Gilberto Monteiro foi médico municipal da freguesia de Carnaxide de 1921 a 1961, Chefe dos Serviços Clínicos da extinta fábrica dos Fermentos Holandeses (F.P.F.H.), sediada na Cruz Quebrada, de 1934 a 1962 e, durante a II Guerrra Mundial, exerceu no Hospital Militar de Belém, na qualidade de tenente médico miliciano. Amante do desporto e desportista, G. Monteiro foi um dos fundadores do Sport Algés e Dafundo (SAD), instituição onde, enquanto membro da sua primeira Comissão Cultural, criou a (...) Biblioteca, organizou conferências, exposições e concertos e outras actividades culturais que ali atrairam figuras de relevo como Aquilino Ribeiro, Viana da Mota, Hernâni Cidade e Norton de Matos, entre outros. Se nas suas crónicas escritas para “O Fermento” deparamos com o G. Monteiro, historiador inconformado, que denuncia os constantes atentados à integridade histórica e patrimonial, no Esboço Histórico do Hospital Militar (1945) convivemos com um testemunho de vertical e desassombrada coragem cívica, denunciadora dos males de que padecia a medicina contemporânea. Finalmente, acompanhamos o esforço e as diligências que, numa linha de justiça, educação e melhoria da qualidade de vida das pessoas, G. Monteiro desenvolveu, em pleno Estado Novo, a fim de instituir na fábrica (FPFH) uma assistência médico-social moderna. (shrink)

Introducción: los accidentes son de las primeras causas de muerte a nivel mundial, por lo que la prevención de los mismos es una emergencia. Objetivo: valorar la repercusión de una intervención comunitaria en la disminución de peligros potenciales de accidentes en familias con niños de 0 a 18 meses. Métodos: se realizó un estudio cuasi experimental multietápico, con enfoques cuantitativo y cualitativo, entre enero de 2009 a junio de 2012. Se trabajó con 39 familias entre las que se produjeron nacimientos (...) en el periodo enero de 2008 a enero de 2010 de los Consultorios Médicos del Consejo Popular 26 de julio del Municipio Santo Domingo. Se efectuó una intervención por un grupo de trabajo comunitario conformado por integrantes del Círculo de interés "Prevención es Salud" y brigadistas de la Cruz Roja, liderados por la enfermera de la familia, se empleó para ello la Guía para Análisis de vulnerabilidades y capacidades de la Cruz Roja, modificada en su etapa I. Resultados: Post intervención se logró la reversión de vulnerabilidades en cuanto a capacidades, se manifestaron cambios favorables en los conocimientos y disminuyó significativamente el número de peligros potenciales en cada hogar. Conclusiones: Cuando se trabaja con familias con instrumentos sencillos y accesibles, y con el grupo de trabajo comunitario, se favorece la toma de conciencia sobre el problema en el entorno donde se generó. Introduction: accidents are one of the first causes of death worldwide, so their prevention is an urgency. Objective: assess the effect of a community intervention in the reduction of potential dangers of accidents in family with children aged from zero to 18 months. Methods: a multiage cuasi experimental study was carried out, with quantitative and qualitative approaches, from January 2009 to June 2012. The sample was taken from thirty-nine families who had children in the period ranging from January 2008 to January 2010 belonging to the family doctor´s house of the community called "26 de Julio" from Santo Domingo municipality. An intervention was carried out by a community group work composed by members of centers of interests called ¨Prevention is health¨ and members of the Red Cross led by the family nurse. It was necessary to ask a guide to analyze the vulnerabilities and capabilities of the Red Cross, modified in the first stage. Results: During the post intervention, it was possible to change the vulnerabilities in terms of capacities, favorable changes were present in the knowledge and the number of potential risks significantly decreased in each house. Conclusions: when families are approached with simple and accessible instruments, and with a community group work it is possible to make favorable changes in terms of awareness of the problem in the same place where it emerged. (shrink)

In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria—where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the “Decisional Competency in Medico-Legal Contexts” section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that (...) takes the question to be asking about the abilities needed to satisfy an idealized view of competent decision-making, according to which decisional competency is a matter of possessing those abilities or attributes that are needed to engage in good or effective or, perhaps, substantially autonomous or rational decision-making. The view has some plausibility—it accords with the way decisional competency is understood in a number of everyday contexts—but fails as an interpretation of the question regarding the abilities that should be needed for decisional competence in medico-legal contexts. Nevertheless, consideration of why it is mistaken suggests a more accurate interpretation and points the way in which the question regarding the evaluation of medico-legal competency criteria is to be answered. Building on other scholarly work in the area, I outline in the “Primary and Secondary Requirements” section several requirements that decisional competence criteria ought to satisfy. Then, in the “Applying the Framework” section, I say something about the extent to which medico-legal competency criteria, as well as some models of decisional competency proposed in the academic literature, fulfil those requirements. (shrink)

According to the ‘fact-plus-value’ model of pathology propounded by K. W. M. Fulford, ‘disease’ is a value term that ought to reflect a ‘balance of values’ stemming from patients and doctors and other ‘stakeholders’ in medical nosology. In the present article I take issue with his linguistic-analytical arguments for why pathological status must be relative to such a kind of medico-ethical normativity. Fulford is right to point out that Boorse and other naturalists are compelled to utilize evaluative terminology when they (...) characterize the nature of diseases and biological dysfunctions. But the relevant ‘biofunctional judgements’ are no less factual and empirical for that. While it is indeed evaluative to say that biological dysfunctions involve failures to execute naturally selected functions, such judgments are not bound to entail anything about what is good or bad for us, and what should be treated or not. In the last part of the paper I ruminate briefly on the relationship between ‘biological evaluationism’, on my construal, and descriptions of ‘causal biology’. As I note in my conclusion, a strict bioevaluative concept of disease can be valid for every species on earth, and thus be of particular usefulness in general biological contexts. (shrink)

Este estudio de relaciones médico-paciente en Mexico involucró entrevistas realizadas a 1700 pacientes inmediatamente de.\pués de salir de su consulta clínica. Se llevó a cabo entre los años 2004-05 en León, More ha, Guanajuato y en Charleston, West Virginia, USA. Los propósitos fueron: 1) establecer un base de datos como punto de referencia para investigaciones futuras en instituciones del cuidado de la salud con referencia a la comunicación médico-paciente, a la satisfacción de los pacientes y al consentimiento infórmado (...) y, 2) hacer una comparación entre las relaciones medico-paciente en Mexico y los Estados Unidos de America. Hicimos varias conclusiones sobre la comunicación médico-paciente, participación del paciente en decisiones con respecto a su cuidado de salud y el ambiente social de la consulta médica. Ofi-ecemos los datos y los cuestionarios completos por internet a cualquier investigador interesado para estudios futuros de acuerdo con sus propios intereses. Además, encontramos que no huho ninguna diferencia importante en las relaciones médico-pacientes con respecto al consentimiento infórmado y la satisfáccián del paciente entre México y los EEUU. (shrink)

The aim of this study was to elucidate municipal night registered nurses’ (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs’ experience of caring is interpreted as meanings in paradoxes: (...) ‘being close at distance’, the condition of ‘being responsible with insignificant control’, and ‘being interdependently independent’. The RNs’ experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding to vocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people. (shrink)

Although there is a history in urban thought wherein scholars view cities as technologies, the encompassing character of such views inherently limits them. In turn, their usefulness does not efficiently support the kind of thinking that is required to deliver worthwhile outcomes that can promote social justice and human flourishing. However, narrowing the focus through examining municipalities as technologies offers possibilities that can help us achieve such goals. To maximize the utility of this endeavor, employing the structural-ethics approach provides a (...) way to assess urban technologies to achieve success. In this paper, the author explores the ideas above, revealing how they advance our thinking when it comes to remaking, planning, and building existing and future cities. The article concludes by linking these claims to other lessons in urban studies and geography. (shrink)

This article attempts to open the debate on a territorial development perspective that fixes the interest in organized territories that are characterized by the existence of a community with a local identity, politically and administratively regulated. We conceive these territories as subjects of development promotion interventions. For this we propose a model for the creation of Municipal Development Forums, which with the participation of local actors, can generate a tailor-made Local Development Program. The development program will consider a diagnosis (...) of the productive profile of the territory and its relationship with the characteristics and origin of goods or services consumed at the municipality. Based on the diagnosis, the causes of the decoupling between the local production system and consumption needs can be detected. And with this, find a way to readjust local production systems to meet the demand for goods and services of the inhabitants, generating new companies and encouraging local consumption. (shrink)

This paper attempts to open the debate on the idea of local and territorial development of microregional nodes in the Province of Buenos Aires. Under this approach, a model that proposes the creation of Municipal Development Forum, with the participation of local actors, generate local development program is proposed. The proposal is formulated for territories over 5,000 and below 30,000 inhabitants. This criterion is based on the applicability of the proposed model to municipalities with potential for territorial development, large (...) and balanced internal consumption, but where progress is hindered by the proximity of one or two political jurisdictions of a larger productive scale that have became regional administrative centers. The development program will consider a diagnosis of the productive profile of the territory and its relationship with the characteristics and origin of goods or services consumed at the municipality. This territorial development model aims to move towards self-sufficiency on goods and services, to create new jobs and to promote effective and efficient use of local resources. In short, we propose to tackle territorial development from an innovative perspective, focusing on the creation of Municipal Development Fora that foster the improvement and growth of the productive system, the creation of jobs, local identity and the consumption of goods and services locally produced. (shrink)

A wave of recent scholarship has warned about the potential for discriminatory harms of algorithmic systems, spurring an interest in algorithmic accountability and regulation. Meanwhile, parallel concerns about surveillance practices have already led to multiple successful regulatory efforts of surveillance technologies—many of which have algorithmic components. Here, we examine municipal surveillance regulation as offering lessons for algorithmic oversight. Taking the 2017 Seattle Surveillance Ordinance as our primary case study and surveying efforts across five other cities, we describe the features (...) of existing surveillance regulation; including procedures for describing surveillance technologies in detail, requirements for public engagement, and processes for establishing acceptable uses. Although the Seattle Surveillance Ordinance was not intended to address algorithmic accountability, we find these considerations to be relevant to the law’s aim of surfacing disparate impacts of systems in use. We also find that in notable cases government employees did not identify regulated algorithmic surveillance technologies as reliant on algorithmic or machine learning systems, highlighting definitional gaps that could hinder future efforts toward algorithmic regulation. We argue that finer-grained distinctions between types of information systems in the language of law and policy, and risk assessment tools integrated into their implementation would strengthen future regulatory efforts by rendering underlying algorithmic components more legible and accountable to political and community stakeholders. (shrink)

This paper examines the institutions for participatory governance that have been created in Chile through a case study of Huechuraba, a low income municipality in the Santiago metropolitan area. The case of Huechuraba suggests that in certain contexts, the meetings that take place between government officials and grassroots organizations can become a forum for the state to colonize public space and bolster the hegemony of the status quo by establishing the parameters of citizenship.

La violencia en México, específicamente en algunos estados de la República mexicana en donde la población se enfrenta a situaciones de peligro, tiene como una de tantas consecuencias la ausencia de personal médico que se desempeñe como profesional y proporcione servicios de salud en estas zonas rurales. En este sentido, es de considerar que la asignación de recursos humanos en salud es fundamental para el funcionamiento de un sistema eficiente y observar las causas por las que médicos que desde (...) el servicio social hasta el desempeño de su especialidad no consideran trabajar en lugares en donde se sienten vulnerables. En este proceso, es importante visibilizar los cuestionamientos éticos que pueden surgir por lo que este trabajo pretende dar importancia al tema de la exposición de circunstancias, hechos y cifras dentro de esta problemática y plantear las cuestiones normativas pertinentes dentro de este contexto. (shrink)

First ever English Translation of Philippe PInel's 2nd Medico-Philosophical Treatise on Mental Alienation. The founder of French psychiatry wrote Medico-Philosophical Treatise on Mental Alienation in 1800 and reworked it nine years later. This book is the "Entirely Reworked and Extensively Expanded" version from 1809. Today, it can give historians of medicine and psychiatrists an overview of mental illnesses as they were viewed in that era. The author, Philippe Pinel, became known as the doctor who worked to free the insane from (...) chains. (shrink)

Guidelines advise that x-rays do not contribute to the clinical management of simple nasal fractures. However, in cases of simple nasal fracture secondary to assault, a facial x-ray may provide additional legal evidence should the victim wish to press charges, though there is no published guidance. We examine the ethical and medico-legal issues surrounding this controversial area.

El libro y el autor(. Una obra ante nosotros y un autor fecundo, generoso, el cual todavía joven, ha hecho sorprendentes aportes. Hay textos, son los menos, que necesitan el conocimiento del autor. Otros en que el autor es más grande o más pequeño que su trabajo. Estamos ante un creador y un libro relativamente autónomos, los dos muy relevantes.Horacio, psiquiatra cultural, exiliado en Alemania, que alcanza allí estatus de docente e investigador, junto con proyectarse hacia América Latina co..

Según la concepción «clásica», el fin de la medicina era el de ayudar a conservar y recuperar la salud, entendida como un bienestar físico, emocional y vital, al cual contribuían acciones materiales, influjos sobrenaturales y cosmológicos. Con el Renacimiento, la ciencia moderna ofrece sus conocimientos a la medicina, en la cual desaparece la consideración de influjos sobrenaturales y cósmicos. Además, la concepción dualista cartesiana reducía la medicina a ocuparse exclusivamente del cuerpo del hombre, interpretado como una máquina según modelos propuestos (...) con base en diferentes ciencias. Esta perspectiva fisicalista y analítica ha permitido logros importantes. Sin embargo, la enfermedad implica, en cuanto experiencia vivida por el paciente, aspectos de malestar existencial, fragilidad, dependencia, pérdida de identidad que, a menudo, la medicina piensa no deber considerar en cuanto subjetivos. Hay que eliminar este error, complementando la competencia médica con las varias fuentes ofrecidas por la filosofía, artes, religión, de modo que permitan al enfermo encontrar en su interioridad los sustentos para darle un sentido y valor a su existencia en sus reales condiciones. (shrink)

This article examines the municipal ID card programs in New Haven and San Francisco. With a municipal ID card, undocumented immigrants can access basic city services and identify themselves with police and other city officials. The article draws on twenty-eight interviews with key stakeholders to show that city officials navigated the conflicting demands of ID card supporters and opponents to create a local membership policy focused on improving city administration, not expanding the rights of undocumented immigrants. In capitalizing (...) on their discretionary administrative powers to develop programs that safeguard the health, safety, and welfare of all city residents, officials in New Haven and San Francisco managed to promote the integration of undocumented immigrants into city affairs without upsetting the federal monopoly over immigration and citizenship powers. This new form of local bureaucratic membership has implications for the urban citizenship literature and illustrates that city officials have some freedom to develop programs that benefit undocumented immigrants. (shrink)

Australian law affirms a binary construction of fertility/infertility. This model is based upon the medical categorization of infertility as a disease. Law supports medicine in prioritizing technology, such as in vitro fertilization, as treatment for infertility. This prioritization of a medico-legal model of infertility in turn marginalizes alternative means of family creation such as adoption, fostering, traditional surrogacy, and childlessness. This paper argues that this binary model masks the impact of medicalization upon reproductive choice and limits opportunity for infertile individuals (...) to create families. While medical technology should be available to enhance reproductive opportunity, infertile individuals will benefit from regulatory change which disentangles the medico-legal construct of infertility as a disease from the desire to create a family. This paper suggests that the medico-legal model of infertility should be reframed to support all opportunities for family creation equally, including non-medical opportunities such as adoption, fostering, and childlessness. (shrink)

A serious yet unstudied consequence of the Christian-Muslim conflict in medieval Spain was the capture and enslavement of soldiers and civilians. Men, women, and children who were seized on raids, taken in battle, or pirated off ships were regarded by their captors as booty, to be used as slaves or to be sold for profit. Since warfare in twelfth-century Spain pitted Christians against Muslims, the usual prohibitions against enslavement of coreligionists clearly did not apply. For Muslims and Christians alike, capture (...) meant a life of slavery. Christian chronicles of this era are replete with stories of captives taken off to be sold in the slave markets of al-Andalus in southern Spain or, even worse, in those of North Africa. Some of these slaves, however, were able to regain their freedom through redemption — that is, to purchase their liberty by paying a ransom. Since the ransom price frequently exceeded what could be gained in the slave auctions, redemption became an attractive option to both captor and captive. (shrink)

This paper describes a half-day class for 200 first year medical students. It is designed like a conference and is intended to raise students’ awareness of legal issues that arise in everyday practice. It uses the Problem Based Learning approach of event-focus, student-guided learning and student teachers. There are three parts.

En el presente artículo se analiza las posibilidades de la teoría de las Representaciones Sociales (RS) para, desde la perspectiva de los sujetos, analizar los elementos cognitivos implicados y socialmente construidos que sustentan las acciones de gestión micro y macro institucional, y de coordinación entre varias municipalidades de un mismo territorio, lo que la literatura de gestión denomina trabajo asociativo o asociativismo. Interesan específicamente las representaciones sociales de la asociatividad en el tema educativo, desde actores político-administrativos y profesionales implicados en (...) la mejora de la educación municipal. Se postula y fundamenta que el estudio de las Representaciones Sociales del Asociativismo Municipal en Educación es pertinente desde los elementos conceptuales de la perspectiva Procesual, dado que el objeto de Representación –el Asociativismo Municipal en Educación- y las técnicas para su análisis se ajustan a las estrategias de implementación del trabajo asociativo en los distintos niveles de organización municipal en el tema educativo. (shrink)

Le populisme est souvent expliqué de façon sociologique et géographique par des raisonnements qui semblent le trouver quasi naturel dans les conditions où ils émergent. L’examen des politiques publiques très contrastées de deux communes de l’ancien bassin minier de Lens invite à se demander si les choix politiques ne peuvent pas être également plus culturels et plus volontairement construits.

The Norwegian Parliament has decided to give priority to ethics in municipal health services. This priority is supposed to raise competence in ethics within municipal health services. As part of the national project, the participating municipalities were encouraged to develop and carry out local projects. In this article, we present a local ethics project in one of the participating municipalities in central eastern Norway. The local project for raising competence in ethics was carried out in cooperation with researchers (...) at the Centre for Medical Ethics (CME) at the University of Oslo. Most people agree that ethics are important in health services. However, there are many ways to increase competence in ethics and to stimulate ethical reflection. In this article we present a broad overview of this local ethics project, but special focus will be put on presenting the actions that have been used for increasing the level of ethical competence and stimulating ethical reflection among the participants. We describe our evaluation of the project and the research we carried out. Explanations will be given for the thought process behind the decisions that were made. (shrink)

All organisations must be able to answer questions from their respective constituencies. It is not an exaggeration to say that, in this respect, it is a challenge to handle the extremely broad action platform of local government administrations (municipalities). The present paper is a walk-through of questions from the citizens that are managed at Botkyrka municipality, Sweden. It is focussed on the use of an ‘intelligent’ citizen assistant.

Background In the coronavirus disease 2019 era, doctors have tried to decrease hospital visits and admissions. To this end, telemedicine was implemented in a non-systematic manner according. The objective of this study was to assess the current knowledge and attitudes of physicians in Alexandria, Egypt, and Punjab, India, toward telemedicine and its ethical and medico-legal issues. Method A cross-sectional study was implemented using an anonymous self-administered questionnaire carried out over two months (July and August 2020). A four-point Likert scale was (...) used to collect data about background knowledge, training in telemedicine and ethical and medico-legal issues in telemedicine practice. Results The questionnaire was completed by 175 Egyptian and 51 Indian physicians from different specialties. A significantly higher percentage of Indian physicians practiced telemedicine than Egyptian physicians during the coronavirus disease 2019 era. Although most physicians had no specific training or licensing to practice telemedicine, most of them practiced telemedicine through their social media accounts. Ethical violations involving waiving patient consent were detected. Significant ethical violations to doctors, for example, blackmail, defamation, hate speech, accusations in a court and violations of privacy, were observed. Indian physicians (39.2%) and Egyptian physicians (24%) thought the penalties should be lower in telemedicine than in traditional practice. Finally, most participants would like to continue using telemedicine after the coronavirus disease 2019 era but with improvements. Conclusions Coronavirus disease 2019 changed the acceptance of telemedicine by physicians. Many ethical and legal issues need to be addressed and clarified using formal training before implementation and standardization of telemedicine services. (shrink)

We examine the influence of social capital in the municipal bond market. Defined as the norms and networks that encourage cooperation, social capital is a social construct which captures a region’s level of altruism, trustworthiness, and propensity to honor obligations. We expect that municipalities with high social capital are more trustworthy and likely to honor their debt obligations, which will result in lower bond yields. Our findings confirm that the bonds issued by municipalities located in high social capital counties (...) exhibit lower yields compared to the municipalities located in low social capital counties. Our findings are also supported by bond prices in the secondary market, which shows that bonds from the municipalities located in high social capital regions have higher prices. Additional tests reveal that the influence of social capital is stronger for general obligation bonds, suggesting that social capital matters more for bonds where the willingness of municipalities to pay taxes is an important factor. Lastly, we document that the bonds of municipalities in high social capital areas are less likely to have insurance, suggesting that social capital may act as a substitute for bond insurance. (shrink)