Executive summary of the position paper on the use of enteral nutrition in advanced dementia.

Dementia is an increasingly prevalent disease in our environment, with significant health and social repercussions. Despite the available scientific evidence, there is still controversy regarding the use of enteral tube nutrition in people with advanced dementia. This document aims to reflect on the key aspects of advanced dementia, tube nutritional therapy and related ethical considerations, as well as to respond to several frequent questions that arise in our daily clinical practice.

[Ethical limits to the promotion of health in the workplace within the framework of the ″healthy organization″ concept]. / Límites éticos a la promoción de la salud en el lugar de trabajo en el marco del concepto de empresa saludable.

In the context of general changes in our societies in relation to health, the healthy organization is proclaimed and accepted as something necessary and legitimate. This phenomenon is expanding globally without being really questioned and promoted by international organizations and large companies. With a global and growing presence in organizational and professional policies and practices, it appears to be gaining even more strength in the aftermath of the pandemic. Faced with the expansion of the phenomenon and because it directly affects people's health, an analysis of it beyond its general positive image is unavoidable. This article identifies some relevant dangers of promoting a culture of health at work, from an ethical perspective, and among them, not only the non-beneficial nature of some practices not scientifically proven, but also their own malignant condition. In this paper, therefore, the ethical limits for this expansive phenomenon are proposed and the fundamental principle to operate in this area of asymmetric relations between employee and employer is not autonomy but non-maleficence.

Límites éticos a la promoción de la salud en el lugar de trabajo en el marco del concepto de empresa saludable / Thical limits to the promotion of health in the workplace within the framework of the “healthy organization” concept

En el contexto de cambios generales en la sociedad en relación con la salud, la empresa saludable se proclama y acepta como algo necesario y legítimo. Este fenómeno se expande globalmente sin apenas cuestionamiento, promocionado por organismos internacionales y grandes empresas. Con presencia global y creciente en políticas y prácticas organizacionales y profesionales, parece ganar aún más fuerza tras la pandemia. Frente a la expansión del fenómeno y por incidir directamente sobre la salud de las personas, es ineludible un análisis del mismo más allá de su imagen positiva generalizada. En este artículo se identifican algunos peligros relevantes del fomento de la cultura de salud en el trabajo, desde una perspectiva ética, y entre ellos, no solo el carácter no beneficiente de algunas prácticas no contrastadas científicamente, sino, también, su propia condición maleficiente. En este trabajo se plantean, pues, los límites éticos para este fenómeno expansivo y se defiende que el principio fundamental para operar en este ámbito de relaciones asimétricas entre empleado y empleador es de no maleficencia y no tanto el de autonomía

In the context of general changes in our societies in relation to health, the healthy organization is proclaimed and accepted as something necessary and legitimate. This phenomenon is expanding globally without being really questioned and promoted by international organizations and large companies. With a global and growing presence in organizational and professional policies and practices, it appears to be gaining even more strength in the aftermath of the pandemic. Faced with the expansion of the pheno- menon and because it directly affects people’s health, an analysis of it beyond its general positive image is unavoidable. This article identifies some relevant dangers of promoting a culture of health at work, from an ethical perspective, and among them, not only the non-beneficial nature of some practices not scien-tifically proven, but also their own malignant condition. In this paper, therefore, the ethical limits for this expansive phenomenon are proposed and the fundamental principle to operate in this area of asymmetric relations between mployee and employer is not autonomy but non-maleficence.

[Patient care, right to information and consent for minors in situations of parental conflict. Clinical guidelines in the context of Spanish legislation]. / Atención a menores con progenitores en conflicto en materia de información y consentimiento relativos a la salud de los hijos. Protocolo asistencial en el contexto de la legislación vigente.

Among the main social and legislative changes as regards family matters that have taken place in Spain in the last few years, are included: (i) the gradual increase in legal disputes between parents, and (ii) the introduction of Law 26/2015 on Child Protection, which modified Law 41/2002 on the Freedom of the Patient. These searched for a balance between the rights of minors and the powers of the parents, particularly when the former had not reached 16 years or had sufficient maturity or, having reached it, the decision puts their life or health at severe risk. Likewise, it has led to a jurisprudence that determines that, for any minor, there are particularly sensitive, "special" or "important" health care actions, such as psychotherapy or surgical treatments, which require, with exceptions, the consent of both parents for it to be carried out. All this, however, subject to the discretion of the doctor responsible, who must always look after the best interests of the minor. For this reason, healthcare for minors, occasionally, lead to complex conflicts as regards information and consent by the parents, particularly when they do not agree. A review is presented on the current legislative framework and the main legal concepts that regulate the healthcare of minors as regards information and consent relative to health, as well a healthcare protocol for the care of minors in situations of conflict between parents, developed in the Gregorio Marañón Hospital of Madrid, and endorsed by the Official Medical Collegiate of Madrid.

[Pandemics, Politics and Science: the Role of Science and Scientifics for the Solution of the COVID-19 Pandemic Conflicts]. / Pandemias, Política y Ciencia: el Papel de la Ciencia y los Científicos en la Solución de los Conflictos derivados de la Pandemia de la COVID-19.

The public health crisis caused by COVID-19 disease has bring again to the public arena the old debate of the role in decision-making process of politics and science. In this paper we analyze, in the context of the current pandemics, how politics has left a stellar role for science, either because science has anticipated in its proposals to politics, or because politics has opted for it as a premeditated strategy. The references to the opinion of scientists as a decision-making criterion or, furthermore, their presence as true spokesmen for authority have been so frequent. This means rediscovering science and health as instruments of power, in terms that remind us of what Foucault denounced almost fifty years ago with his Biopolitics.