Publicaciones
Publicación
Advance Requests for Medical Assistance in Dying
(10-diciembre-2024)
Recientemente se ha publicado un artículo del investigador Luis Espericueta donde reúne y analiza por primera vez todas las normativas en el mundo sobre solicitudes de eutanasia por medio de instrucciones previas.
Enlace al artículo: https://www.longwoods.com/content/27478/healthcare-policy/advance-requests-for-medical-assistance-in-dying-in-the-international-context-some-legal-issues-for
Enlace al preprint: https://hdl.handle.net/10481/97669
Abstract
An advance request for medical assistance in dying (ARM) is a document that allows individuals to request euthanasia if they lose their decision-making capacity. Currently, it is available in all countries where medical assistance in dying is permitted for individuals suffering from a serious and incurable illness whose natural death is not reasonably foreseeable, except in Canada. In this country, various citizen and parliamentary initiatives are considering the inclusion of this document in national legislation. This article presents for the first time a compilation of all ARM regulations worldwide. Analysis of the international framework suggests that the requirements for drafting an ARM could influence the effective implementation of patients' wishes.
Advance Requests for Medical Assistance in Dying
(10-diciembre-2024)
Recientemente se ha publicado un artículo del investigador Luis Espericueta donde reúne y analiza por primera vez todas las normativas en el mundo sobre solicitudes de eutanasia por medio de instrucciones previas.
Enlace al artículo: https://www.longwoods.com/content/27478/healthcare-policy/advance-requests-for-medical-assistance-in-dying-in-the-international-context-some-legal-issues-for
Enlace al preprint: https://hdl.handle.net/10481/97669
Abstract
An advance request for medical assistance in dying (ARM) is a document that allows individuals to request euthanasia if they lose their decision-making capacity. Currently, it is available in all countries where medical assistance in dying is permitted for individuals suffering from a serious and incurable illness whose natural death is not reasonably foreseeable, except in Canada. In this country, various citizen and parliamentary initiatives are considering the inclusion of this document in national legislation. This article presents for the first time a compilation of all ARM regulations worldwide. Analysis of the international framework suggests that the requirements for drafting an ARM could influence the effective implementation of patients' wishes.
Publicación
Contraceptive digital pills and sexual and reproductive healthcare of women with mental disabilities: Problem or solution?
(20-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un capítulo un artículo en la revista Bioethics.
Autoras: Rosana Triviño, María Victoria Martínez-López
Se puede acceder a través de este enlace: doi.org/10.1111/bioe.13372
Contraceptive digital pills and sexual and reproductive healthcare of women with mental disabilities: Problem or solution?
(20-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un capítulo un artículo en la revista Bioethics.
Autoras: Rosana Triviño, María Victoria Martínez-López
Se puede acceder a través de este enlace: doi.org/10.1111/bioe.13372
Publicación
Exploring the Ethics of Interaction with Care Robots
(20-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un capítulo en el libro Ethics Of Artificial Intelligence. The International Library of Ethics, Law and Technology.
Autores: María Victoria Martínez-López, Gonzalo Díaz-Cobacho, Aníbal M. Astobiza & Blanca Rodríguez López
Se puede acceder a través de este enlace:
link.springer.com/chapter/10.1007/978-3-031-48135-2_8
Exploring the Ethics of Interaction with Care Robots
(20-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un capítulo en el libro Ethics Of Artificial Intelligence. The International Library of Ethics, Law and Technology.
Autores: María Victoria Martínez-López, Gonzalo Díaz-Cobacho, Aníbal M. Astobiza & Blanca Rodríguez López
Se puede acceder a través de este enlace:
link.springer.com/chapter/10.1007/978-3-031-48135-2_8
Publicación
Eutanasia: razones, mitos y desatinos
(12-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en AMF: Actualización de Medicina en Familia. El artículo tiene como objetivo analizar cinco argumentos comúnmente utilizados en contra de la Ayuda Médica para Morir (AMpM), que a menudo se basan en tradiciones o intuiciones poco respaldadas por evidencia, pudiendo considerarse mitos. No busca defender ideológicamente la eutanasia, sino revisar las falencias en estos argumentos para clarificar el debate. Aunque estos razonamientos no invalidan completamente la AMpM, es importante tenerlos en cuenta para advertir sobre posibles riesgos y situaciones éticamente problemáticas. Se subraya la necesidad de una reflexión ética rigurosa respecto a la AMpM, tanto antes de su legalización como en su proceso de implementación.
Autores: Ramón Ortega Lozano, María Victoria Martínez-López y Belén Liedo
Se puede acceder a través de este enlace: www.inedyto.com/uploads/8/1/2/1/81219138/03_no_todo_es_clinica_eutanasia_mayo_22.pdf
Eutanasia: razones, mitos y desatinos
(12-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en AMF: Actualización de Medicina en Familia. El artículo tiene como objetivo analizar cinco argumentos comúnmente utilizados en contra de la Ayuda Médica para Morir (AMpM), que a menudo se basan en tradiciones o intuiciones poco respaldadas por evidencia, pudiendo considerarse mitos. No busca defender ideológicamente la eutanasia, sino revisar las falencias en estos argumentos para clarificar el debate. Aunque estos razonamientos no invalidan completamente la AMpM, es importante tenerlos en cuenta para advertir sobre posibles riesgos y situaciones éticamente problemáticas. Se subraya la necesidad de una reflexión ética rigurosa respecto a la AMpM, tanto antes de su legalización como en su proceso de implementación.
Autores: Ramón Ortega Lozano, María Victoria Martínez-López y Belén Liedo
Se puede acceder a través de este enlace: www.inedyto.com/uploads/8/1/2/1/81219138/03_no_todo_es_clinica_eutanasia_mayo_22.pdf
Publicación
Eutanasia y libertad de conciencia: derechos y obligaciones profesionales
(12-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en AMF: Actualización de Medicina en Familia en el que abordan la eutanasia y la objeción de conciencia en el ámbito médico. Destacan que los profesionales de la salud pueden invocar la objeción de conciencia si tienen objeciones personales a practicar la eutanasia, pero esto no debe afectar el acceso ni la calidad de la atención médica.
Se puede acceder a través de este enlace: search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=16999029&asa=N&AN=156958453&h=XAhSIzUw4%2F14dBAQy2BOyDu2ii6DZlw2CIXe1NihvFyvq7%2FATP1aznBq5oicLtqnRMnom6qaKSLjUJh1I%2FZgcQ%3D%3D&crl=c
Eutanasia y libertad de conciencia: derechos y obligaciones profesionales
(12-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en AMF: Actualización de Medicina en Familia en el que abordan la eutanasia y la objeción de conciencia en el ámbito médico. Destacan que los profesionales de la salud pueden invocar la objeción de conciencia si tienen objeciones personales a practicar la eutanasia, pero esto no debe afectar el acceso ni la calidad de la atención médica.
Se puede acceder a través de este enlace: search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=16999029&asa=N&AN=156958453&h=XAhSIzUw4%2F14dBAQy2BOyDu2ii6DZlw2CIXe1NihvFyvq7%2FATP1aznBq5oicLtqnRMnom6qaKSLjUJh1I%2FZgcQ%3D%3D&crl=c
Publicación
Narrativas de final de vida: cuando su voz debería ser el centro
(12-noviembre-2024)
Iris Parra ha publicado un artículo en la colección seminario Ética y valores de cuidar en la revista Cuidado y ética del cuidado: Necesidades y evidencias para investigar y avanzar en el que habla sobre su experiencia en el proyecto "Narrativas de final de vida de pacientes que solicitan ayuda para morir", liderado por David Rodríguez-Arias y todo el equipo de INEDyTO.
Se puede acceder a través de este enlace: www.researchgate.net/profile/Iris-Parra-Jounou/publication/374532334_Narrativas_de_final_de_vida_cuando_su_voz_deberia_ser_el_centro/links/6521c5d5fc5c2a0c3bbff44d/Narrativas-de-final-de-vida-cuando-su-voz-deberia-ser-el-centro.pdf
Narrativas de final de vida: cuando su voz debería ser el centro
(12-noviembre-2024)
Iris Parra ha publicado un artículo en la colección seminario Ética y valores de cuidar en la revista Cuidado y ética del cuidado: Necesidades y evidencias para investigar y avanzar en el que habla sobre su experiencia en el proyecto "Narrativas de final de vida de pacientes que solicitan ayuda para morir", liderado por David Rodríguez-Arias y todo el equipo de INEDyTO.
Se puede acceder a través de este enlace: www.researchgate.net/profile/Iris-Parra-Jounou/publication/374532334_Narrativas_de_final_de_vida_cuando_su_voz_deberia_ser_el_centro/links/6521c5d5fc5c2a0c3bbff44d/Narrativas-de-final-de-vida-cuando-su-voz-deberia-ser-el-centro.pdf
Publicación
Hit by the virtual trolley: When is experimental ethics unethical?
(12-noviembre-2024)
Jon Rueda ha publicado un artículo en la revista Teorema en el que presenta fundamentos para investigar la conducta moral en escenarios más realistas a través de la Realidad Virtual y resumen las evidencias generadas por los experimentos con tranvías virtuales.
Se puede acceder a través de este enlace: www.jstor.org/stable/27118201
Hit by the virtual trolley: When is experimental ethics unethical?
(12-noviembre-2024)
Jon Rueda ha publicado un artículo en la revista Teorema en el que presenta fundamentos para investigar la conducta moral en escenarios más realistas a través de la Realidad Virtual y resumen las evidencias generadas por los experimentos con tranvías virtuales.
Se puede acceder a través de este enlace: www.jstor.org/stable/27118201
Publicación
Rethinking the Role of Experimental Philosophy in Bioethics
(12-noviembre-2024)
Gonzalo Díaz-Cobacho e Ivar R. Hannikainen han publicado un artículo en la revista The American Journal of Bioethics en el que comentan el artículo "The Place of Pholosophy in Bioethics Today" repensando el papel que tiene hoy en día la Filosofía Experimental en la Bioética.
Se puede acceder a través de este enlace: doi.org/10.1080/15265161.2022.2134494
Rethinking the Role of Experimental Philosophy in Bioethics
(12-noviembre-2024)
Gonzalo Díaz-Cobacho e Ivar R. Hannikainen han publicado un artículo en la revista The American Journal of Bioethics en el que comentan el artículo "The Place of Pholosophy in Bioethics Today" repensando el papel que tiene hoy en día la Filosofía Experimental en la Bioética.
Se puede acceder a través de este enlace: doi.org/10.1080/15265161.2022.2134494
Publicación
A letter to the article "Whole Body Gestational Donation" published by Anna Smajdor in Theoretical Medicine and Bioethics.
(4-noviembre-2024)
Gonzalo Díaz-Cobacho ha publicado un artículo en la revista Theoretical Medicine and Bioethics en el que hace un análisis del artículo “Whole Body Gestational Donation” de Anna Smajdor en el que plantea un experimento mental en el que se propone el uso de cuerpos de personas fallecidas con muerte cerebral para gestar bebés.
Se puede acceder a través de este enlace: doi.org/10.1007/s11017-023-09630-6
A letter to the article "Whole Body Gestational Donation" published by Anna Smajdor in Theoretical Medicine and Bioethics.
(4-noviembre-2024)
Gonzalo Díaz-Cobacho ha publicado un artículo en la revista Theoretical Medicine and Bioethics en el que hace un análisis del artículo “Whole Body Gestational Donation” de Anna Smajdor en el que plantea un experimento mental en el que se propone el uso de cuerpos de personas fallecidas con muerte cerebral para gestar bebés.
Se puede acceder a través de este enlace: doi.org/10.1007/s11017-023-09630-6
Publicación
The toll of COVID-19 on organ donation and kidney transplantation in Europe: Do legislative defaults matter?
(4-noviembre-2024)
Alberto Molina Pérez ha publicado un artículo en la revista Health Policy en el que investiga cómo la pandemia de COVID-19 afectó las tasas de donación y trasplante de órganos en Europa.
Se puede acceder a través de este enlace: doi.org/10.1016/j.healthpol.2023.104890
Abstract:
This study investigates the cascading effects of COVID-19 pandemic on organ donation and transplantation in Europe. We also check whether legislative defaults for organ donation have a role in these outcomes. For this purpose, we used data from 32 European countries, between 2010 and 2021, and estimated pooled OLS regressions. We find that COVID-19 pandemic reduced deceased organ donation rates by 23.4%, deceased kidney transplantation rates by 27.9% and live kidney transplantation rates by 31.1% after accounting for health system capacity indicators. While our study finds that presumed consent legislation under normal circumstances leads to notable benefits in terms of deceased kidney transplantation and organ donation rates, the legislative defaults did not have a significant impact during the pandemic. Additionally, our findings indicate a trade-off between living and deceased transplantation that is influenced by the legislative default.
The toll of COVID-19 on organ donation and kidney transplantation in Europe: Do legislative defaults matter?
(4-noviembre-2024)
Alberto Molina Pérez ha publicado un artículo en la revista Health Policy en el que investiga cómo la pandemia de COVID-19 afectó las tasas de donación y trasplante de órganos en Europa.
Se puede acceder a través de este enlace: doi.org/10.1016/j.healthpol.2023.104890
Abstract:
This study investigates the cascading effects of COVID-19 pandemic on organ donation and transplantation in Europe. We also check whether legislative defaults for organ donation have a role in these outcomes. For this purpose, we used data from 32 European countries, between 2010 and 2021, and estimated pooled OLS regressions. We find that COVID-19 pandemic reduced deceased organ donation rates by 23.4%, deceased kidney transplantation rates by 27.9% and live kidney transplantation rates by 31.1% after accounting for health system capacity indicators. While our study finds that presumed consent legislation under normal circumstances leads to notable benefits in terms of deceased kidney transplantation and organ donation rates, the legislative defaults did not have a significant impact during the pandemic. Additionally, our findings indicate a trade-off between living and deceased transplantation that is influenced by the legislative default.
Publicación
Death Pluralism: a proposal
(12-noviembre-2024)
Gonzalo Díaz-Cobacho junto a otros miembros de INEDyTO han publicado un artículo en la revista Philosophy, Ethics, and Humanities in Medicine que examina los principales enfoques teóricos y prácticos sobre la determinación de la muerte y propone un nuevo enfoque denominado "pluralismo débil" como una alternativa ética y política razonable para respetar la diversidad en este ámbito.
Se puede acceder a través de este enlace: www.doi.org/10.1186/s13010-023-00139-3
Death Pluralism: a proposal
(12-noviembre-2024)
Gonzalo Díaz-Cobacho junto a otros miembros de INEDyTO han publicado un artículo en la revista Philosophy, Ethics, and Humanities in Medicine que examina los principales enfoques teóricos y prácticos sobre la determinación de la muerte y propone un nuevo enfoque denominado "pluralismo débil" como una alternativa ética y política razonable para respetar la diversidad en este ámbito.
Se puede acceder a través de este enlace: www.doi.org/10.1186/s13010-023-00139-3
Publicación
Primer informe oficial de la eutanasia en España: comparación con las experiencias canadiense y neozelandesa
(4-noviembre-2024)
Luis Espericueta ha publicado un artículo en la revista Medicina Clínica donde analiza el primer reporte anual del Ministerio de Sanidad español sobre la prestación de ayuda para morir, y compara la implementación de esta práctica en España con las experiencias de Canadá (2016) y Nueva Zelanda (2022).
Se puede acceder a través de este enlace: doi.org/10.1016/j.medcli.2023.06.014
Primer informe oficial de la eutanasia en España: comparación con las experiencias canadiense y neozelandesa
(4-noviembre-2024)
Luis Espericueta ha publicado un artículo en la revista Medicina Clínica donde analiza el primer reporte anual del Ministerio de Sanidad español sobre la prestación de ayuda para morir, y compara la implementación de esta práctica en España con las experiencias de Canadá (2016) y Nueva Zelanda (2022).
Se puede acceder a través de este enlace: doi.org/10.1016/j.medcli.2023.06.014
Publicación
Mapping trust relationships in organ donation and transplantation: a conceptual model
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista BMC Medical Ethics.
Autores: María Victoria Martínez-López, Alberto Molina-Pérez, David Rodríguez-Arias, Jorge Suárez, Janet Delgado
Se puede acceder a través de este enlace: doi.org/10.1186/s12910-023-00965-2
Abstract
The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates.
Mapping trust relationships in organ donation and transplantation: a conceptual model
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista BMC Medical Ethics.
Autores: María Victoria Martínez-López, Alberto Molina-Pérez, David Rodríguez-Arias, Jorge Suárez, Janet Delgado
Se puede acceder a través de este enlace: doi.org/10.1186/s12910-023-00965-2
Abstract
The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates.
Publicación
End-of-Life Narratives of Patients who request medical Assistance in Dying: A Qualitative Study Protocol
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista International Journal of Qualitative Methods
Autores: Mar Vallès-Poch, Iris Parra Jounou, Ramón Ortega-Lozano, Janet Delgado, María Victoria Martínez-López, Silvia M. Sánchez Garrido, Maria Isabel Tamayo-Velázquez, Rosana Triviño-Caballero, David Rodríguez-Arias
Se puede acceder a través de este enlace: doi.org/10.1177/16094069231202196
Abstract
Many groups (healthcare professionals, lawyers, philosophers, non-governmental organisations, bioethics committees, journalists, religious groups, etc.) participate in the bioethical debate about medical assistance in dying (MAiD). Bioethics literature on the topic involve different approaches (analytic, empirical, policy oriented, activist) and various normative perspectives (discourses based on deontological premises as the sanctity of life and human dignity, or on utilitarianism, libertarianism, etc.), some of which are at times irreconcilable. Regarding empirical studies, some voices (e.g., healthcare professionals) have been widely considered but the voice of people who request MAiD has been neglected. Understanding the personal and medical circumstances that lead to MAiD, which can only be achieved by listening to the phenomenological discourse of those involved, is key. This study aims to provide knowledge from the testimonies and experiences of patients who have initiated a MAiD request. We believe this research protocol can increase our understanding of a social and academic controversy that lacks important information to be complete. By doing so, this type of research could inform and improve end-of-life public policies, and particularly the health care of individuals who request a MAiD. We propose a qualitative phenomenological study using semi-structured interviews of people in the process of requesting MAiD, as outlined in the Ley Orgánica 3/2021, de regulación de la eutanasia (LORE), the Spanish Law on the Regulation of Euthanasia. The study is conducted nationally using a convenience sampling. The number of interviews is determined sequentially and cumulatively, depending on the richness of the narratives and the saturation of the information that has been collected. For the purposes of analysis, the interviews are transcribed verbatim and pseudonymised afterwards. Data analysis is conducted at the same time as data collection. The proposed study has received a favourable report from the Coordinating Committee on Biomedical Research Ethics of Andalusia (CCEIBA).
End-of-Life Narratives of Patients who request medical Assistance in Dying: A Qualitative Study Protocol
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista International Journal of Qualitative Methods
Autores: Mar Vallès-Poch, Iris Parra Jounou, Ramón Ortega-Lozano, Janet Delgado, María Victoria Martínez-López, Silvia M. Sánchez Garrido, Maria Isabel Tamayo-Velázquez, Rosana Triviño-Caballero, David Rodríguez-Arias
Se puede acceder a través de este enlace: doi.org/10.1177/16094069231202196
Abstract
Many groups (healthcare professionals, lawyers, philosophers, non-governmental organisations, bioethics committees, journalists, religious groups, etc.) participate in the bioethical debate about medical assistance in dying (MAiD). Bioethics literature on the topic involve different approaches (analytic, empirical, policy oriented, activist) and various normative perspectives (discourses based on deontological premises as the sanctity of life and human dignity, or on utilitarianism, libertarianism, etc.), some of which are at times irreconcilable. Regarding empirical studies, some voices (e.g., healthcare professionals) have been widely considered but the voice of people who request MAiD has been neglected. Understanding the personal and medical circumstances that lead to MAiD, which can only be achieved by listening to the phenomenological discourse of those involved, is key. This study aims to provide knowledge from the testimonies and experiences of patients who have initiated a MAiD request. We believe this research protocol can increase our understanding of a social and academic controversy that lacks important information to be complete. By doing so, this type of research could inform and improve end-of-life public policies, and particularly the health care of individuals who request a MAiD. We propose a qualitative phenomenological study using semi-structured interviews of people in the process of requesting MAiD, as outlined in the Ley Orgánica 3/2021, de regulación de la eutanasia (LORE), the Spanish Law on the Regulation of Euthanasia. The study is conducted nationally using a convenience sampling. The number of interviews is determined sequentially and cumulatively, depending on the richness of the narratives and the saturation of the information that has been collected. For the purposes of analysis, the interviews are transcribed verbatim and pseudonymised afterwards. Data analysis is conducted at the same time as data collection. The proposed study has received a favourable report from the Coordinating Committee on Biomedical Research Ethics of Andalusia (CCEIBA).
Publicación
Causes for Conscientious Objection in Medical Aid in Dying: A Scoping Review
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista Canadian Journal of Bioethics / Revue canadienne de bioéthique.
Autores: Rosana Triviño-Caballero, Iris Parra Jounou, Isabel Roldán Gómez y Teresa López de la Vieja
Se puede acceder a través de este enlace: doi.org/10.7202/1108007ar
Abstract
In the light of current legislation on Medical Aid in Dying (MAiD; also known as euthanasia and assisted suicide) in different countries worldwide, there have been some arguments devoted to the right to conscientious objection for healthcare professionals in these specific practices. The goals of this scoping review are to provide an overview of the motivations and causes that lie behind conscientious objection identified by previous literature according to professionals’ experiences and to verify if these motives match with theoretical debates on conscientious objection. As the results show, there is a dissonance between the motivations included in the traditional and mainstream definition of conscientious objection used in theoretical and speculative frameworks and the actual factors that empirical studies note as reported motivations to object to MAiD. Hence, either we consider new factors to include as causes of “conscience”, or we accept that there are motivations that are not actually applicable to conscientious objection and should be addressed by other means. As conscientious objection to MAiD is multifaceted, there can be different kinds of motivations acting at the same time. It is thus pertinent to rebalance theoretical and empirical considerations to fully understand the complexity of the phenomenon and so provide insights on how to best deal with conscientious objection.
Causes for Conscientious Objection in Medical Aid in Dying: A Scoping Review
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista Canadian Journal of Bioethics / Revue canadienne de bioéthique.
Autores: Rosana Triviño-Caballero, Iris Parra Jounou, Isabel Roldán Gómez y Teresa López de la Vieja
Se puede acceder a través de este enlace: doi.org/10.7202/1108007ar
Abstract
In the light of current legislation on Medical Aid in Dying (MAiD; also known as euthanasia and assisted suicide) in different countries worldwide, there have been some arguments devoted to the right to conscientious objection for healthcare professionals in these specific practices. The goals of this scoping review are to provide an overview of the motivations and causes that lie behind conscientious objection identified by previous literature according to professionals’ experiences and to verify if these motives match with theoretical debates on conscientious objection. As the results show, there is a dissonance between the motivations included in the traditional and mainstream definition of conscientious objection used in theoretical and speculative frameworks and the actual factors that empirical studies note as reported motivations to object to MAiD. Hence, either we consider new factors to include as causes of “conscience”, or we accept that there are motivations that are not actually applicable to conscientious objection and should be addressed by other means. As conscientious objection to MAiD is multifaceted, there can be different kinds of motivations acting at the same time. It is thus pertinent to rebalance theoretical and empirical considerations to fully understand the complexity of the phenomenon and so provide insights on how to best deal with conscientious objection.
Publicación
Por una salud pública feminista, otra lectura sobre la pandemia
(20-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la Revista Española de Salud Pública.
Autores: Iris Parra Jounou, Rosana Triviño, María Victoria Martínez-López
Este artículo reflexiona sobre la necesidad de repensar las instituciones de atención sanitaria, destacando la importancia de modelos de cuidado interdependientes y la lucha contra las jerarquías en profesiones feminizadas, desde la perspectiva de autoras con experiencia en atención sanitaria y bioética.
Se puede acceder a través de este enlace: ojs.sanidad.gob.es/index.php/resp/article/view/358
Por una salud pública feminista, otra lectura sobre la pandemia
(20-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la Revista Española de Salud Pública.
Autores: Iris Parra Jounou, Rosana Triviño, María Victoria Martínez-López
Este artículo reflexiona sobre la necesidad de repensar las instituciones de atención sanitaria, destacando la importancia de modelos de cuidado interdependientes y la lucha contra las jerarquías en profesiones feminizadas, desde la perspectiva de autoras con experiencia en atención sanitaria y bioética.
Se puede acceder a través de este enlace: ojs.sanidad.gob.es/index.php/resp/article/view/358
Publicación
A Slippery Argument: Ableism in the Debate on Medical Assistance in Dying
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista The American Journal of Bioethics.
Autores: Rosana Triviño, Jon Rueda, David Rodríguez-Arias
Se puede acceder a través de este enlace: doi.org/10.1080/15265161.2023.2256263
A Slippery Argument: Ableism in the Debate on Medical Assistance in Dying
(4-noviembre-2024)
Varios miembros del equipo de INEDyTO han publicado un artículo en la revista The American Journal of Bioethics.
Autores: Rosana Triviño, Jon Rueda, David Rodríguez-Arias
Se puede acceder a través de este enlace: doi.org/10.1080/15265161.2023.2256263
Publicación
Analysis of the legal situation regarding euthanasia in Ecuador, Colombia, and Peru: Towards a Latin American model of medical assistance in dying?
(23-julio-2024)
Luis Espericueta ha publicado un artículo en la revista Developing World Bioethics donde resume por primera vez toda la normativa vigente en materia de eutanasia en América Latina, a través de un estudio de fuentes primarias en español, y analiza algunas de las convergencias entre estos tres países vecinos.
Enlace a la versión de la revista:
https://onlinelibrary.wiley.com/share/author/VUAVIKMHMSTJPQEQQH4I?target=10.1111/dewb.12457
Enlace a la versión preprint: https://hdl.handle.net/10481/93392
Analysis of the legal situation regarding euthanasia in Ecuador, Colombia, and Peru: Towards a Latin American model of medical assistance in dying?
(23-julio-2024)
Luis Espericueta ha publicado un artículo en la revista Developing World Bioethics donde resume por primera vez toda la normativa vigente en materia de eutanasia en América Latina, a través de un estudio de fuentes primarias en español, y analiza algunas de las convergencias entre estos tres países vecinos.
Enlace a la versión de la revista:
https://onlinelibrary.wiley.com/share/author/VUAVIKMHMSTJPQEQQH4I?target=10.1111/dewb.12457
Enlace a la versión preprint: https://hdl.handle.net/10481/93392
Publicación
Euthanasia in detention and the ethics of caring solidarity: A case study of the ‘Tarragona Gunman’
(26-junio-2024)
Luis Espericueta ha publicado un artículo en la revista Bioethics donde identifica algunas deficiencias de los principales argumentos que se han esgrimido para justificar la ayuda médica para morir en prisión y propone la perspectiva de la ética del cuidado solidario para abordar este tipo de solicitudes éticamente complejas.
Se puede acceder a través de este enlace: https://doi.org/10.1111/bioe.13325
Abstract:
Almost a year after the enactment of the law regulating euthanasia in Spain, public opinion was shocked to learn that a defendant in criminal proceedings obtained medical assistance in dying following injuries sustained in an exchange of gunfire with the police after having committed a series of severe crimes. Although there are very few cases in the world where prisoners have received euthanasia, the one we will discuss in this article is the only known case where both the public prosecutor's office and the private prosecutors judicially opposed the defendant's euthanasia. This article aims to offer a new perspective on the ethical legitimacy of detainees' access to euthanasia: the ethics of caring solidarity. To do this, we will first place the case in its legal context. Subsequently, we will address the two main arguments proposed in the literature to justify euthanasia in detention: respect for the autonomy of the detainee and the principle of equivalence of care. Finally, after having identified serious shortcomings in both arguments, we will argue that the perspective of caring solidarity offers a better ethical basis for people in detention's access to euthanasia.
Euthanasia in detention and the ethics of caring solidarity: A case study of the ‘Tarragona Gunman’
(26-junio-2024)
Luis Espericueta ha publicado un artículo en la revista Bioethics donde identifica algunas deficiencias de los principales argumentos que se han esgrimido para justificar la ayuda médica para morir en prisión y propone la perspectiva de la ética del cuidado solidario para abordar este tipo de solicitudes éticamente complejas.
Se puede acceder a través de este enlace: https://doi.org/10.1111/bioe.13325
Abstract:
Almost a year after the enactment of the law regulating euthanasia in Spain, public opinion was shocked to learn that a defendant in criminal proceedings obtained medical assistance in dying following injuries sustained in an exchange of gunfire with the police after having committed a series of severe crimes. Although there are very few cases in the world where prisoners have received euthanasia, the one we will discuss in this article is the only known case where both the public prosecutor's office and the private prosecutors judicially opposed the defendant's euthanasia. This article aims to offer a new perspective on the ethical legitimacy of detainees' access to euthanasia: the ethics of caring solidarity. To do this, we will first place the case in its legal context. Subsequently, we will address the two main arguments proposed in the literature to justify euthanasia in detention: respect for the autonomy of the detainee and the principle of equivalence of care. Finally, after having identified serious shortcomings in both arguments, we will argue that the perspective of caring solidarity offers a better ethical basis for people in detention's access to euthanasia.
Publicación
Knowledge Gaps in Heart and Lung Donation after the Circulatory Determination of Death
(05-marzo-2024)
Nuestro IP, David Rodríguez-Arias, ha publicado en coautoría el artículo "Knowledge Gaps in Heart and Lung Donation after the Circulatory Determination of Death" en la revista The Journal of Heart and Lung Transplantation.
Se puede acceder a través de este enlace.
Abstract:
In a workshop sponsored by the U.S. National Heart, Lung, and Blood Institute, experts identified current knowledge gaps and research opportunities in the scientific, conceptual, and ethical understanding of organ donation after the circulatory determination of death and its technologies. To minimize organ injury from warm ischemia and produce better recipient outcomes, innovative techniques to perfuse and oxygenate organs postmortem in situ, such as thoracoabdominal normothermic regional perfusion, are being implemented in several medical centers in the US and elsewhere. These technologies have improved organ outcomes but have raised ethical and legal questions. Re-establishing donor circulation postmortem can be viewed as invalidating the condition of permanent cessation of circulation on which the earlier death determination was made and clamping arch vessels to exclude brain circulation can be viewed as inducing brain death. Alternatively, TA-NRP can be viewed as localized in-situ organ perfusion, not whole-body resuscitation, that does not invalidate death determination. Further scientific, conceptual, and ethical studies, such as those identified in this workshop, can inform and help resolve controversies raised by this practice.
Knowledge Gaps in Heart and Lung Donation after the Circulatory Determination of Death
(05-marzo-2024)
Nuestro IP, David Rodríguez-Arias, ha publicado en coautoría el artículo "Knowledge Gaps in Heart and Lung Donation after the Circulatory Determination of Death" en la revista The Journal of Heart and Lung Transplantation.
Se puede acceder a través de este enlace.
Abstract:
In a workshop sponsored by the U.S. National Heart, Lung, and Blood Institute, experts identified current knowledge gaps and research opportunities in the scientific, conceptual, and ethical understanding of organ donation after the circulatory determination of death and its technologies. To minimize organ injury from warm ischemia and produce better recipient outcomes, innovative techniques to perfuse and oxygenate organs postmortem in situ, such as thoracoabdominal normothermic regional perfusion, are being implemented in several medical centers in the US and elsewhere. These technologies have improved organ outcomes but have raised ethical and legal questions. Re-establishing donor circulation postmortem can be viewed as invalidating the condition of permanent cessation of circulation on which the earlier death determination was made and clamping arch vessels to exclude brain circulation can be viewed as inducing brain death. Alternatively, TA-NRP can be viewed as localized in-situ organ perfusion, not whole-body resuscitation, that does not invalidate death determination. Further scientific, conceptual, and ethical studies, such as those identified in this workshop, can inform and help resolve controversies raised by this practice.
Artículo
El cuerpo como un todo y no como una suma de partes: la propuesta holista de Walter B. Cannon
Autores: Ramón Ortega Lozano
(CRÍTICA; 12/2022; DOI: https://doi.org/10.22201/iifs.18704905e.2022.1382 ).
There is a discrepancy in the literature as to whether authorising or refusing the recovery of organs for transplantation is of direct benefit to families in their subsequent grieving process. This study aims to explore the impact of the family interview to pose the option of posthumous donation and the decision to authorise or refuse organ recovery on the grieving process of potential donors’ relatives.
Puede accederse al artículo aquí.
Publicación
Inconsistency between the circulatory and the brain criteria of death in the Uniform Determination of Death Act
Autores: Alberto Molina-Pérez, James L. Bernat & Anne Dalle-Ave
(Journal of Medicine and Philosophy (forthcoming)).
Since 1968, a brain-based criterion of death has been adopted in medical practice and passed into law or national guidelines in most countries worldwide. In some countries, such as Australia, Spain, and the United States, death can be determined by either the circulatory and respiratory criterion or by the neurological criterion. This practice corresponds to recommendations by the World Health Organization and the World Medical Association. In the USA, the Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions”. By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency.
Inconsistency between the circulatory and the brain criteria of death in the Uniform Determination of Death Act
Autores: Alberto Molina-Pérez, James L. Bernat & Anne Dalle-Ave
(Journal of Medicine and Philosophy (forthcoming)).
Since 1968, a brain-based criterion of death has been adopted in medical practice and passed into law or national guidelines in most countries worldwide. In some countries, such as Australia, Spain, and the United States, death can be determined by either the circulatory and respiratory criterion or by the neurological criterion. This practice corresponds to recommendations by the World Health Organization and the World Medical Association. In the USA, the Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions”. By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency.
Publicación
Artificial moral experts: asking for ethical advice to artificial intelligent assistants
Autores: Blanca Rodríguez López y Jon Rueda
(AI and Ethics (2023); DOI: https://doi.org/10.1007/s43681-022-00246-5).
In most domains of human life, we are willing to accept that there are experts with greater knowledge and competencies that distinguish them from non-experts or laypeople. Despite this fact, the very recognition of expertise curiously becomes more controversial in the case of “moral experts”. Do moral experts exist? And, if they indeed do, are there ethical reasons for us to follow their advice? Likewise, can emerging technological developments broaden our very concept of moral expertise? In this article, we begin by arguing that the objections that have tried to deny the existence (and convenience) of moral expertise are unsatisfactory. After that, we show that people have ethical reasons to ask for a piece of moral advice in daily life situations. Then, we argue that some Artificial Intelligence (AI) systems can play an increasing role in human morality by becoming moral experts. Some AI-based moral assistants can qualify as artificial moral experts and we would have good ethical reasons to use them.
Puede accederse al artículo aquí.
Artificial moral experts: asking for ethical advice to artificial intelligent assistants
Autores: Blanca Rodríguez López y Jon Rueda
(AI and Ethics (2023); DOI: https://doi.org/10.1007/s43681-022-00246-5).
In most domains of human life, we are willing to accept that there are experts with greater knowledge and competencies that distinguish them from non-experts or laypeople. Despite this fact, the very recognition of expertise curiously becomes more controversial in the case of “moral experts”. Do moral experts exist? And, if they indeed do, are there ethical reasons for us to follow their advice? Likewise, can emerging technological developments broaden our very concept of moral expertise? In this article, we begin by arguing that the objections that have tried to deny the existence (and convenience) of moral expertise are unsatisfactory. After that, we show that people have ethical reasons to ask for a piece of moral advice in daily life situations. Then, we argue that some Artificial Intelligence (AI) systems can play an increasing role in human morality by becoming moral experts. Some AI-based moral assistants can qualify as artificial moral experts and we would have good ethical reasons to use them.
Puede accederse al artículo aquí.
Publicación-Ethics Protocol
Family bereavement and organ donation in Spain: a mixed method, prospective cohort study protocol
Autores: Ma. Victoria Martínez-López, Elisabeth Coll, Francisco Cruz-Quintana, Beatriz Dominguez, Ivar R. Hannikainen (...) David Rodríguez-Arias.
(BMJ OPEN; 06/01/2023; DOI: http://dx.doi.org/10.1136/bmjopen-2022-066286).
There is a discrepancy in the literature as to whether authorising or refusing the recovery of organs for transplantation is of direct benefit to families in their subsequent grieving process. This study aims to explore the impact of the family interview to pose the option of posthumous donation and the decision to authorise or refuse organ recovery on the grieving process of potential donors’ relatives.
Puede accederse al artículo aquí.
Family bereavement and organ donation in Spain: a mixed method, prospective cohort study protocol
Autores: Ma. Victoria Martínez-López, Elisabeth Coll, Francisco Cruz-Quintana, Beatriz Dominguez, Ivar R. Hannikainen (...) David Rodríguez-Arias.
(BMJ OPEN; 06/01/2023; DOI: http://dx.doi.org/10.1136/bmjopen-2022-066286).
There is a discrepancy in the literature as to whether authorising or refusing the recovery of organs for transplantation is of direct benefit to families in their subsequent grieving process. This study aims to explore the impact of the family interview to pose the option of posthumous donation and the decision to authorise or refuse organ recovery on the grieving process of potential donors’ relatives.
Puede accederse al artículo aquí.
Artículo
"Just" accurancy? Procedural fairness demands explainability in AI-based medical resource allocations
Autores: Jon Rueda, Janet Delgado, Iris Parra, Joaquín Hortal, Txetxu Ausín & David Rodríguez-Arias.
(AI & Society; 21 dic 2022; DOI: 10.1007/s00146-022-01614-9 ).
The increasing application of artificial intelligence (AI) to healthcare raises both hope and ethical concerns. Some advanced machine learning methods provide accurate clinical predictions at the expense of a significant lack of explainability. Alex John London has defended that accuracy is a more important value than explainability in AI medicine. In this article, we locate the trade-off between accurate performance and explainable algorithms in the context of distributive justice. We acknowledge that accuracy is cardinal from outcome-oriented justice because it helps to maximize patients’ benefits and optimizes limited resources. However, we claim that the opaqueness of the algorithmic black box and its absence of explainability threatens core commitments of procedural fairness such as accountability, avoidance of bias, and transparency. To illustrate this, we discuss liver transplantation as a case of critical medical resources in which the lack of explainability in AI-based allocation algorithms is procedurally unfair. Finally, we provide a number of ethical recommendations for when considering the use of unexplainable algorithms in the distribution of health-related resources.
Puede accederse al artículo aquí.
Open Peer Commentaries
Rethinking the Role of Experimental Philosophy in Bioethics
Autores: Gonzalo Díaz Cobacho e Ivar Hannikainen
(AJOB 2022; https://doi.org/10.1080/15265161.2022.2134494).
Puede accederse al artículo aquí.
Rethinking the Role of Experimental Philosophy in Bioethics
Autores: Gonzalo Díaz Cobacho e Ivar Hannikainen
(AJOB 2022; https://doi.org/10.1080/15265161.2022.2134494).
Puede accederse al artículo aquí.
Artículo
Attitudes of European students towards family decision-making and the harmonisation of consent systems in deceased organ donation: a crooss-national survey.
Autores: Alberto Molina Pérez, Janet Delgado, Ivar Hannikainen, David Rodríguez-Arias et al.
(BMC Public Health 2022; https://doi.org/10.1186/s12889-022-14476-z).
European countries are increasingly harmonising their organ donation and transplantation policies. Although a growing number of nations are moving to presumed consent to deceased organ donation, no attempts have been made to harmonise policies on individual consent and the role of the family in the decision-making process. Little is known about public awareness of and attitudes towards the role of the family in their own country and European harmonisation on these health policy dimensions. To improve understanding of these issues, we examined what university students think about the role of the family in decision-making in deceased organ donation and about harmonising consent policies within Europe.
Puede accederse al artículo aquí.
Attitudes of European students towards family decision-making and the harmonisation of consent systems in deceased organ donation: a crooss-national survey.
Autores: Alberto Molina Pérez, Janet Delgado, Ivar Hannikainen, David Rodríguez-Arias et al.
(BMC Public Health 2022; https://doi.org/10.1186/s12889-022-14476-z).
European countries are increasingly harmonising their organ donation and transplantation policies. Although a growing number of nations are moving to presumed consent to deceased organ donation, no attempts have been made to harmonise policies on individual consent and the role of the family in the decision-making process. Little is known about public awareness of and attitudes towards the role of the family in their own country and European harmonisation on these health policy dimensions. To improve understanding of these issues, we examined what university students think about the role of the family in decision-making in deceased organ donation and about harmonising consent policies within Europe.
Puede accederse al artículo aquí.
Artículo
COORDINATION AND EXPERTISE FOSTER LEGAL TEXTUALISM
Autores: Ivar Rodríguez, R., Tobia, K. P., de Almeida, G. D. F., Struchiner, N., Kneer, M., Bystranowski, P. & Żuradzki, T.
Proceedings of the National Academy of Sciences (PNAS) (2022) (https://www.pnas.org/doi/10.1073/pnas.2206531119)
Un experimento de encuesta transcultural reveló una tendencia dominante a confiar en la letra de la regla sobre su espíritu al decidir qué comportamientos violan la regla. Esta tendencia osciló notablemente entre (k = 15) países, debido a la variación en el impacto de las valoraciones morales sobre los juicios de violación de reglas. En comparación con los legos, los expertos legales estaban más inclinados a ignorar por completo sus evaluaciones morales de los actos y, en consecuencia, exhibieron tendencias textualistas más fuertes. Finalmente, evaluamos un mecanismo plausible para el surgimiento del textualismo: en un juego de coordinación de dos jugadores, los incentivos para coordinarse en ausencia de comunicación reforzaron la adherencia de los participantes al significado literal de las reglas. Juntos, estos estudios (total n = 5.794) ayudan a aclarar los orígenes y el atractivo del textualismo, especialmente en el derecho. Dentro de comunidades heterogéneas en las que los miembros difieren en sus valoraciones morales relacionadas con el propósito de una regla, el significado literal de la regla proporciona un punto focal claro: un punto de acuerdo identificable que permite una interpretación coordinada entre ciudadanos, legisladores y jueces.
COORDINATION AND EXPERTISE FOSTER LEGAL TEXTUALISM
Autores: Ivar Rodríguez, R., Tobia, K. P., de Almeida, G. D. F., Struchiner, N., Kneer, M., Bystranowski, P. & Żuradzki, T.
Proceedings of the National Academy of Sciences (PNAS) (2022) (https://www.pnas.org/doi/10.1073/pnas.2206531119)
Un experimento de encuesta transcultural reveló una tendencia dominante a confiar en la letra de la regla sobre su espíritu al decidir qué comportamientos violan la regla. Esta tendencia osciló notablemente entre (k = 15) países, debido a la variación en el impacto de las valoraciones morales sobre los juicios de violación de reglas. En comparación con los legos, los expertos legales estaban más inclinados a ignorar por completo sus evaluaciones morales de los actos y, en consecuencia, exhibieron tendencias textualistas más fuertes. Finalmente, evaluamos un mecanismo plausible para el surgimiento del textualismo: en un juego de coordinación de dos jugadores, los incentivos para coordinarse en ausencia de comunicación reforzaron la adherencia de los participantes al significado literal de las reglas. Juntos, estos estudios (total n = 5.794) ayudan a aclarar los orígenes y el atractivo del textualismo, especialmente en el derecho. Dentro de comunidades heterogéneas en las que los miembros difieren en sus valoraciones morales relacionadas con el propósito de una regla, el significado literal de la regla proporciona un punto focal claro: un punto de acuerdo identificable que permite una interpretación coordinada entre ciudadanos, legisladores y jueces.
Artículo
¿PERMISO PARA INVESTIGAR? REFLEXIONES SOBRE LOS REQUISITOS ÉTICOS DE LA OBSERVACIÓN PARTICIPANTE EN EL CONTEXTO DE LA ENTREVISTA FAMILIAR DE OBTENCIÓN DE ÓRGANOS
Autores: María Victoria Martínez-López, Eva María Martín Nieto y Maite Cruz Piqueras
(Recerca 2022, 27(2), 107; https://doi.org/10.6035/recerca.6148).
Aunque se han identificado muchos de los factores que pueden influir en la donación, el momento de la entrevista en la que se les solicita a las familias su autorización para la extracción de órganos parece ser decisivo. Sin embargo, son escasos los estudios que analizan este proceso cuando dicha entrevista tiene lugar. Técnicas cualitativas como la observación participante podrían ayudar a comprender mejor las claves de este contexto. Uno de los argumentos más recurrentes para no realizar este tipo de estudios es la dificultad de cumplir todos los requisitos éticos exigibles a cualquier investigación tal y como vienen definidos en las guías y los comités de investigación biomédica. Este artículo pretende contribuir a una discusión sobre la viabilidad ética de la realización de un estudio in situ sobre la entrevista familiar y propone una estrategia de minimización de posibles riesgos para diseñar un estudio de estas características.
Puede accederse al artículo aquí.
¿PERMISO PARA INVESTIGAR? REFLEXIONES SOBRE LOS REQUISITOS ÉTICOS DE LA OBSERVACIÓN PARTICIPANTE EN EL CONTEXTO DE LA ENTREVISTA FAMILIAR DE OBTENCIÓN DE ÓRGANOS
Autores: María Victoria Martínez-López, Eva María Martín Nieto y Maite Cruz Piqueras
(Recerca 2022, 27(2), 107; https://doi.org/10.6035/recerca.6148).
Aunque se han identificado muchos de los factores que pueden influir en la donación, el momento de la entrevista en la que se les solicita a las familias su autorización para la extracción de órganos parece ser decisivo. Sin embargo, son escasos los estudios que analizan este proceso cuando dicha entrevista tiene lugar. Técnicas cualitativas como la observación participante podrían ayudar a comprender mejor las claves de este contexto. Uno de los argumentos más recurrentes para no realizar este tipo de estudios es la dificultad de cumplir todos los requisitos éticos exigibles a cualquier investigación tal y como vienen definidos en las guías y los comités de investigación biomédica. Este artículo pretende contribuir a una discusión sobre la viabilidad ética de la realización de un estudio in situ sobre la entrevista familiar y propone una estrategia de minimización de posibles riesgos para diseñar un estudio de estas características.
Puede accederse al artículo aquí.
Artículo
GENETIC ENHANCEMENT, HUMAN EXTINCTION, AND THE BEST INTERESTS OF POSTHUMANITY
Autores: Jon Rueda
Bioethics (2022). Genetic Enhancement, Human Extinction, and the Best Interests of Posthumanity.
Las tecnologías de mejora genética pueden alterar la especie humana a largo plazo. Esta posibilidad plantea intrincadas cuestiones éticas: ¿Debemos crear una especie posthumana? ¿Es deseable la extinción humana si dejamos una especie descendiente con mayor bienestar? En un nuevo artículo publicado en la revista Bioethics (Genetic Enhancement, Human Extinction, and the Best Interests of Posthumanity|doi.org/10.1111/bioe.13085), Jon Rueda trata de responder a esas desafiantes preguntas.
Pulsa aquí para acceder al artículo.
GENETIC ENHANCEMENT, HUMAN EXTINCTION, AND THE BEST INTERESTS OF POSTHUMANITY
Autores: Jon Rueda
Bioethics (2022). Genetic Enhancement, Human Extinction, and the Best Interests of Posthumanity.
Las tecnologías de mejora genética pueden alterar la especie humana a largo plazo. Esta posibilidad plantea intrincadas cuestiones éticas: ¿Debemos crear una especie posthumana? ¿Es deseable la extinción humana si dejamos una especie descendiente con mayor bienestar? En un nuevo artículo publicado en la revista Bioethics (Genetic Enhancement, Human Extinction, and the Best Interests of Posthumanity|doi.org/10.1111/bioe.13085), Jon Rueda trata de responder a esas desafiantes preguntas.
Pulsa aquí para acceder al artículo.
Artículo
BEYOND THE ALTRUISTIC DONOR: EMBEDDING SOLIDARITY IN ORGAN PROCUREMENT POLICIES
Autores: María Victoria Martínez-López, Gonzalo Díaz-Cobacho, Belén Liedo, Jon Rueda y Alberto Molina-Pérez
(Philosophies 2022, 7(5), 107; https://doi.org/10.3390/philosophies7050107).
El altruismo y la solidaridad son conceptos estrechamente relacionados con la donación de órganos para trasplantes. Por un lado, suelen utilizarse para animar a la gente a donar. Por otro lado, también sirven de base a las normativas vigentes en cada país en diferente medida. A menudo se utilizan de forma indistinta y equívoca, a pesar de las diferentes implicaciones éticas de cada concepto. Este artículo pretende aclarar hasta qué punto podemos hablar de altruismo y solidaridad en los modelos predominantes de donación de órganos. También plantea la cuestión ética de si estas categorías son adecuadas como base de dichos modelos, teniendo en cuenta que los órganos son un recurso escaso y que su escasez puede significar que se salven o mejoren menos vidas.
Puede accederse al artículo aquí.
BEYOND THE ALTRUISTIC DONOR: EMBEDDING SOLIDARITY IN ORGAN PROCUREMENT POLICIES
Autores: María Victoria Martínez-López, Gonzalo Díaz-Cobacho, Belén Liedo, Jon Rueda y Alberto Molina-Pérez
(Philosophies 2022, 7(5), 107; https://doi.org/10.3390/philosophies7050107).
El altruismo y la solidaridad son conceptos estrechamente relacionados con la donación de órganos para trasplantes. Por un lado, suelen utilizarse para animar a la gente a donar. Por otro lado, también sirven de base a las normativas vigentes en cada país en diferente medida. A menudo se utilizan de forma indistinta y equívoca, a pesar de las diferentes implicaciones éticas de cada concepto. Este artículo pretende aclarar hasta qué punto podemos hablar de altruismo y solidaridad en los modelos predominantes de donación de órganos. También plantea la cuestión ética de si estas categorías son adecuadas como base de dichos modelos, teniendo en cuenta que los órganos son un recurso escaso y que su escasez puede significar que se salven o mejoren menos vidas.
Puede accederse al artículo aquí.
Artículo
GLOBAL DISTRIBUTION OF COVID-19 VACCINE: MINE FIRST
Autores: Joaquín Hortal-Carmona y Gonzalo Díaz-Cobacho
Philosophies 2022, 7(5), 106; https://doi.org/10.3390/philosophies7050106
The COVID-19 (SARS-CoV-2) pandemic dealt a severe blow to society as a whole and required countries to confront a situation that exceeded the limits of their borders. In this paper, we analyze how these countries as well as supranational organizations responded to this unprepared global emergency. We also explore what alternative models have been proposed in the wake of this crisis and propose some changes—other ways of acting—so that in future pandemics or global emergencies, we can deal with the situation more effectively. View Full-Text
Keywords: COVID-19; public health ethics; equity; distribution; allocation; vaccine
GLOBAL DISTRIBUTION OF COVID-19 VACCINE: MINE FIRST
Autores: Joaquín Hortal-Carmona y Gonzalo Díaz-Cobacho
Philosophies 2022, 7(5), 106; https://doi.org/10.3390/philosophies7050106
The COVID-19 (SARS-CoV-2) pandemic dealt a severe blow to society as a whole and required countries to confront a situation that exceeded the limits of their borders. In this paper, we analyze how these countries as well as supranational organizations responded to this unprepared global emergency. We also explore what alternative models have been proposed in the wake of this crisis and propose some changes—other ways of acting—so that in future pandemics or global emergencies, we can deal with the situation more effectively. View Full-Text
Keywords: COVID-19; public health ethics; equity; distribution; allocation; vaccine
Open Peer Commentaries
Neuroethics, Consciousness and Death: Where Objective Knowledge Meets Subjective Experience
Autores: Alberto Molina-Pérez, Anne Dalle Ave.
AJOB Neuroscience (https://doi.org/10.1080/21507740.2022.2126541)
Neuroethics, Consciousness and Death: Where Objective Knowledge Meets Subjective Experience
Autores: Alberto Molina-Pérez, Anne Dalle Ave.
AJOB Neuroscience (https://doi.org/10.1080/21507740.2022.2126541)
Artículo
Differential impact of opt-in, opt-out policies on deceased organ donation rates: a mixed conceptual and empirical study
Autores: Alberto Molina-Pérez, David Rodríguez-Arias y Janet Delgado
BMJ OPEN (http://dx.doi.org/10.1136/ bmjopen-2021-057107)
Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt- out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives.
Design Based on previous work regarding consent policies, we created a conceptual model of the decision- making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply.
Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery.
Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out.
Conclusions This study may warn policy makers
that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might
be overestimating the influence of the default and underestimating the power granted to families.
Differential impact of opt-in, opt-out policies on deceased organ donation rates: a mixed conceptual and empirical study
Autores: Alberto Molina-Pérez, David Rodríguez-Arias y Janet Delgado
BMJ OPEN (http://dx.doi.org/10.1136/ bmjopen-2021-057107)
Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt- out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives.
Design Based on previous work regarding consent policies, we created a conceptual model of the decision- making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply.
Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery.
Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out.
Conclusions This study may warn policy makers
that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might
be overestimating the influence of the default and underestimating the power granted to families.
Artículo
Brain death debates: from bioethics to philosophy of science
Autores: Alberto Molina-Pérez
F1000Research 2022, 11:195 (https://doi.org/10.12688/f1000research.109184.2)
50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. Here I plead for a different approach that has been overlooked in the literature: the philosophy of science approach. Some scholars claim that human death is a matter of fact, a biological phenomenon whose occurrence can be determined empirically, based on science. We should take this claim seriously, whether we agree with it or not. The question is: how do we know that human death is a scientific matter of fact? Taking the philosophy of science approach means, among other things, examining how the determination of human death became an object of scientific inquiry, exploring the nature of the brain death criterion itself, and analysing the meaning of its core concepts such as “irreversibility” and “functions”.
Brain death debates: from bioethics to philosophy of science
Autores: Alberto Molina-Pérez
F1000Research 2022, 11:195 (https://doi.org/10.12688/f1000research.109184.2)
50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. Here I plead for a different approach that has been overlooked in the literature: the philosophy of science approach. Some scholars claim that human death is a matter of fact, a biological phenomenon whose occurrence can be determined empirically, based on science. We should take this claim seriously, whether we agree with it or not. The question is: how do we know that human death is a scientific matter of fact? Taking the philosophy of science approach means, among other things, examining how the determination of human death became an object of scientific inquiry, exploring the nature of the brain death criterion itself, and analysing the meaning of its core concepts such as “irreversibility” and “functions”.
Artículo
Public Perception of Organ Donation and Transplantation Policies in Southern Spain
Autores: Gonzalo Díaz-Cobacho, Maite Cruz-Piqueras, Janet Delgado, Joaquín Hortal-Carmona, M. Victoria Martínez-López, Alberto Molina-Pérez, Álvaro Padilla-Pozo, Julia Ranchal-Romero y David Rodríguez-Arias
Transplantation Proceedings (2022)
https://doi.org/10.1016/j.transproceed.2022.02.007
This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation.
Public Perception of Organ Donation and Transplantation Policies in Southern Spain
Autores: Gonzalo Díaz-Cobacho, Maite Cruz-Piqueras, Janet Delgado, Joaquín Hortal-Carmona, M. Victoria Martínez-López, Alberto Molina-Pérez, Álvaro Padilla-Pozo, Julia Ranchal-Romero y David Rodríguez-Arias
Transplantation Proceedings (2022)
https://doi.org/10.1016/j.transproceed.2022.02.007
This research explores how public awareness and attitudes toward donation and transplantation policies may contribute to Spain's success in cadaveric organ donation.
Artículo
European and comparative law study regarding family’s legal role in deceased organ procurement
Autores: Marina Morla-González, Clara Moya-Guillem, Janet Delgado-Rodríguez y Alberto Molina-Pérez
Revista General de Derecho Público Comparado (2021)
Several European countries are approving legislative reforms moving to a presumed consent system in order to increase organ donation rates. Nevertheless, irrespective of the consent system in force, family’s decisional capacity probably causes a greater impact on such rates. In this contribution we have developed a systematic methodology in order to analyse and compare European organ procurement laws, and we clarify the weight given by each European law to relatives’ decisional capacity over individual’s preferences (expressed or not while alive) regarding the destination of his or her organs after death. In this sense, the results constitute the first comprehensive and comparative legislative mapping on European transplantation laws.
European and comparative law study regarding family’s legal role in deceased organ procurement
Autores: Marina Morla-González, Clara Moya-Guillem, Janet Delgado-Rodríguez y Alberto Molina-Pérez
Revista General de Derecho Público Comparado (2021)
Several European countries are approving legislative reforms moving to a presumed consent system in order to increase organ donation rates. Nevertheless, irrespective of the consent system in force, family’s decisional capacity probably causes a greater impact on such rates. In this contribution we have developed a systematic methodology in order to analyse and compare European organ procurement laws, and we clarify the weight given by each European law to relatives’ decisional capacity over individual’s preferences (expressed or not while alive) regarding the destination of his or her organs after death. In this sense, the results constitute the first comprehensive and comparative legislative mapping on European transplantation laws.
Artículo
Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe
Autores: Alberto Molina-Pérz, Janet Delgado, Michaela Frunza, Myfanwy Morgan, Gurch Randawa, Jeantine Reiger-Vandwijdeven, Silke Schicktanz, Eline SChicks, Sabine Wöhlke, David Rodríguez-Arias
Transplantation Reviews Volume 36, Issue 1, January 2022, 100673
https://doi.org/10.1016/j.trre.2021.100673
To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe, a systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017...
Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe
Autores: Alberto Molina-Pérz, Janet Delgado, Michaela Frunza, Myfanwy Morgan, Gurch Randawa, Jeantine Reiger-Vandwijdeven, Silke Schicktanz, Eline SChicks, Sabine Wöhlke, David Rodríguez-Arias
Transplantation Reviews Volume 36, Issue 1, January 2022, 100673
https://doi.org/10.1016/j.trre.2021.100673
To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe, a systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017...
Artículo
Attitudes about Brain-Computer Interface (BCI) technology among Spanish rehabilitation professionals
Autores: Aníbal Monasterio Astobiza, David Rodriguez-Arias, Txetxu Ausín, Mario Toboso, Manuel Aparicio & Daniel López
AI and Society: (2021)
https://doi.org/10.1007/s00146-021-01292-z
To assess—from a qualitative perspective—the perceptions and attitudes of Spanish rehabilitation professionals (e.g. rehabilitation doctors, speech therapists, physical therapists) about Brain–Computer Interface (BCI) technology. A qualitative, exploratory and descriptive study was carried out by means of interviews and analysis of textual content with mixed generation of categories and segmentation into frequency of topics. We present the results of three in-depth interviews that were conducted with Spanish speaking individuals who had previously completed a survey as part of a larger, 3-country/language, survey on BCI perceptions. 11 out of 15 of these Spanish respondents (survey) either strongly or somewhat accept the use of BCI in rehabilitation therapy. However, the results of our three in-depth interviews show how, due to a strong inertia of attitudes and perceptions about BCI technology, most professionals feel reluctant to use BCI technology in their daily practice (interview).
Artículo
Socrates in the fMRI Scanner: The Neurofoundations of Morality and the Challenge to Ethics
Autores: Jon Rueda
Cambridge University Press
2021
DOI: https://doi.org/10.1017/S0963180121000074
The neuroscience of ethics is allegedly having a double impact. First, it is transforming the view of human morality through the discovery of the neurobiological underpinnings that influence moral behavior. Second, some neuroscientific findings are radically challenging traditional views on normative ethics. Both claims have some truth but are also overstated. In this article, the author shows that they can be understood together, although with different caveats, under the label of “neurofoundationalism.” Whereas the neuroscientific picture of human morality is undoubtedly valuable if we avoid neuroessentialistic portraits, the empirical disruption of normative ethics seems less plausible. The neuroscience of morality, however, is providing relevant evidence that any empirically informed ethical theory needs to critically consider. Although neuroethics is not going to bridge the is–ought divide, it may establish certain facts that require us to rethink the way we achieve our ethical aspirations.
Socrates in the fMRI Scanner: The Neurofoundations of Morality and the Challenge to Ethics
Autores: Jon Rueda
Cambridge University Press
2021
DOI: https://doi.org/10.1017/S0963180121000074
The neuroscience of ethics is allegedly having a double impact. First, it is transforming the view of human morality through the discovery of the neurobiological underpinnings that influence moral behavior. Second, some neuroscientific findings are radically challenging traditional views on normative ethics. Both claims have some truth but are also overstated. In this article, the author shows that they can be understood together, although with different caveats, under the label of “neurofoundationalism.” Whereas the neuroscientific picture of human morality is undoubtedly valuable if we avoid neuroessentialistic portraits, the empirical disruption of normative ethics seems less plausible. The neuroscience of morality, however, is providing relevant evidence that any empirically informed ethical theory needs to critically consider. Although neuroethics is not going to bridge the is–ought divide, it may establish certain facts that require us to rethink the way we achieve our ethical aspirations.
Artículo
La confiscación de órganos a la luz del derecho constitucional a la protección de la salud
Autores: Clara Moya-Guillem, David Rodríguez-Arias, Marina Morla-González, Iñigo de Miguel-Beriain, Alberto Molina-Pérez, Iván Ortega-Deballón
Revista Española de Derecho Constitucional
2021
DOI: https://doi.org/10.18042/cepc/redc.122.06
En este trabajo analizamos los argumentos a favor y en contra del que hemos denominado modelo de obtención automática en relación con los órganos de fallecidos. Para ello aportamos datos empíricos que permiten valorar su potencial impacto en las cifras de donación y en la opinión pública. Específicamente, por un lado, examinamos las razones que lo respaldan, haciendo especial referencia a aquellas relativas a la utilidad y la justicia. Por otro lado, estudiamos las manifestaciones que se oponen a este modelo teórico fundadas en la vulneración de intereses pre mortem y post mortem, y en el rechazo que generaría en la población. Por último, a modo de conclusión, subrayamos los aspectos que, a nuestro juicio, deberían regularse exhaustivamente si se implantase. En particular, nos referimos al estatuto jurídico del cuerpo humano, al trato al paciente en la última etapa de su vida, a los incentivos para los profesionales sanitarios y al reconocimiento del derecho a la objeción de conciencia.
La confiscación de órganos a la luz del derecho constitucional a la protección de la salud
Autores: Clara Moya-Guillem, David Rodríguez-Arias, Marina Morla-González, Iñigo de Miguel-Beriain, Alberto Molina-Pérez, Iván Ortega-Deballón
Revista Española de Derecho Constitucional
2021
DOI: https://doi.org/10.18042/cepc/redc.122.06
En este trabajo analizamos los argumentos a favor y en contra del que hemos denominado modelo de obtención automática en relación con los órganos de fallecidos. Para ello aportamos datos empíricos que permiten valorar su potencial impacto en las cifras de donación y en la opinión pública. Específicamente, por un lado, examinamos las razones que lo respaldan, haciendo especial referencia a aquellas relativas a la utilidad y la justicia. Por otro lado, estudiamos las manifestaciones que se oponen a este modelo teórico fundadas en la vulneración de intereses pre mortem y post mortem, y en el rechazo que generaría en la población. Por último, a modo de conclusión, subrayamos los aspectos que, a nuestro juicio, deberían regularse exhaustivamente si se implantase. En particular, nos referimos al estatuto jurídico del cuerpo humano, al trato al paciente en la última etapa de su vida, a los incentivos para los profesionales sanitarios y al reconocimiento del derecho a la objeción de conciencia.
Artículo
The Frailty of Disability: A Controversial Triage Criterion
Autores: Joaquín Hortal-Carmona, Belén Liedo, Jon Rueda y Rosana Triviño-Caballero
The American Journal of Bioethics
28-octubre-2021
DOI: https://doi.org/10.1080/15265161.2021.1980140
Disability has been traditionally understood as a med- ical condition. However, people with disabilities have claimed in recent decades for a dephatologized social model of disability--i.e. the functional diversity model aimed to fight social discrimination of people with disabilities and openly controversial toward the med- ical-rehabilitation model (Oliver 2013). COVID-19 has been a challenging event to reach this goal... ver texto completo.
The Frailty of Disability: A Controversial Triage Criterion
Autores: Joaquín Hortal-Carmona, Belén Liedo, Jon Rueda y Rosana Triviño-Caballero
The American Journal of Bioethics
28-octubre-2021
DOI: https://doi.org/10.1080/15265161.2021.1980140
Disability has been traditionally understood as a med- ical condition. However, people with disabilities have claimed in recent decades for a dephatologized social model of disability--i.e. the functional diversity model aimed to fight social discrimination of people with disabilities and openly controversial toward the med- ical-rehabilitation model (Oliver 2013). COVID-19 has been a challenging event to reach this goal... ver texto completo.
Artículo
Governance quality indicators for organ procurement policies / Indicadores de calidad para la gobernanza de las políticas de obtención de órganos para trasplante
Autores: Rodríguez-Arias D, Molina-Pérez A, Hannikainen IR, Delgado J, Söchtig B, Wöhlke S and Schicktanz S.
Plos One
04-junio-2021
DOI: https://doi.org/10.1371/journal.pone.0252686
Las políticas de consentimiento presunto o explícito para la donación de órganos actúan como nudges: establecen un curso de acción predeterminado que se ofrece por defecto y al hacerlo sirven de mecanismo para orientar la toma de decisiones en una dirección que se considera beneficiosa. Así, los distintos modelos de consentimiento para la donación ayudan a los profesionales de la salud y a las familias de los potenciales donantes a decidir si deben o no obtenerse los órganos tras la muerte, en particular cuando esa persona no había expresado ninguna preferencia al respecto. Ahora bien, al establecer una acción que se aplica por defecto esas políticas pueden ignorar o vulnerar los intereses de quienes discrepan de la opción prioritaria pero nunca llegaron a expresar sus preferencias, quizá por desconocimiento de la necesidad de hacerlo. ¿Sabe la población si, cuando muera, se le considerará como donante de órganos? ¿En qué medida coinciden sus preferencias con la opción que establece por defecto su jurisdicción de la donación? ¿Dejan las personas constancia de sus preferencias para asegurarse de que se cumplirán? Un estudio publicado en PLOS ONE por David Rodríguez-Arias (FiloLab-UGR), Alberto Molina (IESA-CSIC, FiloLab-UGR), Ivar Hannikainen (FiloLab-UGR) junto con investigadoras del Hospital Universitario de Canarias y de las universidades alemanas de Göttingen y Hamburgo pone a prueba un modelo teórico para valorar los modelos de consentimiento para la donación de los diferentes países en función de su capacidad para respetar y atender a las preferencias de la ciudadanía. El estudio forma parte del proyecto de investigación INEDyTO (MINECO FFI2017-88913-P) ver texto completo.
Governance quality indicators for organ procurement policies / Indicadores de calidad para la gobernanza de las políticas de obtención de órganos para trasplante
Autores: Rodríguez-Arias D, Molina-Pérez A, Hannikainen IR, Delgado J, Söchtig B, Wöhlke S and Schicktanz S.
Plos One
04-junio-2021
DOI: https://doi.org/10.1371/journal.pone.0252686
Las políticas de consentimiento presunto o explícito para la donación de órganos actúan como nudges: establecen un curso de acción predeterminado que se ofrece por defecto y al hacerlo sirven de mecanismo para orientar la toma de decisiones en una dirección que se considera beneficiosa. Así, los distintos modelos de consentimiento para la donación ayudan a los profesionales de la salud y a las familias de los potenciales donantes a decidir si deben o no obtenerse los órganos tras la muerte, en particular cuando esa persona no había expresado ninguna preferencia al respecto. Ahora bien, al establecer una acción que se aplica por defecto esas políticas pueden ignorar o vulnerar los intereses de quienes discrepan de la opción prioritaria pero nunca llegaron a expresar sus preferencias, quizá por desconocimiento de la necesidad de hacerlo. ¿Sabe la población si, cuando muera, se le considerará como donante de órganos? ¿En qué medida coinciden sus preferencias con la opción que establece por defecto su jurisdicción de la donación? ¿Dejan las personas constancia de sus preferencias para asegurarse de que se cumplirán? Un estudio publicado en PLOS ONE por David Rodríguez-Arias (FiloLab-UGR), Alberto Molina (IESA-CSIC, FiloLab-UGR), Ivar Hannikainen (FiloLab-UGR) junto con investigadoras del Hospital Universitario de Canarias y de las universidades alemanas de Göttingen y Hamburgo pone a prueba un modelo teórico para valorar los modelos de consentimiento para la donación de los diferentes países en función de su capacidad para respetar y atender a las preferencias de la ciudadanía. El estudio forma parte del proyecto de investigación INEDyTO (MINECO FFI2017-88913-P) ver texto completo.
Artículo
Addressing organ shortage: An automatic organ procurement model as a proposal
Autores: Marina Morla-González, Clara Moya-Guillem, David Rodríguez-Arias, Íñigo de Miguel Beriain, Alberto Molina-Pérez, Iván Ortega-Deballón
Clinical Ethics
27-abril-2021
DOI: https://doi.org/10.1177%2F14777509211011429
Organ shortage constitutes an unsolved problem for every country that offers transplantation as a therapeutic option. Besides... ver texto completo.
Addressing organ shortage: An automatic organ procurement model as a proposal
Autores: Marina Morla-González, Clara Moya-Guillem, David Rodríguez-Arias, Íñigo de Miguel Beriain, Alberto Molina-Pérez, Iván Ortega-Deballón
Clinical Ethics
27-abril-2021
DOI: https://doi.org/10.1177%2F14777509211011429
Organ shortage constitutes an unsolved problem for every country that offers transplantation as a therapeutic option. Besides... ver texto completo.
Artículo
Absolutely Right and Relatively Good: Consequentialists See Bioethical Disagreement in a Relativist Light
Autores: Hugo Viciana, Ivar R. Hannikainen, David Rodríguez-Arias
AJOB Empirical Bioethics
26-abril-2021
DOI: https://doi.org/10.1080/23294515.2021.1907476
Los desacuerdos en bioética son muy comunes. Lo comprobamos cotidianamente en los debates sobre la eutanasia, el aborto, la gestación subrogada o la reticencia vacunal, donde personas aparentemente razonables –y que incluso pueden llegar a gozar de cierta reputación y credibilidad–discrepan no obstante entre sí. ¿Cómo entender esos desacuerdos?... ver texto completo.
Absolutely Right and Relatively Good: Consequentialists See Bioethical Disagreement in a Relativist Light
Autores: Hugo Viciana, Ivar R. Hannikainen, David Rodríguez-Arias
AJOB Empirical Bioethics
26-abril-2021
DOI: https://doi.org/10.1080/23294515.2021.1907476
Los desacuerdos en bioética son muy comunes. Lo comprobamos cotidianamente en los debates sobre la eutanasia, el aborto, la gestación subrogada o la reticencia vacunal, donde personas aparentemente razonables –y que incluso pueden llegar a gozar de cierta reputación y credibilidad–discrepan no obstante entre sí. ¿Cómo entender esos desacuerdos?... ver texto completo.
Capítulo en el libro "Ethical Challenges of Organ Transplantation: Current Debates and International Perspectives"
Models of Consent, Autonomy and the Role of the Family
Autores: Alberto Molina Pérez, Janet Delgado Rodríguez, David Rodríguez-Arias.
PDF
Models of Consent, Autonomy and the Role of the Family
Autores: Alberto Molina Pérez, Janet Delgado Rodríguez, David Rodríguez-Arias.
Capítulo en el libro "Hacer Justicia haciendo compañía"
Cuando los donantes se enteran de que lo son
Autores: Marina Morla González, Alberto Molina Pérez.
Editorial Universidad de Salamanca. Lanzamiento en 2021.
Cuando los donantes se enteran de que lo son
Autores: Marina Morla González, Alberto Molina Pérez.
Editorial Universidad de Salamanca. Lanzamiento en 2021.
Artículo
The Value of Communities of Practice as a Learning Process to Increase Resilience in Healthcare Teams
Autores: Janet Delgado Rodríguez, Serena Siow, Janet M. de Groot.
15-agosto-2020
This paper addresses the role that communities of practice (CoP) can have within the healthcare environment when facing uncertainty and highly emotionally impactful situations, such as the current COVID-19 pandemic.... ver texto completo.
European Journal of Medicine and Natural Sciences. 2020;4(2).
The Value of Communities of Practice as a Learning Process to Increase Resilience in Healthcare Teams
Autores: Janet Delgado Rodríguez, Serena Siow, Janet M. de Groot.
15-agosto-2020
This paper addresses the role that communities of practice (CoP) can have within the healthcare environment when facing uncertainty and highly emotionally impactful situations, such as the current COVID-19 pandemic.... ver texto completo.
European Journal of Medicine and Natural Sciences. 2020;4(2).
Artículo
La eficiencia no basta. Análisis ético y recomendaciones para la distribución de recursos escasos en situación de pandemia
Autores: Joaquín Hortal Carmona, Javier Padilla Bernáldez, Miguel Melguizo Jiménez, Txetxu Ausín, Maite Cruz Piqueras, M. Teresa López de la Vieja, Angel Puyol, David Rodríguez-Arias, Maribel Tamayo Velázquez, Rosana Triviño.
Gaceta Sanitaria. 2020.
La eficiencia no basta. Análisis ético y recomendaciones para la distribución de recursos escasos en situación de pandemia
Autores: Joaquín Hortal Carmona, Javier Padilla Bernáldez, Miguel Melguizo Jiménez, Txetxu Ausín, Maite Cruz Piqueras, M. Teresa López de la Vieja, Angel Puyol, David Rodríguez-Arias, Maribel Tamayo Velázquez, Rosana Triviño.
Gaceta Sanitaria. 2020.
Artículo
Examining Public Trust in Categorical versus Comprehensive Triage Criteria
Autores: Jon Rueda, Ivar Hannikainen, Joaquín Hortal Carmona, David Rodríguez-Arias.
27-julio-2020
Debates about the ethics of ICU triage often build on the assumption that prioritization principles exhibit a tradeoff between feasibility and justice. The policies that are easier to implement (e.g., simple exclusion criteria) appear unjust to many, while policies that are typically seen as just can be unviable from a practical standpoint... lectura completa.
The American Journal of Bioethics. 2020;20(7).
Examining Public Trust in Categorical versus Comprehensive Triage Criteria
Autores: Jon Rueda, Ivar Hannikainen, Joaquín Hortal Carmona, David Rodríguez-Arias.
27-julio-2020
Debates about the ethics of ICU triage often build on the assumption that prioritization principles exhibit a tradeoff between feasibility and justice. The policies that are easier to implement (e.g., simple exclusion criteria) appear unjust to many, while policies that are typically seen as just can be unviable from a practical standpoint... lectura completa.
The American Journal of Bioethics. 2020;20(7).
Capítulo de libro "Compelling Ethical Challenges in Critical Care and Emergency Medicine"
Organ Donation and Transplantation
Autores: Dale Gardiner y David Rodríguez-Arias
23-jul-2020
An ethical organ donation and transplantation program regarding deceased patients donors would balance the needs of the organ recipient with the needs of the organ donor and his or her family. The solution to achieve ethical balance is not easy. The donation community leans toward Kantian ethics to justify actions on the donor, while the transplant community tends toward utilitarian justifications that focus on recipient outcomes. Yet the responsibility to achieve balance lies with both communities (and their wider healthcare colleagues) to work together so that good end-of-life care for donors is achieved while simultaneously increasing the number and quality of deceased organ transplants... ver abstract completo.
Organ Donation and Transplantation
Autores: Dale Gardiner y David Rodríguez-Arias
23-jul-2020
An ethical organ donation and transplantation program regarding deceased patients donors would balance the needs of the organ recipient with the needs of the organ donor and his or her family. The solution to achieve ethical balance is not easy. The donation community leans toward Kantian ethics to justify actions on the donor, while the transplant community tends toward utilitarian justifications that focus on recipient outcomes. Yet the responsibility to achieve balance lies with both communities (and their wider healthcare colleagues) to work together so that good end-of-life care for donors is achieved while simultaneously increasing the number and quality of deceased organ transplants... ver abstract completo.
Artículo
La difusa frontera entre la vida y la muerte. Reflexiones sobre el objeto material de los delitos contra la vida humana independiente
Autora: Clara Moya Guillem.
Julio-2020
Este trabajo tiene dos objetivos fundamentales: por un lado poner de manifiesto los problemas que suscita el problema legal de muerte que adoptan la doctrina y la jurisprudencia penales; y por otro lado, explorar la necesidad y la oportunidad de definirlo de un modo distinto.
Revista Penal. 2020;46:141-56.
La difusa frontera entre la vida y la muerte. Reflexiones sobre el objeto material de los delitos contra la vida humana independiente
Autora: Clara Moya Guillem.
Julio-2020
Este trabajo tiene dos objetivos fundamentales: por un lado poner de manifiesto los problemas que suscita el problema legal de muerte que adoptan la doctrina y la jurisprudencia penales; y por otro lado, explorar la necesidad y la oportunidad de definirlo de un modo distinto.
Revista Penal. 2020;46:141-56.
Artículo
Death Determination And Clinicians’ Epistemic Authority
Autores: Rodríguez-Arias, Molina-Pérez & Díaz-Cobacho
22-mayo-2020
¿Qué autoridad tienen expertos y legos para determinar el momento de la muerte humana? La exigencia de un consentimiento familiar para llevar a cabo la prueba de apnea ha suscitado un debate entre aquellos que defienden que hacerlo resta control sobre la determinación de la muerte a los profesionales de la salud y los que defienden que los procedimientos de diagnóstico unilaterales de los médicos –contra la oposición de la familia– son inaceptables. En este artículo abordamos este problema intentando responder a la pregunta de si la determinación de la muerte por criterios neurológicos -incluida la prueba de la apnea- excede los límites de la autoridad epistémica de los expertos clínicos.
Death Determination And Clinicians’ Epistemic Authority
Autores: Rodríguez-Arias, Molina-Pérez & Díaz-Cobacho
22-mayo-2020
¿Qué autoridad tienen expertos y legos para determinar el momento de la muerte humana? La exigencia de un consentimiento familiar para llevar a cabo la prueba de apnea ha suscitado un debate entre aquellos que defienden que hacerlo resta control sobre la determinación de la muerte a los profesionales de la salud y los que defienden que los procedimientos de diagnóstico unilaterales de los médicos –contra la oposición de la familia– son inaceptables. En este artículo abordamos este problema intentando responder a la pregunta de si la determinación de la muerte por criterios neurológicos -incluida la prueba de la apnea- excede los límites de la autoridad epistémica de los expertos clínicos.
Libro
La trata de seres humanos con fines de extracción de órganos. Análisis criminológico y jurídico-penal
Autora: Clara Moya Guillem.
16-abril-2020
Tirant lo Blanch, 2020, ISBN: 978-84-1355-209-5.
La trata de seres humanos con fines de extracción de órganos. Análisis criminológico y jurídico-penal
Autora: Clara Moya Guillem.
16-abril-2020
Tirant lo Blanch, 2020, ISBN: 978-84-1355-209-5.
Capítulo de libro "Setenta años de Constitución Italiana y cuarenta años de Constitución Española. Vol V"
Algunas consideraciones acerca de las referencias a la dignidad en el Derecho penal
Autores: Clara Moya Guillem.
2020
Lectura completa.
Centro de Estudios Políticos y Constitucionales (BOE), Madrid, 2020, págs. 405-419.
Algunas consideraciones acerca de las referencias a la dignidad en el Derecho penal
Autores: Clara Moya Guillem.
2020
Lectura completa.
Centro de Estudios Políticos y Constitucionales (BOE), Madrid, 2020, págs. 405-419.
Artículo
Should we have a right to refuse diagnostics and treatment planning by artificial intelligence?
Autor: Íñigo de Miguel Beriain.
20-enero-2020
Should we be allowed to refuse any involvement of artificial intelligence (AI) technology in diagnosis and treatment planning? This is the relevant question posed by Ploug and Holm in a recent article in Medicine, Health Care and Philosophy. In this article, I adhere to their conclusions, but not necessarily to the rationale that supports them... ver abstract.
Medicine, health care and Philosophy. 2020;23:247-52.
Should we have a right to refuse diagnostics and treatment planning by artificial intelligence?
Autor: Íñigo de Miguel Beriain.
20-enero-2020
Should we be allowed to refuse any involvement of artificial intelligence (AI) technology in diagnosis and treatment planning? This is the relevant question posed by Ploug and Holm in a recent article in Medicine, Health Care and Philosophy. In this article, I adhere to their conclusions, but not necessarily to the rationale that supports them... ver abstract.
Medicine, health care and Philosophy. 2020;23:247-52.
Artículo
How do people use ‘killing’, ‘letting die’ and related bioethical concepts? Contrasting descriptive and normative hypotheses
Autores: David Rodríguez-Arias, Blanca Rodríguez López, Anibal Monasterio-Astobiza, Ivar Hannikainen.
13-enero-2020
Bioethicists involved in end‐of‐life debates routinely distinguish between ‘killing’ and ‘letting die’. Meanwhile, previous work in cognitive science has revealed that when people characterize behaviour as either actively ‘doing’ or passively ‘allowing’, they do so not purely on descriptive grounds, but also as a function of the behaviour’s perceived morality... ver abstract.
Bioethics. 2020;34(5):509-18.
How do people use ‘killing’, ‘letting die’ and related bioethical concepts? Contrasting descriptive and normative hypotheses
Autores: David Rodríguez-Arias, Blanca Rodríguez López, Anibal Monasterio-Astobiza, Ivar Hannikainen.
13-enero-2020
Bioethicists involved in end‐of‐life debates routinely distinguish between ‘killing’ and ‘letting die’. Meanwhile, previous work in cognitive science has revealed that when people characterize behaviour as either actively ‘doing’ or passively ‘allowing’, they do so not purely on descriptive grounds, but also as a function of the behaviour’s perceived morality... ver abstract.
Bioethics. 2020;34(5):509-18.
Artículo
The Role of the Family in Deceased Organ Procurement. A Guide for Clinicians and Policymakers
Autores/as: Janet Delgado Rodríguez, Alberto Molina Pérez, David Shaw, David Rodríguez-Arias.
Mayo-2019
Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal... seguir leyendo abstract.
Transplantation. 2019;103(5):e112-e118. doi: 10.1097/TP.0000000000002622.
The Role of the Family in Deceased Organ Procurement. A Guide for Clinicians and Policymakers
Autores/as: Janet Delgado Rodríguez, Alberto Molina Pérez, David Shaw, David Rodríguez-Arias.
Mayo-2019
Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal... seguir leyendo abstract.
Transplantation. 2019;103(5):e112-e118. doi: 10.1097/TP.0000000000002622.
Artículo
Public knowledge and attitudes towards consent policies for organ donation in Europe. A systematic review.
Autores/as: Alberto Molina Pérez, David Rodríguez-Arias, Janet Delgado Rodríguez, Myfanwy Morgan, Mijaela Frunza, Gurch Randhawa, Jeantine Reiger-Van de Wijdeven, Eline Schiks, Sabine Wöhlke, Silke Schicktanz.
Enero-2019
Transplant Rev (Orlando). 2019 Jan;33(1):1-8. doi: 10.1016/j.trre.2018.09.001
Public knowledge and attitudes towards consent policies for organ donation in Europe. A systematic review.
Autores/as: Alberto Molina Pérez, David Rodríguez-Arias, Janet Delgado Rodríguez, Myfanwy Morgan, Mijaela Frunza, Gurch Randhawa, Jeantine Reiger-Van de Wijdeven, Eline Schiks, Sabine Wöhlke, Silke Schicktanz.
Enero-2019
Transplant Rev (Orlando). 2019 Jan;33(1):1-8. doi: 10.1016/j.trre.2018.09.001
Artículo
Re-thinking relational autonomy: Challenging the triumph of autonomy through vulnerability
Autora: Janet Delgado Rodríguez.
Enero-2019
Relational autonomy is a key concept in challenging the “triumph of the principle of autonomy” in bioethics. Considering the inextricable relationship between the concept of vulnerability and relational autonomy, it can be seen that autonomy and vulnerability are not incompatible... ver abstract.
Bioethics update. 2019;5(1):50-65.
Re-thinking relational autonomy: Challenging the triumph of autonomy through vulnerability
Autora: Janet Delgado Rodríguez.
Enero-2019
Relational autonomy is a key concept in challenging the “triumph of the principle of autonomy” in bioethics. Considering the inextricable relationship between the concept of vulnerability and relational autonomy, it can be seen that autonomy and vulnerability are not incompatible... ver abstract.
Bioethics update. 2019;5(1):50-65.
Capítulo de libro "Cultura dual. Nuevas identidades en interacción Universidad-Sociedad"
Juntar saberes y órganos: la contribución de la bioética a la cultura universitaria
Autores: Janet Delgado Rodríguez, Antonio Casado.
2019
Juntar saberes y órganos: la contribución de la bioética a la cultura universitaria
Autores: Janet Delgado Rodríguez, Antonio Casado.
2019
Artículo
Reflexiones sobre la ley orgánica 1/2019 en materia de tráfico de órganos. nuevos horizontes de interpretación
Autora: Clara Moya Guillem.
2019
La Ley Orgánica 1/2019, de 20 de febrero, ha reformado el delito de tráfico de órganos humanos (art. 156 bis CP). En este trabajo se examinan, con carácter general, los efectos de dicha modificación penal, que fuerza a reinterpretar algunos de los principales elementos de esta figura delictiva. En primer lugar, se estudian las repercusiones relativas al bien jurídico protegido, a las conductas típicas y al objeto material. En segundo lugar, se analizan las circunstancias agravantes que han sido incorporadas al tipo penal. Y, en tercer lugar, a la vista de los solapamientos existentes entre el delito de tráfico de órganos y el de trata de seres humanos con fines de extracción de órganos, se ofrece una propuesta de resolución a los problemas concursales a partir del análisis precedente... ver abstract.
Revista General de Derecho Penal. 2019;31.
Reflexiones sobre la ley orgánica 1/2019 en materia de tráfico de órganos. nuevos horizontes de interpretación
Autora: Clara Moya Guillem.
2019
La Ley Orgánica 1/2019, de 20 de febrero, ha reformado el delito de tráfico de órganos humanos (art. 156 bis CP). En este trabajo se examinan, con carácter general, los efectos de dicha modificación penal, que fuerza a reinterpretar algunos de los principales elementos de esta figura delictiva. En primer lugar, se estudian las repercusiones relativas al bien jurídico protegido, a las conductas típicas y al objeto material. En segundo lugar, se analizan las circunstancias agravantes que han sido incorporadas al tipo penal. Y, en tercer lugar, a la vista de los solapamientos existentes entre el delito de tráfico de órganos y el de trata de seres humanos con fines de extracción de órganos, se ofrece una propuesta de resolución a los problemas concursales a partir del análisis precedente... ver abstract.
Revista General de Derecho Penal. 2019;31.
Libro
La protección jurídica frente al tráfico de órganos humanos: Especial referencia a la tutela penal en España
Autores: Clara Moya Guillem.
Noviembre-2018
Marcial Pons, 2018, ISBN: 978-84-9123-573-6.
La protección jurídica frente al tráfico de órganos humanos: Especial referencia a la tutela penal en España
Autores: Clara Moya Guillem.
Noviembre-2018
Marcial Pons, 2018, ISBN: 978-84-9123-573-6.
Artículo
Uncontrolled DCD: When Should We Stop Trying to Save the Patient and Focus on Saving the Organs?
Autores: Iván Ortega-Deballon, David Rodríguez-Arias.
Noviembre-2018
Uncontrolled donation after circulatory death, which occurs when an individual has experienced unexpected cardiac arrest, usually not in a hospital, generates both excitement and concern... ver abstract.
Hasting Center Report. 2018;48(4):S33-S35. doi: 10.1002/hast.950.
Uncontrolled DCD: When Should We Stop Trying to Save the Patient and Focus on Saving the Organs?
Autores: Iván Ortega-Deballon, David Rodríguez-Arias.
Noviembre-2018
Uncontrolled donation after circulatory death, which occurs when an individual has experienced unexpected cardiac arrest, usually not in a hospital, generates both excitement and concern... ver abstract.
Hasting Center Report. 2018;48(4):S33-S35. doi: 10.1002/hast.950.
Artículo
The Dead Donor Rule as Policy Indoctrination
Autores: David Rodríguez-Arias.
Noviembre-2018
Since the 1960s, organ procurement policies have relied on the boundary of death-advertised as though it were a factual, value-free, and unobjectionable event-to foster organ donation while minimizing controversy.... ver abstract.
Hasting Center Report. 2018;48(4):S39-S42. doi: 10.1002/hast.952.
The Dead Donor Rule as Policy Indoctrination
Autores: David Rodríguez-Arias.
Noviembre-2018
Since the 1960s, organ procurement policies have relied on the boundary of death-advertised as though it were a factual, value-free, and unobjectionable event-to foster organ donation while minimizing controversy.... ver abstract.
Hasting Center Report. 2018;48(4):S39-S42. doi: 10.1002/hast.952.
Artículo
Vulnerability and Professionalism in Healthcare
Autores: Janet Delgado Rodríguez.
Agosto-2018
Ver artículo completo.
Professional Formation Newsletter.
Vulnerability and Professionalism in Healthcare
Autores: Janet Delgado Rodríguez.
Agosto-2018
Ver artículo completo.
Professional Formation Newsletter.
Artículo
An Interview with Mildred Z. Solomon, President of The Hastings Center
Autores: Janet Delgado Rodríguez.
31-enero-2018
Ver artículo completo.
Dilemata. 2018;26.
An Interview with Mildred Z. Solomon, President of The Hastings Center
Autores: Janet Delgado Rodríguez.
31-enero-2018
Ver artículo completo.
Dilemata. 2018;26.
Capítulo de libro "Trasplantes en el siglo XXI"
El marco jurídico español sobre trasplantes de órganos: ¿un sistema respetuoso con la autonomía individual?
Autor: Íñigo de Miguel Beriain.
2018
De la Torre, J. (ED.), Trasplantes en el Siglo XXI, Madrid, UPCO, 2018, pp. 55-76. ISBN: 978-84-8468-755-9
El marco jurídico español sobre trasplantes de órganos: ¿un sistema respetuoso con la autonomía individual?
Autor: Íñigo de Miguel Beriain.
2018
De la Torre, J. (ED.), Trasplantes en el Siglo XXI, Madrid, UPCO, 2018, pp. 55-76. ISBN: 978-84-8468-755-9