BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...) enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology.ResultsFollowing 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas, such as corridors, elevators, the cafeteria, stairs, and locker rooms.ConclusionsIn addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches, thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. (shrink)

The physician’s duty of confidentiality is based on the observance of the patient’s privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. The main objective of this work consists of analyzing the aspects that are related to the confidentiality of patients’ data with respect to the training, conduct and opinions of doctors from different Clinical Management Units of a third-level hospital via a questionnaire. The (...) present study aimed to define the problem and determine whether the opinions of these professionals correspond to those observed in a previous work conducted at the same center. Of the 200 questionnaires that were collected, 62.5% were from consultants and the rest were from residents with an average of 14.4 ± 12.5 years in professional practice. The respondents noted habitual situations in which confidentiality was breached in the reference hospital. The section on their attitudes and behaviors towards situations related to confidentiality showed a slightly lower average score than that of their medical knowledge; significant differences in these scores were observed between the consultants and residents as well as between the extreme age groups and years of professional practice, thus more inadequate attitudes were consistently noted in younger doctors who had fewer years of experience. Finally, the respondents answered that the training of doctors in the aspects of healthcare law and ethics was the most important measure that the hospital could adopt regarding confidentiality practices. (shrink)

BackgroundMoral distress (MD) is the psychological damage caused when people are forced to witness or carry out actions which go against their fundamental moral values. The main objective was to evaluate the prevalence and predictive factors associated with MD among health professionals during the pandemic and to determine its causes.MethodsA regional, observational and cross-sectional study in a sample of 566 professionals from the Public Health Service of Andalusia (68.7% female; 66.9% physicians) who completed the MMD-HP-SPA scale to determine the level (...) of MD (0-432 points). Five dimensions were used: i) Health care; ii) Therapeutic obstinacy-futility, iii) Interpersonal relations of the Healthcare Team, iv) External pressure; v) Covering up of medical malpractice.ResultsThe mean level of MD was 127.3 (SD=66.7; 95% CI 121.8-132.8), being higher in female (135 vs. 110.3; p<0.01), in nursing professionals (137.8 vs. 122; p<0.01) and in the community setting (136.2 vs. 118.3; p<0.001), with these variables showing statistical significance in the multiple linear regression model (p<0.001; r2=0.052). With similar results, the multiple logistic regression model showed being female was a higher risk factor (OR=2.27; 95% CI 1.5-3.4; p<0.001). 70% of the sources of MD belonged to the dimension "Health Care" and the cause "Having to attend to more patients than I can safely attend to" obtained the highest average value (Mean=9.8; SD=4.9).ConclusionsFemale, nursing professionals, and those from the community setting presented a higher risk of MD. The healthcare model needs to implement an ethical approach to public health issues to alleviate MD among its professionals. (shrink)

In Lukács: Praxis and the Absolute, Daniel Andrés López reassembles Lukács’s philosophy of praxis on a Hegelian basis, as a conceptual-historical totality, both defending him and proposing an unprecedented, immanent critique that raises problems for Marxian philosophy as a whole.

This book tells the story of the Scientific Buddha, "born" in Europe in the 1800s but commonly confused with the Buddha born in India 2,500 years ago. The Scientific Buddha was sent into battle against Christian missionaries, who were proclaiming across Asia that Buddhism was a form of superstition. He proved the missionaries wrong, teaching a dharma that was in harmony with modern science. And so his influence continues. Today his teaching of "mindfulness" is heralded as the cure for all (...) manner of maladies, from depression to high blood pressure.In this potent critique, a well-known chronicler of the West's encounter with Buddhism demonstrates how the Scientific Buddha's teachings deviate in crucial ways from those of the far older Buddha of ancient India. Donald Lopez shows that the Western focus on the Scientific Buddha threatens to bleach Buddhism of its vibrancy, complexity, and power, even as the superficial focus on "mindfulness" turns Buddhism into merely the latest self-help movement. The Scientific Buddha has served his purpose, Lopez argues. It is now time for him to pass into nirvana. This is not to say, however, that the teachings of the ancient Buddha must be dismissed as mere cultural artifacts. They continue to present a meaningful challenge, even to our modern world. (shrink)

Shows the relevance of Schiller’s thought for contemporary philosophy, particularly aesthetics, ethics, and politics. This book seeks to draw attention to Friedrich Schiller (1759–1805) as a philosophical thinker in his own right. For too long, his philosophical contribution has been neglected in favor of his much-deserved reputation as a political playwright. The essays in this collection make two arguments. First, Schiller presents a robust philosophical program that can be favorably compared to those of his age, including Rousseau, Kant, Schelling, and (...) Hegel, and he proves to be their equal in his thinking on morality, aesthetics, and politics. Second, Schiller can also guide us in our more contemporary philosophical concerns and approaches, such as phenomenology, hermeneutics, aesthetics, and politics. Here, Schiller instructs us in our engagement with figures such as Walter Benjamin, Michel Foucault, Jacques Rancière, Roberto Esposito, and others. María del Rosario Acosta López is Associate Professor of Philosophy at DePaul University. She has published several books, including La tragedia como conjuro: el problema de lo sublime en Friedrich Schiller. Jeffrey L. Powell is Professor of Philosophy at Marshall University and the editor of Heidegger and Language. (shrink)

Through the mental experiment that I suggest, it is possiblc to demonstrate that Hugh Everett’s quantum interpretation, known as of the “many universes”, is incongruent with the special theory of relativity.

In most domains of human life, we are willing to accept that there are experts with greater knowledge and competencies that distinguish them from non-experts or laypeople. Despite this fact, the very recognition of expertise curiously becomes more controversial in the case of “moral experts”. Do moral experts exist? And, if they indeed do, are there ethical reasons for us to follow their advice? Likewise, can emerging technological developments broaden our very concept of moral expertise? In this article, we begin (...) by arguing that the objections that have tried to deny the existence (and convenience) of moral expertise are unsatisfactory. After that, we show that people have ethical reasons to ask for a piece of moral advice in daily life situations. Then, we argue that some Artificial Intelligence (AI) systems can play an increasing role in human morality by becoming moral experts. Some AI-based moral assistants can qualify as artificial moral experts and we would have good ethical reasons to use them. (shrink)

Consensual homicide remains a crime in jurisdictions where active voluntary euthanasia has been legalized. At the same time, both jurisdictions, in which euthanasia is legal and those in which it is not, recognize that all patients (whether severely ill or not) have the right to refuse or withdraw medical treatment (including life-saving treatment). In this paper, I focus on the tensions between these three norms (the permission of active euthanasia, the permission to reject life-saving treatment, and the prohibition of consensual (...) homicide), assuming a justification of euthanasia based on the right to (personal) autonomy. I argue that the best way to provide a coherent account of these norms is to claim that patients have two distinct rights: the right to autonomy and the right to bodily integrity. This solution has some relevant implications for the discussion of the legalization of active euthanasia. (shrink)

When travelling to a new city, we acquire knowledge about its physical terrain, directions, historical facts and aesthetic features. Engaging in tourism practices, such as guided walking tours, provides experiences of a city that are necessarily mediated and partial. This has led scholars in tourism studies, and more recently in philosophy, to question the epistemological value of city tours, critiquingthem as passive, lacking in autonomous agency, and providing misrepresentative experiences of the city. In response, we argue that the mediated and (...) partial knowledge of a city acquired through city tours is not epistemologically disvaluable. Although city tours involve the transmission of testimonial knowledge, this does not necessarily render tourists as passive and non-autonomous. Instead,tourists have the potential to participate in the generation of their knowledge actively. Moreover, we argue that city tours also provide a tourist with valuable ‘objectual’ knowledge of a city, whichhas the potential to be first-personal and active, and does not necessarily misrepresent the city’s identity. This type of knowledge is valuable both for tourists as credible epistemic agents, and for the city itself, as the knowledge generated by the tour can facilitate an accurate representation of the city and promote social transformation. We conclude by highlighting four further epistemic and ethical implications of our argument. (shrink)

La muerte resulta problemática para la contemporaneidad. El existencialismo es una corriente filosófica que presenta la facticidad de la mortalidad como propia de la vida. El pensador Albert Camus articula los pilares fundamentales de su filosofía en torno a la experiencia de la muerte, que lleva al absurdo, del que debe partir la acción rebelde. En esta investigación se analizan algunas dinámicas que, pretendiendo huir de la muerte, solo han conseguido hacernos débiles frente a ella. Presentaremos a Sísifo y Rieux, (...) dos de los personajes de sus escritos, como aquellos paradigmas de conducta que pueden contribuir a hacernos más conscientes del absurdo y poder, de este modo, vivir, amar y luchar. (shrink)

Critical studies in higher education often embrace the ideas of the slowness movement to address time pressure. However, this desirable horizon presents some limitations. On the one hand, by emphasizing solutions at the individual level, boosting slowness may promote tactics incapable of producing changes to the underlying structural dynamics of time pressure. On the other hand, approaches based on slowness may also inadvertently foster a form of ethical paternalism within the context of ethical pluralism by prescribing substantive models of practice (...) ultimately based on ‘do this quickly or do it slowly.’ This theoretical research moves away from the temporal paradigm to that of the way of relating. Building upon the ethical concept of resonance, the approach focuses on a formal critique of the current socioeconomic and ethical dynamics of social acceleration, growth, and innovation that can contribute to projecting non-alienated relationships in higher education. (shrink)

Después de una visión general del Gorgias de Platón, se hace una presentación del realismodel personaje Calicles y la respuesta de Sócrates, así como de las tesis centrales sobre la justicia en el texto. Posteriormente se sintetizan algunas de los elementos nucleares de la ética de la investigación que compete a los comités de regulación de los estudios clínicos, poniendo énfasis en los vacíos que dejan ver desde la perspectiva filosófica, a la luz del propio texto platónico, y los aportes (...) que este último podría ofrecer, sobre todo desde perspectiva de la prudencia y la equidad griegas.After an overview of Plato’s Gorgias a presentation of Callicles’ realism and the response of Socrates is made, as well as the main theses on justice in the text. Then some of the main elements of research ethics concerning regulation committees of clinical studies is synthesized, pointing out the gaps that appear there from a philosophical perspective, in the light of the platonic text and the contributions that this text can make, in particular from the perspective of Greek prudence and equity. (shrink)

In Leibniz’s New Essays stands out, within many important topics, his doctrine of innate ideas, which supposes the division between sense knowledge and innate knowledge and implies the distinction between truths of reason and truths of fact. That doctrine is particularly relevant for Leibniz’s philosophy, but implicitly entails the epistemological difference between belief, on one hand, and certainty, on the other. In this paper I outline, according to my interpretation, how Leibniz explains that humans can have certainty about innate ideas. (...) This topic is important because if Leibniz demonstrates the possibility of having certainty of those ideas, then, it is feasible to believe in its existence. However, if his explanation is unsatisfactory his metaphysical doctrine would be seriously weakened and, at the same time, both skepticism and Locke’s empiricist doctrine would be reinforced. (shrink)

This book highlights the powerful impact of some important Spanish Jesuits (Suárez, Acosta, Ribadeneira, Mariana) on some relevant English thinkers such as Locke, Bacon, and others, regarding politics, law and natural rights, an influence sometimes hidden and always controversial.

This book highlights the powerful impact of some important Spanish Jesuits (Suárez, Acosta, Ribadeneira, Mariana) on some relevant English thinkers such as Locke, Bacon, and others, regarding politics, law and natural rights, an influence sometimes hidden and always controversial.

In this article there is a criticism of the thesis that defines the Spanish political transition as a successful attempt to put an end to the "law of the pendulum" that had been governing our constitutional history. On the one hand, this thesis underestimates the conditions of the Spanish situation of 1978, marked by the transit between two worlds, the modern one that inherited and the emerging postmodern, which would become an unquestionable reality from 1989. In addition, the Spanish Constitution (...) of 1978 was drafted at a time when the political-normative conceptual assumptions of the dominant constitutional paradigm in Europe after World War II were declining. Likewise, the thesis ignores the specific spanish differential feature: the civil war of 1936-1939 and the subsequent rupture and radical separation of Spanish modernity into two distinct historical sections: one initiated with the French Revolution and culminated in the most absolute destruction of the pre-existing political and social order; and another that starts in 1939, since the construction of zero of a radically new pattern of society and culture, with which the Spaniards encountered in December 1975 when they assumed their full political protagonism in a situation unprecedented and completely devoid of precedents in our national constitutional tradition. (shrink)

Love enhancement can give us as a say on whom we love and thus ‘free’ us from our brain chemistry, which is mostly out of our control. In that way, we become more autonomous in love and in our life in general, as long as love enhancement is a free, voluntary choice. So goes the argument in favour of this addition to medical interventions of relationships. In this paper, I show that proponents of love enhancement have overlooked, or at least (...) underestimated, the fact that love itself impacts people’s choices. Since this could include the choice for love or anti-love drugs, I call for a re-formulation of the underlying view on autonomy before this medical intervention is made available to the public. (shrink)

Las 15 piezas que ahora lo conforman abrevan en la Historia, en confeciones personales y entrevistas, y mezclan la literatura y el periodismo de manera audaz y perfecta. Los protagonistas son hombres excepcionales y el momento que se ha elegido para contar son las visperas de sus muertes -tal vez el momento de mayor soledad y de mayor intimidad de un hombre. A traves de la magistral escritura de Tomas Eloy Martinez tenemos el privilegio de asistir a los ultimos (...) minutos de sus vidas, el momento previo a perderlo todo y cuando, resistiendo a la indiferencia del mundo, se suena con alguna inmortalidad. (shrink)

In contrast to individualistic explanations of social injustice that appeal to implicit attitudes, structural explanations are unintuitive: they appeal to entities that lack clear ontological status, and the explanatory mechanism is similarly unclear. This makes structural explanations unappealing. The present work proposes a structural explanation of one type of injustice that happens in conversations, discursive injustice. This proposal meets two goals. First, it satisfactorily accounts for the specific features of this particular kind of injustice; and second, it articulates a structural (...) explanation that overcomes their unattractiveness. The main idea is that discursive injustice is not the result of biased interlocutors, but of problematic discursive norms. (shrink)

El objetivo de este artículo es definir la concepción del acto involuntario de Francisco Suárez y mostrarla como un medio que permite comprender y profundizar en su teoría de la acción humana. En esta cuestión, el Doctor Eximio parte de presupuestos elaborados por Tomás de Aquino que amplía y adapta siguiendo sus propias tesis metafísicas y teológicas sobre la relación entre Dios y las creaturas. Mostraremos cómo Suárez vincula el verdadero involuntario con el _simpliciter_, lo forzado, necesario e indeseado, dejando (...) al _secundum quid_ como un acto mixto en el que la libertad y la voluntad, pese a las injerencias externas, no quedan anuladas. Por último, subrayaremos las consecuencias de la definición suareciana de lo involuntario sobre la noción de libertad, haciendo patente que tanto una como otra serían imposibles fuera del marco teórico que él sustenta, caracterizado por la eficiencia humana (y su dependencia de la divinidad) y no por la premoción física. (shrink)