La pandemia COVID-19: Priorización sanitaria en España

La pandemia COVID-19, desarrollada durante 2020 y 2021, ha sido un acontecimiento que ha ocasionado que varios aspectos en la organización de nuestra sociedad se hayan visto afectados, produciendo el desarrollo de una crisis originalmente sanitaria, que ha tenido numerosas consecuencias. Dentro del ámbito de la salud, uno de los procesos más relevantes que ha tenido que ser adaptado a esta nueva situación ha sido el triaje a causa de los escasos recursos sanitarios. Este proceso ha pasado por numerosas etapas con el fin de conseguir un protocolo estandarizado para toda España, elaborado mediante la colaboración del Ministerio de Sanidad, el Comité de Bioética de España y otras entidades. Para ello ha sido fundamental el papel de la bioética, así como el de expertos en el ámbito de la salud, científicos y juristas, ya que la visión conjunta de todos ellos ha permitido una evaluación más amplia de la situación. Al igual que en España, otros países como Francia e Italia han tenido que recurrir a comités de bioética para el manejo de la situación. La vacunación también ha necesitado del establecimiento de un triaje al no haber suficientes dosis para todos. Estos aspectos se analizan en este estudio. The COVID-19 pandemic, developed during 2020 and 2021, has been an event that has caused that several aspects in the organization of our society have been affected, producing the development of an originally health crisis, which has had numerous consequences. Within the health field, one of the most relevant processes that has had to be adapted to this new situation has been triage due to scarce health resources. This process has gone through numerous stages in order to achieve a standardized protocol for Spain, prepared in collaboration with the Ministry of Health, the Bioethics Committee of Spain and other entities. For this, the role of bioethics has been fundamental, as well as that of experts in the field of health, scientists and lawyers, since the joint vision of all of them has allowed a broader evaluation of the situation. As in Spain, other countries such as France and Italy have had to resort to bioethics committees to manage the situation. Vaccination has also required the establishment of a triage as there are not enough doses for everyone. These aspects are evaluated in this study.

Current overview of assistance bioethics committees in Chile

The article examines and analyzes the functioning of healthcare ethics committees in Chile. For this, through an extensive bibliographic review, parameters were established that allow indicating improvements to the system that regulates the Ethical-Assistance Committees (CEA) in the Latin American nation, based on a case study that corresponds to the University of Chile.

Ethics and nutrition safety in patient care during COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic has impacted all aspects of our population. Ethical dilemmas related to the care of patients in the COVID-19 pandemic need to be rapidly addressed by multidisciplinary bioethics committees, with the development of policies and procedures to assist providers in making difficult allocation decisions. Recent ethical considerations regarding allocation of scarce resources, such as mechanical ventilators, have been proposed. These can apply to other disciplines such as nutrition support, although decisions regarding nutrition support have a diminished potential for devastating outcomes. The nutrition support professionals are pivotal in assessing the patient’s overall condition and need for, if any, nutrition interventions.

OC 8535 AN OVERVIEW OF RESEARCH ETHICS COMMITTEES OPERATING IN LUSOPHONE AFRICAN COUNTRIES

BackgroundIn 2017, a North-South partnership was created, to strengthen Bioethics Committees in African Lusophone African countries (LAC), by joining the forces of National and Institutional Research Ethics Committees (REC) and Universities in Angola, Cape Verde, Mozambique and Portugal. This study is part of an EDCTP2-funded project and aims to describe key RECs operating in LAC, its establishment dates and further characteristics.MethodsDocument analysis and interviews with REC representatives of five LAC were conducted in April 2018. Legal documents were obtained through official national sources.ResultsWe identified four National Ethics Committees, created between 2000 and 2008 by ministerial or governmental decree; only S. Tomé e Principe does not have an established REC. In Angola, the National REC was created in 2000, and since 2007, seven Institutional Committees were implemented at faculty level. National REC in Cape Verde and Guinee-Bissau (CNES) are unique and were founded in 2007 and 2009 respectively. In Mozambique, National REC (CNBS) dates to 2002, and since 2011, 8 Institutional Committees were formed; they functioned as a network under the umbrella of CNBS. Most National REC have representatives from health professional associations, lawyers, civil society and religious communities and have regular meetings (usually monthly). The number of members ranges between 6 (CNES) and 13 (CNBS). In 2007, around 200 protocols were reviewed by CNBS and 29 by CNES. Most of the National REC members attended training activities in bioethics but at different levels.ConclusionFew publications described REC operating in LAC; this study fills this gap by reporting historical and functional characteristics of RECs in five Lusophone African countries. Additional tools based on quantitative and qualitative approaches are being developed to assess more in-depth REC operational characteristics and to identify their needs in order to target training and capacity building initiatives underlying our project.

DEONTOLOGY IN PREVENTIVE MEDICINE: SCIENTIFIC AND HISTORICAL BASES, CHALLENGES OF THE PRESENT AND SOLUTIONS

The article presents the peculiarities of medical deontology in preventive medicine. The differences between deontological problems in the activity of a Clinician and a Physician in the specialty of medical and preventive medicine are considered. The historical stages of the formation and development of ideas of deontology and medical ethics in Russia are shown. The comparative plan presents an analysis of the main legislative acts in the field of bioethics and deontology of medical and preventive medicine. The world community was noted to show a great interest in topical problems of bioethics: several World Congresses and European Conferences were held, in most countries of Europe and America national bioethics committees were established (in the USA and France they were organized under the Presidents of these States). The main goal of the doctor’s professional activity is to preserve human life, prevent diseases and restore health, as well as reduce suffering from incurable diseases. Much attention is paid to this problem in the Federal law of November 21, 2011. (N 323-FZ) about bases of the protection of the health of citizens in the Russian Federation “which is fundamental in the field of healthcare”. It establishes the obligation of medical and pharmaceutical workers to carry out their activities in accordance with the legislation of the Russian Federation, guided by the principles. The aim of this study was to develop and substantiate the main differences between deontological problems in the activities of clinicians and physicians in the specialty medical and preventive care in the historical aspect. An invaluable role in the development of the principles of deontology was played by outstanding doctors of the past: Hippocrates, Abu-l-Faraj, as well as Russian and Soviet scientists and doctors M.Ya. Mudrov, 8N.I. Pirogov, V.A. Manassein, V.I. Davydovsky, N.Kh. Petrov, B.V. Petrovsky. Separately, it is noted that the role of medicine can be radically changed, if not exclude the importance of the preventive direction, but, on the contrary, through it to strengthen the ideological and controlling.