Medicina y Ética

Introduction

María Elizabeth de los Ríos Uriarte — Thu, 02 Jan 2025 00:00:00 -0600

We open this new year with new energy and renewed enthusiasm to continue promoting scientific research in bioethics through our journal. Starting this year, we will try to increase the number of articles published per year in order to continue and ensure our current indexing and those to come in 2025. That is why, in this issue we have published seven articles and a review and we have varied topics ranging from rigorous reflections that take up ethical and bioethical aspects of the COVID-19 pandemic that, four years later, have been analyzed more objectively, to innovative proposals on current topics of research and organ transplantation.

Bridging divides: bioethics insights in navigating trust and polarization in a post-covid era

José Tham — Thu, 02 Jan 2025 00:00:00 -0600

The polarization of opinions and positions during the COVID-19 pandemic is unmistakable. While there are many areas of debate, our primary focus surrounds the controversies of the COVID-19 vaccine. The SAGE Report (who 2014) on vaccine hesitancy listed three critical factors —complacency, convenience and confidence— which recurred during the pandemic. Of these, trust or confidence emerges as the central driver of polarization. Distrust spans various dimensions: government, science, pharmaceutical companies, novel vaccines, and information sources linked to peer groups and social media. Polarization is not due to information scarcity but is deeply intertwined with social identity. The echo chamber effect exacerbates this phenomenon, reinforcing beliefs within like-minded circles. The paper explores how different trust facets significantly influenced vaccine hesitancy during COVID. Finally, there is a need to reevaluate the effectiveness of vaccine mandates and social media screening, do they reduce hesitancy or inadvertently worsen polarization by eroding trust?

Compassion in the world of therapeutic relationships: a practical tool to introduce it in an intelligent way

Luis Gerardo Dávila Rodríguez — Thu, 02 Jan 2025 00:00:00 -0600

This article is part of the creation of a culture of care for the other, a sign of civilization and humanization, whose objective is to reflect on the role of compassion in the improvement of therapeutic links. It is noted that the world of medicine is often overtaken by the advances of technology and science, leaving aside the compassionate and humanistic part. Therefore, it is necessary to re-found compassion in therapeutic bonds and to insert it in the dynamics of medical and therapeutic care. In turn, a more complete understanding of the person and of the different stages of life that make up the person is proposed. Finally, the aim is to introduce compassion in a concrete way, through “successful conversation”, i.e. intelligent and compassionate listening and dialogue.

Embryonic models with stem cells: a pending ethical-legal reflection

Marta Reguera Cabezas — Thu, 02 Jan 2025 00:00:00 -0600

In recent years, the development of in vitro models with human stem cells that simulate early embryonic development has experienced great progress. Difficulties in accessing human embryos, the scarcity of embryonic material and the technical, legal and ethical challenges to research and experimentation with human embryos in vitro continue to be a barrier to progress in the knowledge of embryogenesis after gastrulation.

The aim of the present research work is to introduce the state of the question and to analyze the ethical-legal situation that regulates these models of development. Briefly exposing the situation in Spanish territory.

The research methodology was based on the analysis of scientific publications, legal norms and ethical principles. The main conclusion drawn is that the limits of embryoid research have not been described and are likely to become indispensable as research advances towards models with the potential to be transferred and gestated in utero.

The Observatory of the Ibero-American Bioethics Network (ORIBI), bases for its operation

Thu, 02 Jan 2025 00:00:00 -0600

The text presents a detailed overview of the importance and operation of the Observatory of the Ibero-American Network of Bioethics (Observatorio de la Red Iberoamericana de Bioética, ORIBI, by its acronym in Spanish), arguing the relevance of bioethics in contemporary times. Bioethics, defined as ethics applied to life, has expanded its influence beyond medicine to encompass areas such as the environment, human rights and the fight against poverty, highlighting the interdisciplinary approach essential to address complex ethical dilemmas. The ORIBI, developed by the Anáhuac Center for Strategic Development in Bioethics (Centro Anáhuac de Desarrollo Estratégico en Bioética CADEBI, by its acronym in Spanish), seeks to consolidate some dispersed efforts in Ibero-America, fostering regional collaboration in bioethics research, training and management. It highlights the need for collaborative work among existing observatories, taking advantage of resources and knowledge to promote social welfare. ORIBI plans its action around continuous monitoring, analysis of activities and networking, relying on tools such as the Ibero American Atlas of Bioethics and a series of follow-up indicators. This strategic and flexible approach allows the observatory’s operation to adapt to emerging challenges.

Violence and pandemic by COVID-19: physicians’ views on scarce resources for health in critical situations

Ivette María Ortiz Alcántara, Felicitas Holzer — Thu, 02 Jan 2025 00:00:00 -0600

The aim of this article is to contribute to the knowledge and reflection on the experiences faced by medical personnel in critical situations. Eleven interviews were conducted with physicians in different regions of the country, using a script developed from a literature review in academic articles and online media. With the data collected, a matrix was constructed, and a thematic analysis was performed. Five sets of themes were identified: (i) Physicians’ general information and motives for working in critical areas; (ii) effects of violence and the COVID-19 pandemic on health service delivery; (iii) Health resources; (iv) The ambivalence of triage: relief from shortages, but moral dissatisfaction towards physicians; and (v) Governance and public policies. As conclusions, it can be said that the interaction of two critical situations, violen- ce and the COVID-19 pandemic, poses ethical challenges that require deep reflection.

Facial transplantation as a human right and preservation of identity

Juan Manuel Palomares Cantero — Thu, 02 Jan 2025 00:00:00 -0600

This article examines the ethical and legal aspects of biolegal issues in the context of facial vascularized composite allotransplantation. It highlights the importance of preserving facial identity as a fundamental right due to the central role of the face in human communication and relationships. Facial transplantation allows people to restore their original appearance, which contributes to regain confidence and emotional connection. From a bioethical and humanistic perspective, this intervention protects human rights and improves the well being of recipients. Informed consent guarantees the recipient’s autonomy, while science provides personalized options and fosters rigorous ethics. Facial transplantation promotes the right to have a recognizable face,

Critical analysis of use of potassium chloride in Abortions and Fetal Suffering

Agustín Antonio Herrera Fragoso, Anastasia Nebel Herrera — Thu, 02 Jan 2025 00:00:00 -0600

This article examines the use of potassium chloride (KCl) in abortions after 20 weeks gestation and the ethical, medical, and legal implications of this practice. There are concerns about possible fetal distress, as research indicates that the fetus may experience pain earlier than previously thought. In addition, the use of KCl, banned in animal euthanasia because of the pain it causes, is contradictory when its use on human fetuses is supported. The text calls for a review of current policies so that they conform to scientific evidence and respect the dignity of all involved.

Eutanasia y objeción de conciencia

Alberto Patiño Reyes — Thu, 02 Jan 2025 00:00:00 -0600

To begin with, its publication is due to the treatment given to conscientious objection in Organic Law 3/2021, of March 24, on the regulation of euthanasia in Spain. With this legislation, euthanasia went from being considered a crime to becoming a right to be provided by the Public Administration. Therefore, its objective is to analyze the conscientious objection of healthcare personnel in the practice of this “new right”.