principios de la bioética 3
Introduction to Bioethics
Welcome and Course Overview
- Dr. Karina Castelana Raga welcomes participants to the preparatory course for the medical degree at Universidad Autónoma de Querétaro, focusing on bioethics.
Learning Objectives
- The course aims to help students understand fundamental ethical principles, analyze ethical dilemmas in healthcare and research, and promote a culture of respect for human dignity.
Understanding Bioethics
Definition and Scope
- According to the World Health Organization (WHO), bioethics is defined as the systematic study of human conduct in life sciences and healthcare, guided by ethical values.
Regulatory Bodies in Mexico
- In Mexico, bioethics is primarily regulated by the National Commission of Bioethics (Comisión Nacional de Bioética), which operates under the Ministry of Health with technical autonomy.
State-Level Commissions
- Each Mexican state has its own bioethics commission that collaborates with the national body to ensure effective communication and implementation of bioethical policies.
Legal Framework of Bioethics
Legal Instruments
- The legal framework governing bioethics in Mexico includes various codes such as the Federal Civil Code, Federal Code of Civil Procedures, and Federal Tax Code.
Coordination System
- The regulation system involves coordination between national and local commissions to effectively address bioethical issues across different sectors like healthcare and research.
Who Studies Bioethics?
Specialists' Role
- Bioethicists are professionals dedicated to ensuring respect for individuals' rights concerning decisions impacting their health and lives while upholding ethics, autonomy, and equality.
Core Principles of Bioethics
Four Fundamental Principles
- Autonomy:
- Refers to individuals' right to make informed decisions about their health while respecting their values; requires obtaining informed consent before medical interventions.
- Beneficence:
- Obliges healthcare providers to act in patients' best interests by promoting well-being while avoiding harm.
- Non-maleficence:
- Encapsulated in "first do no harm," this principle emphasizes minimizing risks associated with treatments or interventions.
- Justice:
- Focuses on equitable distribution of healthcare resources ensuring access regardless of social or economic status; promotes equality among all patients.
Application of Ethical Principles in Healthcare
Responsibilities of Psychologists
- Psychologists must adhere strictly to non-maleficence by avoiding any form of harm towards clients or subjects involved in their professional activities.
Autonomy Considerations
- Patient autonomy is crucial; it involves providing adequate information for informed consent while recognizing that autonomy may conflict with other principles like beneficence or justice during decision-making processes.
Clinical Ethics and Patient Autonomy
Importance of Clinical Ethics Training
- Emphasizes the need for clinical ethics training among healthcare professionals to foster genuine alliances with patients.
- Highlights that patient autonomy is crucial, defined as a person's ability to make informed decisions regarding their care.
Patient Interaction and Experience
- A patient expresses discomfort with a new nurse, requesting someone more experienced for better care.
- The nurse reassures the patient, encouraging open communication about their concerns and ensuring they feel comfortable during the examination.
Principles of Beneficence in Nursing
- Introduces the principle of beneficence, which focuses on promoting well-being and avoiding harm to patients.
- Discusses how nurses should act within their competencies while providing care, emphasizing ethical responsibilities.
Justice in Patient Care
- Explains the principle of justice in healthcare, advocating for equality and fairness in treating patients based on urgency rather than bias.
Ethical Dilemmas in Practice
- Describes a conflict between nurses regarding appropriate treatment methods for a patient, highlighting ethical standards in practice.
- Stresses that all patients deserve respectful treatment regardless of circumstances; unethical behavior must be addressed by higher authorities.
Patient Autonomy: Key Concepts
Informed Consent
- Defines informed consent as a patient's right to accept or reject medical treatments based on personal reasoning, even if deemed irrational by others.
Refusal of Treatment
- Provides an example where a patient may refuse life-saving blood transfusions due to religious beliefs (e.g., Jehovah's Witnesses), illustrating respect for individual choices.
Treatment Options
- Discusses how patients can choose less invasive treatments despite potentially lower effectiveness, underscoring the importance of respecting patient preferences.
Ethical Considerations in Medical Practice
Patient Autonomy and Religious Beliefs
- Patients, such as Jehovah's Witnesses, may refuse blood transfusions due to religious beliefs, opting for alternatives like crystalloid solutions.
- Decisions regarding end-of-life care can involve patients choosing to discontinue life-prolonging treatments or designating a family member to make decisions on their behalf if they lose capacity.
Euthanasia and Assisted Death
- The discussion includes the increasing requests for assisted death or euthanasia from patients suffering from terminal illnesses, highlighting ethical dilemmas faced by healthcare providers.
Confidentiality and Professional Secrecy
- The principle of professional secrecy mandates that patient information shared with physicians must remain confidential unless legally required to disclose it during judicial processes.
Beneficence in Medical Care
- Beneficence involves providing medical care to vulnerable populations, ensuring access regardless of financial status. This includes emergency treatment at private hospitals when necessary.
- Vaccination is highlighted as an act of beneficence that protects both individuals and community health through collective immunity.
Preventive Interventions and Patient Rights
- Preventive measures like early disease detection and promoting healthy habits are essential acts of beneficence aimed at reducing disease severity.
- Advocacy for patient rights ensures they receive appropriate care even in complex situations, emphasizing the importance of emotional support for patients facing serious health challenges.
Non-Maleficence: Avoiding Harm
- Non-maleficence is a fundamental ethical principle guiding clinical practice, focusing on preventing unnecessary harm to patients.
- Healthcare professionals should avoid prescribing harmful medications without proper evaluation and ensure safe procedures that minimize pain during treatment.
Ethical Research Practices
- In medical research, ethical standards must be upheld by minimizing risks to participants while ensuring informed consent about potential dangers associated with treatments.
Justice in Medical Ethics
Principles of Justice in Healthcare
- In emergency situations, it is crucial to stabilize the patient while avoiding interventions that may cause further harm. This highlights the importance of ethical decision-making in medical emergencies.
- Justice is defined as the equitable distribution of healthcare resources, ensuring all patients have access based on their individual needs and without discrimination.
- Access to medical resources must be guaranteed for all patients, regardless of geographic location or socioeconomic status. Vulnerable populations often face significant barriers to accessing necessary consultations, treatments, and medications.
- Equitable allocation of medical resources involves considering the diverse needs of different patient groups and actively working to prevent discrimination in healthcare delivery.
- Adapting healthcare services to meet the specific needs of marginalized groups—such as individuals with disabilities or elderly patients—is essential for achieving justice in medical ethics.
Combating Discrimination and Ensuring Transparency
- Addressing discrimination within healthcare ensures that all patients are treated with respect and dignity, irrespective of their ethnic background, gender, sexual orientation, or other personal characteristics.
- Transparency in decision-making processes regarding access to treatment and resources is vital. Patients and communities should be involved in these decisions to ensure fairness and equity.
Conclusion: The Role of Bioethics
- Bioethics emerges as a necessary framework for regulating moral decision-making under uncertainty concerning human life. It encourages ongoing reflection on ethical practices within healthcare settings.