Time and communication are important aspects of the medical consultation. Physician behavior in real-life pediatric consultations in relation to ethical practice, such as informed consent (provision of information, understanding), respect for integrity and patient autonomy (decision-making), has not been subjected to thorough empirical investigation. Such investigations are important tools in developing sound ethical praxis.

This original article outlines a theoretical path and posterior critical analysis regarding two relevant matters in modern nursing: patterns of knowing in nursing and commodification contexts in contemporary health systems. The aim of our manuscript is to examine the development of basic and contextual nursing knowledge in commodified contexts. For this purpose, we outline a discussion and reflexive dialogue based on a literature search and our clinical experience. To lay the foundation for an informed discussion, we conducted a literature search (...) and selected relevant articles in English, Spanish, and Portuguese that included contents on patterns of knowing, commodification, and nursing published from 1978 to 2017. Globalization, commodification, and austerity measures seem to have negative effects on nursing. Work conditions are worsening, deteriorating nurse–patient relationships, and limiting reflection on practice. Nurses must develop knowledge to challenge and participate in institutional organization and public health policies. Development of nursing knowledge may be difficult to achieve in commodified environments. Consequently, therapeutic care relationships, healthcare services, and nurses' own health are compromised. However, by obtaining organizational, sociopolitical, and emancipatory knowledge, nurses can use strategies to adapt to or resist commodified contexts while constructing basic knowledge. (shrink)

The commodification of health care, particularly primary care, presents challenges to care and knowledge development. The purpose of this study is to examine how nurses perceive and develop their knowledge in a commodified context. A mixed‐methods study was conducted that included a closed‐question survey and in‐depth interviews with nurses in public primary care in Catalonia. There were 104 valid responses to the questionnaire and 10 in‐depth interviews. The main findings of the survey were related to workload and limited time for (...) nursing care. Six themes emerged from the in‐depth interviews: (1) limited time for nursing, (2) feelings of burnout, (3) awareness of patient and family satisfaction, (4) organizational factors that favor nurses' needs, (5) organizational factors that hinder nurses' needs, and finally (6) public administration requirements. Participants perceive excessive workload and time constraints and feel that this affects their nursing care and their physical and mental health. However, nurses purposefully use knowledge patterns to cope with the problems associated with commodification. Nurses have multidimensional, contextualized, and integrated knowledge that allows them to optimize their care based on the needs of their patients. This research examines many challenges related to nursing practice and the nursing discipline and opens the door for further research that encompasses all areas of nursing. (shrink)

Este trabajo ha sido seleccionado para la V Olimpiada de Filosofía queorganiza FICUM en la modalidad de secundaria y bachillerato, para promocionar la filosofía entre los jóvenes.

A la hora de plantearse la realización de actividades relacionadas con la enseñanza de los aspectos astronómicos, se presentan problemas prácticos evidentes que no ayudan a desarrollar una adecuada actividad científica escolar. Las TIC son un instrumento de gran utilidad para sortear estas dificultades, dado que permiten reproducir los fenómenos celestes y experimentar con ellos. El objetivo de este artículo es, en concreto, reflexionar sobre la utilidad de las simulaciones informáticas para la enseñanza de los aspectos histórico-astronómicos. Como muestra de (...) sus posibilidades se presentan simulaciones que pueden realizarse para visualizar diversos fenómenos astronómicos descubiertos por Galileo Galilei. (shrink)

This bulletin contains a summary of the main topics of discussion in truthmaker theory, namely: the definition of truthmakers, problems with Truthmaker Necessitarianism and Truthmaker Maximalism, the ontological burden of truthmakers and the recalcitrant topic of truthmakers for negative truths.

Edmund Husserl intentó excluir supuestos metafísicos y ajustarse a lo dado en la experiencia inmediata, con el fin de buscar una verdad primera e indubitable sobre la cual basar verdades ulteriores, teóricas. Pero, en la segunda etapa de su pensamiento, él abandonó ese camino para usar, sin tematizarlo, el supuesto subjetivista de René Descartes. Para reconducir la fenomenología al proyecto original de ir a las cosas mismas, eliminando supuestos y ateniéndose a la experiencia inmediata, el lósofo español Antonio González Fernández (...) propone la praxeología. Esta aproximación reemplaza el concepto de sujeto, que considera al ser humano como una cosa pensante, por el de persona, entendida como acto encarnado. Esta definición antropológica, coherente con la visión teológica del ser humano como imagen y semejanza de Dios, posibilita orientaciones éticas de las acciones en pro de la descosificación y dignificación del ser humano y el cuidado de la naturaleza. (shrink)

Bernardo de Monteagudo en su texto: Diálogo entre Atahualpa y Fernando VII en los Campos Eliseos, parte de una crítica a las atrocidades llevadas a cabo por los españoles contra los americanos en la Conquista –atrocidades que sobrepasan las llevadas a cabo por Napoleón contra Fernando VII–, para proponer una integración social y cultural que movilice a los pueblos latinoamericanos a la independencia del colonialismo español. Sin embargo, su propuesta no reivindica al indígena, sino que su imagen es usada por (...) el escritor como símbolo de una Latinoamérica que se limita a los criollos. Es decir, el indígena quedará, luego de las independencias latinoamericanas, en una situación similar a la colonial, sólo que ahora bajo el dominio de los criollos. De igual manera, esto nos puede suceder en nuestra realidad bogotana: pensar que Latinoamérica, y especialmente Colombia, se reduce a los Andes, a las ciudades del interior, excluyendo así al Caribe. (shrink)

Regarding the epistemological borderlines between science and philosophy, this article approaches the human mind and ethics from biological and philosophical theories. For this purpose, the Darwinian theory of evolution by natural selection provides a scientific foundation to understand the human mind and ethics. However, not only Charles Darwin has studied mental faculties and ethics, this is also a topic researched by eminent contemporary paleontologists and biologists. Prior to modern biology, going back to Greek philosophy, philosophers have traditionally studied the human (...) mind and ethics, separating human beings and the rest of nature ontologically. Following modern biology, the philosopher Hans Jonas has developed a philosophical biology from the perspective of hermeneutical phenomenology to understand life. With the help of his hermeneutical phenomenology, Jonas has presented an ontological theory of organism-metabolism to understand the phenomenon of life from simple living beings to the human mind in relation to nature, based on the body. Recently, the evolutionary biologist Francisco Ayala has proposed a coherent scientific and philosophical theory about biological and cultural roots for ethics, considering the evolution of human mental and intellectual capacities and the three conditions for ethical behavior as a part of human intellectual capacity, which scientifically complements and informs Hans Jonas’s philosophical biology and ethics of responsibility. (shrink)

Children with complex communication needs (CCN) regularly have barriers to express and discuss emotions, and have fewer opportunities to participate in emotional conversations. The study explores and analyzes the changes after a training program focused on offering an interactive home learning environment that encouraged and modeled emotion-related conversations between a parent and a child with CCN within storybook-reading contexts. An observational design (nomothetic/follow-up/multidimensional) was used to explore and analyze the changes in the communicative interaction around emotions between mother-child. Augmentative and (...) alternative communication (AAC) technologies were used to provide the child access to emotion-related vocabulary. The training program resulted in the mother providing more opportunities to engage her child in emotional conversations, suggesting that when opportunities and resources to talk about emotions were promoted, the child showed more engagement in emotion-related conversations using his AAC system. The mother–child communicative patterns and behavioral relationships observed during the phases are also presented. This case study illustrates the importance of a primary communication partners’ role in facilitating emotional conversations, and the promising efficacy of a training program implemented in a storybook interactive learning environment to promote conversations about emotion-related events while encouraging children with CCN to learn, explore, express, and discuss emotions. (shrink)

In this paper I undermine the Entailment Principle according to which if an entity is a truthmaker for a certain proposition and this proposition entails another, then the entity in question is a truthmaker for the latter proposition. I argue that the two most promising versions of the principle entail the popular but false Conjunction Thesis, namely that a truthmaker for a conjunction is a truthmaker for its conjuncts. One promising version of the principle understands entailment as strict implication but (...) restricts the field of application of the principle to purely contingent truths (i.e. those that contain no necessary proposition at any level of analysis). But a conjunction of purely contingent truths strictly implies its conjuncts. So this version of the principle is committed to the Conjunction Thesis. The same is true of the version of the principle where entailment is understood in the sense of systems T, R, and E of relevant logic, since in these systems conjunctions entail their conjuncts. I argue that the Conjunction Thesis is false because a truthmaker is that in virtue of what a certain proposition is true and it is false that, for example, what the proposition that Peter is a man is true in virtue of is the conjunctive fact that Peter is man and Saturn is a planet (or the facts that Peter is a man and that Saturn is a planet taken together). I also argue against other versions of the principle. (shrink)

In this article we defend the inferential view of scientific models and idealisation. Models are seen as “inferential prostheses” (instruments for surrogative reasoning) construed by means of an idealisation-concretisation process, which we essentially understand as a kind of counterfactual deformation procedure (also analysed in inferential terms). The value of scientific representation is understood in terms not only of the success of the inferential outcomes arrived at with its help, but also of the heuristic power of representation and their capacity to (...) correct and improve our models. This provides us with an argument against Sugden’s account of credible models: the likelihood or realisticness (their “credibility”) is not always a good measure of their acceptability. As opposed to “credibility” we propose the notion of “enlightening”, which is the capacity of giving us understanding in the sense of an inferential ability. (shrink)

Jamin Asay’s A Theory of Truthmaking is one of the most important books on truthmaking, full of important ideas from beginning to end. One of the most interesting parts of the book is Asay's attack on the explanation-first truthmaking. Explanation-first truthmaking is the explanatory project of explaining why truths are true. This is in contrast with ontology-first truthmaking, the project defended by Asay, and which is the project of answering the fundamental ontological question “What is there?”. Asay thinks explanation-first truthmaking (...) should be abandoned because it is problematic and it offers no benefits over those of ontology-first truthmaking. In this brief paper, I argue that he has not established the problematicity of explanation-first truthmaking, and that explanation-first truthmaking offers benefits over ontology-first truthmaking. (shrink)

This paper is a response to replies by Dan López de Sa and Mark Jago to my ‘Truthmaking, Entailment, and the Conjuction Thesis’. In that paper, my main aim was to argue against the Entailment Principle by arguing against the Conjunction Thesis, which is entailed by the Entailment Principle. In the course of so doing, although not essential for my project in that paper, I defended the Disjunction Thesis. López de Sa has objected both to my defence of the Disjunction (...) Thesis and my case against the Conjunction Thesis. I shall show that his objections are unfounded and based on serious misunderstandings of my position, what the relevant debate is, and some fundamental notions of Truthmaker Theory. Jago argues that accepting the Disjunction Thesis and rejecting the Conjunction Thesis is hard to maintain. But I show that Jago has not shown that accepting the Disjunction Thesis while rejecting the Conjunction Thesis is impossible or even hard to maintain. Jago believes that, to accept the Disjunction Thesis while rejecting the Conjunction Thesis, one needs to reject his axiom (T3), which says that all the truthmakers for <P&P> are truthmakers for <P>. I argue that there are reasons to reject such a principle, and the version of it that says that what makes <P&P> true makes <P> true. (shrink)

What is the relationship between morals and politics? What is the relationship between moral philosophy and political philosophy? Defenders of political moralism postulate moral aims or constraints for politics, and hence they see political philosophy as a chapter of moral philosophy. Contrastingly, advocates of political realism describe politics as an independent endeavor aiming at providing order and security, and conceive of political philosophy as an autonomous discipline. This article claims that political moralism and political realism share the mistake of assuming (...) that politics has substantial, permanent goals or constraints. After criticizing political substantialism, the article explains the main ingredients of its alternative, political minimalism: the idea that politics, understood as collective instrumental rationality, aims at providing adequate means for the accomplishment of people's goals, whatever these are; and the conception of the relationship between morality and politics as one of “reciprocal containment.” Finally, it addresses some foreseeable criticisms of political minimalism. (shrink)

We investigated the role of honour concerns in mediating the effect of nationality and gender on the reported intensity of anger and shame in reaction to insult vignettes. Spain, an honour culture, and The Netherlands, where honour is of less central significance, were selected for comparison. A total of 260 (125 Dutch, 135 Spanish) persons participated in the research. Participants completed a measure of honour concerns and answered questions about emotional reactions of anger and shame to vignettes depicting insults in (...) which type of threat was manipulated. It was found that Spanish participants responded especially intensely to insults that threaten family honour, and that this effect of nationality on emotional reactions to threats to family honour was mediated by individual differences in concern for family honour. (shrink)

how does one inquire into the truth of first principles? Where does one begin when deciding where to begin? Aristotle recognizes a series of difficulties when it comes to understanding the starting points of a scientific or philosophical system, and contemporary scholars have encountered their own difficulties in understanding his response. I will argue that Aristotle was aware of a Platonic solution that can help us uncover his own attitude toward the problem.Aristotle's central problem with first principles arises from the (...) fact that they cannot be demonstrated in the same way as other propositions. Since demonstrations proceed from prior and better-known principles, if the principles themselves were in need of... (shrink)

In the context of the end of life, many authors point out how the experience of identity is crucial for the well-being of patients with advanced disease. They define this identity in terms of autonomy, control, or dependence, associating these concepts with the sense of personal dignity. From the perspective of the phenomenology of embodiment, Kay Toombs and other authors have investigated the ways disease can impact on the subjective world of patients and have stressed that a consideration of this (...) personal world can promote understanding and recognition of their experience. Based on the findings of qualitative studies of the perception of dignity and autonomy in patients at the end of life, this analysis assesses concepts such as being-in-the-world in illness, embodiment, lived body versus objective body or the gaze of the other from a Toombsian phenomenological perspective. (shrink)

Business Ethics: A European Review, EarlyView.

Since the 1960s, organ procurement policies have relied on the boundary of death—advertised as though it were a factual, value‐free, and unobjectionable event—to foster organ donation while minimizing controversy. Death determination, however, involves both discoveries of facts and events and decisions about their meaning (whether the facts and events are relevant to establish a vital status), the latter being subjected to legitimate disagreements requiring deliberation. By revisiting the historical origin of the dead donor rule, including some events that took place (...) in France prior to the report by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death, I want to recall that those who first promoted the DDR did not take into account any scientific rationale to support the new proposed criteria to determine death. Rather, through a process of factual re‐semantization, they authorized themselves to decide about the meaning of death in order to implicitly prioritize the interests of organ recipients over those of dying people. (shrink)

The ever‐increasing demand for organs led Spain, France, and other European countries to promote uncontrolled donation after circulatory determination of death (uDCDD). For the same reason, New York City has recently developed its own uDCDD protocol, which differs from European programs in some key ways. The New York protocol incorporates a series of technical and management improvements that address some practical problems identified in response to European uDCDD protocols. However, the more fundamental issue of whether uDCDD donors are dead when (...) organs are procured remains problematic for the New York City protocol and, indeed, for all uDCDD protocols. In the United States, two amendments to the legal criteria of death have been suggested to avoid a formal violation of the dead donor rule in DCDD protocols: first, replacing the requirement “irreversible” with the weaker term “permanent,” and second, using the term “circulatory” instead of “cardiac” to identify the key function that must be lost to declare death. While intended to facilitate controlled DCDD, these modifications create a problem for uDCDD protocols: if extracorporeal membrane oxygenation is introduced to preserve the organs, then circulation is restored after death is declared. In this issue of the Hastings Center Report, Kevin Munjal and colleagues call for a new ethical construct and policy so that uncontrolled and controlled DCDD can coexist. (shrink)

Providing quality education means to respond to the diversity in the classroom. The teacher is a key figure in responding to the various educational needs presented by students. Specifically, special education professionals are of great importance as they are the ones who lend their support to regular classroom teachers and offer specialized educational assistance to students who require it. Therefore, special education is different from what takes place in the regular classroom, demanding greater commitment by the teacher. There are certain (...) behaviors, considered good teaching practices, which teachers have always been connected with to achieve good teaching and good learning. To ensure that these teachers are carrying out their educational work properly it is necessary to evaluate. This means having appropriate instruments. The Observational Protocol for Teaching Functions in Primary School and Special Education (PROFUNDO-EPE, v.3., in Spanish) allows to capture behaviors from these professionals and behavioral patterns that correspond to good teaching practices. In this study the behavior of two special education teachers who carry out their educational work in different contexts is evaluated. It reveals that teachers who were analyzed adapt their behavior depending on the context in which they carry out their educational work, providing the most appropriate response to the needs presented by students and showing good teaching practices. (shrink)

Antonio Caso, “La existencia como economía y como caridad” (1916). Translated with Jose G. Rodriguez Jr. as “Existence as Economy and as Charity,” in 20th Century Mexican Philosophy: Essential Readings, eds. Carlos Alberto Sánchez and Robert Eli Sanchez, Jr. (New York: Oxford University Press, 2017).

Different theoretical models have proposed cognitive and affective components in empathy and moral judgments encompassing compassion. Furthermore, gender differences in psychological and neural functions involving empathic and moral processing, as well as compassionate experiences, have been reported. However, the neurobiological function regarding affective and cognitive integration underlying compassion and gender-associated differences has not been investigated. In this study, we aimed to examine the interaction between cognitive and emotional components through functional connectivity analyzes and to explore gender differences for the recruitment (...) and interaction of these components. Thirty-six healthy participants were exposed to social images in an fMRI session to judge whether the stimuli elicited compassion. The results showed a different connectivity pattern for women and men of the insular cortex, the dorsomedial prefrontal cortex, the orbitofrontal cortex, and the cingulate cortex. The integration of affective and cognitive components follows a complex functional connectivity pattern that is different for both genders. These differences may indicate that men largely make compassionate judgments based on contextual information, while women tend to notably take internal and introspective processes into account. Women and men can use different affective and cognitive routes that could converge in similar learning of moral values, empathic experiences and compassionate acts. (shrink)

The goal of this piece is to put some pressure on Brian O’Shaughnessy’s claim that perceptual experiences are necessarily mental processes. The author targets two motivations behind the development of that view. First, O’Shaughnessy resorts to pure conceptual analysis to argue that perceptual experiences are processes. The author argues that this line of reasoning is inconclusive. Secondly, he repeatedly invokes a thought experiment concerning the total freeze of a subject’s experiential life. Even if this case is coherent, however, it does (...) not show that perceptual experiences are processes. (shrink)

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and (...) nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science. (shrink)

In the context of solving large distributed constraint optimization problems, belief-propagation and incomplete inference algorithms are candidates of choice. However, in general, when the problem structure is very cyclic, these solution methods suffer from bad performance, due to non-convergence and many exchanged messages. As to improve performances of the MaxSum inference algorithm when solving cyclic constraint optimization problems, we propose here to take inspiration from the belief-propagation-guided decimation used to solve sparse random graphs. We propose the novel DeciMaxSum method, which (...) is parameterized in terms of policies to decide when to trigger decimation, which variables to decimate and which values to assign to decimated variables. Based on an empirical evaluation on a classical constraint optimization benchmarks, some of these combinations of policies, using periodic decimation, cycle detection-based decimation, parallel and non parallel decimation, random or deterministic variable selection and deterministic or random sampling for value selection, outperform state-of-the-art competitors in many settings. (shrink)

It is not uncommon for patients with advanced disease to express a wish to hasten death. Qualitative studies of the WTHD have found that such a wish may have different meanings, none of which can be understood outside of the patient’s personal and sociocultural background, or which necessarily imply taking concrete steps to ending one’s life. The starting point for the present study was a previous systematic review of qualitative studies of the WTHD in advanced patients. Here we analyse in (...) greater detail the statements made by patients included in that review in order to examine their moral understandings and representations of illness, the dying process and death. We identify and discuss four classes of assumptions: assumptions related to patients’ moral understandings in terms of dignity, autonomy and authenticity; assumptions related to social interactions; assumptions related to the value of life; and assumptions related to medicalisation as an overarching context within which the WTHD is expressed. Our analysis shows how a philosophical perspective can add to an understanding of the WTHD by taking into account cultural and anthropological aspects of the phenomenon. We conclude that the knowledge gained through exploring patients’ experience and moral understandings in the end-of-life context may serve as the basis for care plans and interventions that can help them experience their final days as a meaningful period of life, restoring some sense of personal dignity in those patients who feel this has been lost. (shrink)

Charles Taylor es comúnmente identificado como uno de los padres fundadores del comunitarismo teórico, pero tal identificación no da cuenta de la amplitud del pensamiento del filósofo canadiense. A través de este trabajo de investigación pretendemos articular la filosofía de Taylor partiendo del proyecto filosófico que explícitamente inicia en sus primeros trabajos, a saber, la configuración de una antropología filosófica, a través de la cual abordaremos los grandes temas que han ocupado su vida -ética, política y religión- en la puesta (...) en marcha de una filosofía con intenciones puramente prácticas.Charles Taylor is commonly identified as one of the founding fathers of theoretical communitarianism, but such identification does not realize the extent of his thinking. Through this research, we try to articulate the Taylor's philosophy from his philosophical project, that he explicitly started in his early work, namely, the configuration of a philosophical anthropology, through which we will address the major issues that have occupied his life - ethics, politics and religion- in the implementation of a philosophy with purely practical intentions. (shrink)

What I call the argument from almost indiscernibles is an argument, put forward by Robert Adams in 1979, for the possibility of indiscernibles based on the possibility of almost indiscernibles. The argument is that if almost indiscernibles are possible, indiscernibles are possible, but since almost indiscernible are possible, indiscernibles are possible. The argument seems to be an improvement over the mere appeal to intuitions, like that suggested by Max Black, that situations in which there are indiscernibles are possible, for the (...) argument purports to give us a reason that indiscernibles are possible. In this paper I shall assess the argument by examining whether there is support for the conditional premise that if almost indiscernibles are possible, indiscernibles are possible. I shall argue that there are reasons to think that either the premise lacks support or almost indiscernibles are dispensable. If the premise lacks support, the argument does not establish the possibility of almost indiscernibles; if almost indiscernibles are dispensable, the argument is not needed to establish the possibility of indiscernibles. (shrink)

In this issue of the Report, James L. Bernat proposes an innovative and sophisticated distinction to justify the introduction of permanent cessation as a valid substitute standard for irreversible cessation in death determination. He differentiates two approaches to conceptualizing and determining death: the biological concept and the prevailing medical practice standard. While irreversibility is required by the biological concept, the weaker criterion of permanence, he claims, has always sufficed in the accepted standard medical practice to declare death. Bernat argues that (...) the medical practice standard may be acceptable on the ground that proving circulatory or brain permanence is sufficient to assure complete accuracy for death diagnosis. -/- The topic requires public deliberation: processes to survey people's opinions and mechanisms to channel their opinions into policy-making. What is at stake is the nature of our society. Do we want an expertocracy, in which an enlightened few design policies for the greater good of the majority and exploit the lack of public knowledge to achieve compliance? (shrink)

El punto de partida de este trabajo es que la idea de autoconservación es constitutiva para la comprensión y el desarrollo histórico de la subjetividad moderna. El análisis kierkegaardiano de la psicología del individuo moderno en La enfermedad mortal retoma y reelabora el tópico de la autoconservación. Anti-Climacus (el pseudónimo kierkegaardiano) sostiene que los seres humanos no están ocupados con el mantenimiento de un yo ya determinado y concluido; sino, más bien, con la constitución misma de ese yo. En su (...) exposición, él considera que la potenciación de la auto-constitución puede conducir a la autodestrucción. Este artículo procura interpretar la desesperación como autodestrucción y ofrecer, desde dicha interpretación, una comprensión consistente de sus dos modalidades principales: no querer ser sí mismo y querer ser sí mismo. Por último, el artículo considera la posibilidad de superación de la desesperación y concluye reflexionando en torno al desarrollo moderno del concepto de autoconservación. (shrink)