Consentimiento informado en anestesiología: la antelación suficiente como requisito de validez / Informed consent in anaesthesiology: Period of notice as a requisite of validity

Se analiza uno de los requisitos de validez del consentimiento informado, en concreto, el tiempo o antelación con que ha de facilitarse la información al paciente para que pueda reflexionar y ejercer con plenitud su derecho kantiano de autodeterminación. Se aprecia cierta insuficiencia de la legislación estatal al tratar este requisito, que es subsanada por algunas legislaciones autonómicas. Concluimos señalando la necesidad de facilitar la información al paciente con la antelación suficiente para que pueda meditar adecuadamente su decisión (AU)

The analysis of one of the requisites of thevalidity of the informed consent, the notice period, during which the patient should be provided with information, so that he/she can reflect and fully exercise his/her Kantian right of self-determination. National legislation appears to be insufficient when dealing with this issue, which is compensated for in some regional legislations. We conclude by pointing the need to provide the patient with information with sufficient notice prior to operations, so that he/she can ponder over his/her decision (AU)

[Informed consent in anaesthesiology: period of notice as a requisite of validity]. / Consentimiento informado en anestesiología: la antelación suficiente como requisito de validez.

The analysis of one of the requisites of the validity of the informed consent, the notice period, during which the patient should be provided with information, so that he/she can reflect and fully exercise his/her Kantian right of self-determination. National legislation appears to be insufficient when dealing with this issue, which is compensated for in some regional legislations. We conclude by pointing the need to provide the patient with information with sufficient notice prior to operations, so that he/she can ponder over his/her decision.

Responsabilidad en Anestesiología: teoría del daño desproporcionado / Liability in Anaesthesiology: theory of disproportionate damage

Se analiza la controvertida aplicabilidad de la doctrina del daño desproporcionado en el acto anestésico, dado el elevado riesgo inherente al mismo, abstracción hecha de la gravedad y trascendencia del acto quirúrgico que lo motiva. La existencia de un resultado desproporcionado, esto es, no previsto ni explicable dentro de la esfera de la actuación profesional del anestesista, no determina por sí sola la existencia de responsabilidad del médico, sino la exigencia al mismo de una explicación coherente acerca del porqué de la importante disonancia existente entre el riesgo inicial que implicaba su actividad y la consecuencia finalmente producida (AU)

[Liability in Anaesthesiology: theory of disproportionate damage]. / Responsabilidad en Anestesiología: teoría del daño desproporcionado.

An analysis is made of the controversial application of the theory of disproportionate damage in the anaesthetic act, due to the high inherent risk, and regardless of the seriousness and importance of the surgery being performed. The existence of a disproportionate damage, that is, damage not foreseen nor accountable within the framework of the professional performance of the anaesthetist, does not by itself determine the existence of liability on the part of the anaesthetist, but the demand from the professionals themselves for a coherent explanation of the serious disagreement between the initial risk implied by their actions and the final consequence produced.

[Autonomy and patient prisoners]. / Autonomía y pacientes reclusos.

The authors study a recent Spanish High Court decision declaring liability on the Administration's part for the death of an inmate in a prison hospital. We analyse the Court's decision using legal, ethical, medical and social perspectives. The conclusions are that: 1. the Administration has no legitimate right to force a prisoner to take medical treatment, except in circumstances in which there is a grave and definite risk to the patient's life, or when the patient lacks capacity or when there is the risk of harm to the health of third parties; 2. That in the case of health decision making that might affect a patient, the Court has mounted a frontal attack on the autonomy of patients in prison; 3. That from a medical point of view the decision is discriminatory since it does not apply the same standards of measurement to all chronic illnesses that might be found in the prison context; 4. That it is inapplicable in daily practice due to the fact that its strictness of application would seriously affect the already highly fragile ordered coexistence that exists in a prison.

Autonomía y pacientes reclusos / Autonomy and patient prisoners

Los autores estudian una reciente sentencia de la Sala 3ª del Tribunal Supremo en la que se declara la responsabilidad patrimonial de la Administración por la muerte de un paciente preso. Se analizan los argumentos de la Sala desde una perspectiva jurídica, ética, médica y social. Concluyen que: 1: la Administración no está legitimada para imponer tratamientos médicos a los reclusos, salvo que medie riesgo grave y cierto para su vida, incapacidad para decidir o riesgo para la salud de terceros; 2: que la sentencia supone un ataque frontal a la autonomía de los pacientes presos en la toma de decisiones sanitarias que les afecten; 3: que desde un punto de vista médico es discriminatoria, ya que no mide por el mismo rasero a todas las enfermedades crónicas que se pueden dar en prisión y 4: que resulta inasumible en la práctica diaria, porque su estricta aplicación alteraría considerablemente la ya de por sí frágil ordenada convivencia en un centro penitenciario

The authors study a recent Spanish High Court decision declaring liability on the Administration’s part for the death of an inmate in a prison hospital. We analyse the Court’s decision using legal, ethical, medical and social perspectives. The conclusions are that: 1. the Administration has no legitimate right to force a prisoner to take medical treatment, except in circumstances in which there is a grave and definite risk to the patient’s life, or when the patient lacks capacity or when there is the risk of harm to the health of third parties; 2. That in the case of health decision making that might affect a patient, the Court has mounted a frontal attack on the autonomy of patients in prison; 3. That from a medical point of view the decision is discriminatory since it does not apply the same standards of measurement to all chronic illnesses that might be found in the prison context; 4. That it is inapplicable in daily practice due to the fact that its strictness of application would seriously affect the already highly fragile ordered coexistence that exists in a prison

Repercusión en atención primaria de la Ley 41/2002 de autonomía del paciente, información y documentación clínica (II) / Repercussions on primary care of Act 41/2002 on patient autonomy, rights to information and clinical documents (II)

No disponible

Repercusión en atención primaria de la Ley 41/2002 de autonomía del paciente, información y documentación clínica (I) / Repercussions on primary care of Act 41/2002 on patient autonomy, right to information and clinical document (I)

No disponible

Aggressive fibromatosis of the sphenoid.

A fibromatosis located primarily in the sphenoid, with secondary invasion of the maxilla, orbit, and subtemporal region, was extirpated by means of a combined craniofacial approach.