Real Orden con indignación y se opusieron a ella porque pensaban que atribuía a las enfermeras las mismas competencias que a ellos, y como consecuencia peligraba su futuro laboral. Además, éstos sostenían que las enfermeras para equipararse en funciones a ellos, podían formarse en un menor periodo de tiempo, con menos prácticas, inferior coste económico y menor esfuerzo que los practicantes. Los colegios profesionales de practicantes iniciaron acciones contra la Real Orden: entrevistas con el ministro de Instrucción Pública para solicitarle la derogación de la Real Orden, envío masivo de telegramas de protesta al ministro y recurso ante el Tribunal Supremo para que se declarase la nulidad de la Real Orden, el cual casi dos años después rechazó las pretensiones de los practicantes. También, desde la prensa de los colegios profesionales, significados practicantes realizaron una oposición ardorosa, extremista, intransigente, radical, irónica y guiada por una marcada ideología de género, fruto de la mentalidad patriarcal de entonces y de la superioridad que la hegemonía masculina le otorgaba al colectivo de los practicantes (AU)

This paper deals with the arguments justifying the Government's passage of the Sovereign Ordinance of 7 May 1915, which officially established a course and qualification in Nursing in Spain; and examines how and why Medical and Surgical practicantes (medical assistants) reacted to this decision. The ordinance legalized nurses' care practices, thereby providing official recognition for a healthcare profession other than that of practicante. The Government based its approval on three arguments: the physicians' recommendations; deficiencies in the basic and professional training of practicantes’; and the fact that the nursing profession emerged as a new path providing Spanish women with an opportunity to acquire training and join the labour force. The new legislation was met with outrage by practicantes, who opposed it in the belief that it equated nurses' scope of practice to their own and thus jeopardized their future employment prospects. Additionally, they contended that nurses would be legally qualified to perform the same medical practices as they did, despite receiving their degrees in a shorter period of time with a less prolonged internship, at a lower economic cost and through less effort. Professional associations of practicantes immediately launched a campaign against the Sovereign Ordinance, meeting with the Minister of Public Instruction to request its repeal, organizing a massive telegram campaign directed at the minister, and requesting the nullity of the ordinance before the Supreme Court, which would reject the appeal by the practicantes two years later. Professional associations also used their press organs to publish the arguments of prominent practicantes, who vehemently voiced their opposition in extremist, uncompromising, radical, and ironic terms, arising from a strong gender ideology in tune with the patriarchal mentality of the era and the dominant position that male hegemony conferred to practicantes (AU)

Código ético y deontológico de la enfermería de la comunidad valenciana / The code of ethics and conduct of nursing of the valencian region: background and content

Con el objeto de proporcionar a los profesionales de la enfermería de la Comunidad Valenciana un código de conducta profesional que les ayudara a afrontar las nuevas situaciones que se plantean en su práctica clínica diaria, derivadas de los cambios sociosanitarios producidos, el Consejo de Enfermería de la Comunidad Valenciana (CECOVA) aprobó en mayo de 2010 el Código Ético y Deontológico de la Enfermería de la Comunidad Valenciana. Este trabajo trata tanto de las razones que llevaron a impulsarlo, como del modo en que se elaboró y de los aspectos más destacables de su contenido (AU)

TIn order to provide to the nursing professionals in the Valencian Region a code of professional conduct to help them deal with new situations that arise in their daily clinical practice, derived from social changes produced, the Board of Nursing of Valencian Region/Consejo de Enfermería de la Comunidad Valenciana (CECOVA) approved in May 2010, the Code of Ethics and Conduct of Nursing of Valencia. This work is as much about the reasons that led to propel it, and the way they was developed and the most important aspects of your content (AU)

Structure and function of the oncologic boards in Greece. Description of the institutional and scientific frame; objective problems and difficulties.

PURPOSE: Oncology boards should constitute a routine in all hospitals that are dealing with the care of cancer patients. Unfortunately the procedure which should be followed to deal with this health problem has some deficiencies. METHODS: A literature review has recently been attempted, searching Internet databases by using key words such as oncologic board, medical legislation and medical ethics. RESULTS: Current mentality suggests that hiding the truth from the patient is wrong and unethical. However, in the Greek society, this is not the case as it seems not right to adopt foreign practices, i.e. to disclose directly to the patient all information relevant to his health status, the intended therapy and possible outcome. Instead, ambiguous information pass onto relatives who in turn bear the burden of informing the patient. CONCLUSIONS: The best solution would be the integration of the positive elements of the patient's awareness and the beneficial effects of the involvement of the Greek family in the general care of the cancer patient.

Medicamentos biocomparables en México: la postura del Colegio Mexicano de Reumatología, 2012 / Biosimilar drugs in Mexico: Position of the Mexican College of Rheumatology, 2012

Los medicamentos biotecnológicos (MBT) son moléculas complejas cuyo proceso de elaboración impide replicar con gran exactitud la sustancia original, por lo que no existe una equivalencia absoluta entre el fármaco original (innovador) y el biocomparable. Los MBT han probado su eficacia en diversas afecciones reumáticas, aunque su alto coste impide su utilización en muchos pacientes. Diversas patentes de medicamentos biotecnológicos han expirado o expirarán próximamente, detonando así el desarrollo de fármacos estructuralmente similares y probablemente con eficacia y seguridad comparable a los medicamentos innovadores, aunque estas características deben ser probadas. La Ley General de Salud Mexicana actual contempla el registro de estos medicamentos para su utilización en nuestro país. Este documento es una reflexión de miembros del Colegio Mexicano de Reumatología, farmacólogos e investigadores en epidemiología, en conjunción con nuestras autoridades sanitarias, sobre los estudios científicos necesarios de los biocomparables previos y posterior a su incursión en el mercado mexicano (AU)

Biotechnological drugs (BTDs) are complex molecules whose manufacturing process precludes the ability to identically reproduce the structure of the original product, and therefore there cannot be an absolute equivalence between the original (innovative) medication and its biosimilar counterpart. BTDs have been proven useful in the treatment of several rheumatic diseases, however their high cost has prevented their use in many patients. Several BTD patents have expired or are close to expire, triggering the development of structurally similar drugs with efficacy and safety profiles comparable to the innovative compound; however, these must be evaluated through evidence based medicine. The Mexican General Health Law contemplates the registry of these biosimilar drugs for their use in our country. This document is a forethought from members of the Mexican College of Rheumatology, pharmacologists, and epidemiologists, in accordance with Mexican health authorities regarding the necessary scientific evidence required to evaluate the efficacy and safety of biosimilar drugs before and after their arrival to the Mexican market (AU)

La ética como misión de la Organización Colegial de Enfermería: evolución histórica en España / Ethics as a mission of the Board of Nursing: historical development in Spain

Los colegios profesionales son los encargados de ordenar y regular las profesiones y, con ese fin, elaboran sus propios códigos deontológicos. La primera referencia en España a las cuestiones éticas y deontológicas en el ámbito de los colegios oficiales de auxiliares sanitarios es de 1929, año en el que sedecretó la colegiación obligatoria para los practicantes. En este artículo se hace un repaso histórico de las referencias fundamentales a la ética y la deontología de la profesión enfermera en las normas reguladoras de los colegios desde esa fecha hasta la actualidad, englobando a practicantes, matronas, enfermeras, ayudantes técnicos sanitarios (ATS), diplomados en Enfermería y, actualmente, graduados en Enfermería.Objetivo: analizar cómo se ha regulado la deontología profesional en los diversos estatutos y reglamentos colegiales que ha tenido la Enfermería desde los primeros colegios obligatorios en España hasta la actualidad.Metodología: búsqueda y análisis retrospectivo de toda la normativa publicada en Gaceta de Madrid y en el Boletín Oficial del Estado, desde 1929 hasta la actualidad, que haya regulado la organización y el funcionamiento de los colegios provinciales de auxiliares sanitarios y sus respectivos consejos generales. Resultados y conclusiones: al hilo de la evolución de la regulación de las profesiones de practicantes, matronas y enfermeras, se fue desarrollando una regulación sobre la ética y ladeontología enfermera que, hasta el momento, ha tenido cincohitos: las reglas deontológicas recogidas en el Reglamento de régimen interior del Colegio Oficial de Matronas de Cataluña, de corta vigencia pero relevante significación; el Código Moral de los ayudantes técnicos sanitarios de 1954, que incorporó el juramento de Florence Nightingale; el Código de Ética de Enfermería del Colegio Oficial de Ayudantes Técnicos Sanitarios y Diplomados(..) (AU)

Professional boards are responsible for setting up the regulations that govern professional conduct and they elaborate their respective codes of conduct to that very end. The first reference in Spain regarding the ethical and professional issues in the field ofauxiliary healthcare personnel dates back to 1929, at which timeboard accreditation for healthcare professionals became compulsory.This article presents a historical overview of the fundamental references to ethics and code of conduct of the nursing profession in terms of the rules governing nursing boards from that date until the present time, encompassing nurse practitioners,midwives, nurses, assistant medical technicians, and nursingschool graduates both in the 3 year (diploma) and 4 year(graduate) nursing programs.Objective: To analyze how professional ethics and code of conduct have been regulated in the various board statutes and regulations that have governed nursing since the first compulsory boards in Spain to the present time.Methodology: Search and retrospective analysis of all the regulations published in Gaceta de Madrid and in the Official Gazette,from 1929 to the present, which have regulated the board and operation of provincial boards of healthcare auxiliary personnel(nurses) and their respective general councils.Results and conclusions: In parallel to the development ofregulations for nurse practitioners, midwives and nurses, asecond type of regulation on nursing ethics and code of nurseswas also established, which to date has had five milestones: the ethical code set forth in the Internal Regulations of the Official MidwiferyBoard, short-lived but of relevant significance; the MoralCode of Assistant Medical Technicians (term used in the past torefer to registered nurses) of 1954, which incorporated the oath of Florence Nightingale; the Ethics Code (..) (AU)