RESUMEN
El artículo repasa la evolución de la deontología de la Organización Médica Colegial a través de cómo se ha plasmado en los Códigos de Deontología aprobados por esta institución. Tras una aproximación al espíritu y contenidos del primer Código de Deontología de 1978, nacido tras la Constitución Española, aprobada ese mismo año, que estableció el reconocimiento y la necesidad de regular los colegios profesionales y el ejerci cio de los profesionales titulados. Se compara Código de 1978 con el recientemente aprobado en diciembre del 2022, utilizando como puente el segundo Código de 1990. En la comparación encontramos muchas cuestiones bioéticas sobre las que, a través de las últimas décadas, se ha reflexionado y se han introducido respuestas que responden a los numerosos cambios sociales y tecnológicos que se han producido. Se hace es pecial referencia al concepto de respeto, plasmado en la relación entre el médico y el paciente. Se trata de una relación que, con frecuencia, no es simétrica porque quien sufre puede sentir o soportar una extrema vulnerabilidad. Se reflexiona también sobre la evolución de temas relevantes o que pueden plantear más controversias, como el respeto a la vida inicial y final. La síntesis del actual Código de Deontología médica de 2022 se puede hacer en tres palabras: Respeto y Derechos Humanos (AU)
The article reviews the evolution of the deontology of the Spanish Medical Organization through how it has been reflected in the diverse codes of deontology approved by this institution. After an approxima tion to the spirit and contents of the first Code of ethics approved in 1978, born after the Spanish Cons titution, passed that same year, which established the recognition and the need to regulate professional associations and the exercise of qualified professionals. The 1978 Code is compared with the one recently approved in December 2022, using the second 1990 Code as a bridge. In the comparison we find many bioethical issues on which, through the last decades, reflections have been made and answers have been introduced that respond to the many social and technological changes that have occurred. Special referen ce is made to the concept of respect, embodied in the relationship between the doctor and the patient. It is a relationship that is often not symmetrical because the sufferer may feel or endure extreme vulnerability. The article also reflects on the evolution of relevant issues or those that may raise more controversies, such as respect for initial and final life. The synthesis of the current 2022 Code of Medical Ethics can be done in three words: Respect and Human Rights (AU)
Asunto(s)
Humanos , Historia del Siglo XX , Historia del Siglo XXI , Códigos de Ética/historia , Ética Médica/historia , Derechos del Paciente , Teoría ÉticaRESUMEN
El artículo describe el proceso de elaboración del nuevo Código español de Deontología Médica apro bado por la Asamblea General del Consejo General de Colegios de Médicos de España en diciembre de 2022. Se analizan los motivos para la actualización de las normas deontológicas, los trabajos llevados a cabo, los principios seguidos en el desarrollo del Código, y las novedades más relevantes introducidas (AU)
This article describes the elaboration process of the new Spanish Code of Medical Deontology ap proved by the General Assembly of the General Council of Medical Colleges of Spain in December 2022. The reasons for updating the deontological rules, the works carried out, the principles followed in the development of the Code and the most relevant new rules are described (AU)
Asunto(s)
Humanos , Derechos del Paciente , Códigos de Ética , Ética Médica , Teoría Ética , EspañaRESUMEN
El artículo describe y analiza los Principios Generales del Código de Deontología Médica de 2022 que están recogidos en los artículos 4 a 6 del capítulo segundo. Los Principios Generales permiten comprender e interpretar el conjunto de preceptos y recomendaciones del Código, por lo que el estu dio de estos artículos tiene especial relevancia. Además, se contextualizan relacionándolos con otros documentos internacionales ético-deontológicos actuales. También revisaremos cómo se prolongan en el amplio articulado del nuevo Código. Observaremos que hay una clara relación entre los Principios Generales del nuevo Código respecto a Códigos de Deontología de la Organización Médica Colegial anteriores, lo cual es lógico puesto que reúnen valores permanentes de la ética médica. Se propone que el médico está al servicio del ser humano y de la sociedad y tiene como deberes primordiales, el respeto a la vida humana, a la dignidad de la persona, así como el cuidado de la salud del individuo y de la comunidad (Artículo 4.1) (AU)
The article describes and analyses the General Principles of the 2022 Code of Medical Ethics that are included in the articles 4 to 6 of the second chapter. The General Principles make it possible to understand and interpret the set of precepts and recommendations of the code, for which reason the study of this second chapter is of special relevance. In addition, I contextualize General Principles by relating them to other current international ethical-deontological documents. We will also review how they are extended in the broad articles of the new code. We will observe that there is a clear relationship between the General Principles of the new code with respect to previous Spanish Medical Codes, which is logical since they gather permanent values of Medical Ethics. In the General Principles is proposed that each doctor is at the service of the human being and of society and has as primary duties, respect for human life, dignity of each person, as well as the health care of the individual and the society (Article 4.1) (AU)
Asunto(s)
Humanos , Ética Basada en Principios , Derechos del Paciente , Códigos de Ética , Ética Médica , Teoría Ética , EspañaRESUMEN
La práctica médica tiene dos dimensiones fundamentales una la científica, y otra la humana, y en ambas es esencial el compromiso del médico. La deontología médica, como rama de la ética que se ocupa de los deberes y obligaciones de los médicos, plasma en los códigos de deontología los principios y están dares éticos de obligado cumplimiento, a fin de que la práctica médica pueda garantizar que los pacientes reciban una atención médica de calidad, y que se les trate con dignidad y respeto. En diciembre del año 2022 el Consejo General de Colegios Oficiales de Médicos de España publicó una nueva versión del Código de Deontología Médica español que pretende, entre otros fines, normativizar una asistencia médica de calidad científica y humana. Práctica médica sustentada en medicina con base científica, lex artis médica, seguridad del paciente, responsabilidad profesional, honestidad e integridad son algunos de los aspectos que en este documento actualizado de deontología médica enmarcan y define el quehacer del médico para un desempeño de medicina con calidad (AU)
Medical practice has two main dimensions, one scientific and the other human, and in both, the com mitment of the doctor is essential. Medical deontology, as a branch of ethics that deals with the duties and obligations of doctors, embodies in the codes of deontology the ethical principles and standards of mandatory compliance. From this point, medical practice should guarantee that patients receive an quality medical care, and to be treated with dignity and respect. In December 2022, the General Council of Official Medical Associations of Spain published a new version of the Spanish Code of Medical Ethics that aims, among other purposes, to standardize medical care of scientific and human quality. Medical practice sup ported by scientifically-based medicine, lex artis médica, patient safety, professional responsibility, honesty and integrity are some of the aspects that in this updated document of medical ethics frame and define the work of the doctor for a performance of medicine with quality (AU)
Asunto(s)
Humanos , Calidad de la Atención de Salud/ética , Seguridad del Paciente/normas , Códigos de Ética , Ética MédicaRESUMEN
Objetivo: analizar la actividad de la Comisión de Ética y Deontología Médica (CEDM) del Colegio Ofi-cial de Médicos de Córdoba, respecto a situaciones conflictivas en la profesión en el período 2013-2021.Material y métodos: estudio observacional transversal, en el que finalmente se recogieron 83 casos de re-clamaciones presentadas ante el Colegio. Resultados: la incidencia fue de 2,6 reclamaciones colegiados/año, con un total de 92 médicos denunciados. El 61,4% fueron presentadas por el paciente, dirigidas en un92,8% a un solo médico. El 30,1% fue en la especialidad de medicina de familia, siendo el 50,6% en el ám-bito público y el 72% en asistencia ambulatoria. En el 37,7% el capítulo del Código de Deontología Médicaafectado fue el IV (calidad de la atención médica). En el 89,2% las partes acudieron a declarar, observán-dose mayor riesgo de expediente disciplinario cuando la declaración era oral y escrita (OR:4,61; p=0,026).La mediana de los plazos de resolución fue de 63 días, significativamente mayores en los casos propuestospara expediente disciplinario (146 días vs. 58,50 días; OR:1,01; p=0,008). La CEDM dictaminó infraccióndeontológica en el 15,7% (n=13), siendo expedientados 15 médicos (16,3%) y 4 sancionados (26,7%) me-diante apercibimiento y suspensión temporal del ejercicio. Conclusiones: La función de la CEDM resultafundamental en la autorregulación del ejercicio profesional. Los comportamientos inapropiados durantela asistencia al paciente o entre compañeros, conllevan graves implicaciones éticas, repercusiones discipli-narias para el médico, y especialmente, socavan la confianza de los pacientes en la profesión médica.(AU)
Objective: to analyse the activity of the Medical Ethics and Deontology Commission (MEDC) of the Co-llege of Physicians of Cordoba regarding conflictive situations in the profession from 2013 through 2021.Material and methods: cross-sectional observational study, in which 83 cases of complaints submitted tothe College were collected. Results: the incidence was 2.6 complaints members/year, with a total of 92doctors reported. 61.4% were submitted by the patient, 92.8% of which were addressed to a single doctor.30.1% were in the speciality of family medicine, 50.6% in the public sector and 72% in outpatient care.In 37.7% the chapter of the Code of Medical Ethics concerned was chapter IV (quality of medical care).In 89.2% of cases the parties came to make a statement, with a higher risk of disciplinary proceedingsbeing observed when the statement was both, oral and written (OR:4.61; p=0.026). The median resolutiontime was 63 days, significantly longer in cases proposed for disciplinary proceedings (146 days vs. 58.50days; OR:1.01; p=0.008). The MEDC found 15.7% (n=13) to be in breach of ethics, with 15 doctors beingdisciplined (16.3%) and 4 sanctioned (26.7%) with a warning and temporary suspension from practice.Conclusions: The role of the MEDC is fundamental in the self-regulation of professional practice. Inappro-priate behaviour during patient care or between colleagues has serious ethical implications, disciplinaryrepercussions for the physician, and it particularly undermines patients trust in the medical profession.(AU)
Asunto(s)
Humanos , Homeostasis , Ética , Teoría Ética , Relaciones Médico-Paciente , Bioética , España , Estudios TransversalesRESUMEN
The article focuses on the problem of the dignity of doctor and patient, in the Russian Federation, their relationship in the context of the modern realities of medicine. Today there is an acute problem of decreasing patient's trust in the doctor. Despite the development of advanced technologies and the appearance of modern effective methods of treatment, which increase the effectiveness of recovery, the human interaction between the patient and the doctor takes second place. This leads to a problem of distrust of treatment methods and psychological tension, which can be a factor impeding healing. It also leads a person to endlessly change doctors in order to compare specialists' opinions, to search for information about his ailment on the Internet, up to self-diagnosis and cases of self-treatment. At the same time, there has been a significant increase in the number of cases of diminishing the dignity of the doctor. This threatens to reduce public respect for medical professionals, disappointment in their own profession, and an increase in conflict situations. Therefore, along with the use of all the medical technologies available today, it is extremely important for the doctor to observe the principles of his and the patient's dignity and not to lose the purely human connection with the patient.
Asunto(s)
Respeto , Humanos , Federación de RusiaRESUMEN
Los deberes legales de información, obtención del consentimiento, confidencialidad y protección dela intimidad del paciente deben ser escrupulosamente cumplidos. Pero la Ética y Deontología médicas im-ponen en la relación médico-paciente un nivel superior de exigencia, el adaptar esos deberes al pacienteconcreto y a la situación concreta. Esto significa individualizar el acto médico y hacerlo absolutamentepersonal; la personalización en la relación médico-paciente hace de esta algo único y excelente, el objetivomoral de la profesión médica desde los preceptos hipocráticos hasta nuestros días.(AU)
Legal duties of information, obtaining consent, confidentiality and protection of patients privacy mustbe scrupulously fulfilled. However, Medical Ethics and Deontology impose a higher level of requirementon the doctor-patient relationship, namely, to adapt these duties to the specific patient and the specificsituation. This means individualizing the medical act and making it absolutely personal; personalization inthe doctor-patient relationship makes it unique and excellent, the moral objective of the medical profes-sion from the Hippocratic precepts to the present day.(AU)
Asunto(s)
Humanos , Relaciones Médico-Paciente , Seguridad Computacional , Privacidad , Confidencialidad , Teoría Ética , Bioética , Discusiones BioéticasRESUMEN
La objeción de conciencia de las profesiones sanitarias fue un tema que Gonzalo Herranz abordó deforma temprana y con una perspectiva muy particular. En todo momento se alejó de la discusión estricta-mente legal para ahondar en los auténticos fundamentos que justifican que un agente sanitario no quierasometerse a una determinada norma, al considerar que atenta contra su conciencia. En este artículo semuestran algunas de las principales cuestiones que, en relación a la objeción de conciencia, abordó el pro-fesor Herranz en sus publicaciones y conferencias.(AU)
Conscientious objection in the healthcare professions was a topic that Gonzalo Herranz addressed earlyon and with a very particular perspective. At all times he moved away from a strictly legal discussion todelve into the real grounds that justify a healthcare agents refusal to submit to a certain rule, consideringthat it goes against his or her conscience. This article presents some of the main issues that Professor He-rranz addressed in his publications and conferences in relation to conscientious objection.(AU)
Asunto(s)
Humanos , Empleos en Salud , Ética , Teoría Ética , Rechazo Conciente al Tratamiento , Bioética , Discusiones BioéticasRESUMEN
Leonardo Botallo (1530-c. 1587) is widely known for the eponymous "foramen Botalli" and "ductus Botalli". The first, most commonly named "foramen ovale", allows blood in the fetal heart to enter the left atrium from the right atrium. The second, named "ductus arteriosus", consists of a blood vessel in the developing fetus connecting the trunk of the pulmonary artery to the proximal descending aorta. However, Botallo was a multifaceted figure who studied many aspects of human anatomy and physiology, also making important contributions to clinical and surgical practices. Moreover, as we will see in the last section of this paper, Botallo wrote a book on medical deontology having significant features in relationship to the history of medical ethics. Botallo's multidisciplinary approach is a typical characteristic of Renaissance physicians and scientists, who contributed to making this period a fundamental prelude to the scientific revolution of the 17th century.
Asunto(s)
Cardiología , Conducto Arterial , Médicos , Traumatología , Libros , Conducto Arterial/anatomía & histología , HumanosRESUMEN
Not available.
Asunto(s)
Atención a la Salud , Consentimiento Informado/historia , Historia del Siglo XX , HumanosRESUMEN
BACKGROUND AND AIM OF THE WORK: The code of deontology of the Italian National Federation of the Colleges of Physicians, Surgeons and Dentists (FNOMCeO) contains the principles and rules to which the professional medical practitioner must adhere. This work identifies and analyzes the medical-linguistic choices and the expressive techniques present in the different editions of the code, and evaluates their purpose and function, focusing on the first appearance and the subsequent frequency of key terms. METHODS: Various aspects of the formal and expressive revisions of the eight editions of the Codes of Medical Deontology published after the Second World War (from 1947/48 to 2014) are here presented, starting from a brief comparison with the first edition of 1903. Formal characteristics, choices of medical terminology and the introduction of new concepts and communicative attitudes are here identified and evaluated. RESULTS: This paper, in presenting a quantitative and epistemological analysis of variations, modifications and confirmations in the different editions of the Italian code of medical deontology over the last century, enucleates and demonstrates the dynamic paradigm of changing attitudes in the medical profession. CONCLUSIONS: This analysis shows the evolution in medical-scientific communication as embodied in the Italian code of medical deontology. This code, in its adoption, changes and adaptations, as evidenced in its successive editions, bears witness to the expressions and attitudes pertinent to and characteristic of the deontological stance of the medical profession during the twentieth century.
Asunto(s)
Códigos de Ética/tendencias , Odontología/normas , Nivel de Atención/tendencias , Códigos de Ética/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Italia , Nivel de Atención/historia , Terminología como AsuntoRESUMEN
The Italian Code of Medical Deontology is a set of self-discipline rules prefixed by the medical profession, that are mandatory for the members of the medical registers, who must conform to these rules. The history of the Italian Code of Medical Deontology dates back to the beginning of the twentieth century. In 1903 it appeared in the form of a "Code of Ethics and Deontology" and was prepared by the Board of the Medical Register of Sassari (Sardinia). This Board inserted the principles inspiring the correct practice of the medical profession in an articulated and self-normative system, also foreseeing disciplinary measures. About ten years later, in 1912, the Medical Register of Turin (Piedmont) elaborated a Code which constituted the basis for a subsequent elaboration leading to a Unified Code of Medical Ethics (1924). After World War II the idea prevailed in Italy that the codes of medical deontology should undergo periodical review, updating and dissemination, and the new 1947 text (Turin) was for the first time amply diffused among Italian physicians. The next national code dates back to 1958, and twenty years later a revision was published. In the 1989 Code new topics appeared, including organ transplantation, artificial in vitro insemination and the role of police doctors; these and other issues were later developed in the 1995, 1998 and 2006 versions of the Code. The last available edition of the Italian Code of Medical Deontology is that of May 2014.
Asunto(s)
Nivel de Atención/historia , Códigos de Ética/historia , Códigos de Ética/tendencias , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Italia , Nivel de Atención/tendenciasRESUMEN
Doctor's task cannot be limited to medical practice and research. As a citizen of society, and above all as a professional, doctors should not evade their social responsibilities. This idea was systematically developed and widely diffused throughout Europe by Pierre-Jean-Georges Cabanis (1757-1808). He was not only a doctor, but also a philosopher and a politician who lived at the time of the French Revolution. His philosophy on the nature of medicine and the social role of the doctor is conceptualized in his idea of medical anthropology (science de l'homme, anthropologie). In order to understand why the social role of the doctor was particularly emphasized in and around France, Cabanis' medical anthropology should be analyzed in depth. His medical anthropology is composed of three major domains: physiology, ethics, and analysis of ideologies. The following ideas of his medical anthropology can be identified in the current articles of the French code of medical deontology. 1) Health and disease being a social problem, a social solution should be sought (1.6, 1.7, 1.10, 2.37, 2.44, 2.50); 2) Medical practice is in principle not a commercial service for profit, but rather a public service supported by the government's power (1.12, 1.19, 1.21, 2.55, 3.57, 3.67); 3) Doctors should maintain their professional autonomy by establishing and observing the principles of self-regulation (1.1, 1.5, 1.31, 2.50, 5.109, 5.110). Referring to the historical experience of French doctors, the Korean medical community should also enter into a broad and fundamental reflection on the nature of medicine and the social role of the doctor.