withdrawal for the elderly

A social phenomenon resulting from the contemporary disintegration of family ties; in medicine, it manifests itself, among other situations, as attempted hospital admissions for trivial causes during the holidays (see withdrawal of patients).

withdrawal of patients

See duty of care.

Patient advocacy

Anglicism for patient advocacy.

Induced abortion

Intervention, generally carried out by medical means, aimed at the elimination of the foetus, either by destruction and subsequent expulsion, or by premature expulsion with subsequent death. It is decriminalised in most European and American countries, provided that it is performed under certain conditions, generally restrictive, aimed at protecting the right to life. On the internship, these restrictions are hardly any obstacle to its implementation.

Ethical abortion

Induced abortion performed on a pregnancy due to rape of the mother. It is decriminalised in Spain, provided that the rape has been reported to the police authorities shortly after it occurs, before it is known whether or not there is a pregnancy.

Abortion and ethics

The performance of an induced abortion is, from an ethical point of view, the elimination of an innocent human life, and can never be a correct decision. This does not prevent the woman, in many cases, from acting under strong external and internal pressures that justify, although never totally, her behaviour. This justification does not exist in the case of the doctors who perform abortions, who, moreover, tend to work exclusively for the economic benefit of their work internship. The ethical solution to requests for abortion is to provide the woman with the appropriate moral, economic and social support; however, this support is extremely scarce in countries where abortion is permitted, leaving the woman with the choice between a heroic decision or allowing her child to be killed.

Eugenic abortion

Induced abortion performed in case of suspicion or certainty of serious illness of the child. Such certainty can never be complete. It is usually performed on the grounds that the life of the child with deficiencies would be of poor quality, and not worth living. The elimination of the unborn with diseases is not an effective measure for the improvement of the human gene pool. In addition to the parents' sadness at their child's illness, this abortion deprives them of the consolation of even seeing their child, even if he or she is only going to live for a few hours.

Legal abortion

Abortion carried out within the conditions foreseen by the law in order not to receive legal penalties. It can be either by decriminalisation (it is a crime, but is not punished in certain cases) or by legal approval (abortion would be considered a non-criminal conduct). In Spain, legal abortion is decriminalised abortion.

Free abortion

A legal concept of abortion that considers its performance as non-criminal in any circumstance, provided it is performed at the request of the mother.

Abortion on grounds of health risk

Induced abortion to safeguard the mother's health from the danger of aggravation of the pregnancy due to a previous or supervening illness. Given the current progress of medicine, it is never necessary to carry it out. The danger to the mother's mental health is the main excuse for the internship of abortion in countries where, like Spain, the law requires some cause, medical or non-medical, for its decriminalisation.

Medical act

The act in which the physician acts as a medical professional, whether to prevent, diagnose, prognosticate, treat, etc. Its ordinary meaning is usually confined to his or her actions for the diagnosis and treatment of an individual patient.

Medical act and ethics

The medical act is fraught with responsibility, since its influence on the patient's way of life concerns not only purely health issues, but, like any human relationship, it has a decisive influence on the way human life is conceived, especially when the doctor's professional prestige is taken into account (see training ).

Negative act

See decision, omission.

Acupuncture

Alternative medicine (see), traditional in China, consisting of sticking needles into certain points of the body to obtain various effects, such as analgesia.

Acupuncture and ethics

See alternative medicines and ethics.

Food and hydration

Basic needs of every patient; it is only right to omit them when they make the terminal patient's last moments very uncomfortable (see euthanasia, proportionate treatment, disproportionate treatment).

Relief

Subjective feeling of improvement in the troublesome symptoms of an illness. It is, together with healing (see) and moral support for the sick (see), one of the aims of medicine.

Altruism

Attitude or behaviour that is characterised by prosocial behaviour involving submission and consideration for others, to the neglect or detriment of self-interest.

Biological altruism

In sociobiology, a hypothesis that attributes altruistic behaviour to reasons of biological utility for the species: a species whose members help each other would have a better capacity to adapt to the environment and a better chance of survival, within a neo-Darwinian explanation of the maintenance and evolution of the species. This theory assumes that humans are exclusively biology (which is false) and that neo-Darwinism is the only explanation of biological evolution (which is also false).

Therapeutic friendship

The relationship of love and friendship that is established between doctor and patient. It is the ideal engine of the relationship between the two. If it exists, it gives the physician the concern to help with health problems, and the patient the confidence to heed the physician's advice. At the same time, it enables the physician to learn lessons of humanity from his patient and to mature as a person. Therapeutic friendship results in the harmonious interaction of doctor and patient (see benevolence, beneficence, solidarity). If it does not exist, the internship of medicine is doomed to commercialisation (see) and defensive medicine (see).

Analgesia and ethics

Although the patient, because of his or her convictions, may prefer to accept suffering (see suffering as atonement), the physician has an obligation to make the patient's illness bearable through appropriate palliative care (see) (see terminal analgesia and shortening of life).

Terminal analgesia and life shortening

Ethical problem that arose in the care of terminally ill patients: the administration of morphine in separate doses sometimes resulted in respiratory depression and hastened the patient's death. In such cases, the physician's action is morally correct, as long as he does not intend the patient's death. With modern patterns of analgesic administration, with patient-controlled, microprocessor-controlled injection systems, this effect is almost non-existent.

Elderly people, right to health care

The right to health care is proportionally increased due to the weakness and fragility of status of old age, which leads to a corresponding obligation of increased care by the doctor (see respect).

Anencephalons as donors

Parallel to the diagnosis of brain death (see), some authors consider that anencephalic children are ipso facto donors. This is not the case, as they live without the need for support measures and, when they die, at least the explicit will of their parents to donate would be required.

Experimental animals

Animals used for the purpose of research or learning medical techniques. Their employment is justified by the potential benefit to man. However, this is not equivalent to considering them as mere subject at the experimenter's discretion: they must be respected (see respect) to the extent required by their sentient nature, avoiding unnecessary suffering, avoiding the use of a issue higher than necessary, preferring to use lower beings in the phylogenetic scale rather than higher ones, and providing them with appropriate care. The ethics of employment of experimental and training animals is also based on the care that the experimenter himself must take to avoid becoming desensitised to suffering, preserving in himself compassion (see) in the face of pain. There is a specific rules and regulations for the protection of experimental animals from abusive employment .

Animals of laboratory

See experimental animals.

Animals in teaching

See experimental animals.

Quality-adjusted life years

This index is obtained by multiplying the survival index (see) by one of the existing quality of life indices (see) applied to the state in which the patient will presumably remain after treatment. goal In this way, the aim is to obtain a survival index that shows survival not in merely chronological terms, but in terms of the vital reality obtained by the treatment for the remaining period of life, so that the results that can be obtained by means of a given medical intervention can be ascertained in a fairly accurate way (see cost of medicine, futility) and thus judge whether or not it is worthwhile to carry it out.

Moral support

Part of palliative care, aimed at getting the patient to come to terms with and accept the limitations of their illness in a manner worthy of a person. Although this result cannot always be achieved, the necessary support must be provided so that the patient can assimilate their status and does not remain in the reactions of denial, rejection or depression that can follow bad medical news. Moral support should also be given to the patient's family.

Life support

Generic name for intensive care measures aimed at maintaining the basic vital functions of the sick: breathing, circulation, etc.

Compassionate fast-track approval

procedure The emergency approval for the use of a drug that is the last resource drug for some patients, skipping some of the usual phases of clinical trials. It has been carried out with combinations of AIDS drugs after repeated requests from patients.

Slippery slope argument

Moral argument on the inconvenience of the legalisation of certain incorrect medical practices, such as abortion or euthanasia, which is based on their foreseeable or proven expansion when authorised, as they would be carried out with an undesirably high frequency or would be performed without the precautions that one wishes to establish for them.

Biological weapons

Weapons designed to cause harm to people by biological means, in particular by dispersing micro-organisms in the environment that cause serious infections, which are not very frequent (so that there are not enough doses of vaccines in stock at the place attacked) and which are difficult to control with existing treatments. Their development and manufacture are contrary to the most elementary ethics of the scientist.

Allocation of scarce resources

A frequent ethical problem for health authorities when it comes to allocating budgets in their various areas. Given the increasing technicalisation and rising cost of medicine, this is an acute problem today. Its solution involves programs of study of the profitability of the different preventive and curative health actions (see justice).

Asilomar

It was here that a lecture of scientists decided in 1974 to place a moratorium on experiments in manipulation Genetics until such time as, under strictly controlled conditions, it could be known that the manipulated beings would not pose a danger to man or nature.

attendance nun

A sick person's right, as stated in a declaration of the World Medical Association association . It is part of the necessary moral support (seeing) the patient in their last moments. It must always be carried out with respect for the patient's convictions.

Attention to suicide

See financial aid to suicide.

Medical care

All the care and assistance provided to patients in the event of illness.

Primary care

Non-specialised medical care that is the initial step in the care of the sick in state health systems.

Terminal care

The set of analgesia and care, both physical and psychological and spiritual, that must be provided to the patient with a poor prognosis in the short term deadline.

Auriculopuncture

Variant of acupuncture (see) which applies needles or staples to specific points in the pinna. There are nerve endings in the auricle whose pathways run parallel to the other nerve pathways, thus allowing analgesia or relief of multiple ailments.

Self-awareness

Perception in act of one's own capacity to perceive and feel. It is an ambiguous term, because it does not specify whether this perception is sensitive (and thus occurs in all animals with report and imagination) or intellectual (which only occurs in man). See human-animal boundary.

Patient self-determination

See patient autonomy.

Self-experimentation

Medical experimentation in which the researcher is simultaneously the subject of research. It is often carried out in high-risk cases by reckless scientists who are very convinced of its potential success. It is discouraged, and is not usually approved by the ethics committees (see) that review the protocol of the experiment (see).

Autonomy

Capacity for choice, freedom. In liberal bioethics, with a Kantian slant, it means the choice of vital ends, but without reference letter to a moral rule : autonomy is the creation of one's own ends and determination by them.

Patient autonomy

The patient's capacity to make decisions in the context of his or her relationship with the physician. The patient is not merely an object of manipulation by the doctor, but a constituent part of a therapeutic relationship (see doctor-patient relationship) in which he or she must participate as a person and a moral subject.

Financial autonomy of the doctor

Medical autonomy with respect to the price of diagnostic tests or recommended treatments. Although it must be maintained to a certain extent, the practice of medicine cannot be carried out independently of the expense it causes, whether public or private (see cost of medicine).

Medical autonomy

Decision-making capacity of the physician in the context of a therapeutic relationship. The active participation of the patient in the therapeutic relationship does not turn the physician into a mere servant who obeys what the patient dictatorially imposes on him: the physician retains his own decision-making capacity, and may refuse to carry out actions he considers inappropriate, either for medical reasons (see futility, scientific objection) or for moral reasons (see conscientious objection).

Autopsy and ethics

Since the autopsy makes it possible to establish with certainty the cause of death in cases where there were doubts, the obligation to attend to patients who come afterwards with skill obliges internship if these doubts are reasonable.

Authority of committees

Moral weight of Ethics Committees' responses to the consultations submitted to them. In some cases, this authority is legally recognised, as in the case of clinical research committees, whose approval to a protocol of research is mandatory in order to be able to carry it out.

AVAC

Acronym for quality-adjusted life years (see).

financial aid to suicide

partnership suicide of the patient, usually by administering drugs in sufficient doses to cause a painless death. It differs from euthanasia in that the physician does not personally apply such means. Paradoxically, his internship does not lead to the patient's suicide in most cases, but gives the patient the peace of mind that, should his illness worsen, he will have a resource at hand. A request by the patient for financial aid to commit suicide often reveals suffering that has been inadequately treated. Thus, the doctor is often (unjustifiably) afraid to prescribe morphine; skimping on it is a very common mistake, which only leads to useless suffering.

Helping to die

Care provided by the doctor in the last moments of a patient's life. It includes the palliative care necessary for physical relief (pain, discomfort) and the necessary moral support and comfort (companionship, calming concerns, attendance religious).

Charity

Part of friendship that leads to actions in favour of the person one esteems. In a liberal sense, to perform the actions that the other person wishes to be performed, regardless of the agent's opinion of their rightness or wrongness.

Physician Beneficence

Part of therapeutic friendship (see), which leads the physician to act to help the patient. From the point of view of liberal bioethics, actions performed by the physician to satisfy the autonomous decisions of the patient, understood as being detached from any moral standards; according to this consideration, the physician would be obliged to perform an intervention if the patient wants it, even if he/she considers it not to be the most convenient.

Benevolence

Part of friendship, including therapeutic friendship (see), which inclines the physician to pay attention to the patient's needs.

Goods

Aims of the action that constitute perfection or enrichment for the agent (see values).

Well-being of the sick

Part of the goal part of health care: health care is not just about curing, but about making the illness bearable while it lasts, or, if it is chronic, providing the necessary relief (see) and moral support (see). The World Health Organisation erroneously equates it with health.

Bioethics

A term that has been used since the 1970s to refer to biomedical ethics (see). In the context of the liberal political Philosophy , political discussion about the public measures to be taken to protect people from the manipulation of biomedical techniques (see ethics committees).

Civil bioethics

A way of doing bioethics that aims to eradicate any particular belief when it comes to bioethical reasoning: only secular or civil arguments would be valid, i.e. those not linked to any religious belief. Under the guise of tolerance of minority opinions, it directly attacks all claims based on religious beliefs and reduces ethics to a question of social consensus (see disagreement in bioethics, cultural diversity, ethics of minimums).

Special bioethics

Part of Bioethics that is dedicated to the study of particular issues, applying the principles of general Bioethics, and seeking practical solutions to specific cases.

General bioethics

Part of Bioethics that studies the philosophical foundations and basic principles of correct action in biomedicine.

Liberal bioethics

A way of doing bioethics that considers medicine as a commercial exchange between unsupportive people, interested only in their own profit and personal plans, and not as a friendly relationship with the patient financial aid (see conflicts of interest).

Principlist bioethics

A widespread approach to bioethics that bases the analysis of the morality of medical actions on the application of the principles of bioethics: autonomy (see), beneficence (see) and justice (see). Usually, these principles are taken in their most liberal version (see liberal bioethics). These principles of bioethics lack a solid foundation, and are used only for their pragmatic utility in resolving cases that may cause ethical perplexity for physicians.

Secular bioethics

See civil bioethics.

Biotechnology

A set of techniques that have in common the manipulation of living organisms. This can be done by mechanical, chemical, physical, genetic, etc. means.

Enhanced biotechnology

Application of biotechnology, not to cure disease, but to try to improve some previously healthy biological aspect. Its application to animals or plants, for the improvement of food production yields, offers no serious ethical drawbacks. Its application to man violates human dignity (see): man has the right to his personal organic peculiarities (height, skin or hair colour, etc.), even if these are not particularly appreciated by others at that historical moment. The aims of human enhancement biotechnology are necessarily the result of fashion and arbitrariness.

Medical biotechnology

Applied biotechnologies for health (see).

Good death

Etymology of the word euthanasia.

Dead body

The material remains of a person after death. It is not a mere thing, but, having been part of a person, deserves proportionate respect (see). This includes cases where the deceased has expressed a wish to donate his or her body for transplantation purposes, research or teaching medical purposes.

Calculation of consequences

Part of the analysis of actions that must be taken into account for their ethical correctness (see Consequentialism, tolerated effects, proportionate treatment, disproportionate treatment).

Calculation of costs and benefits

assessment of the benefits of performing a given diagnostic or therapeutic technique in relation to its economic and human cost (see Calculation of consequences, cost of medicine, futility).

Risk calculation

See Calculation of consequences.

Quality of care

Quality of health service, which can be assessed using systems similar to those applicable to other service professions. It includes the quality of the medical act (see) together with other issues of organisation of work and human relations, especially in hospitals, which allow not only medically correct but also time- and cost-effective care.

Quality of life

Set of aspects that can give an idea of the Degree limitation of life staff caused by a disease. It can be understood in a goal way (see Quality of Life Index) or subjectively, as a set of factors desired for life staff without objective references (see Autonomy) that are satisfied in the present health condition. This second way of understanding it allows to establish, erroneously, lives that are not worth living (see euthanasia, value of human life).

Quality of the medical act

Degree of correspondence between the internship of a medical act and the lex artis (see).

Gender reassignment

See Transsexuality.

Capacity

In general, aptitude or skill. Power to perform a physical or mental act. Quality of the person to be able to understand and decide autonomously (see Autonomy).

Legal capacity

status of capacity to perform legal acts. If someone loses capacity due to illness, whether physical or mental, the third parties concerned can apply for declare the patient legally incapacitated.

Prison

See Hunger strike in prison, salaried doctor.

Cases

See teaching for medical ethics and casuistry.

Castration

Surgical removal of the testicles or ovaries. This may be necessary in certain diseases of these organs. Otherwise, it is an injury that can never be inflicted by the physician.

Court-ordered castration

In some countries, it is proposed as the most appropriate penalty for rapists. Its application would be contrary to medical ethics, as the doctor would be injuring or mutilating the prisoner, thus going against the basic principle of his profession: financial aid to the sick.

Casuistry

The recording and study of cases of a disease. A method of study in bioethics based on the exhibition of paradigmatic cases of various clinical situations that may cause ethical perplexity. From the solutions to these cases, doctors can acquire an ethical orientation for dealing with similar cases. Its usefulness is limited, since the goal of the physician's ethical training is to enable him or her to acquire the habits of reasoning to resolve the situations that arise, not to provide a prescription book that, while useful, is insufficient.

certificate of complacency

certificate doctor who, untruthfully, certifies a non-existent illness so that the patient can obtain benefits of various kinds subject (compensation, absence from work, etc.). Issuing this kind of certificate subject is contrary to medical ethics and may constitute the offence of falsification of a public document.

certificate doctor

A document in which a doctor officially describes aspects of a patient's health, usually at the patient's request. Its content must conform to what the physician has personally observed, must be truthful (see certificate of complacency) and must not be given to persons other than the patient himself or those involved in his care (see Medical confidentiality).

Scientism

A view of science and medicine that only accepts as true what can be verified by means of the observation of the hypothetical-deductive scientific method. Its consequence in medicine is the reduction of the patient to a damaged organism, with the consequent neglect of moral support (see) for the patient and the family.

Human cloning

Production of a human being genetically identical to another human being, from the genetic material of a cell of the person to be copied. So far, it has only been carried out successfully in some animals. It is of no medical use to the subject result of the cloning. The 1997 UNESCO Convention on Genome and Human Rights has recommended governments to ban it. Spanish law prohibits it internship.

Code of ethics

A set of ethical rules that guide the professional internship . Although their main goal is the ethical orientation of the medical internship , they have a mixed ethical-legal nature that allows the application of sanctions to non-compliant doctors by the professional associations, thanks to the existence of compulsory membership.

Professional code

Collection of rules and guidelines for professional conduct. They are necessary for the orientation of correct professional conduct (see Prudence).

Coercion

Exercise of violence, usually psychological, to force a patient to make a decision in a certain direction. The physician is obliged to avoid it (see Autonomy), both on his own part (as in enthusiasm for a clinical opinion staff) and on the part of the family (who may become obsessed with a futile treatment); this does not preclude trying to persuade a patient about something that is deemed desirable (see futility).

Colleague

Generic name of the professional partner.

high school professional

Grouping that arises from the existence of a profession. It is not a professional association with a specific purpose, but brings together all professionals in order to ensure, as far as possible, the proper exercise of their profession work. This goal can only be achieved through compulsory membership (see Mala internship).

Commercialism

See Commercialisation of Medicine.

Commercialisation of Medicine

A way of practising medicine that conceives it as a mere service sector activity, where services are exchanged for money. Although the internship of medicine involves economic exchanges (medicines, surgical equipment, salaries of staff, etc.), it cannot be reduced to economic categories. Thinking only of the potential profitability of health care services leads to disregard for the real interests of the patient and to poor medical internship (see).

Beginning of human life

The moment when a new member of the human species begins. This beginning can be determined exactly, because it coincides with the beginning of a new biological identity, usually in the fertilisation of an ovum with a spermatozoon. In some cases, this origin is in the division of a young embryo, which gives rise to identical twins: one embryonic human being produces another by vegetative division. Some authors, alleging such a possible division, claim that the newly formed embryo is not an individual human life (see Pre-embryo); however, such a claim is contradictory (if it is not a man, what is it?), and is usually only used to justify assisted reproduction procedures (see) in which most of the embryos that are formed die.

Ethics Commissions

See ethics committees.

Health care ethics committees

training Ethics committees that are responsible for the study of the ethical aspects of the clinical cases referred to them, as well as for the continued training of physicians in ethical issues and the preparation of documents on medical issues of particular ethical relevance.

Bioethics committees

See ethics committees.

Ethics committees

Commissions of varying composition responsible for studying the ethical aspects of clinical internship , basic or clinical research , animal experiments, etc. (see ethics committees for health care, ethics committees of research). Very often, especially in the Anglo-Saxon sphere, they limit themselves to providing a committee that provides guidance on legal liability, avoiding the actual ethical analysis of the problems they are faced with.

Research Ethics Committees

Ethics committees are responsible for the supervision and approval of experimental protocols before they are carried out. They are independent of the medical researchers, and their favourable opinion is required by law in order to carry out the experiment. Scientific journals require, as a mandatory condition for the publication of the work of research , the approval of the experiment by the ethics committee of committee at research.

Hospital ethics committees

See Care Ethics Committees.

Medical committees

Groups of work made up of medical experts, responsible for reviewing and updating technical issues relating to patient care. Although their opinions carry the weight of their members' experience and expertise, they are not necessarily binding in the provision of health care (see Lex artis, mala internship).

National Bioethics Committees

See National Ethics Committees.

National ethics committees

Ethics committees constituted by law in some countries that issue ethical opinions on medical matters at the request of various state bodies in order to advise them, usually with a view to drafting the text of a law that may affect essential aspects of the ethics of professional internship . Unfortunately, their composition is often politically motivated and their opinions are often limited to a compilation of the views of their members, reflecting the heterogeneity of societal opinions, with minimalist ethical recommendations that do not satisfy any of the conflicting positions within committee.

Insurance companies

Private companies, usually for profit, that provide health care for illnesses that may occur in the insured person (see Salaried doctor, medical confidentiality).

Compassion

Initial movement of affection towards someone who is suffering for some reason. It is at the root of medical care (see beneficence), in which it must be combined with ethical reflection and the necessary expertise (see skill professional, euthanasia).

Compensation for damages

Financial compensation for damages due to health care. Due to the nature internship of medical care, injuries and damages are unavoidable and compensation is intended to alleviate the possible costs of care for the damages incurred. They are covered by some insurance policies taken out by physicians and, in some countries, by the State. These damages do not necessarily imply professional malpractice (see internship ).

skill

Anglicism. See Capacity.

skill professional

The doctor's ability internship , based on the necessary theoretical knowledge, enables him to treat patients in the best possible way, both from a technical point of view (see Lex artis) and from a human point of view (see Patient support).

Economic competitiveness

The cost/service ratio provided by a business, which allows it to survive in a free market Economics . The application of strictly economic criteria to hospitals or healthcare institutions in order to achieve their competitiveness may go against the aims of medicine, and should be subordinated to these (see Aims of Medicine).

Professional commitment

Involvement staff of the doctor in the ideals of financial aid to the patient. It is fundamental for the development of correct medical care (see).

Awareness

To become aware of, realise or recognise something. In psychology, an integrative psychic function that enables human beings to become aware of themselves, to perceive what is external to them and to relate reflexively to their environment.

Moral awareness

Intellectual capacity to appreciate the goodness or badness of personal actions (see training of conscience, prudence), including intentions, decisions and effects accepted voluntarily.

Conditions of work of the doctor

A set of conditions that all physicians, whether working on their own account or under contract, must try to guarantee in order to be able to provide their patients with care at agreement with the development of the medical technique at the time (see Lex artis).

Behaviourism

approach of psychology that tends to reduce human behaviour to responses to conditioning acquired by reinforcement (due to rewards) or inhibition (due to punishments) of spontaneous behaviour. It radically empties human behaviour of its ethical content, which is exclusively due to the influence of the environment. Although it is true that experience influences behaviour, it does not determine it: we are truly free and responsible for our actions.

Involuntary confinement

Commitment of a patient to a health institution against his or her will, due to a physical (some infectious diseases) or psychological (manic psychosis, etc.) illness that poses a danger to himself or herself or to public order or health. certificate It can only be carried out by means of an order from the judicial authority, following a medical report on the patient's status .

Involuntary confinement and ethics

It has lent itself to serious abuse in totalitarian regimes, which classified civil service examination to the political regime as a psychiatric pathology.

Conflicts of interest

An essential constituent part of social relations, including the doctor-patient relationship, in the enlightened or liberal conception of society, in which man is not sociable or beneficent by nature and meets others merely for selfish convenience. The functioning of society is then reduced to the attempt - doomed to failure - to harmonise the conflicting interests of its members (see beneficence, ethical dilemmas).

Consequentialism

A method of ethical analysis that focuses exclusively on the intentions of the actor and the consequences of his action, and disregards consideration of the action itself. According to this method of analysis, the end justifies the means: if the intended end is good and the consequences are not negative, any action that leads to that end is valid.

Bioethics advisers

See Ethical experts, prudence.

committee genetic

The process of providing individuals affected by a disease Genetics and their family with information about the disease, the risks of developing or transmitting it, and the means of treating, preventing or mitigating it (see Autonomy, informed consent, eugenics).

committee genetics and ethics

The genetic committee must provide truthful but not catastrophic information, admitting the possibility of false positives in the analyses, so as not to provoke unnecessary anxiety or anguish; it must be accompanied by the necessary support (see) so that the couple can freely decide to have children, knowing that, in the event that one of them is born ill, they will have the necessary financial aid and treatment. In the various consultations that follow one after the other until data can be provided, the doctor should try to discourage abortion as a way out of a pregnancy with a sick child, and should never perform it (see Eugenic abortion).

Consensus

agreement on a committee for concurrence of opinions. This agreement is often partial, or may not even be reached, so that the opinions of the committees often refer to ethical minimums, and include individual votes with dissenting opinions (see ethics committees).

Consent

Express or tacit manifestation of will by which a person approves an act to be carried out by another person. In the patient-physician relationship, approval of a particular medical action by the patient, after appropriate information - or sometimes without it - by the physician. See informed consent.

Delegated consent

Consent to a medical procedure consent given by a person other than the patient, who has been previously authorised by the patient to give it, either formally or presumed (as is the case with the next of kin). In Spain, presumed delegated consent is not legally admitted for certain interventions, such as voluntary sterilisation (see).

Informed consent

Consent given by a patient, donor, or subject of research to the diagnostic or therapeutic procedures to be performed on him/her, after having received the relevant information in this respect. Current legislation requires that such consent be given in writing, in order to have a documentary test that both the physician's information and the patient's authorisation have been given. As far as possible, such information should be complete, and should be provided in a manner that does not put undue pressure on the patient's legitimate autonomy (see patient autonomy). The patient's consent does not absolve the physician from responsibility for the results of his or her intervention, so that, weighing the risks and benefits involved, the physician may not perform the intervention even if the patient wishes to do so (see science objection).

Consent for donation

See Organ donation.

Presumptive consent

See Delegated consent.

enquiry médica

application Formal technical committee that a doctor makes to one or more of his colleagues, either to clarify a particularly sensitive medical problem or to obtain advice on medical aspects of the patient that do not belong to his specialization program.

enquiry of clinical ethics

Medical consultations with experts (see Ethics consultants) to clarify ethical aspects of medical actions before acting (see Prudence). They are a valid alternative to ethics committees (see).

consultant of ethics

Expert in the ethical aspects of medicine to whom clinical ethics consultations are made (see).

Consumer

Economistic consideration of the patient as Username of a medical business , belonging to the service sector (see Commercialisation of Medicine).

Containment of expense medical

Ethical imperative of health care, necessary to be able to care for more sick people. It encompasses both general health policy measures and particular diagnostic and treatment decisions for a particular patient (see cost of medicine, proportionate treatment, disproportionate treatment, triage).

Contraception

Generic name for technical procedures that prevent fertility. Strictly speaking, it is limited to the very varied contraceptive methods used to prevent conception: they prevent the fertilisation of the ovum by the spermatozoon. Other methods, abortifacients, whose mechanism of action prevents the development embryo or foetus, are also normally considered contraceptive methods. Contraceptive methods can be mechanical (condoms and vaginal diaphragms), spermicides, hormonal, coitus interruptus, sterilisation (usually irreversible). See hormonal contraception, voluntary sterilisation, barrier methods, natural methods.

Hormonal contraception

Contraception using various combinations of female sex hormones to prevent pregnancy after sexual intercourse. Injections or long-acting implants can be used, but the most common system employee is the pill administered daily for 21 consecutive days with a one-week break. Its effectiveness is very high.

Contraception and prescription ethics

All contraceptive pills currently on the Spanish market have, in addition to an anovulatory effect, an anti-implantation effect on the embryo if ovulation has not been prevented, and their administration implies the internship of micro-abortions (see Abortion) with the appearance of normal menstruation; this effect is not ethically justifiable for any reason, especially if there are other equally effective methods (see Natural methods). It is also possible to argue against their prescription on the grounds of the side effects they produce (see science objection), or the moral disorder they cause in marital relations (see conscientious objection).

Steroidal contraceptives

See Hormonal contraception.

Contract

Explicit commitment between two people to a pre-agreed course of action for mutual benefit. It is applicable to some extent to the patient-physician relationship, where there is a agreement to achieve the purpose of treatment. See physician-patient contract.

Doctor-patient contract

View of the doctor-patient relationship (see) from the exclusive point of view of the economic or contractual exchange (see Commercialisation of Medicine).

Social contract

Conception of interpersonal relationships in society, including the doctor-patient relationship, which considers people as absolutely independent and without mutual obligations; these only arise through the establishment of an optional commitment (see Autonomy). In this conception of society, friendship as source of interpersonal relations disappears and only self-interest remains (see Therapeutic friendship, beneficence).

Countervalue

Subjectively appreciated evil (see) (see values).

Moral convictions

Set of principles of conduct assumed as ethical guide for behaviour staff. They cannot be reduced to the arbitrariness of a mere capricious choice (see Autonomy), but must be based on reasonable intellectual decisions. Discordant moral convictions may lead to situations of disagreement in doctor-patient relationships. In such cases, polite disagreement can always be reached, and a change to another physician with whom there is a rapport can be made. In no case is it reasonable to violate the convictions of one of the parties.

Medical Corporation

See high school professional.

Corporeality

Quality of the person as a material organism. In medical care, respect (see) for the person is to be manifested, among other things, as respect for his corporeality.

Corporatism

A fierce defence of colleagues within high school, even to the detriment of the quality of medical care.

Cost of medicine

Cost of health care. Although it is not strictly a health care factor, medical care cannot ignore it, not only when treating fee-paying patients, but also when practising in hospital medicine, public or private: it must be taken into account when organising work (see Quality of care), and when recommending a diagnostic test or a treatment (see futility, proportionate treatment, disproportionate treatment). Properly saved expendable expense may allow more patients to be treated who would otherwise go untreated (see Triage). It is particularly relevant when considering the treatment of chronic patients.

Genetic screening

Carrying out a genetic diagnosis test on the whole population or on a specific group to determine whether they or their offspring have a gene or chromosomal alteration that causes a certain disease.

Genetic screening of pre-embryos

Elimination of young embryos in which the study of some of their cells shows genetic or chromosomal abnormalities (see eugenic abortion, genetic screening, eugenics).

Genetic screening and ethics

In the current state of medical technology, in which we are in a position to treat very few diseases of genetic origin, it is only justified to carry out internship on those that have a possible curative or palliative remedy, taking into account the cost of diagnosis (see cost of medicine). It is not correct to carry it out on candidates for certain jobs in order not to accept those who may suffer from an occupational disease in the future, or for health insurance purposes in order to increase the premium or reduce the health benefits for those who may subsequently fall ill (see Equal right to health care).

Genetic screening of clients

See genetic screening.

Criteria of Admissions Office for students

Medical Schools systems for the selection of students to enter degree program. They can be based on academic results alone, on a assessment staff , or a mixed criterion.

Admissions Office criteria for students and ethics

The exclusively academic assessment does not guarantee an adequate human level, and the exclusively staff does not guarantee an adequate technical level. Although there are difficulties in doing so, a mixed system seems preferable (see training human).

Criteria for brain death

A set of facts that must be verified in a patient in order to admit the state of brain death (see) and to be able to carry out a transplant in the case of a donor.

Patient selection criteria

See Triage.

Care

Generic name for patient care measures.

Intensive care

Consistent, complex, detailed health care provided in certain life-threatening circumstances, such as polytrauma, severe burns, acute myocardial infarction or after certain surgical interventions.

Intensive care and ethics

They are required for critically ill patients in whom there is reasonable hope of recovery. They should not be applied if the patient considers them an intolerable discomfort or excessive expense (see futility, proportionate treatment, disproportionate treatment).

Medical care

Generic name for patient care resulting from a medical diagnosis and the implementation of a specific treatment on internship . This distinguishes it from nursing care, nutritional care, etc.

Palliative care

A set of medical measures aimed at alleviating (see) illnesses, either because they lack curative treatment or because the discomfort they cause is difficult to tolerate without specific treatment. Correctly practised, they allow patients to live in dignified conditions and with physical suffering reduced to perfectly tolerable limits (see euthanasia, moral support).

End-of-life care

Palliative care (see) applied to terminally ill patients.

Guilt in illness

The patient's responsibility for his or her own illness, due to previous potentially or certainly harmful conduct. It cannot be the cause of lesser care by the physician (see Patient discrimination).

Compliance

Degree of patients' compliance with medical prescriptions. It is a twofold problem: the doctor's ability to convince patients of the appropriateness of the treatment (see Persuasion), and strategies to avoid patient forgetfulness once they have accepted it as appropriate (see Informed consent). This is sometimes a very serious problem, as poor compliance in major diseases can be fatal (see Cultural diversity).

Healing

Recovery of health (see) due to cessation or disappearance of an injury or illness.

Miraculous cures

Surprising cures attributed to a remedy that is not officially accepted (see Lex artis) that some doctors advertise and even guarantee to perform in order to attract clients (see Marketing of Medicine). This subject of internship is proscribed by medical ethics. Normally, these miracle remedies are reduced to surrounding with a halo of results and guarantees some medical techniques that are well known, but little disseminated because of their potential danger (see Cost-benefit calculation), as is the case with certain slimming regimes.

Quackery and witchcraft

Non-medical practices that claim a cure by somehow supernatural means. It is not professional intrusion (see) if they do not present themselves to their clients as medicine and do not charge for the intervention that is intended to heal the sick person. This does not prevent practitioners from selling herbs or other products, as long as they are not medicines, as the distribution of the latter is reserved for pharmacists.

Darwinism

A scientific hypothesis that attributes the evolution of species (see Evolutionism) to random variations in the characteristics of individuals in a population and to the selection of those best adapted to the environment. It is not strictly speaking a scientific hypothesis, as there is no experiment with which to test it, and chance cannot be the object of science; it is, rather, a philosophical explanation that attributes the origin of everything to chance. Although it explains some observed facts (the appearance of closely related species, for example), it leaves many others unanswered (such as the unidirectionality of evolution, its progress in leaps and bounds, the origin of many complex anatomical Structures , etc.).

Duty

Tension of the consciousness (see) towards the realisation of a value (see) or towards the avoidance of a counter-value.

Duty of care

Duty (ver) to provide professional assistance to any sick person who requests it. It applies to all physicians, regardless of their specialization program. Like all positive duties (see), its enforceability is limited by other positive duties that may be more urgent. From a legal point of view, refusal to provide care may constitute the crime of refusal of assistance, which is covered by the Spanish Penal Code.

Duty to report

group The duty (see) of doctors to bring to the attention of the competent authority in the specific case situations that pose a danger to the health of a specific patient or of a population knowledge (see Duty to preserve health). It involves both reporting potentially harmful social situations (e.g., smoking) to the media and reporting an incompetent colleague to the collegial or health authorities (to protect patients).

Duty to inform

The physician's duty (see) to communicate the relevant details of a disease to his patient (see Telling the truth). It also applies to the general duty to keep the population informed about health measures aimed at preventing disease, improving dietary habits, etc. (see knowledge dissemination scientific).

Duty to investigate

See research clinic.

Duty to preserve health

The physician's general duty (ver) to avoid situations harmful to health; it derives directly from the nature of his profession. This basic duty explains certain medical interventions that appear at first glance to be meddling by medicine in areas where it is not called upon to have a say: civil service examination institutional support for boxing, recommendation of political measures aimed at remedying the extreme poverty that causes illnesses, etc. It also obliges the protection of people threatened with contagion or injury by other patients, always trying to maintain medical secrecy (see Medical secrecy, derogation from medical secrecy). It is also the duty of each person towards himself or herself and towards those with whom he or she comes into contact.

Duty to respect life

Duty (see) that affects every man who lives with others in society. It affects physicians in a particularly intense way because of the aims of their profession (see Duty to preserve health, respect for human life).

Duty to know

The physician's duty (see) to keep up to date from a technical point of view, in order to be able to provide adequate care to each patient (see Lex artis). This duty begins with the study of degree program and never ends. Because of its involvement in patient care, it must also include the human training (see), which is not subject to updating, but to continuous care.

College duties

Duties (see) that exist towards colleagues (see). In the case of the medical profession, there is a duty to financial aid towards each other, with a view to ensuring the correct care of the sick. This translates into the custom of not charging them fees (see) when they are professionally treated, and the obligation to defend them in the professional high school (see) against unjust accusations, and to report them to high school if, after a counterclaim of incompetent or immoral conduct, they do not attempt to make amends (see discipline corporate, bad internship).

Duties of the sick

See Duties of the patient.

Duties of the patient

Duties (see) of the patient with respect to the health care provider. They usually refer to the polite attention and consistency in their commitment staff to the treatment of the illness (see Compliance). When one has agreed to participate in a research, these duties change according to the commitment made.

Negative duties

Duties (see) which are formulated as prohibitions. They are binding always and everywhere: they refer to realities that it is never good or proper to will or desire voluntarily.

Positive duties

Duties (see) that are formulated as obligations. They actually bind depending on the circumstances, mainly urgency: a positive duty displaces others, which are also in force, by the peremptoriness it requires of the action.

Prima facieduties

Duties (see) that derive directly from a value to be realised, and not in a secondary or derivative way.

Weakness

status of defencelessness and inferiority that goes hand in hand with the state of illness or certain life situations (childhood, old age). From this derives the duty of care (see) on the part of the doctor and staff , which is the only appropriate response to the human dignity of the patient, wounded and weakened by the illness.

Telling the truth

Obligation of the doctor and the healthcare team towards patients, aimed at enabling the patient to organise their life in accordance with the reality of their illness, and to be able to make their last moments dignified in the event of a fatal process (see Terminal care, patient dignity, medical confidentiality). It also applies to scientific publications and knowledge dissemination (see Scientific fraud).

Decision

Elective act of the will that refers to action, and selects the concrete means to achieve the pre-set goals. It allows the agent's moral grade according to the object to which it refers, although for this grade it is also necessary to take into account the intention (ver) that moves this decision and the tolerated effects (ver) that the action produces.

Clinical decision

A physician's decision regarding the patient's diagnosis or treatment.

Delegated decision

A decision by the patient about the medical care to be provided in certain circumstances, which has been delegated, in a written document, to persons of his or her trust, to be exercised in the event of his or her incapacity (see Capacity, incapacity).

Clinical ethics decision

Clinical decision in that it concerns, or is primarily determined by, the ethical aspects of the action. It is always made personally by the person acting, even if advice is sought from an ethics committee (see) or a medical ethicist (see consultant for clinical ethics).

Ethical-medical decision

See Decision on clinical ethics.

Surrogate decision

Anglicism. See delegated decision.

Advance decisions

Decisions of the patient regarding medical treatment in the event of incapacity due to illness. They may be detailed, or generic, and include delegation in cases of doubt (see Delegated decision, living will).

Defence of life

An ethical principle that must be present in all medical care (see Human dignity, respect, value of human life).

Patient advocacy

Anglo-Saxon term, recently spread in Spain, which designates the work of defending the interests of the patient that the nursing team assumes as its own mission statement , together with the close partnership with the medical team for the care of the patient.

Deficiency

A generic term for physical or psychological disorders that make the persons suffering from them inferior in capacity compared to healthy persons. Considered in isolation, it is never a reason for second-rate medical care or for the denial of effective treatment (see futility, withholding of treatment).

Deficient

Generic name for patients suffering from an impairment (see).

Letting die

An ambiguous expression, widely used in the medical literature, which encompasses situations in which the physician does not apply treatments to the patient because they are futile (see futility) or involve therapeutic overkill (see), and situations in which the physician wishes and voluntarily executes the death of the patient by withdrawing treatment (see euthanasia), even though the patient can and should still be helped. Letting die in the first two situations is ethically correct, but not in the latter.

Ethics

The study or science of professional duties (see Code of Ethics).

Medical ethics

The study or science of the professional duties of the physician.

Deontologism

See Deontological ethics.

Right to attendance religious

See attendance religious.

Right to health care

The patient's right corresponding to the duty of care (see) that both the doctor and the rest of the healthcare staff have. written request Although it is institutionalised and regulated in many Western countries, in parallel with the socialisation of public health systems, its actual validity depends ultimately on the fulfilment of the professional duties of those who work in health care.

Right to information

See Telling the truth.

Right to health

Misnomer of the right to health care: health cannot be guaranteed by health care, which is only the provision of means to health; health may or may not be achieved, even if the means put in place to achieve it have been the most adequate.

Right to life

Every human being has the right to have his or her life respected by the rest of society (see Respect for human life), since living is a condition of possibility for the exercise of any other human right (see Right to die).

Right to die

A subjective right that supporters of euthanasia claim that doctors must carry out when the patient so requests. This right would correspond to the doctor's duty to kill; this duty would go against the basic principles of the rule of law (see Right to life) and against the basic ethical principles of medicine (see Respect for human life, withholding treatment).

Right not to know

The right not to be informed about one's own illness. The desire not to even want to know what happens when, for example, a bad diagnosis is expected, which can be explained from a psychological point of view, has been considered as a right of the patient in some judgements in the United States. However, it is not reasonable to admit it as such, as it would imply a duty not to inform (see Telling the truth) and would make it very difficult to help the patient (see Moral support). The truth should always be told, even if only sparingly in cases where the patient does not wish to know.

Right to know

The patient's right to know the truth about his or her illness. It corresponds to the doctor's duty to communicate it (see Telling the truth), although in some cases this must be done with the necessary prudence and precautions.

Right to live

See Right to life.

Right to treatment

See Right to health care.

Animal rights

Set of prerogatives that must be respected in animals in a way that corresponds to their way of being (beings capable of sentient suffering), and because of man's obligation not to brutalise them at attention , which would be the case if he were to inflict ill-treatment or cause unjustified suffering. They are not strictly speaking rights in the same sense as the rights of man (see Human rights), even if they are legally protected by positive laws.

Sick people's rights

A set of rights that patients have in correlation with the duties of healthcare professionals. They are systematised in many Western countries, including Spain. Their effective realisation is impossible without a determined will to comply with professional duties (see duty of care, duty to report, duty to preserve health, duty to respect life).

Children's rights

Children's human rights are greater than those of adults in proportion to their status dependency and weakness (see).

Embryo rights

Rights of the embryonic human being that are proportionate to its status of dependence and weakness (see). They are frequently violated in the performance of assisted reproduction techniques, which put their lives in very serious danger (embryo mortality in in vitro fertilisation with embryo transfer reaches, in the best cases, 96%), as well as in hormonal contraception (see) and prenatal diagnosis (see).

Patient's rights

See Rights of the sick.

Human rights

Human dignity (see) in that it calls for proportionate conduct on the part of other members of society. Such proportion is justice (see) in behaviour towards people.

Human Rights in Medicine

Human rights (see) that can be affected by the professional actions of the doctor. Because of the status weakness (see) of the patient, human rights call for a greater attitude of respect (see) on the part of the health professional.

Repeal of medical confidentiality

Disappearance of the obligation to keep medical confidentiality due to legal imperative (injuries that may be the consequence of the commission of a crime) or to avoid harm to other persons, always (e.g. aggressive paranoid obsessions) or if the patient refuses to disclose it personally (e.g. existence of serious contagious diseases). In such cases, the secret should only be disclosed to the competent authority or to persons at risk. Even if they take appropriate measures to avoid harm, they are obliged to keep the secret disclosed by the physician.

Disagreement on bioethics

Lack of unanimous opinion within an ethics committee (see) when it comes to providing a committee for a specific case or drawing up a guiding directive for a health body. Although their occurrence can be greatly reduced by an appropriate work system, and by referring to the statement of core values adopted by the committee for its work, they are bound to occur. In these cases, while acknowledging this disagreement, the committee cannot be satisfied with a minimal ethics (see), but must provide all the reasons that have been considered so that their opinion can guide the action of the person who consulted them (see Prudence).

Disagreement among doctors

Disagreement between two or more doctors about the most appropriate way of approaching a clinical status , either from a technical point of view (diagnostic tests, treatment, etc.) or from an ethical point of view. The technical discrepancy, provided that neither of the doctors intends to be absurd (see Lex artis), should be resolved by means of a considered discussion at a medical enquiry , also seeking the opinion of the patient (see Informed consent). The same procedure should be followed in the event of a discrepancy on ethical grounds, by sending an e-mail to enquiry to the ethics committee (see) responsible for the case, or to enquiry for clinical ethics (see).

Disobedience to the doctor

See Compliance.

Civil disobedience

resource extreme of outright refusal to obey a law or provision that is deemed to be radically inappropriate, generally because of serious and unavoidable ethical implications. Before resorting to this measure, the ordinary remedies provided for by the current legal system, scientific objection (see) or conscientious objection (see), may be used.

Decriminalisation of abortion

See Induced abortion.

Decriminalisation of drug use

The disappearance of legal penalties for the consumption of certain drugs (whether medicinal or not: from cannabis to heroin or cocaine), with a view to tolerating addicts, who are considered sick, while continuing to prosecute the trafficking of these products. On the internship, if it is not associated with a serious detoxification programme, it encourages the spread of drug addiction, as addicts tend to spread their employment.

Diagnosis

Medical judgement on the nature of a patient's illness or injury based on evaluation of their symptoms and signs.

Differential diagnosis

A process that leads from a list of diseases that may be the cause of the symptoms and signs suffered by a patient, obtained through anamnesis and physical examination, to the exact determination of the disease in question, generally by means of complementary diagnostic tests. It also refers to the doctor's argumentation about the greater or lesser probability of suffering from one or other diseases in view of the patient's clinical picture; a written record is usually made in the clinical history, as a diagnostic judgement, in order to guide the complementary tests (radiology, analysis of laboratory, etc.) that must be carried out until a diagnosis of certainty is made.

Diagnosis and ethics

It must be based on the data observed, by means of a coherent reasoning, with the performance of the necessary issue of complementary tests, none of which are superfluous. In case of doubt, refer to the medical enquiry (see) (see Prudence).

Diagnosis of death

Diagnosis of the irreversible cessation of the functions of the organism as a unitary whole (see Death) on the basis of the signs produced by this cessation of functions. Since the signs take some time to occur, this cannot be done with mathematical accuracy, and there are a few minutes in which resuscitation manoeuvres can be attempted (see Therapeutic incarceration, DNR orders, proportionate treatment, disproportionate treatment) in the suspicion that, although there is cardiac arrest, an irreversible status has not yet been reached for the organism.

Genetic diagnosis

Aetiological diagnosis of diseases of cause Genetics, carried out in patients or healthy carriers.

Predictive genetic diagnosis

Genetic diagnosis in people with no apparent disorder that can predict an increased risk of certain diseases in the future (see Genetic screening).

Computer diagnostics

Diagnosis carried out by a suitably trained computer programme which is supplied with the data obtained from the patient. Due to the nature of health (see) and illness (see), which includes not only physical aspects but also human aspects that are difficult to reduce to objective quantification, such a diagnosis can only constitute an auxiliary element in the doctor-patient relationship.

Prenatal diagnosis

Diagnosis of diseases of the foetus or embryo while still in the womb. It is carried out either by analysis of substances or cells extracted from maternal blood, by ultrasound, PET, etc., or by taking samples of amniotic fluid or chorionic villus sampling. It allows chromosomal and morphological abnormalities to be detected. Its precision, in many cases, is not very high, and the risks of causing a miscarriage with invasive tests are not negligible (depending on the technique used, they range from 5 to 20%); for this reason, the generalised use of the latter is usually discouraged internship ; It is carried out in cases of high parental anxiety and in cases of a family history of congenital diseases; non-invasive tests are systematically performed, such as ultrasound monitoring, which allows the detection of anatomical anomalies without risk to the foetus, and allows early treatment of the newborn or even intrauterine treatment. It is never justified with a view to aborting a child with a possible disease (see Induced abortion, rights of the embryo).

Social dialogue on bioethics

Within the liberal view of human life in society, procedure to reach a purely pragmatic consensus about what things should or should not be done in society: it is a matter, within the liberal approach, not of reality, but of sociological majority opinion, which determines what is good and what is bad (see Autonomy).

Dichotomy

submission of part of the fees (see) to a colleague who has agreed, in exchange, to refer his patients for a enquiry, complementary examinations, or analyses, often unnecessary. This is unethical conduct, expressly censured in the Spanish Code of Ethics and Medical Deontology.

Digitopuncture

Alternative medicine (see) consisting of action on acupuncture points (see) by finger pressure. There are also small plastic cones with an adhesive material that can be applied for hours or days for the same purpose.

Dignity

See Human Dignity.

Dignity of nascent life

Intrinsic dignity (see Human dignity) peculiar to the unborn, derived from their state of weakness (see) and dependence.

Patient dignity

Intrinsic dignity (see Human dignity) peculiar to the patient, derived from his or her state of weakness (see) and dependence. It is aptly expressed in the medical aphorism Res sacra miser: he who suffers is something sacred.

Human dignity

In its primary sense, ontological goodness intrinsic to every man, which makes him worthy of the respect (see) and attention of others. In its secondary sense, accidental ontological goodness (see Virtues) which a man acquires by behaviour appropriate to his rational nature.

Clinical dilemmas

Ethical dilemmas (see) on the internship clinic.

Ethical dilemmas

Situations of ethical perplexity in the face of decisions that have both desirable and undesirable effects. Properly speaking, after a diligent study of all the relevant aspects of a case, there is no such perplexity, and one solution is sample preferred over the others; the perplexity can only be initial, as the detailed study will always show the goods or values (see) at stake and, consequently, the most appropriate choice, although this does not detract from the fact that such ethical examination may be complex or difficult (see conflicts of interest, principle of double effect, proportionate treatment, disproportionate treatment).

Money

See Economics medical.

Public money

See Public funding.

Ethical guidelines

A set of general guidelines issued by an ethics committee (see) to guide the actions of physicians in a nation, region or health institution.

Disabled

See Deficient.

discipline corporate

A set of provisions of the Medical Association that are binding on all practising physicians, and in some cases also on non-practising physicians, because of the very nature of the profession and its intrinsic duties (see Collegial duties).

Patient discrimination

Preference in medical care for some patients over others based on non-medical grounds, such as sex, race, age (see Age discrimination), political opinion, etc. Preferential care for emergency or other medical reasons is not discrimination (see Equal right to health care).

Medical discrimination

Refusal of a physician as candidate to work for reasons beyond his or her professional competence, such as race, religious affiliation or pro-prenatal life stance (see Conscientious objection).

Age discrimination

Discrimination of the patient (see) on the grounds of age, very young or old.

speech morality of medicine

The possibility of value judgements (see) as treatment advice to the patient. If the doctor sees that a patient's ethical problem is the cause of a pathology, he or she should point this out to the patient, although without imposing his or her criteria, but rather trying to make the ethical aspects clear so that the patient can make the appropriate decision of his or her own accord. This aspect of medicine is one of the basic reasons why physicians should always improve their human training (see Duty to know).

Dissection

Dissecting operation. It is carried out ex profeso, with the appropriate instruments, during life (e.g. during a surgical intervention, extirpations, identification of anatomical Structures , cannulation of arteries or veins, etc.), or post mortem, to carry out an autopsy, for the purposes of research or teaching. Even in the case of a post mortem, it requires a respectful attention (see respect) of the corpse, commensurate with the fact that it was the body of a person.

Intrauterine device

Plastic pessary often surrounded by a copper wire or containing a gestagen. It is inserted into the uterus to prevent pregnancy. subject The presence of this foreign body inside the uterus leads to the appearance of inflammatory reactions in the endometrium that make embryo nidation impossible: its mechanism of action is fundamentally anti-implantation, although modifications of tubal motility and alterations in sperm migration through the uterus are also reported. Important side effects are described as ascending infections of the female genital tract and sometimes perforation of the uterus. Since fertilisation does not always occur, the moral grade of its employment is not equivalent to that of abortion (see), although it is not morally comparable to a system that only prevents conception.

Distribution of health resources

Organisational problem of large-scale health care, which should try to optimise the expense employee so as to obtain the highest possible health benefits (see cost of medicine). Very cost-effective investments in health (e.g. for malaria prevention) are often not made at the expense of investments in more fashionable or more worrying issues in the short term (e.g. AIDS treatment) deadline .

Cultural diversity

A contemporary sociological fact, particularly frequent in certain countries, such as the United States, whose population is very heterogeneous due to immigration. It requires a proportionate effort of understanding on the part of staff when providing medical care, so that it does not violate the deep convictions of those belonging to a cultural minority (see patient autonomy, respect for convictions).

Scientific dissemination

The task of making medical expertise available to the general public. The knowledge of the peculiarities of the media (tendency to highlight the triumphs of science, sensationalism) should make the doctor very cautious when providing data concerning the latest research published in the scientific press, so that the information published is truthful (see Telling the truth), does not raise false hopes among patients and does not involve a more or less open criticism of colleagues who hold a different scientific opinion (see Medical committees, Lex artis).

DNR

Acronym for do not resuscitate (see DNR orders).

Double effect

See Principle of double effect.

Dual loyalty

Ethical problem that some salaried physicians may have (see), who must serve their patients and the business that employs them, which sometimes has interests contrary to those of the patient. The physician should not subordinate the good of the patient to the interests of the employer, and should always maintain his or her independence of professional judgement.

Pain

Subjective impact of the disease, either as a physical sensation that responds to treatment with painkillers or other drugs, or as a human reaction to the limitations of the disease (see Suffering). One of the missions of Medicine is to alleviate it (see Relief) both in its organic and experiential facet, due to the peculiar dignity of the patient (see).

Donation

Decision staff and action of giving, usually free of charge, something from our living (blood and blood products, kidney, skin, part of the liver or lung) or dead body (donation of cadaver organs and tissues for transplantation) to another sick person who can be cured (see organ donation, transplantation).

Organ donation

The action of donating organs, generally for transplantation. This can be done with regenerative organs (blood, bone marrow) or non-regenerative organs (kidney, heart); the latter can be obtained either from a living donor (see Inter vivos donation) or from a donor who is brain dead (heart, liver; see Brain death) or recently deceased (corneas, bone), sometimes using special techniques (see Heart-stopping donors). The donor's wishes must always be stated (see Informed consent).

Blood donation

It must always be a free donation. In almost all countries, the legal limitation, currently in force in Spain, of not receiving any financial remuneration in return is gradually being imposed, although the donor may be offered refreshments to replenish his or her energy immediately after the donation.

Donation between relatives

Donation in which the donor is a close relative of the recipient. This usually ensures a better tissue match between donor and recipient (see Inter vivos donation).

Inter vivosdonation

Organ donation in which the donor is a healthy individual. It is feasible to carry it out with paired organs, such as the kidney, after carrying out the necessary tests to ensure that the organ remaining to the donor will adequately fulfil its function. It is usually only accepted between close relatives (see). Psychological pressure from the family environment on the potential donor should be avoided (see Informed consent).

Donor

A person who expresses a willingness to donate organs for transplantation.

Donors with a stopped heart

Patients who have expressed their willingness to donate and who have died of cardiac arrest are still able to donate some highly perishable organs (such as kidneys), provided that a special removal technique is used and no more than 15 to 20 minutes have elapsed since death at the latest.

Donum vitae

Latin name of the Instruction on Human Life at Birth and the Dignity of Procreation, issued in 1987 by the Sacred Congregation for the Doctrine of the Faith of the Catholic Church, which expresses the ethical principles to be taken into account in these special bioethical issues.

Ecology

See Animal rights.

Economics médica

Part of the Economics relating to the cost of the technical means necessary for the internship of medicine (see cost of medicine). It must be an integral part of the medical Education , to avoid an illusory practice of medicine that is disconnected from reality.

Economics medical and ethical

Excessive medical expense prevents the treatment of more patients and should therefore be a constant concern of the physician (see cost of medicine, triage).

Education

See training human.

Education continued

See Duty to know.

Education and ethics

See Duty to know.

Medical education

See Duty to know.

Education health

The task of the physician is to provide the population with the basic knowledge of health issues necessary for disease prevention, emergency treatment, proper nutrition, etc. This can be provided through articles or works from knowledge dissemination, which can never replace the physician's direct committee applied to the specific case. In doing so, physicians should not spread false hopes in knowledge dissemination works and articles. Nor should they directly or indirectly promote any particular physician or health care institution (see Marketing of Medicine).

Placebo effect

An organic or psychic effect produced by the administration of substances without pharmacological effect. When it occurs with medicinal products, it produces a difference between the change observed and that which is attributable to the pharmacological action of a drug. This effect is produced by the neurovegetative reaction associated with the psychological influence produced by the administration of the product or some related circumstances (appearance of the product as a medicine, hospital environment, tension before an examination, etc.). These are real effects, and not the patient's imagination (see Placebo). The existence of this effect requires double-blind trials to test the effectiveness of new medicines (see Clinical trials of medicines).

Psychological effects of abortion

Psychopathological effects of induced abortion on the woman (see). Although they serve as a medical argument against its performance, they are of very secondary ethical importance to the argument of respect for human life.

Tolerated effects

Intended effects of an action that are not what is intended by the action. In medicine, tolerated effects are the side effects of medicines or medical interventions (see Calculation of consequences).

Reductionist exercise in medicine

The practice of medicine that considers the patient only as a diseased organism and its activity as a service sector activity (see Moral support, commercialisation of medicine, palliative care).

Ectopic pregnancy and the ethics of treatment

A typical case of double effect in medical action: an ectopic pregnancy can be removed as long as it poses a real danger to the mother's health, with the intention of helping the woman and without the intention of killing the foetus. This possibility is usually abused, and intervention is carried out before there is real danger to the mother, without taking into account that most of them die and reabsorb on their own, without the need for intervention: careful monitoring of the evolution of the case is sufficient if it has been observed in a routine ultrasound scan, and intervention would be carried out only if there are complications. It would not be correct to selectively destroy the child by injection of methotrexate, a technique recommended by some manuals.

Emergentism

Theory which, in its anthropological facet, attributes intelligence, will and psychic phenomena to an accumulation of neuronal phenomena, exclusively analysable with the hypothetical-deductive scientific method. Consequently, he deduces that our scientific ignorance about the human psyche is simply a lack of development of our neurophysiological knowledge. The analytical Philosophy has recently demonstrated once again what the classical Philosophy already defended: psychic phenomena are irreducible to the organic or material.

Empathy

Term used since the 18th century to refer to the affective attunement that establishes the therapeutic friendship (see) with the patient. It would be the intuitive knowledge of the sense of the feelings, emotions and behaviour of another person.

Therapeutic embodiment

Application of medical means that will not bring about the patient's recovery but only slightly prolong his or her life under distressing conditions, such as endotracheal intubation, intravenous feeding, etc. (see Disproportionate treatment). It is ethically wrong. Moreover, it produces an erroneous view of what medicine can bring to a patient's last moments (see Moral support, Palliative care).

Disease

Pathological alteration of one or more organs, resulting in a set of characteristic symptoms, with loss or decrease in health (see).

Nursing

Health profession responsible for the care of the sick in close cooperation with the doctor and other auxiliary services (see Care, duties of the patient). partnership .

Nursing and ethics

For your best financial aid to the patient, you should not take over strictly medical issues (diagnosis, general approach to treatment), but you should maintain a close contact with the doctor(s) in order to provide quality care (nursing diagnosis, dialogue with the patient to assess his or her primary needs, cooperation in informed consent, etc.).

Sick

See Disease.

Terminally ill

See End-of-life care.

Cheating the sick

A frequent attitude of doctors and relatives, who try to hide a bad or unfortunate prognosis from the patient in order to avoid adding psychological distress to their own suffering from the disease. From an ethical point of view, it is never correct (see Telling the truth).

Deception in the clinical essay

Keeping hidden from the patient some aspect of the clinical essay being performed on him or her, or even hiding the fact that a essay is being performed.

Deception on the essay clinical and ethical

This subject of deception or concealment may be correct if it is certain that the knowledge of any of the terms of the essay by the subject would make the results unreliable (e.g. with some psychotropic drugs). It should be C by an ethical committee .

Therapeutic Ensañamiento

See Therapeutic embodiment.

essay random

essay clinical trial (see) in which subjects are randomly selected to receive the product being tested and those who receive placebo or another existing treatment.

essay randomness and ethics

See Placebo.

essay clinical

research clinical trial (see) which is conducted to find out the efficacy, toxicity, etc. of a new medicine.

teaching of medical ethics

See Duty to know.

teaching of medical ethics and literature

resource from teaching of ethics, which focuses the attention of student on role models staff and professional conduct of exemplary physicians.

teaching of medical ethics and casuistry

resource of the teaching of ethics, consisting of the presentation of paradigmatic cases that force us to reflect on what we want to teach.

Equity

See patient discrimination, medical discrimination.

Team

See Shared responsibility, responsibility staff in a team.

Medical error

Incorrect application of a diagnostic test or, more frequently, of a treatment, usually as a consequence of a totally or partially wrong diagnosis. It may be due to negligence (see) in professional performance or only to imponderables that are very difficult to detect (see Defensive medicine).

Shortage

See cost of medicine, triage.

State of the art

See Lex artis.

Chronic vegetative state

See Persistent vegetative state.

Chronic vegetative state and ethics

Even if there is a conviction that the patient will not regain consciousness, elementary care for nutrition (see), hydration and postural change, which is not aimed at the patient's survival, but at his or her cure (see futility), cannot be considered disproportionate. Moral support (see) for the family can prevent them from requesting the death of the patient due to starvation and dehydration.

Persistent vegetative state

Chronic and irreversible loss of all cognitive functions, while retaining wakefulness, which can be observed in patients who have suffered very severe brain damage.

Sterilization

Medical intervention aimed at eliminating fertility in either the male or the female. Vasectomy is used in men and tubal ligation in women. It is usually performed for contraceptive purposes (see Voluntary sterilisation).

Coercive sterilisation

Involuntary sterilisation (see) in which the sterilised subject undergoes the intervention to avoid inconveniences of another subject, generally imposed by political authorities, such as the Chinese policy of a partner, a child. It violates the most basic personal freedoms.

Sterilisation of deficient persons

Sterilisation carried out on mentally handicapped subjects, usually women, to prevent pregnancy. Although it reassures the family or caregivers by eliminating the possibility of pregnancy, it leaves the mentally handicapped person defenceless against possible rape (see Involuntary sterilisation).

Involuntary sterilisation

Sterilisation carried out without the consent (see Informed consent) of the sterilised person. It has been attempted for eugenic purposes (see Eugenics) in many Western countries in this century (e.g. Germany, USA, Sweden). In Spain it is only permitted when performed on incapable persons, at the request of their parents or guardians, with the express approval of the judge.

Voluntary sterilisation

Sterilisation carried out at the request of the sterilised subject, without medical reasons for the sterilisation. It is usually requested from doctors for permanent contraceptive purposes. Apart from other ethical considerations, due to its practically irreversible effect, it is inadvisable internship, especially in young people.

Hierarchical structure

A system of medical organisation, widespread in the hospital environment, in which, although decisions are taken with financial aid by colleagues, ultimately a hierarchical superior decides, who must be a doctor if the decision is to be taken by subject doctor (see Salaried doctor, responsibility staff in a team).

Medical student

See Duty to know.

Ethos of Medicine

An ethical attitude that is intrinsically linked to the internship of medicine (see respect).

Hippocraticethos

Ethos of Medicine (see) spread in classical Greece by the Hippocratic medical school. Its basic principles are set out in the Hippocratic Oath, which includes the principles of respect (see) for life and for the individual.

Ethics

discipline internship which deals with human actions from the point of view of their goodness or badness. Although a theoretical ethics can be elaborated that studies how man perceives and executes good or bad actions, the ultimate goal of ethics is not to know, but to act well.

Biomedical ethics

Part of ethics that deals with the correct actions within the professional practice of biomedicine (see Bioethics).

Civil ethics

See civil bioethics.

Clinical ethics

Bioethics applied to ethical issues arising in clinical internship .

Contractualist ethics

Ethics that bases the rightness or wrongness of actions solely on the mutual benefit of the members of society, and on their injury if the parties involved do not cooperate for the common benefit. This view is at the root of American liberal bioethics (see Principlist Bioethics) and civil bioethics (see; see Commercialisation of Medicine).

Consensus ethics

Ethics developed through public discussion of the diverse opinions found in society on the issue in question (see Bioethics - 2nd meaning - cultural diversity).

Virtue ethics

Ethical current born about 10 years ago in the Anglo-Saxon sphere, which attempts to find an alternative to "objective" ethics, and to the endless discussion between deontological ethics (see) and teleological ethics (see), focusing on the virtues that should adorn the professional conduct of the doctor. Although he makes interesting contributions, his development has remained just another option when it comes to the foundations of bioethics, and provides much less concrete guidance to the clinical internship than other types of reasoning.

Minimalist ethics

Ethics that aims to find out the common points on which various divergent opinions present in society can be found at agreement in order to arrive at principles of common acceptance in a heterogeneous society. This consensual procedure leaves ethics almost empty of content (see civil bioethics, consensus ethics).

Deontological ethics

A common name in American bioethics for Kantian-style ethics, which claim that good conduct consists of adapting behaviour to absolute rules, disconnected to a greater or lesser extent from concrete actions and their consequences (see Teleological ethics). Although this method of analysis is valid to a certain extent, it cannot be disconnected from the actions of the person acting (see Intention, decision), nor from the analysis of consequences (see Tolerated effects) if it is to arrive at realistic results. Codes of medical ethics and deontology are often summarily dismissed as deontological ethics, whose principles are based on medical tradition but cannot be rationally demonstrated.

Descriptive ethics

See Empirical ethics.

Empirical ethics

An abbreviated term to refer to the research and exhibition of the usual internship of physicians analysed from an ethical point of view.

Enlightened ethics

See Contractualist ethics.

Medical ethics

Physician's ethics in professional practice. Together with technical knowledge, it underpins correct professional internship (see Therapeutic friendliness, benevolence, beneficence of the physician, medical deontology, biomedical ethics, solidarity).

Christian medical ethics

Medical ethics inspired by Christian moral principles. It coincides for the most part with the Hippocratic ethos (see), and also brings to it a transcendent and hopeful vision of life, pain and suffering.

Medical ethics at status of war

The doctor is obliged to all the wounded or sick caused by the war status , without being more obliged to those on one side than those on the other (see Discrimination of the patient).

International medical ethics

Principles of medical ethics defined in international declarations. The best known of these are the numerous declarations on a wide variety of topics issued by the World Medical Association ( association ).

Jewish medical ethics

Principles of medical ethics derived from rabbinic exegesis of Old Testament texts. They coincide for the most part with the Hippocratic Ethos (see).

Liberal medical ethics

See Contractualist ethics.

Public ethics

See civil bioethics, ethics of consensus, ethics of minimums.

Reproductive ethics

Part of bioethics relating to technical actions concerning human sexuality and reproduction.

Secular ethics

See civil bioethics.

Teleological ethics

A common name in American bioethics for consequentialism (see): in order to rationally know whether something should or should not be done, the proper way is to look at the consequences of actions and weigh the desirable and undesirable ones. Although this method of analysis is valid up to a point (see Calculation of consequences), if it is the only method employee, it does not provide any criteria for knowing which consequences are desirable and which are not, leaving it to subjectivity to decide what is desirable and what is not (see Autonomy). Although it is called ethics, it does not speak of what is good or bad, but of what is desirable or undesirable.

Cross-cultural ethics

See cultural diversity.

Utilitarian ethics

See Teleological ethics.

Clinical ethicist

See consultant for ethics.

Eugenics

Term introduced by Galton in the 19th century to designate breed improvement work.

Negative Eugenics

Eugenics which aims to achieve its goal by preventing the birth of diseased individuals.

Positive Eugenics

Eugenics which aims to achieve its goal by encouraging the birth of individuals with favourable qualities.

Eugenics and effectiveness

Due to spontaneous variations in the gene pool, positive eugenic manoeuvres have a very slight impact on the general population. Negative eugenics can be of importance in the case of a particular marriage (see committee genetics).

Eugenics and ethics

There are no objections to pursuing an improvement in the physical characteristics of men (resistance to disease, for example), but this must always be done with respect for the freedom of couples to have or not to have a child; this respect must be not only formal, but real, so that no financial subject obstacles are placed in the way of those who refuse to participate in a eugenic programme, and no advantages are given to those who do wish to participate. This reduces their ethically correct internship almost exclusively to the genetic committee (see).

Euthanasia

Action or omission intended as goal the death of the patient, usually out of compassion, in order to end the patient's suffering or that of the family. association The internship was condemned by the World Medical Association in 1987 as contrary to medical ethics. It is never necessary, as medicine always has resources to relieve (see Relief) and support (see Moral support) the patient, so that his or her last moments are always tolerable (see Palliative care). It is usually practised, rather than because of the physical suffering of the patient, because of the existence of chronic limitations (see Quality of life) or because of the psychological burden for the family of having to suffer seeing their loved one increasingly limited and declining.

Active euthanasia

Euthanasia performed by administering a product that causes death.

Involuntary euthanasia

Euthanasia carried out without the patient's request. It is generally performed on unconscious patients, at the request of relatives.

Legal euthanasia

Euthanasia carried out within a framework provided for by civil law.

Neonatal euthanasia

Euthanasia carried out on a newborn child, generally in the face of mental retardation or malformations that would limit the child's later life. It is carried out more for the sentimental reaction of parents and doctors than because the child's life will necessarily be unhappy later on.

Passive euthanasia

Euthanasia carried out by withholding life-sustaining treatments or food and water (see Nutrition). Passive euthanasia is not to be confused with the refusal of therapeutic incarceration (see; see report Remmelink); for this reason, this expression, which is avoided in medical statements, should not be used.

Voluntary euthanasia

Euthanasia performed at the request of the patient.

Evaluation.

Detailed study of a patient's clinical status in order to accurately determine the diagnosis or to advise on the most appropriate treatment.

Developments

Variations of a disease throughout its course.

Evolutionism

Scientific hypothesis that postulates that living beings of one species come from living beings of another species by generation, through genotypic and phenotypic variations. It is currently the only coherent possibility to explain the observed facts (biological, anatomical, palaeontological, etc.). There are numerous hypotheses to explain evolution, the most popular of which was initiated by Darwin in the last century (see Darwinism). This scientific hypothesis moves on a purely biological level, and is not opposed to affirming the creation of the world by God, the existence of spirit in man, etc., questions that science cannot study with its method.

Radical evolutionism

Scientistic evolutionism (see Scientism) which attributes the origin of everything observed to physico-chemical processes; it negates the possibility of extracting from the observed facts philosophical statements implying natural finality, creation and dependence on being, etc. It is often linked to an exclusively Darwinian interpretation of evolutionism, and to an interpretation of man as a purely biological reality (see Emergentism).

EVP

Acronym for persistent vegetative state (see).

Premarital examination

See committee genetic, negative eugenics.

Experimentation

See research scientific.

Animal experimentation

See Experimental animals.

Clinical experimentation

See research clinic.

Embryo experimentation

research scientifically using human embryos as experimental subjects.

Embryo experimentation and ethics

It must comply with the same requirements as any other clinical research : potential benefit for the subject of research, informed consent (in this case of the parents), avoidance of unnecessary risks. Given the state of development of the art of embryo manipulation, which involves the death of most embryos, it only seems justifiable at present to try to experimentally treat fatal diseases in embryos.

Experimentation on children

research scientific research that is developed in children as the subject of experimentation.

Experimentation on children and ethics

It must comply with the same requirements as other clinical research (see); it must include the consent of the parents or guardians, and also the child's own consent if the child is old enough to understand the nature of the experiment.

Ethics experts

Specialists in the ethical aspects of clinical care (see consultant ethics).

Impact factor

Relevance index of a scientific article obtained by checking the issue number of times that article has been cited by other scientific publications.

Impact factor and ethics

This system can introduce a bias in the evaluation of the true relevance of a article of research as, apart from its intrinsic importance, purely environmental or sociological factors come into play: reputation of the journal in which it is published, agreement or not with other generally accepted but unproven theories, etc. As this impact factor is usually taken as a guideline for obtaining positions at teaching or research, there may be injustices that the assessment tribunals must take into account.

Naturalistic fallacy

Fallacy that scientism (see Scientism) argues against the existence of behaviour that is naturally more human than its opposite, i.e. of a moral law natural to man. It can be formulated as: "You cannot derive premises must from premises is". If reality were only what can be perceived by scientific observation, it would not be able to show us ought. But, as it covers aspects that do not fall under the scientific method (see Goods, values), its observation can obtain statements of ought, which are not derived from the observation of empirically verifiable facts.

Family of the sick person

See Moral support, tell the truth.

Pharmacy

Health profession primarily responsible for the preparation, distribution and control of medicinal products.

Pharmacy and ethics

The pharmacist must ensure the quality, safety and efficacy of medicines, whether in their manufacture, distribution or application to the individual patient. Due to the nature of some of their professional practice, the lack of up-to-date professional knowledge and the profit motive are widespread shortcomings (see Duty to know, commercialisation of medicine).

Artificial insemination

See in vitro fertilisation, artificial insemination.

In vitro fertilisation

An intervention that takes the male and female gametes and joins them together outside the human body, and then transfers the embryo formed into the mother's uterus so that it can implant and pregnancy can begin.

In vitro fertilisation and ethics

Its internship is incorrect because of the issue of embryonic human lives that are lost in the process (between 96 and 99%), because of the undignified manner of conception (children have the right to be born as the fruit of their parents' love expressed bodily), and because of the subject manipulation it implies for human sexuality; It is also inadvisable from a technical point of view, because of its leave efficacy and high cost (both economic and human), and the eugenic mentality that accompanies it, which leads to the internship of abortion at the slightest suspicion of foetal diseases; although it is considered a treatment for infertility, it does not really cure anything, it only produces a child for the infertile couple, who leave the clinic with their suffering unresolved.

Fetuses as donors

See foetal tissue transplantation.

Foetuses and transplants

See foetal tissue transplantation.

Reliability of science

Degree of truth or certainty of a scientific knowledge .

Philosophy of science

Philosophical study of the nature of science using the hypothetico-deductive method, its reliability, its scope of study, the nature of its explanations, etc. (see Scientism).

Philosophy of medicine

Philosophical study of the nature of health and illness, of medical care, of the doctor-patient relationship, etc. It is part of the doctor's training (see training human). In American liberal bioethics (see), the procedure goal of resolving conflicts of interest (see) in health care is considered to be Philosophy of medicine.

End of human life

See Death.

Abortion funding

Provision of the medical expense which involves the performance of induced abortions (see). Most of them are carried out against payment by the woman who requests it in very poor sanitary conditions, as they are performed by unqualified doctors who see abortion as a way to prosper financially (see Commercialisation of Medicine).

Financing end-of-life care

A very frequent economic problem, as patients consume, from average, half of their health care expense in the last year of their lives.

Financing end-of-life care and ethics

Cost may be reason enough to omit some treatments (see futility), but it is no excuse for not providing the necessary care to keep the patient comfortable and pain-free (see End-of-life care).

Public funding

Allocation of health resources from society's obligatory contributions, either through taxes or through specific contributions paid by workers or companies. The public source of health care resources requires a particularly efficient economic management , given that assets are handled that do not belong to doctors or health care employees (see cost of medicine, Economics medical).

Aims of medicine

Natural aims of therapeutic friendship (see), which are summary in the classical medical adage "If you can, cure, if you can't, relieve, always comfort" (see Relief, moral support, healing).

Phytotherapy

Alternative medicine (see) which aims to cure illnesses exclusively by means of plants. It is closely linked to the contemporary mentality of rejection of the technological or artificial.

Phytotherapy and ethics

Given the existence of numerous pharmacologically active products in many plants, a serious and thorough knowledge is necessary before phytotherapy treatments can be recommended, especially when dealing with plants containing potentially toxic alkaloids (see Alternative medicines and ethics).

FIVTE

Acronym for in vitro fertilisation (IVF) with embryo transfer (see Assisted reproduction).

training of conscience

Refining the capacity for ethical perception through study and research at committee (see Prudence).

training human

Intellectual and practical habits of physicians that enable them to behave in a humane manner, both in their life staff and in their attention with patients (see Virtues). It includes in particular general knowledge (see Duty to know), and affability and cordiality at attention, which are essential for dealing with patients (see Empathy).

form

A standardised document that simplifies the flow of information, especially in the hospital environment.

form of informed consent

form in which the patient expresses his/her agreement consent to the diagnostic or therapeutic intervention to be carried out on him/her. They constitute more of a legal guarantee than a written endorsement of the truthful information provided to the patient and of his or her consent.

form request for analysis or enquiry

form requesting another department to carry out a medical enquiry or an exploratory or analytical test . Their existence encourages requests for unnecessary consultations or tests, especially by inexpert doctors, as they only need to fill in a box with a cross.

Scientific fraud

Scientific communication that, in order to obtain notoriety, funding, or other objectives, publishes data invented, inaccurate, or more or less arbitrarily modified (see Telling the truth, objectivity).

Scientific fraud and ethics

Although incorrect in all cases, its Degree of incorrectness varies according to the subject of the fraud: from mild, in the case of multiplying publications by cleverly fractioning the results of a single research, to serious, in the case of inventing data that provide results whose application can have serious consequences.

Human-animal boundary

Problem of the scientistic view of man which, by reducing intelligence and freedom to emergent phenomena (see Emergentism) of a complex nervous system, has difficulty in defining when a specific entity is a man or a person. It usually establishes the difference in the presence or not of sensibility (see) or self-consciousness (see).

Philosophical sources of medical morality

See Fundamentals of Bioethics.

Foundations of Bioethics

Philosophical study that leads to making the principles that should govern bioethics more evident. It is not a demonstration of the ethical principles, as these can only be demonstrated on the basis of ethical evidence, and some of this evidence must be ultimately undemonstrable. The rationale attempts to make these more primary ethical evidences more evident, and to show their connection with the principles applicable in the professional internship .

Theological foundation of bioethics

Founding of bioethics (see) on the basis of religiously rooted ethical principles, the evidence for which is provided by faith. Theologically founded principles coincide for the most part with those obtained through non-liberal philosophical foundations.

Ethical basis of medicine

See respect.

Fundamentals of medicine

See Philosophy of Medicine.

Futility

Quality of a medical action that is either useless in achieving a beneficial goal or achieves it, but at the cost of disproportionate discomfort or suffering for the patient or at the cost of serious economic, family or social inconvenience (see Disproportionate treatment). Futile medical actions should not be initiated (see Therapeutic Embarrassment).

expense doctor

See cost of medicine.

Twinning

Vegetative division of one embryo to give rise to two. It establishes an origin of the human person (see) different from fertilisation: before twinning there is one person (see), after twinning there are two. Its existence does not contradict the personality (see) of the young embryo with the potential (see Potentiality) to divide: it remains an individual of the human species.

Genetics clinic

Part of the Genetics that deals with the prevention and treatment of diseases of genetic origin, either with conventional treatments or with genetic treatments (see committee genetic, telling the truth, right not to know, eugenics, manipulation Genetics).

Human genome

See Manipulation Genetics, project genome.

GIFT

Acronym for Gamete intra Fallopian Transfer: intratubal gamete transfer (see).

group from work

See Shared responsibility, responsibility staff in a team.

Age groups

Distribution of patients by age group corresponding to the usual prognoses for this age group (see Age Discrimination).

Related diagnostic groups

Grouping of diseases by similar diagnostic criteria. They allow a certain standardisation of diagnoses, treatments and economic agreements between the entities of attendance sanitary and the public or private insurance entities that finance them.

War

See Medical Ethics at status war.

Facts and values

A somewhat artificial division of the two types of perception of reality: on the one hand, that of the physical facts as they can be described by science with the hypothetical deductive method, and on the other hand, that of the values involved in a status (see Goods, scientism, values).

Desired child

Ambiguous expression, popularised after the generalisation of hormonal contraception, which introduces confusion between the desire for the child, understood as love and acceptance of the child as it comes and is, and the desire for the child, understood as possessive desire for satisfaction staff (see liberal bioethics). Its employment is often associated with the conception of sexuality as another means for the enjoyment of staff or of the couple, and not as a means of submission staff to the spouse.

Unwanted child

Son whose coming hinders some previously decided plan of realisation staff (see Desired Son).

Scientific hypothesis

In the hypothetico-deductive scientific method, an invented idea or starting assumption of a scientific research (see).

Medical history

A set of documentation containing diagnostic tests, doctors' opinions and therapeutic interventions performed on a patient. It contains objective elements (such as the results of analyses and tests or the description of a surgical intervention), of which the patient can apply for copy in order to obtain a second opinion (see), change doctor, etc. (see Medical confidentiality).

Computerised medical records

Medical records (see) whose information is in computerised format (database centralised, database local, card with report in microprocessor), thus facilitating its enquiry by those attending to the patient.

Computerised medical records and ethics

The international medical ethics rules and regulations requires that clinical information networks are not physically connected to non-medical data networks (see Medical confidentiality).

Holism

View of man as a whole, composed of physical, psychological and spiritual facets. It is of utmost importance when initiating diagnostic or therapeutic action (see scientism).

Homeopathy

Alternative medicine (see) born in the 19th century, which aims to cure by similarity: instead of attacking the cause of a disease by means of an antagonistic product, very small doses of products that cause the same symptoms as the disease to be treated should be administered. According to homeopathic theory, the organism would react to these micro-doses by repelling the disease itself and achieving a cure. Its efficacy has been proven in many cases, and there is effective human and veterinary homeopathy. However, its mechanism of action is unknown, and there are many opportunists who practice it without having thoroughly studied the little that is known about it (see Mala internship).

Homosexuality

Exclusive or predominant sexual attraction to persons of the same sex.

Homosexuality and ethics

The doctor cannot accept homosexual behaviour as just another fact to be respected in the patient's life, but as a habit that must be corrected because, in many cases, it causes serious psychological disorders (see Therapeutic friendship). Because of its profound moral repercussions, it causes a bias in the research on it, and many times an attempt is made to justify it as a totally involuntary consequence of Education or heredity (see Scientific fraud).

Fees

The name given to the money received by a doctor or, in general, by any liberal professional, for the exercise of his profession. The name reference letter refers to the fact that this money is, rather than payment, a reward for the honour merited by attentive dedication to others (see Therapeutic friendship): medical care and money are disproportionate, and money is inadequate to measure the value of medical care.

schedule from work and ethics

The physician must maintain it in a manner that allows him/her to provide adequate care for all his/her patients (see Residents).

Hospital

Institution for health care.

Hospital and ethics

Every hospital, whether public or private, must have a statement of core values and a health policy on the activities to be carried out there, so that every patient who enters knows what subject care he or she can receive there. It must take care of organisational and economic aspects, so that the best care can be obtained with the resources available (see cost of medicine). And it must ensure good coordination and work teamwork of doctors (see Hospital as a business, shared responsibility, responsibility staff in a team).

Hospital as a business

Hospitals whose purpose of care is subordinated to the profit motive of the business that installs it.

Hospital as business and ethics

There are no objections to the establishment of hospitals as companies, provided that the purpose of care is not undermined by an unjustified attempt to reduce costs (see Hierarchical structure).

Hospital professor

Hospital (see) where medical students or doctors are trained.

Hospital professor and ethics

Because of their teaching function, physicians working and teaching in them have a special obligation to be up to date in their scientific and human training (see Duty to know).

Hunger strike

A person's refusal to eat, made notorious in order to draw attention to a problem staff or injustice that he/she wishes to have remedied. It may pose a serious health problem for the striker, from which the doctor should not be inhibited.

Hunger strike and ethics

The physician must convince the striker that the strike will cease when it has had the desired impact, and when the strike poses a serious danger to the striker's life.

Hunger strike in prison

The doctor, according to Spanish jurisprudence, can force the striker to feed himself, as he is under the guardianship of the state, which must guarantee his health and has the doctor contracted to do so.

Medical strike

Strike of the staff salaried doctor, generally belonging to a hospital entity, to demand from the contracting entity either less demanding remuneration or conditions of work or adequate means to be able to treat patients properly (see Salaried doctor).

Medical strike and ethics

However just its causes may be, a medical strike cannot deprive patients of medical care (emergencies, normal consultations, in-patients, etc. must always be attended to); this reduces its impact to merely testimonial levels, which can also be achieved by means of an appropriate public opinion campaign, avoiding possible risks for patients.

Humanae Vitae

Encyclical published by Paul VI, expressing Catholic doctrine on parenthood manager and birth control (see Contraception).

Humanities medical

See training human.

Humility

Virtue (see Virtues) that every doctor should practise during clinical care, so as not to act with arrogance towards the patient, to let him express all his doubts (see Informed consent) and to accept his physiological and human peculiarities (see Cultural diversity).

Identity staff

See Personality.

Sexual identity

See Transsexuality.

Ideology

A set of thoughts about man or human life, in its political, economic, religious or social facets. It is largely inherited from the cultural environment. It has a decisive influence on the objectivity (see) of the doctor and that of the patient (see Informed consent, cultural diversity). In a pejorative sense, prejudices about these issues.

Equal right to health care

Equal consideration that every sick person should receive simply because he or she is sick. It is not a right to health but only to the means available to restore it. It does not imply the application of the same techniques in all cases of a given disease (see Patient discrimination, health).

Egalitarianism of care

Ethical stance that postulates absolute equality of treatment for a given illness, following a rigid protocol , without making exceptions. It is a position that is disconnected from the reality of the particular status of each patient, which requires different care for each case (see Therapeutic incarnation, futility).

Impartiality

See patient discrimination, medical discrimination.

Incapacity

Lack of aptitude to carry out certain acts or activities produced by the deficits of some physical or psychological disorder, congenital or acquired.

Unable

Person with a disability (see Best interests of the patient).

Economic incentives

Financial reward mechanisms established by public or private physician employing entities (see salaried physician) to encourage better work performance or to reduce health care costs (see cost of medicine).

Economic incentives and ethics

These incentives should in no case collide with adequate health care (see Patient discrimination, science objection).

Incompetence

Anglicism for incapacity (see). Absence of the required technical expertise (see duty to know).

Professional independence

The physician's ability to decide what he/she considers to be in the best interest of his/her patient, without external pressure from subject economic, political, ideological, etc. (see Patient discrimination, salaried physician, scientific objection, conscientious objection).

Indication

Generic name for the action that the doctor considers to be the most appropriate in a given status ; this may be a diagnostic test or a treatment (see professional independence).

Quality of Life Index

Approximate quantification of the limitations that a disease produces on the patient. There are numerous indices, some of which can be found at subject in general, others specialised in the repercussions of a specific disease or in a specific patient population. Their application a priori is disorienting, as each patient has different vital needs (see Health); a quality of life that is intolerable for some is perfectly acceptable for others. The application of quality of life criteria to undertake or omit treatment should only be done at contact directly with each individual patient (see Informed consent, futility, proportionate treatment, disproportionate treatment).

Survival rate

Percentage of patients who survive a disease with a given treatment. It can only be known through appropriate programs of study . It is the initial determinant of the effort to be made to treat a patient (see futility, proportionate treatment, disproportionate treatment).

Quality of life-adjusted survival rate

See Quality-adjusted life years.

Pharmaceutical industry

Generic name for companies active in the research and manufacture of medicinal products.

Pharmaceutical industry and ethics

This industry subject is often heavily conditioned by profit-maximising management schemes (see, for example, Orphan drugs), which are detrimental to patients. Doctors and pharmacists working for them must have the good of patients as their priority (see respect).

Medical influence

See Best interest of the patient, persuasion.

Patient information

See Telling the truth.

Computing

See computer diagnosis, computerised medical records, medical confidentiality.

report Remmelink

report presented in 1991 on the status of euthanasia in the Netherlands, which was illegal at the time. It is so named because it was commissioned by Attorney General Remmelink. Although its data has been distorted in the course of its dissemination, it concludes that approximately one third of the patients who die under medical care in the Netherlands have been killed by their doctor (see euthanasia).

report Warnock

report drafted by a committee chaired by Mary Warnock, in 1984, at the request of the English authorities, on the implications of assisted reproductive technologies (see).

Genetic engineering

See Manipulation Genetics.

Coercive income

See involuntary confinement.

Start treatment

Decision to start medical treatment. Although in many cases this is indicated (see Indication), in other cases there may be serious doubts about its appropriateness, as once started, it is more difficult to discontinue treatment (see futility, discontinuation of treatment), especially in the eyes of family members.

Beginning of human life

See Potentiality, personality.

Artificial insemination

Fertilisation of the woman through the introduction of spermatozoa, without coitus.

Artificial insemination and ethics

The separation of the physical submission of the spouses and generation makes it ethically incorrect; it acts as if the children were a manufactured product, and not procreated, that is, a gift that is received as a consequence of the loving submission . Even if they are materially similar, there is no ethical objection to techniques which, after intercourse has taken place, aim to help the spermatozoa with some technical device to reach their destination, the fertilisation of the ovum.

Donor insemination

Artificial insemination (see) in which the sperm are not from the husband of the fertilised woman.

Professional integrity

Degree identification of a physician's conduct with the ethical requirements of his or her profession (see Medical care, professional commitment).

Intention

Act of the will by which a person aims at a goal (see Decision, tolerated effects). For an action to be good, the intention must necessarily be good.

multidisciplinarity

See Shared responsibility, responsibility staff in a team.

Privacy

A set of incommunicable facets of a person (see) that establish their non-biological differentiation from others. It is at the root of the doctor's obligation of professional secrecy (see Medical secrecy), as the patient is often obliged to disclose his or her intimate peculiarities with a view to diagnosis and treatment.

Professional intrusiveness

Acting as a medical professional by a person who is not qualified to practise medicine. This is explicitly punishable under civil law. It is not intrusion if, although it is intended to cure, it is not carried out under the guise of a doctor (e.g. quacks) and for which no remuneration is paid (e.g. sale of herbs). In some countries, this activity subject is financed by social security (see Alternative medicines).

Professional intrusiveness and ethics

A layman's ignorance of many basic medical subjects makes professional intrusion reckless. This does not preclude that for mild chronic ailments (headaches, rheumatism, etc.), previously diagnosed by a doctor, herbal preparations of efficacy handed down from folk tradition or from the experience of the healer, or other remedies from alternative medicines, can be recommended (see).

research scientific

A process that attempts a description of nature through the invention of explanatory hypotheses and their subsequent testing by observation or experimentation (observation under controlled conditions).

research scientific and ethical

The explanatory hypothesis on which the research is based must be coherent and consistent with previously tested facts, the design of the experiment must be effective in testing the hypothesis, the least costly alternative experiment or research should be attempted, both from the point of view of economics (see cost of medicine) and human and animal suffering (see Experimental animals, research clinical).

research clinic

Experimentation carried out to ascertain the efficacy of a new diagnostic or therapeutic procedure , carried out on patients who agree to try it (see Informed consent, ethics committees of research, essay clinical).

research clinical and ethical

It should be carried out in order to improve medical knowledge and to be able to better help patients, after assessing whether it is really necessary to acquire the knowledge sought. It must be carried out with a prior calculation of the issue number of subjects who should participate, in order to avoid false positives, false negatives or work and unnecessary inconvenience to volunteers who exceed the issue really necessary.

research clinic in the third world

research requirements carried out in countries with a lower level of development, where they can easily be carried out without the need to comply with all the necessary ethical requirements (informed consent, ensuring the integrity of the experimental subjects).

research as a business

See Pharmaceutical industry.

research empirics in medical ethics

See Empirical ethics.

research in animals

See Experimental animals.

research in bioethics

See Empirical ethics, foundations of bioethics.

research in children

See Informed consent, weakness, research clinical, respect.

research in prisoners

See Informed consent, weakness, medical ethics at status war, research clinical, respect.

research non-therapeutic

research scientific research on human subjects that has no therapeutic benefit for the research subject. It is necessary in a number of situations, such as phase I drug trials.

research non-therapeutic and ethical

It should always be done on volunteers (see Informed Consent) and avoid that the small remuneration that compensates for the cessation of income during the experiment attracts those who are financially strapped (medical students, residents) to these experiments.

research on embryos

See Weakness, research clinical, respect.

research therapeutics

See research clinic.

Iridology

Alternative medicine (see) that claims to diagnose diseases by observing the alterations they produce in the colouring and appearance of the iris. Photographs of irises of patients previously diagnosed by the usual means have been interpreted contradictorily by different iridologists, leading to the serious suspicion that this alternative medicine is unfounded and useless.

IVE

Acronym for "voluntary termination of pregnancy". It does not exist in Spain, where abortion is only decriminalised under certain circumstances, which do not include the woman's wishes. It is an expression frequently used as a morally innocuous euphemism by those who are in favour of free abortion.

Hierarchy

See Shared responsibility.

Clinical judgement

Statement about a patient's clinical status . In scientific medicine (see) it must be arrived at by evidence or logical reasoning from evidence (see).

Trials of fact

Assertions concerning physical facts, which are the starting point for the elaboration of scientific models or hypotheses that can subsequently be tested, thus constituting scientific laws. From this subject of statements about reality, ethics cannot be elaborated (see Value judgements).

Value judgements

Assertions concerning values (see) that are discovered by perceiving reality, not only in its material aspect (see Scientism, judgements of fact), but also in its human facets, which include the goodness of what is perceived and its connotation as a value to be realised or an evil to be avoided.

Hippocratic Oath

code of ethics of the medical class , in the form of an oath, whose origin dates back to the Hippocratic medical school in the 5th century BC.

Justice

Moral habit that leads to acting in accordance with the nature of each thing. In the case of the physician, it leads to respect (see) for the patient. In American liberal bioethics, a principle of bioethics that allows a rational calculation of the health benefits that each person should receive, within the existing economic possibilities; although this principle aims at perfect equity (in a rationalist way, within the enlightened mentality), the options for this calculation that have been described are extremely varied, from an absolute socialisation of all health care to a radical liberalism, and none can claim to have achieved the theoretical solution to the problem, because this solution is internship: only the acquired habit of the person acting can determine what is right here and now (see cost of medicine, prudence).

Justice in health care distribution

See Patient discrimination, principle of justice.

Social justice

See Social security.

Laetrile

An unproven substance that was frequently sought after by doctors because of rumours that it cured certain types of cancer.

Critical reading

An attitude that every good doctor should have towards the academic publication that informs him/her, and allows him/her to separate data from its discussion and interpretation (see Duty to know).

Legality

framework of conduct established by legislation (see). It is not a sufficient guarantee of ethically correct behaviour (see Code of ethics, professional code).

Legality and morality

Different but related aspects of medical actions; legality deals with their external facets and morality especially with their internal ones (see Decision, tolerated effects, intention); both must look at human perfection as goal, which each of them fosters in a different way (see training human, values).

Legalism

Professional attitude that limits conduct to what is legally required (see Legality), to the detriment of proper health care (see Physician beneficence). In bioethics, reduction of the committee of ethics committees (see) to advice on what is legally permitted or prohibited.

Legislation

Set of legal norms that oblige certain professional conduct (see Rights of the sick). It has sometimes replaced bioethics (see Legalism).

Scientific legislation

Legislation relevant to scientific activity, especially abundant with regard to research (see research scientific) on human beings.

Pharmaceutical legislation

Legislation relevant to pharmaceutical activity. It is particularly abundant due to the scarcity of collegial rules and regulations , corresponding to a lack of collegial rights to self-legislation (see Code of Ethics).

Lex artis

A set of medical practices generally accepted as appropriate for treating the sick at the present time. By definition, it changes with the technical progress of medicine (see Medical Committees, bad internship), as well as with the personal peculiarities of each patient (see Health).

Abortion time limits law

Legal figure of induced abortion, which considers its performance as non-criminal or non-criminalised as long as it is requested by the mother within a certain deadline period from the beginning of the pregnancy; this deadline is different in the various countries where this subject legislation is in force, but it is usually short (20 to 24 weeks).

Scientific laws

Set of tested scientific hypotheses (see research scientific).

Drug liberalisation

Disappearance in legislation of any limitation on the trade in some drugs (especially narcotics) in the belief, among other things, that, with the disappearance of the black market, making it cheaper would reduce the thefts that addicts need to carry out to obtain new doses.

Drug liberalisation and ethics

data The empirical evidence available does not clearly support the belief underlying this measure; moreover, it would be at the cost of further spreading addiction, to the detriment of the addicted population. For this reason, it would be wrong to implement it.

Freedom of choice

See Autonomy, patient autonomy, free choice of doctor.

Patient freedom

See patient autonomy.

Reproductive freedom

A subjective right to reproduction, which has been taken up as such by American jurisprudence, which brings as a corollary the right to induced abortion (see) and to the means of assisted reproduction (see). Properly speaking, there is no right to reproduction, as it would be equivalent to a right to a child, i.e. a right to a person. On the internship, it is a formally acceptable cloak for sexual licentiousness.

Therapeutic freedom

See science objection.

Libertarianism

See Autonomy (2nd meaning).

Free choice of doctor

Part of the patient's autonomy (see) that allows him/her to choose the doctor he/she prefers to treat him/her. It is included as a patient's right in Spanish legislation. It poses serious organisational problems in national health systems that are strongly state-run, such as the Spanish one.

Limit of confidentiality

See Repeal of medical confidentiality.

Germline

A set of cells involved in the production of gametes and thus in the transmission of genetic traits to the next generation. See Manipulation Genetics.

Somatic line

See Manipulation Genetics.

Literature

See training human.

Medical literature

See Duty to know, critical reading.

Locke

18th century English philosopher who initiated the modern political Philosophy on which American principlist (see) bioethics is based.

Profit in Medicine

See Fees, hospital as a business.

Affective maturation of the doctor

The process of integrating affective impulses within a context of rational behaviour. It is part of the practical skills of the physician (see Duty to know).

Affective maturation of the doctor and ethics

The physician must strive for this maturation, otherwise he will not be able to help his patients adequately, as he will not be able to maintain clarity of thought due to the commotion of uncontrolled feelings.

Mal

Absence of the good (see) due.

Mala internship

Medical action that is not in accordance with current medical knowledge, due to ignorance or carelessness, imprudence or poor organisation (see Lex artis).

Malformation

Alteration of body morphology or function due to an abnormal development . It can be congenital or acquired.

Malformation and ethics

Medical care cannot be of inferior quality just because the patient has a malformation (see Weakness, quality of life index, nutrition, respect).

Manipulation Genetics

Technical intervention that modifies the genetic heritage of an organism or some of its tissues or cells.

Manipulation Genetics and ethics

Although currently very ineffective, it is hoped that, in the future, this technology will be developed sufficiently to be able to treat congenital diseases of genetic origin, and for other applications, such as the treatment of certain tumours or the development of certain vaccines. It is subject to the same ethical principles as any other medical intervention. See Gamete Manipulation Genetics .

Manipulation Genetics of germ cells

Anglicism. See gamete manipulation Genetics .

Gamete manipulation Genetics

Manipulation Genetics in which, in addition to treating the cells involved in a specific disease, the gametes of the treated patient are also modified, so that the manipulated genes are passed on to the offspring, who would not suffer from the hereditary disease.

Gamete Manipulation Genetics and ethics

This manipulation is subject to the ethical principles of all manipulation Genetics (see). As it directly affects the identity staff, it should not be undertaken for eugenic purposes (see Eugenics). Given that current techniques have, moreover, a high risk of causing unforeseeable problems, their application would not be ethically correct until the absence of these side effects is sufficiently guaranteed.

Kill

See Letting die, euthanasia.

Materialism

Philosophical theory that claims that reality is only subject (see Scientism).

Maternity

Biological, psychological and spiritual link between a mother and her child.

Maternity Genetics

Maternity relationship that is established by the origin of the ovum from the mother.

Gestational maternity

Maternity relationship that is established by having carried the pregnancy.

Legal motherhood

Legal recognition of maternity. In Spain, it always corresponds to gestational maternity.

Surrogacy

Gestational maternity contracted in exchange for money to a woman, who may or may not be the mother Genetics of the child. It is legally prohibited in Spain; it is carried out in other countries, with serious problems of identification of maternity or paternity (see).

Surrogacy and ethics

Surrogate motherhood is wrong because of the violence it imposes on the mother and the objectification of the child: after having gestated the child and established bonds of affection with it, the mother must hand it over as a product sold to the contracting partner.

Medicalisation

Absorption of problems of a non-medical nature by medicine, either by external attribution (such as induced abortion; see), or by incorrect view of man by the medical class (such as the confusion of conscience issues with psychiatric cases). See Scientism.

Medicines

Products which, when administered to the organism, cooperate with it in the recovery of health (see).

Orphan drugs

Medicines whose research is blocked because they are intended for rare diseases, or for diseases that are more prevalent in less developed countries, in which the pharmaceutical industry (see) does not see any economic interest in placing them on the market.

Medicine

Technique used by the physician to help restore health (see). It is also called medical art, in the Latin sense of the term "art": the ability internship to perform professionally. It involves both intellectual and manual skills and attention staff .

Evidence-based medicine

The practice of medicine that accepts only scientifically proven knowledge as the basis for clinical judgements, and rejects treatments that, although frequently applied, have no grounds to argue in their favour (see Scientific medicine). It is often referred to by the anglicism Evidence-based medicine.

Scientific medicine

Medicine based on theoretical knowledge about man, his illness, and the peculiarities of the healthy and sick organism; this approach of medicine dates back to classical Greece.

Medicine as a business

See Commercialisation of Medicine.

Defensive medicine

A way of practising medicine that tries to avoid complaints of medical malpractice internship . It achieves this goal by carrying out an excessive issue of diagnostic tests to rule out even unusual situations (when another diagnosis is already reasonably clear) and by ensuring that the patient signature gives written consent to all the tests or treatments carried out. The very serious drawbacks are the exorbitant increase in the cost of medicine (see) and the loss of mutual trust between doctor and patient (see doctor-patient relationship).

Military medicine

See Medical ethics at status war, shared responsibility, responsibility staff in a team.

Private medicine

A mode of medical practice in which the physician receives his fees directly from the patient or from an insurance company that pays the patient's medical expenses.

Socialised medicine

State systematisation of the way medicine is practised in an attempt to guarantee access to medical care for the entire population. This is usually carried out by creating state-owned medical institutions in which state-employed doctors work (see Salaried doctor).

Socialised and ethical medicine

The usual system employee for the socialisation of medicine leads to a lack of incentives (see Economic Incentives) to develop a competent work , and this defect cannot be remedied either by legal regulations or by the meticulous implementation of the internship deontological rules and regulations (see Code of Ethics), although both collaborate to try to achieve this goal.

Medicine and Philosophy

See Philosophy of Medicine.

Alternative medicines

Practices that aim to diagnose or cure diseases by means that are not scientifically proven or whose mechanism of action is unknown, and which are not taught at Schools of medicine. They can be effective methods to achieve health. As research demonstrates the efficacy of such procedures, they become part of normal medicine (see Lex artis). These include homeopathy, acupuncture, herbal medicine, iridology, acupressure, acupressure, etc. Some are proven to be effective for some pathologies, while others are not, and are used purely out of empirical tradition, without any serious basis, giving rise to medical roguery. In some countries, the social security system also finances these unproven ways of practising medicine in order to lighten the burden of care in primary care and hospitals.

Alternative medicines and ethics

These techniques should only be carried out when the practitioner is properly versed in them, has sufficient medical knowledge (so as not to confuse trivial symptoms that may be treatable with these techniques with incipient symptoms of serious conditions), and existing remedies in conventional medicine have proven ineffective or have very unpleasant side effects.

Unorthodox medicines

See Alternative medicines.

Parallel medicines

See Alternative medicines.

Salaried doctor

Doctor who performs his or her professional work under contract with a public or private entity and does not receive his or her fees from the patients, but from the contracting entity. The fees are often fixed, although there are also contracting systems with remuneration proportional to a greater or lesser extent to issue of medical acts performed.

Salaried doctor and ethics

The physician must maintain his or her independence of professional judgement regardless of the interests, financial or otherwise subject, of the contracting entity. An employed physician may not accept conditions from work that would jeopardise the treatment of his or her patients (see Misconduct internship). He or she may not accept contracts that involve submitting his or her judgement in medical matters to non-medical staff (see Medical Autonomy). Fixed fees should not lead you to reduce your patient care, and fees dependent on issue of consultations should not lead you to reduce the time spent on each consultation.

Student doctor

See Medical autonomy, shared responsibility.

Medical expert

See enquiry medical, consultant ethics.

Heroic measures

See futility, disproportionate treatment.

Extraordinary means

See Disproportionate treatment.

Ordinary means

See treatment provided.

Best interest of the patient

A scale institutionalised in Anglo-Saxon countries to decide on the therapeutic interventions to be carried out in the case of incapacitated patients. It is usually interpreted in the sense of fulfilling the patient's subjective wishes (see Autonomy), and not as the search for the best good objectively considered; this allows euthanasia (see) to be considered in the patient's best interest (see Right to die).

Ethical improvement

See training human.

Lying to the sick

See Deceiving the sick.

Billings Method

A natural method (see) that determines a woman's fertility by observing cervical mucus. It was published by Dr. Billings in the early 1970s.

Scientific method

Method which, by means of establishing hypotheses and verifications, attempts to reach a reasonable explanation of the material reality that surrounds us (see research scientific, scientific medicine).

Abortifacient methods

Generic name for birth planning methods that include among their mechanisms of action the death of the newly formed embryo, although this is not always the case.

Barrier methods

Generic name for birth planning methods whose mechanism of action prevents meeting between sperm and egg. By far the most widespread is the condom. It is very effective leave, with a failure rate of between 14% and 36%, depending on the different programs of study.

Natural methods

Generic name for birth planning methods based on the observation of symptoms indicative of fertility in women (cervical mucus, temperature, other minor symptoms) and abstinence from intercourse during presumably fertile periods. Correctly practised, they have a very high efficacy, which the WHO puts at 98%. They also allow the treatment of infertility and have no side effects worth mentioning on accredited specialization.

Mifepristone

Name of a molecule developed to induce abortion without the need for surgical intervention; it is only effective in the first 2 months of pregnancy, and not always; it is also known as RU-486, issue from transcript of research by laboratory Roussel-Uclaf, who developed it in the 1980s. It is approved in some countries, but only for hospital use, as it often causes serious side effects (heavy bleeding, pain). It causes foetal malformations.

Mifepristone and ethics

Its employment is morally comparable to abortion provoked (see) by other means.

mission statement of the doctor

See Aims of Medicine.

Ethical reasoning models

See Duty to know.

Modernity

Generic name for the Enlightenment movement, which aims at human happiness by means of a technical mastery of nature that enables all men to satisfy their desires. It reduces human nature to material needs. Its de facto implementation, either as capitalism or communism, has systematically led to the human impoverishment of society. In medicine, this impoverishment has been translated into the technified dehumanisation that can be observed today in professional practice (see patient autonomy, medical autonomy, commercialisation of medicine).

Moral

See Ethics.

Catholic morality

See Theological foundation of Bioethics.

Scientific morality

See Biomedical ethics.

Christian morality

See Theological foundation of Bioethics.

Medical morality

See Biomedical ethics.

Moral staff of the doctor

See training human.

Morality

See Ethics.

Dying

See End-of-life care.

Die

See Death.

Dying in peace

See End-of-life care.

Hospice Movement

Palliative care movement (see) initiated by Cicely Saunders in England, which advocates the care of the terminally ill in specialised establishments (Hospice) where they reside and are adequately cared for during the last period of their life.

Death

Cessation of the integrated activity of the organism, manifested by a series of clinical signs (see Diagnosis of death). There are no intermediate states between life and death: it is only possible that this vital organic activity is maintained (albeit with financial aid) or that it no longer exists. Despite this law of all or nothing, the diagnosis of death can be difficult to make when we are very close to the moment of death. Since man is a corporeal-spiritual unity, the death of man as a corporeal being (biological death) cannot be dissociated from the death of man as a spiritual being or person. There are not several deaths that can occur in succession (see brain death, neocortical death).

Assisted Dying

See financial aid to suicide, help to die

Brain death

One in which normal neurological functions have ceased, but in which circulation and respiration are maintained by external mechanical means. This term is quite commonly used, but is totally inappropriate, as there is only one class of death. In this state, all treatment is futile (see Therapeutic incarceration, DNR orders, proportionate treatment, disproportionate treatment) and, although the patient may be kept alive for some time with the intensive care financial aid , it is correct to disconnect life support. Legally, this state is considered death, and if the sufferer was a donor (see), transplantation can proceed with his or her odd vital organs (see Organ donation, death, neocortical death).

Death with dignity

See euthanasia.

Neocortical death

Irreversible destruction of the function of the cerebral cortex, either all or a large part of it, so that the patient is incapable of relational activity, but retains many brain and brainstem functions intact (see Persistent vegetative state). It is not equivalent to the death (see) of the person, although some authors equate it. Even if they are donors (see), organs cannot be harvested for transplantation from patients in this state.

Death and ethics

In man, it is not merely a biological fact, and the physician must be aware of this facet, especially for the support of the sick person and the family at this time (see Moral support, end-of-life care).

Incapacitated pregnant woman

See Sterilisation of deficient persons.

Wrong birth

See Wrong life.

Patient needs

See Moral support, care, medical purposes.

Refusal of treatment

Refusal by the patient of the treatment proposed by the physician (see Patient discrimination, cultural diversity, indication, tolerance).

Negligence

Conscious omission or culpable ignorance (see Duty to know) of a check or due action. It is ethically reprehensible, regardless of whether or not it results in harm to the patient (see internship, prudence).

Neonates with disabilities

See patient discrimination, malformation.

Malformed neonates

See patient discrimination, malformation.

Child

Human being between the ages of 2 and 12. See weakness, respect.

Malformed child

See patient discrimination, malformation.

Child with AIDS

See Weakness, patient discrimination.

Children with disabilities

See patient discrimination, malformation.

Do not discriminate

See patient discrimination, medical discrimination.

Do no harm

Medical adage on the first condition of any diagnostic or therapeutic action: first and foremost, do no harm (see Principle of non-maleficence).

No treatment

See futility.

Do not resuscitate

See DNR orders.

Normality

framework of physiological, psychological and vital parameters of a person that are considered not to deviate from what is appropriate; it is not what is usual, the average in a population, but what is perceived to be the case.

New reproductive technologies

See Assisted reproduction.

Nutrition

See euthanasia, persistent vegetative state, futility, hydration, disproportionate treatment, proportionate treatment.

Patient obedience

See Compliance.

Science objection

Refusal with technical roots to internship of some action required of the doctor. Within the internship of medicine, there can be several different opinions on the same technical question, and only the wrong ones should be considered incorrect (see enquiry medical, Lex artis, bad internship, second opinion).

Conscientious objection

Ethically rooted refusal to internship of some action required of the physician. This is the last bastion of defence of the doctor's conscience when, despite purely technical objections (see scientific objection), and his possible substitution by a colleague, he is pressured to do something that, in conscience, he cannot accept as good. In our legal system, this refusal is admitted as a doctor's right with respect to certain actions, such as the internship abortion.

Objectivity

Quality of information that adequately reflects the reality to which it refers. It can be used at the level of scientifically observable facts (see Scientific fraud) and at the level of human appreciation of the status of a patient, of the nature and aims of an experiment (see Telling the truth, training human, training of consciousness).

Duty of care

See duty of care.

Obligation to investigate

See research clinic.

Health obligation

See Duty to preserve health.

Therapeutic Obstinacy

See Therapeutic embodiment.

Hiding the truth

Not telling the patient the truth about their illness (see Telling the truth). It may be ethically correct in some cases, where the knowledge of the truth may do more harm than good to the patient. These exceptional cases do not include a fatal illness: this status only requires tactful or progressive truth-telling, but does not justify misleading the patient about the last moments of his or her life.

Omission

A decision not to perform an action. It entails responsibility (see) for the effects (see Tolerated effects), like any other decision. See passive euthanasia.

ONR

Acronym for do not resuscitate orders (see).

Scientistic optimism

A quality generally present in scientism (see): scientismists often assume, without solid grounds, that the future technical development will bring about the unravelling of the secrets that nature still hides, and that its mastery through technology will bring peace and happiness to mankind. It may be objected that, although the technical development may bring about a more humane world, it may also bring about the opposite, as history has repeatedly shown (see training human).

Do Not Resuscitate Order

See DNR orders.

Advance orders

See Advance decisions.

Do not resuscitate orders

Orders in a patient's medical record that, in the event of cardiac arrest, neither the nursing team nor the on-call physician should attempt resuscitative manoeuvres and leave the patient to die. It is used for patients in whom it is positively known that such manoeuvres would constitute therapeutic overkill (see) or would be futile (see futility, proportionate treatment, disproportionate treatment).

Do not resuscitate orders without consent

Do-not-resuscitate order established for non-medical reasons (to avoid suffering or economic, family or social problems; see futility) without taking into account the opinion of the capable patient, which is the only one that should be taken into account to be able to assess the repercussions of the illness (see Informed consent). staff, economic etc. Its application is ethically incorrect.

Organs for transplantation

See organ transplantation.

Organs for transplantation, procurement policies

See Health policy on transplantation.

Origin of human life

See Potentiality.

Patient

Sick (see Disease) as the subject of medical action (see Medicine).

Capable patient

See Informed consent, incapacity, incapable patient.

Patient as a person

See Moral support, personality.

Incapable patient

A patient who, because of his or her illness, cannot be adequately informed about or consent to the diagnostic or therapeutic procedures used on him or her (see Informed consent, incapacity).

Incompetent patient

Anglicism. See incapable patient.

Terminally ill patient

See autonomy, end-of-life care, futility, DNR orders.

Expensive patients

See cost of medicine.

Difficult patients

Patients who, due to their clinical, psychological, character or belief peculiarities, require much more dedication from the healthcare team than the normal patient (see duty of care, cultural diversity, Jehovah's Witnesses).

Important patients

Patients who, because of their position public or because of their work special responsibility, deserve special attention from doctors. Paradoxically, this better care is provided by treating them with the same application as other patients. This may raise problems with professional confidentiality (see), which can be resolved by having the doctor report the patient or his or her representative; the latter, given the patient's importance, will subsequently communicate the data he or she deems relevant to the media.

Disabled patients

See duty of care, weakness.

Dangerous patients

See involuntary commitment, waiver of medical confidentiality.

Poor patients

See Patient discrimination.

Countries in development

See duty of care, pharmaceutical industry, research clinical in the third world.

placement

The medical student's learning period, which takes place at contact with the sick.

placement and ethics

This period binds the student to the same duties as the doctor, insofar as they concern him or her status (especially medical confidentiality - see).

Pastoral care of the sick

internship of the religious attendance (see) to which the sick are entitled.

Biological patents

Patents on organisms or parts of organisms. According to the European legislation in force until a few years ago, they are feasible as long as such organisms or parts are not found spontaneously in nature, and have required some prior invention or technical application by the researcher. Today, the criterion has been extended to cover, for example, discovered natural genetic sequences.

Paternalism

A way of conducting the relationship between the doctor and the patient in which the doctor bears the full weight of the decisions. It is justified to a certain extent in cases of difficulties in understanding the clinical status by the patient or the patient's family. Very common a few decades ago; it is a common topic of liberal criticism of the classical way of practising medicine (see Autonomy, doctor-patient relationship, Incapacity).

Paternalism in paediatrics

See best interests of the patient.

Paternity

The biological, psychological and spiritual bond that exists between a parent and child.

Legal parenthood in assisted reproduction

Arbitrary attribution of paternity from the legal point of view, either to the mother's husband or to the donor of the sperm that allowed the woman's reproduction. In Spain it is always applied to the husband of the mother (see Maternity, assisted reproduction).

Paternity manager

Quality of paternity (see) and maternity (see) that consists in the capacity to decide the most appropriate issue of children in the status concrete in which the marriage finds itself (see Prudence).

Pedagogy of ethics

See teaching for medical ethics.

Death penalty

Doctors are prohibited by international professional codes of ethics from participating as executioners in the execution of the death penalty when it is carried out by medical means (lethal injection); they may only act as coroners, for certify that the condemned person is dead.

Bodily perfection

Idealised concept of health (see), which does not correspond to reality: such perfection does not exist; it is rooted in a scientistic attempt (see Scientism) to define health, based exclusively on organic parameters.

Person

Individual subject of a rational nature. It is a way of being, which may have corresponding manifestations in behaviour (see Personality).

Human person

Person (see) of the human species. Although it may be legally established otherwise for convenience, every individual of the human species is a person.

Personality

Personhood (see). If there is sufficient physical and psychological maturity and there are no health problems, it manifests itself in man as freely decided conscious rational behaviour. Personality is not the manifestations, but the possession of a way of being staff, which may or may not manifest itself at a given moment (e.g. during wakefulness or sleep).

Personality of the human embryo

Personhood of the human embryo. It exists from the moment of conception, when we can affirm that a new individual of the human species exists (see Gemination).

Persuasion

Reasoned conviction that the physician must develop on numerous occasions with his patient, to convince him of the convenience of a treatment (see Compliance), or of a change in lifestyle (see speech moral in Medicine). Although the patient is de facto free to follow the doctor's committee (see patient autonomy), the doctor must initiate his persuasive reasoning if he believes that his committee is in the best interest of his patient: Medicine cannot be a dumb service, attentive only to the patient's orders.

Request for committee

See enquiry medical, enquiry clinical ethics, prudence.

Birth control pills

See Hormonal contraception.

Placebo

A substance that has no pharmacological effect, but may exert a psychological or psychophysiological effect due to the expectations of active treatment on the part of the recipient subject. The employment of placebo on the clinical research (see) cannot deprive those undergoing a treatment of an existing valid treatment essay.

Health care planning

See Health policy.

Family planning

A set of health services aimed at enabling couples to decide responsibly on the number of children they wish to have issue . It is usually interpreted in a narrow sense, as services to avoid having children, by means of barrier methods, hormonal contraception (see), intrauterine device (see) or postcoital administration of hormones to prevent the nidation of the embryo. Properly speaking, they should openly discuss natural methods (see), the basic principles of which are ignored by most gynaecologists, thus leaving the door open to the couple's freedom to have or not to have children. Usually, it is considered necessary to limit the birth rate, especially in countries on development, forgetting that wealth is not static, but a product of human activity: it is necessary to maintain the birth rate in these countries in order to overcome underdevelopment, although more factors are necessary.

Pluralism in bioethics

See cultural diversity, civil bioethics.

Moral pluralism

See cultural diversity.

Poor

See Patient discrimination.

Medical power of attorney

See Liability, medical liability.

Controversy in ethics

See Disagreement in bioethics.

Biomedical policy

See Health policy.

Policy on research

A set of measures, either by the state or by a private entity, aimed at promoting scientific research (see Duty to know, research clinical) and at establishing rules that provide an ethical basis for the control of scientific research research (see Scientific legislation).

Health policy

See Health policy.

Health policy

A set of government measures aimed at preventing disease and improving the health of a population.

Health policy on transplantation

Organisational measures to facilitate the connection between recipients on the transplant waiting list and potential donors, wherever they arise, and to encourage donations. It is very effective in Spain.

Potentiality

Capacity not yet brought to the act. Among the arguments that situate the beginning of the human person (see) at a moment other than its biological origin, there is the reduction of the person to the actual manifestation of personal qualities. The potential to develop rational acts would not imply the existence of personality (which would be in the potential to act rationally, although it might never do so). This argument always runs up against the difficulty that a sleeping man would not be a person either.

internship médica

See Empirical ethics.

Pre-embryo

A term coined in the early 1990s to designate an embryo less than 14 days old. As has been acknowledged in subsequent medical literature, this term is merely a make-up for download moral weight the death of embryos of that age that occurs in the internship of in vitro fertilisation (see).

Scientistic prejudices

See Scientism. Regarding alternative medicines, which systematically dismisses all data on patient healing that is not based on scientifically acquired knowledge (see Scientific medicine).

Prejudice on the assessment of the patient

See cultural diversity.

Social concern

See Duty to preserve health.

Pharmaceutical prescription

Recommendation of a medicine by the pharmacist. Although prescription by a doctor is the norm, in Spain pharmaceutical prescription is commonly accepted for minor problems, although in other countries it is radically forbidden.

Prisoners

See Prison hunger strike.

Provision of health services

See duty of care, Socialised medicine.

Prevention

A set of measures aimed at preventing the occurrence of diseases.

AIDS prevention and ethics

Since the only effective means of preventing its spread is not sharing needles with someone infected, and abstaining from sex, or having sex with a healthy and mutually faithful partner (condom failure ranges from 14-36%), needle and condom campaigns are counterproductive, creating a false sense of confidence that one is safe from the disease. There is no such thing as "safe sex", except in the context of faithfulness with a healthy partner.

Principle of autonomy

Principle of bioethics (see Principlist bioethics) that postulates absolute respect for the patient's autonomous decisions, of which the physician would be a mere servant (see Autonomy). A moderate version can be accepted, which considers the existence of natural limits to the patient's requests (see scientific objection, conscientious objection).

Principle of beneficence

Principle of bioethics (see Principlist bioethics) that postulates the duty to give others what they want and pay for in a fair economic exchange (see second meaning of beneficence). A moderate version can be accepted, which would be equivalent to the duty of care (see Therapeutic friendliness, first meaning of beneficence, solidarity) which, like any positive duty (see), is variable depending on concrete situations and cannot be rationally deduced (see Prudence).

Principle of justice

Principle of bioethics (see Principlist bioethics) that attempts to deal with the problem of the allocation of scarce resources (see) by applying rules of distribution, which vary according to the authors, from extreme liberalism to a complete socialisation of health resources (see conflicts of interest, ethical dilemmas, justice).

Principle of non-maleficence

Principle in bioethics (see Principlist bioethics) that affirms the duty not to do to others what they do not want. In liberal bioethics, this principle is understood as not doing what others do not in fact want, regardless of any standards (see Autonomy). In Hippocratic medical ethics, this principle (see Do no harm) is understood as not doing to others something that is reasonably inappropriate for man (see Prudence).

Principle of double effect

A rule of moral action that, when correctly applied, makes it possible to know whether it is right to carry out an action that simultaneously produces good and bad effects (see Proportionate treatment, Disproportionate treatment).

Moral principles

Moral evidence that is the starting point for moral reasoning (see Goods, value judgements, values). Many of the self-styled principles of bioethics are not strictly speaking moral principles, as they do not lead to concrete moral conclusions (see Prudence) and can lead to completely contradictory results.

Principlism

A pragmatic way of resolving moral doubts by quasi-mechanically applying the principles of bioethics (see Principlist bioethics).

Priorities among patients

See Patient discrimination.

Prisons

See Hunger strike in prison, salaried doctor.

Procreation

A name proper to human reproduction; it makes reference letter that the biological phenomena that generate a new man are insufficient to explain his spirituality (intelligence and freedom), which come from a direct act of creation by God. This is held by the Judeo-Christian tradition, by the classical pagan Philosophy and by the religions of many primitive peoples, and is denied by scientism (see Scientism) in its optimism (see Scientistic optimism). The merely biological explanation of procreation leaves out the deeper psychological and spiritual aspects of human sexuality (see Scientism).

Profession

A person's field of work (see Vocation).

Life extension

See futility, proportionate treatment, disproportionate treatment.

Forecast

Prediction about the evolution (see) of a patient and the final result of the disease. It can only be done reliably by a serious statistical study that associates the prognosis with certain symptoms or clinical signs, although clinical experience can allow fairly approximate prognoses to be made. See telling the truth.

Protection of the sick

See duty of care, patient duties, respect.

Legal protection of biotechnological research

See Biological patents.

Legal protection of biotechnological discoveries

See Biological patents.

Professional HIV protection

See Repeal of medical confidentiality.

protocol

A set of actions that are applied in a standardised way, either for the treatment of a certain disease (see Lex artis) or to carry out a research (see protocol experimental). Although it is usually reasonable to apply a treatment protocol for a certain disease, it is also necessary to take into account the peculiarities of the patient, which may make it necessary to modify it (see Health).

protocol experimental

protocol that takes place in order to carry out a research. It should be C by an ethical committee of research (see).

project genome

project of research , initiated in the 1980s, which has as mission statement exhaustive knowledge of the human Genetics endowment. The knowledge of the human genetic heritage can help in the treatment of many diseases; however, it is wrong to think that it will provide us with a complete knowledge of human biology, and the possibility to manipulate it at will (see Manipulation Genetics).

Prudence

Intellectual habit that allows one to adequately grasp the various technical factors and values (see) involved in an action, so that the most appropriate decision can be made for the case (see training of conscience). Such a decision is not a deduction from known data . It implies a request to committee in case of doubt (see enquiry medical, enquiry of clinical ethics). In ordinary language it simply means caution.

HIV testing and ethics

They must be carried out in order to allow adequate protection of the staff health care provider (see patient autonomy, derogation of medical confidentiality, medical confidentiality), although there may be civil service examination of the patient to its implementation (see Right not to know, cultural diversity), which will have to be solved with appropriate dialogue (see Persuasion).

Biomedical publications

See Telling the truth.

Pudor

Resistance to showing intimacy (see), both in its personal and physical aspects (which go together, as man is a psychophysical unit).

Catholic point of view

See Theological foundation of Bioethics.

QALY

Acronym for quality-adjusted life years(see).

Rationality

A quality of the human mind that allows it to connect the different phenomena it observes and to draw logical inferences that provide it with new knowledge.

Technical rationality

Rational process of determining the most appropriate means to achieve a predetermined end.

Ethical rationality

Rational process that allows judgements to be made about the ends to be achieved by the action, thus contributing objectives to technical rationality (see naturalistic fallacy).

Rationing

See cost of medicine, futility, justice in health care distribution, triage.

Racism

See Patient discrimination.

Resuscitation

A set of first aid and measures used to achieve recovery of the patient in the event of cardiac and/or respiratory failure.

Resuscitation and ethics

See Futility, DNR orders.

Refusal of treatment

See Compliance.

Scarce resources

See cost of medicine, justice in health care distribution, triage.

Scarce medical resources

See cost of medicine, justice in health care distribution, triage.

Networks of attendance primary

See Socialised medicine.

Redistribution of resources

See cost of medicine, justice in health care distribution, triage.

Reductionism

See Scientism.

Fertility regulation

See Contraception.

State regulation

See legislation, legalism.

Natural fertility regulation

See Natural methods.

Natural birth control

See Natural methods.

Nurse-patient relationship

See Dignity of the patient.

Doctor-patient relationship

A relationship of friendship that is established between the physician and his patient with a view to cure (see), relief (see) and moral support (see) in illness.

Doctor-family relationship

See Moral support.

Doctor-patient relationship

See doctor-patient relationship.

Patient-family relationship

See Moral support.

Moral relativism

An ethical stance that defends the ethical equivalence of all choices, without being able to show that any is superior, preferable or more humane than its opposite. It empties the ethical discussion of its content, from being a discussion about what is most suitable for man to being a discussion about who executes his arbitrary choices and who does not (see conflicts of interest, ethical dilemmas, cultural diversity).

Religion

See attendance religious, cultural diversity, theological foundation of bioethics.

Reproduction

Purely biological aspect of human procreation (see).

Artificial reproduction

See Assisted reproduction.

Assisted reproduction

Generic name for the various procreation techniques, introduced in the last two decades, which generally have in common the manipulation of the couple's gametes and the absence of the need for the couple to maintain normal conjugal relations (see In vitro fertilisation, gamete intrafallopian gamete transfer).

Old people's homes

See Elderly, right to care.

Residents

Physicians in the period of training of a specialization program. From an ethical point of view, the resident's training should be seriously supervised by the doctors who have them under their care position, they should not be given tasks beyond their present capacity, they should have reasonable rest periods between shifts (see schedule of work). Adequate supervision of their work by their superiors reduces medical expense (see cost of medicine) and incorrect diagnosis and treatment (see Medical error, bad internship).

Respect

An ethical attitude of benevolence (see), beneficence (see) and solidarity (see) corresponding to the intrinsic goodness (see Goods) of something or someone. It is the ethical basis for the professional conduct of physicians.

Respect for human life

Respect (see) due to every human life corresponding to its unrepeatable dignity (see). Physicians have an even greater obligation of respect, due to the Ethos of Medicine (see).

Respect for convictions

A physician's respect for the patient's deeply held convictions, which he or she may not violate in the course of professional practice (see Cultural diversity). It is morally binding on the physician only when it is not a matter of arbitrary or capricious choices by the patient, and when it does not contradict his or her conscience staff (see Conscientious objection).

Respect for the patient

See Ethos of Medicine.

Respect for autonomy

See cultural diversity, paternalism, principle of autonomy, respect for convictions.

Responsibility

Attribution of facts to a person as a result of his or her free decision. It gives rise to relations of justice (see) and corresponding duties (see Tolerated effects, teleological ethics).

Scientific responsibility

Main responsibility (see) of coordinator and director of a work of research or of a academic publication. His responsibility does not override that of his subordinates (see Responsibility staff in a team), nor does their partial responsibility override his, as he has the duty to supervise their correct performance.

Shared responsibility

Responsibility (see) of all members of a medical team involved in the treatment of a patient (see Responsibility staff in a team).

Responsibility for one's own health

Responsibility (see) of each person for his or her own body and its proper functioning in order to lead a fully human life (see Compliance, duty to preserve health).

Medical liability

Professional liability of the physician; it gives rise to the duty to treat (see) and the physician's other positive duties, as well as the duty to repair iatrogenic injuries. The latter duty, if it can be performed, is enforced by the courts when it is due to negligence and, in certain cases, even if there is no negligence.

Responsibility staff

See Responsibility.

Responsibility staff in a team

Responsibility for one's own decisions in a medical team. Although there must be a doctor coordinator of the team, manager before the patient for all the care provided, his responsibility staff does not override that of those who work in his team (see science objection, conscientious objection).

Professional liability

See Medical liability.

Social responsibility

The responsibility inherent in the medical profession vis-à-vis the society in which it lives. Although a medical act usually has a specific patient as its immediate object, the physician must look beyond this: among other things, he must be attentive to the epidemiological, health and economic aspects of his professional activity. Since he has a monopoly on health care, he has a corresponding duty to look after all social aspects of health care (see Duty to preserve health).

Social responsibility of expense medical

See cost of medicine.

Socio-political responsibility of the physician

See Social responsibility.

Community responsibilities

See Social responsibility.

Resuscitation

Anglicism for resuscitation (see).

Withdrawal of nutrition-hydration

See euthanasia, futility, nutrition.

Removal of respirator

See futility.

Mentally retarded

See Malformation.

Rich

See Important patients.

Risk

See Tolerated effects.

Acceptable risk

See Tolerated effects, futility.

Risk of contagion

See AIDS prevention and ethics.

Health risk

See Duty to preserve health.

Biological risks

See AIDS prevention and ethics.

Health

The physical and mental state that makes it possible to carry out daily activities. Since the daily life of each person makes different demands on subject physical or psychological, the state of health depends on the way of life of the person. subject The doctor cannot apply treatments in a standardised way, based only on the lesions he observes, but must also do so on the basis of the patient's lifestyle, which he has to get to know through dialogue with the patient. Thus, even if they suffer from the same disease, different patients require different intensity of treatment or relief, depending on their particular characteristics.

Sanctity of human life

Anglicism. See human dignity.

Medical secrecy

The physician's obligation to maintain absolute confidentiality of everything that has come to his or her attention at knowledge in connection with his or her professional relationship with a patient. It implies the safe custody of medical records (see). It may lapse in very specific circumstances (see Derogation from medical confidentiality). It must also be maintained vis-à-vis the contracting entity (see Salaried physician) and despite possible pressures, seeking alternative ways to resolve potential conflicts (see Insurance companies, important patients).

Secularism in bioethics

See cultural diversity, civil bioethics.

Second opinion

result of the patient's enquiry to a second doctor, in order to confirm the diagnosis or prognosis made by the first doctor. To obtain it, the patient usually apply for the results of the analyses and tests carried out (see Medical history) by the first doctor and this often arouses suspicion, which is unfounded if the doctor's actions have been correct: the patient is only trying to be more certain; for this reason, the application of the medical history must be carried out with the greatest tact and courtesy on the part of the patient, and the doctor who receives the request for a second opinion must refrain from criticising his colleague, even if his technical opinion is different.

Social security

See Socialised medicine.

Free insurance

See Insurance companies.

Insurance

See Insurance companies.

Health insurance

See Insurance companies.

Health insurance

See Insurance companies.

Patient selection

See Triage.

Sensitivity

Capacity to feel. It is a concept core topic to determine the humanity or personality of a biological entity when there is a reductionist view of the person (see scientism).

Meaning of life

The patient's ultimate orientation in life. It is essential for the doctor to knowledge in order to be able to give adequate support to the patient (see Moral support, attendance religious), which he/she can only do if he/she has cultivated adequate sensitivity (see training human). In the physician, the meaning of life is confused with his profession (see Vocation).

Feeling of guilt

See Medicalisation.

National Health Service

See Socialised medicine.

Sexuality

See Procreation.

Meaning of illness

See Meaning of Life.

Sincerity

See Telling the truth, difficult patients.

Acquired immunodeficiency syndrome and ethics

See duty of care, medical confidentiality derogation, cultural diversity, AIDS prevention and ethics, medical confidentiality.

Expert systems

See Computer Diagnostics.

Public protection systems

See Socialised medicine.

Pluralistic society

See cultural diversity.

Sociobiology

Ethical theory that attributes the basis of the goodness and badness of actions to their biological utility for the species. The behaviours that we call good would be those that have brought about the biological progress of the species through natural selection, and the bad ones would be those that have not acted in that sense. It has the merit of attempting an exclusively biological explanation of human behaviour, but it empties the moral language of good or bad, which is reduced to what is useful or not useful.

Sociobiology and medical ethics

Sociobiology renders meaningless the respect (see) for the human being, the basis of medical activity, which is branded as "speciesism", i.e. an unfounded preference for the species homo sapiens over other animal or plant species.

Solidarity

Behaviour directed towards a common goal with another person. In the case of health care, medical action directed towards the good of the sick person (see therapeutic friendliness, autonomy, benevolence, beneficence, informed consent, empathy).

Underdevelopment

See Countries at development.

Subrogation

Anglicism. See delegated decision.

Doctors' salaries

See Fees, salaried doctor.

Good luck

The set of circumstances peculiar to a person that determines his or her possibility of proper health care. It is used as an argument by liberal bioethics (see): whoever is unlucky and cannot afford treatment, should go without it.

Suffering

Subjective appreciation of situations of physical, psychological or moral pain. It is highly variable even under the same objective circumstances, as it depends on the patient's character, temperament and convictions (see Meaning of life). Its relief (see) is one of the aims of medicine; it has to be achieved partly by treating the causes of suffering (analgesia, treatment of anxiety or depression) and partly by moral support (see).

Suffering as atonement

Acceptance staff of suffering as a consequence of a religious meaning of life (see Meaning of life). It cannot be imposed on the patient (see Analgesia), although their reflection on the status of suffering, together with their dialogue with the care team, may lead them to such acceptance (see Moral support, attendance religious).

Assisted suicide and ethics

See financial aid suicide, euthanasia. His internship spreads the conviction that a life with less satisfaction issue may not be worth living, which is false (see Wrongful birth). When a case of suicide occurs, it should not be given advertising, partly because of the general obligation of the physician (see Medical secrecy), partly because of its triggering effect on other suicides (see Duty to preserve health).

Rational suicide

Coldly decided suicide in a person receiving adequate palliative care and moral support for their illness (see Right to die).

Experimental subjects

See Informed Consent, research clinical.

Survival

See Forecast.

Suspension of care

Cessation of nursing treatment, usually in view of the patient's imminent death. From an ethical point of view, it is never justified because, even if there is no possibility of cure, relief (see) and comfort (see Moral support, futility) can always be provided.

Suspension of treatment

Cessation of therapeutic measures as futile (see futility, initiate treatment).

Withdrawal of treatment for incapable, disabled and handicapped persons

See Impairment, euthanasia, best interests of the patient. From an ethical point of view, it should not give the impression to the patient's family that death is being sought, and should only be carried out when the family is convinced that there is nothing to be done.

Tobacco and ethics

See duty to preserve health.

Smart cards

Personal electronic cards containing data on medical history, medication consumption and other relevant medical data , which facilitate medical care (see Computerised medical records).

Assisted reproduction techniques

See Assisted reproduction.

Medical technology and ethics

See cost of medicine, indication, futility.

Reproductive technology

See Assisted reproduction.

Teleologism

See Teleological ethics.

Theology

See Theological foundation of Bioethics.

Catholic moral theology

See Theological foundation of Bioethics.

Theory

A body of intellectual knowledge on a given subject. Scientific hypothesis (see).

Scientistic theory of life

See Scientism.

Rational Therapeutics

See Scientific medicine.

Gene therapy

See Manipulation Genetics.

Third World

See duty of care, pharmaceutical industry, research clinical in the third world.

Mandatory AIDS tests

Anglicism. See HIV testing and ethics.

Living will

Inadequate name for advance directives (see), as the will implies the death of the testator. This is often one of the channels used by pro-euthanasia associations to make their voice heard in society: to encourage the drafting of advance decisions ordering the withdrawal of all care if it is foreseen that the patient will be left with chronic and irreversible limitations. However, although the patient's final state must be taken into account in clinical decisions, it is not a decisive factor most of the time (see futility, DNR orders).

Jehovah's Witnesses

Religious movement whose health care sometimes poses serious problems because of its refusal to infuse blood or blood products (see cultural diversity). This refusal is not expressed by all its branches, nor by all its members. It is not a suicidal attitude, but the maintenance of the convictions that give meaning to their lives (see Meaning of life). It cannot cause us to abandon the care of the sick person (see Duty of care); in the event of an outright refusal, we will have to seek ingenious therapeutic alternatives to transfusion.

Tolerance

Attitudes and behaviours of respect or consideration for the opinions or behaviours of others, even if they contradict or are opposed to one's own value system, beliefs, opinions, etc. (see Cultural diversity). As a term with a positive connotation, it is used by advocates of liberal bioethics (see) to defend their extreme positions, such as the right to procured abortion or the right to die (see), override the professional freedom of physicians (see science objection, conscientious objection).

Deficiency tolerance

See Eugenics.

Decision-making

See Decision. In American liberal bioethics (see), a process of logical reasoning that leads to a medical decision appropriate to the clinical status by balancing the different interests at stake (see conflicts of interest).

Computer-based decision making

See Computer Diagnostics.

Torture

Causing pain or suffering to a person in order to obtain from them something that they would not ordinarily be willing to do or say.

Torture and ethics

Because it is contrary to the ethos of medicine, physicians are prohibited by international statements of medical ethics from engaging in any form of torture.

Traditions

See cultural diversity.

Transsexuality

Surgical intervention that transforms the appearance of the external genitalia into those of the opposite sex. It is accompanied by castration (see) and hormone replacement treatment. It is performed in some cases of psychological problems of identification staff with one's own sex, but the intervention rarely manages to solve the underlying psychological problem, which is often complicated by depression.

Gamete intrafallopian transfer

An intervention for the treatment of infertility, consisting of bringing the male and female gametes into the woman's fallopian tube, thus facilitating the natural conditions for fertilisation. It is rarely practised, as the desire for effectiveness leads to a preference for in vitro fertilisation (see), which has somewhat better results.

Gamete Intrafallopian Gamete Transfer and Ethics

issue Although this technique respects the dignity of procreation and its natural sphere (conjugal love), it produces a higher number of miscarriages than normal pregnancy, which makes it ethically inadvisable, unless it is perfected through animal experimentation and avoids this effect. It is also inadvisable from a technical point of view, as it is usually limited to being an unsubstantiated essay , which is applied to cases of idiopathic infertility, without being an aetiological treatment.

Blood transfusion and ethics

See Jehovah's Witnesses, organ transplantation.

Transmission of life

See Procreation.

Transplant

The action or effect of moving an organ or tissue from one place to another. It can be within the same individual (autologous transplantation) or between individuals of the same species (allotransplantation) or of different species (xenotransplantation) (see Organ donation).

Organ transplantation and ethics

Transplantation, like any other medical technique, must offer reasonable expectations of success (see futility), and guarantees that it will not harm the donor (see; see cost of medicine).

Foetal tissue transplantation

Transplantation of human embryonic tissues, obtained through induced abortions (see) coordinated with the transplant, in order to replace damaged or degenerated tissues, so that the transplant, which does not undergo rejection, is functionally integrated in the recipient. Their usefulness has been postulated for the treatment of Parkinson's disease, spinal cord injuries, etc., but the results are so far very poor; to avoid induced abortions, there is the alternative possibility, more internship, of using progenitor cell lines cultured in vitro.

Treatment

Set of means (hygienic, dietetic, pharmacological, surgical or physical) that are placed on internship to cure or alleviate a disease.

Palliative treatment

Treatment that is intended to relieve pain and discomfort but is not intended to achieve a cure.

Radical treatment

Application of technical measures aimed at the recovery of health (see Aims of Medicine).

Disproportionate treatment

Treatment that, because of its expected results, the discomfort it may cause to the patient, the cost and the family or social problems it may cause, is not reasonable to apply (see futility).

Extraordinary treatment

See Disproportionate treatment.

Forced treatment

See involuntary confinement.

Indicated treatment

See Indication.

Ordinary treatment

See treatment provided.

Treatment provided

Treatment that, because of its expected results, the discomfort it may cause to the patient, the cost and the family or social problems it may cause, is reasonable to apply (see futility).

attention human

See Moral support, scientism.

Triage

Initial triage to establish order and priority of care when all patients cannot be seen or treated immediately. Although this term is usually confined to catastrophic situations, triage also applies to other circumstances with scarce medical means (see cost of medicine, neonatal triage ). Usually, in emergency medicine, after examining all patients, those who are not too critically ill and can be saved with the means available are selected for treatment, because if they were to be used for patients with the worst prognosis, only very few could be treated and more would die than could have been saved.

Neonataltriage

Selection of neonates for treatment in the neonatal intensive care unit if it is impossible to treat them all. This should be done according to prognosis, established by objective parameters (see Survival Index, Quality of Life Adjusted Survival Index, Quality of Life Index).

UCI

Acronym for Intensive Care Unit (see).

Intensive care unit and ethics

See futility, proportionate treatment, disproportionate treatment.

Use of textiles

employment of tissues obtained from a biopsy, autopsy or donation for basic or applied scientific purposes research .

Tissue use and ethics

The consent of the patient or the patient's family must be obtained, as appropriate (see informed consent, organ transplantation).

Use of the corpse

employment of the corpse of a person for transplantation (see), research or teaching medical. Although Spanish law allows the use of the cadaver for transplantation if there has been no express will against donation, it is only correct to use it if this has been given expressly, and with the consent of the next of kin (see Informed consent, donation).

Rational use of medicines

See Scientific medicine, pharmacy and ethics.

Utilitarianism

See Teleological ethics.

Use of carcasses for research

See Use of the corpse.

Value of human life

Subjective assessment of human dignity (see). If this assessment is correct, human life will be attributed the highest value, which cannot be equated with any other value (see respect).

Value of prenatal life

See Weakness, value of human life.

Ethical value

See Values.

evaluation of life

assessment The economic cost of human life, which is often used by insurance companies to calculate their premiums, is based on the cost of medical care for illnesses according to their frequency and the loss of earnings of the sick person.

Values

Goods (see) appreciated subjectively. The subjective appreciation of goods only corresponds faithfully to the real goods if there is a well-formed conscience (see Conscience, training of conscience, prudence).

Moral values

See values.

Advantages to the handicapped

See Weakness.

Truthfulness

See Telling the truth.

Life

Integrated activity of an organic body (see Death).

Wrong life

grade of a sick life by comparison to not being born; it is used as an argument in support of induced abortion (see). The comparison has no place, because not being born does not give rise to any life subject , and nothingness is no better or worse than living with or without limitations.

Human life

See Human dignity, personality.

Unworthy life

See Human dignity, meaning of life, wrong life.

Terminal life

See End-of-life care.

Vegetative life

See Persistent vegetative state.

HIV

Acronym for human immunodeficiency virus. See Acquired immunodeficiency syndrome.

Virtues

Good operational habits. These are a person's dispositions that guide them in their actions towards the most appropriate conduct. They are acquired through repeated acts with effort. Their content cannot be determined by deduction from formal rules or principles, as claimed by rationalist ethical treatises (see training of conscience). They are fundamental for a correct clinical internship .

Vocation

A set of positive duties (see) that a person feels called to perform in his or her life in preference to others, without urgency or other special circumstances (see Meaning of life).

Zygote and ethics

See weakness.