The necessity of ethical support for health care professionals in Intensive Care: Role and competencies of the Clinical Ethics Committee / La necesidad de apoyo ético para los profesionales de la salud en Medicina Intensiva: papel y competencias del Comité de Ética Asistencial / La necessitat de suport ètic per a professionals de la salut en Medicina Intensiva: paper I competències del Comitè d'Ètica Assistencial

Promoting measures that aim to mitigate discrepancies in the decision-making process, ensuring adequate training of physicians in the ethical aspect of care, and incrementing the wellbeing of patients and their families are becoming the principal objectives for high-quality care, especially in the Intensive Medicine Unit (ICU). In this paper, we're going to deal with the implementation of a specific ethics support for the ICU health care professionals, and considering the advanced Spanish experience on this matter, it deals with the current potentialities and limits of CEC's role to improve the quality of health care assistance

Promover medidas que tengan como objetivo mitigar las discrepancias en el proceso de toma de decisiones, garantizar la capacitación adecuada de los médicos en el aspecto ético de la atención e incrementar el bienestar de los pacientes y sus familias se están convirtiendo en los objetivos principales para una atención de alta calidad, especialmente en Medicina Intensiva. En este artículo abordaremos la implementación de un apoyo ético específico para los profesionales de la salud de la UCI. Teniendo en cuenta la amplia experiencia española en este tema, nos centraremos en el potencial y los límites actuales del rol del CEA para mejorar la calidad de asistencia sanitaria

Promoure mesures que tinguin com a objectiu mitigar els discrepàncies en el procés de presa de decisions, garantir la capacitació adequada dels metges respecte a l'aspecte ètic de l'atenció I incrementar el benestar dels pacients I els seves families s'estan convertint en els objectius principals per a una atenció de qualitat, especialment a Medicina Intensiva. En aquest article abordarem la implementació d'un soport ètic específic per a professionals de la salut de l'UCI. Tenint en compte l'àmplia experiència espanyola en aquest tema, ens centrarem en el potencial I els límits actuals del rol del CEA per a millorar la qualitat de l'assistència sanitària

Calendario de vacunaciones de la Asociación Española de Pediatría: recomendaciones 2015 / Immunisation schedule of the Spanish Association of Paediatrics: 2015 Recommendations

El Comité Asesor de Vacunas de la Asociación Española de Pediatría actualiza anualmente su calendario de vacunaciones, tras un análisis tanto epidemiológico como de la seguridad, efectividad y eficiencia de las vacunas actuales, incluyendo grados de recomendación. Es el calendario que se estima idóneo actualmente para los niños residentes en España. En cuanto a las vacunas oficiales incluidas en el calendario común, se recalca la posibilidad de vacunar indistintamente frente a hepatitis B desde el nacimiento o desde los 2 meses; la recomendación de la primera dosis de triple vírica y de varicela a los 12 meses y la segunda a los 2-3 años; la administración de la vacuna DTPa o Tdpa a los 6 años, con refuerzo en la adolescencia; estrategias con Tdpa en embarazadas y convivientes del recién nacido, y la inmunización frente al papilomavirus en niñas a los 11-12 años con pauta de 2 dosis (0, 6 meses). Este comité insiste en la vacunación antineumocócica universal, tal y como se está llevando a cabo en todos los países de Europa Occidental. La vacuna frente al meningococo B, autorizada pero bloqueada actualmente en España, presenta un perfil de vacuna sistemática y se reivindica que, al menos, esté disponible en las farmacias comunitarias. Se propone, igualmente, la disponibilidad pública de las vacunas frente a la varicela, ya que han demostrado ser efectivas y seguras a partir del segundo año de vida. La vacunación frente al rotavirus es recomendable en todos los lactantes. La vacunación antigripal anual y la inmunización frente a la hepatitis A están indicadas en grupos de riesgo

The Advisory Committee on Vaccines of the Spanish Association of Paediatrics updates the immunisation schedule every year, taking into account epidemiological data as well as evidence on the safety, effectiveness and efficiency of current vaccines, including levels of recommendation. In our opinion, this is the optimal vaccination calendar for all children resident in Spain. Regarding the vaccines included in the official unified immunization schedule, the Committee emphasizes the administration of the first dose of hepatitis B either at birth or at 2 months of life; the recommendation of the first dose of MMR and varicella vaccine at the age of 12 months, with the second dose at the age of 2-3 years; DTaP or Tdap vaccine at the age of 6 years, followed by another Tdap booster dose at 11-12 years old; Tdap strategies for pregnant women and household contacts of the newborn, and immunization against human papillomavirus in girls aged 11-12 years old with a 2 dose scheme (0, 6 months). The Committee reasserts its recommendation to include vaccination against pneumococcal disease in the routine immunisation schedule, the same as it is being conducted in Western European countries. The recently authorised meningococcal B vaccine, currently blocked in Spain, exhibits the profile of a universal vaccine. The Committe insists on the need of having the vaccine available in communitary pharmacies. It has also proposed the free availability of varicella vaccines. Their efectiveness and safety have been confirmed when they are administred from the second year of life. Vaccination against rotavirus is recommended in all infants. The Committee stresses the need to vaccinate population groups considered at risk against influenza and hepatitis A

Misconduct in third-party assisted reproduction: a committee opinion.

Physicians who are told or discover information that would be material to another party's participation in an assisted reproductive technology (ART) arrangement (such as lawyer's, donor's, gestational carrier's, or intended parent's) should encourage disclosure to that party. In some instances, it is ethically and legally permissive for the physician to either disclose material information to an affected party or to transfer care of a patient to another willing provider. In all cases involving the legal status or rights of the parties, referral to legal professionals is advised.

When is medical industry backing lacking?

A sales representative from Megastint approached Dr A. Krasia with an offer to financially support future educational conferences and allow his institution to be a training center if he participates in a new study comparing an old product to a recently approved and more expensive one. Dr Krasia and his department currently use Megastint's products. The medical center's utilization committee must approve the addition of more expensive pharmaceuticals, devices, or equipment, and Dr Krasia is the chair. How should Dr Krasia respond to Megastint's offer of financial support and to become a training center?

La educación en bioética, camino para la profesionalidad / Education in bioethics, a way for professionalism

Uno de los elementos que han definido históricamente las profesiones diferenciándolas de los oficios es que sus responsabilidades se han definido más en términos morales que jurídicos. Porque no es el obligado respeto a la ley, sino la tendencia a la excelencia moral la característica fundamental de las profesiones. La profesionalidad es la base del contrato de la medicina con la sociedad y exige colocar los intereses de los pacientes por encima de los del médico, suministrando estándares de competencia e integridad, y proporcionando asesoría experta a la sociedad en cuestiones de salud. Un instrumento adecuado para conseguirla es la educación en bioética en cuanto estudio interdisciplinario de los problemas creados por los progresos médicos, biológicos y sus correspondientes tecnologías, para encontrar lo que es más humano en su aplicación práctica(AU)

One of the elements that have historically defined professions making them different from mere occupations is the fact that their responsibilities have been defined more in moral than juridical terms. Because it is not the due respect to the law but the tendency to moral excellence the fundamental characteristic of professions. Professionalism is the base of medicine's contract with society and it obliges to put patients’ interests above the doctors’ ones, supplying competence and integrity standards, and providing expert help to society in health matters. Education in bioethics is an appropriate instrument to reach this goal, as it promotes an interdisciplinary analysis of the problems created by the medical and biological progress and its correspondent technologies, to find what is most human in its practical application(AU)

Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008 / European Guideline of Cardiovascular Disease Prevention in the Clinical Practice. Spanish Adaptation of the CEIPC 2008

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Towards a European programme in human morphology - A masters degree in anatomy?

Human morphological sciences are facing an "identity crisis" and, in Europe, there is an urgent need for a dedicated programme of training for teachers and researchers in anatomy. The "Bologna process" (which in 1999 proposed harmonization of academic curriculum in order to favour exchange of students and researchers inside the European Union) provides a unique opportunity to organise a common curriculum in anatomy. The first step could be the creation of modules for a European Master 2 course in anatomy/biomorphology. At the present time, in the University of Paris Descartes, there is no Master's course in Anatomy (except in the osteo-articular part of the Master 2 Health and Life Science programme or in the neurobiology Master's programme). Anatomists at the University of Paris Descartes are endeavouring to find other European universities to help organise a programme of training for future teachers of anatomy in France (and perhaps elsewhere in Europe) (AU)

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The participation of Anatomy Departments in the continuing professional development of surgeons

We have divided this article into five sections organised as follows. The first section expresses our views concerning the relevance of anatomy to the training of clinicians and surgeons. The second section analyses clinicians and surgeons perceptions about the relevance of anatomy for their training and is based upon the results of a questionnaire. The third section discusses whether surgeons or anatomists should be organising Continuing Professional Development (CPD) courses. The fourth section attempts to define the criteria for organising and developing surgical training courses. The fifth, and final, section outlines our experiences of planning and initiating surgical training courses (AU)

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