En las unidades de cuidados intensivos el equipo de salud utiliza todas las medidas posibles para preservar la vida de sus pacientes. No obstante, cuando las terapias son fútiles, se decide limitar el esfuerzo terapéutico. Este artículo tiene como objetivo describir los factores que pueden llevar a enfermería a deshumanizar sus cuidados en pacientes en LET en UCI. Revisión de la literatura en bases de datos, con las palabras clave: critical care, intensive care unit, limitation of therapeutic effort, end of (...) life care, humanized/human care, nursing. Los hallazgos fueron agrupados en seis categorías que pueden influir en la deshumanización del cuidado en UCI. Se concluye que en el cuidado humanizado se destacan los roles de enfermería como defensora de los intereses del paciente y como agente comunicador. (shrink)

Voluntades anticipadas: desafíos éticos en el cuidado del paciente Diretivas antecipadas de vontade: desafios éticos no cuidado do paciente Advance healthcare directives are intended for the individual to personally express their will and preferences about healthcare and treatment ahead of time. This literature review aims to describe the concept and structure of advance directives and the ethical aspects involved in patient care. Using the keywords “Advance Healthcare Directive” AND “Ethical Implication” and its Spanish equivalents, five databases were accessed: ProQuest, Philosophy, (...) PubMed, Web of Science and Scielo. Publications were narrowed down to the 2010-2018 period. Thirty-one articles were obtained and read critically. Results of this review were grouped into the following categories: concept, structure, clinical situations in which advance directives apply, strengths and limitations, as well as the ethical aspects involved. End of life-related experiences in which a person loses their ability to make decisions and cannot express their wishes, so it is impossible to know their will, are more common nowadays. Most health workers are not appropriately trained in the preparation and application of advance directives, which becomes an opportunity to research and delve deeper into the subject. Advance directives are a tool that gives health workers reliable information on a patient’s values and wishes, so it is vital to train them to provide respectful quality care. Para citar este artículo / To reference this article / Para citar este artigo Forero J, Vargas I, Bernales M. Voluntades anticipadas: desafíos éticos en el cuidado del paciente. Pers Bioet. 2019;23:224-244. DOI: https://doi.org/10.5294/pebi.2019.23.2.5 Recibido: 26/01/2019 Aceptado: 22/08/2019. (shrink)

Durante la crisis sanitaria mundial, gobiernos dictan medidas de emergencia; universidades peruanas interrumpieron la labor académica e inician enseñanza remota. Se analizan los cambios en el proceso de enseñanza no presencial y la adaptación de docentes a la enseñanza virtual. Es una investigación mixta, realizando regresiones y caracterizando cada componente. Se identifican brechas de conectividad, conocimiento en herramientas digitales, enfoque pedagógico y, tecnológico; que afectan eficiencia y productividad docente del proceso de enseñanza no presencial. La comunidad universitaria requiere desarrollar y (...) reforzar nuevas capacidades tecnopedagógicas hacia la educación híbrida en un escenario de nueva normalidad. (shrink)

While philosophical questions about health and disease have attracted much attention in recent decades, and while opinions are divided on most issues, influential accounts seem to embrace negativism about health, according to which health is the absence of disease. Some subscribe to unrestricted negativism, which claims that negativism applies not only to the concepts of health and disease as used by healthcare professionals but also to the lay concept that underpins everyday thinking. Whether people conceptualize health in this manner has (...) implications for medical care and public health, and so we set out to examine this claim in two studies. Participants were asked to assess and compare the health states of two people presented in two vignettes. We found that both lay people and medical students conceptualize health as something more than the absence of disease. We argue that our findings highlight a need to rethink unrestricted negativism and indicate a need to rethink the way the debate has traditionally focused on disease. (shrink)

Are proneness to forgive, optimism and gratitude associated with life satisfaction? The main aim of the current study was to examine whether and how life satisfaction is related to propensity to forgive one's transgressor. Additionally, it also explored the relationship between life satisfaction and other chosen psychological variables, such as optimism and gratitude. The study involved 338 persons between 16 and 83 years of age. For the measurement of psychological variables the following research tools were used: Satisfaction With Life Scale, (...) Transgression-Related Interpersonal Motivations Inventory, Gratitude Questionnaire, and Learned Optimism Test. Among the study participants satisfaction with life was positively correlated with the conviction about a permanent and ubiquitous nature of positive events, optimism and gratitude. The study also observed a negative correlation between satisfaction with life, the motivation for revenge and avoidance motivation, and the perception of a permanent and ubiquitous nature of adverse events. (shrink)

While many profound philosophical questions arise about psychopaths, I wish to draw attention to two limitations in current debates. First, philosophers mainly deal with offender and forensic populations neglecting so-called ‘successful’ psychopaths. Second, philosophers mainly focus on the issue of empathy and responsibility, while relatively little attention is paid to volitional aspects. I address these two limitations together and argue that ‘successful’ psychopaths are volitionally constrained. In order to grasp and explore this deficiency, I argue in favour of a more (...) refined and fine-grained understanding of identifications. (shrink)

In this paper I criticize libertarianism and skepticism about free will. The criticism of libertarianism takes some steps towards filling in an argument that is often mentioned but seldom developed in any detail, the argument that libertarianism is a scientifically implausible view. I say "take some steps" because I think the considerations I muster (at most) favor a less ambitious relative of that argument. The less ambitious claim I hope to motivate is that there is little reason to believe that (...) extant libertarian accounts satisfy a standard of naturalistic plausibility, even if they do satisfy a standard of naturalistic compatibility. The argument against skepticism about free will tries to show (1) perhaps the most prominent form of skeptical argument against the existence of free will does not work, and (2) there is a good general argument against skepticism about free will. (shrink)

A partir del contexto que la crisis de la modernidad delimita, la función de la técnica ha sido objeto de controversia en el pensamiento del siglo XX. Esta aportación pretende dar cuenta de la concepción que Ortega y Blumenberg tuvieron de la técnica y de cómo se articula esa idea en su filosofía. A su vez, también pretende establecer los puntos de unión que existen en las ideas sobre la técnica que ambos filósofos defendieron en tanto que estas ideas tienen (...) validez para pensar hoy nuestra realidad. La comprensión de la técnica como el medio propio del ser humano para la realización de su proyecto vital y para su autoafirmación ofrece una mirada positiva frente a discursos que demonizan la técnica. (shrink)

Artículos Naturaleza, carácter y violencia: derivas a partir de Schopenhauer. Nature, character and violence: roads from Schopenhauer. Grave, Crescenciano Sobre la posibilidad de un fundamento analógico y simbólico. Ensayo de hermenéutica analógica. About the possibility of an analogical and symbolic fundament. Essay of analogical hermeneutic.Maldonado, Rebeca Consideraciones biojurídicas sobre la vida en el embrión humano. Biojuridical considerations on life of the human embryo. Parra Tapia, Ivonne La Europa unificada según Leibniz: irenismo y política. A unified Europe according to Leibniz: (...) irenism and politics. Rensoli Laliga, Lourdes Repensar el "dilema" comunitarista-liberal en Venezuela. To rethink the communitarism-liberalism "dilemma" in Venezuela. Seoane C., Javier B. Una introducción a la doctrina platónica del alma. An introduction to the platonic doctrine of the soul. Suzzarini, Andrés De vuelta al tribuno. Back to the tribune. Terán Pimentel, Milagros Discusiones en torno a la reparación del daño moral. Discussions about the redress of pain and suffering. Vielma Mendoza, Yoleida Interdisciplinares El giro en la obra de Milan Kundera: un reflejo de la contemporaneidad. The turning on Milan Kundera´s work: a reflex of contemporaneity. Pérez Lo Presti, Alirio Aproximación histórica sobre el consumo de drogas en Venezuela. Historical approach about drug consumption in Venezuela. Salazar, Teresa Informaciones Índice acumulado. (shrink)

In this paper, we explore the conception of nature as a book in Francis Bacon. On the one hand, using this image and confronting the reading of the book of nature and the reading of the books of established authors, Bacon contrasts two completely different ways of the natural philosophy: the Interpretation of Nature in contrast to the Anticipation of the Mind. On the other hand, by considering the revealed book and the book of creatures, Bacon contends for the specificity (...) of the scientific investigation of nature and its relative autonomy in relation to the sphere of religion, although he indicates the character of continuity and complementation of the two books of the same authorship. (shrink)

There is a familiar chain of reasoning that goes something like this: if everything is caused, no one is free, and thus, no one can be morally responsible. Reasoning like this has made scientific explanations of human behavior (e.g., biology, psychology, and neuroscience) threatening to familiar ideas of responsibility, blameworthiness, and merit. Rather than directly attacking the chain of reasoning that gives rise to these worries, I explore an alternative approach, one that begins by considering the "use" of moral responsibility. (...) What role does the concept play for us? What structure, if any, would an ideal set of practices and attitudes about moral responsibility have to it? I outline a new account of responsibility and consider what it might mean for traditional worries about causal, scientific explanations of human behavior. (shrink)

This article explores the respective roles that medical and technological cognitive enhancements, on the one hand, and the moral and epistemic virtues traditionally understood, on the other, can play in enabling us to lead the good life. It will be shown that neither the virtues nor cognitive enhancements (of the kind we have access to today or in the foreseeable future) on their own are likely to enable most people to lead the good life. While the moral and epistemic virtues (...) quite plausibly are both necessary and sufficient for the good life in theory, virtue ethics is often criticised for being elitist and unachievable in practice for the vast majority. Some cognitive enhancements, on the other hand, might be necessary for the good life but are far from sufficient for such an existence. Here it will be proposed that a combination of virtue and some cognitive enhancements is preferable. (shrink)

Se aborda la crítica que realiza Nélida Piñon, desde la postura de la teoría feminista que rompe con los esquemas tradicionales de la subordinación de la mujer en la cultura occidental; deconstruye la dicotomía hombre-mujer a través de un lenguaje poético erotizado que parte del cuerpo de la mujer para articular su propia experiencia. Esto lo convierte en texto clave dentro de la tradición de la escritura femenina.

Resumen En este artículo se examina el Darwinismo Neural en su explicación de la evolución de la conciencia humana, contrastando su metodología con la utilizada por Richard Lewontin, Richard Levins y Steven Rose, quienes han hecho importantes aportaciones en el estudio de los sistemas vivos desde un punto de vista dialéctico. Concluimos que la explicación interaccionista de la evolución de la conciencia planteada en el DN, supera muchas de las deficiencias del determinismo biológico; sin embargo, al compartir algunos lineamientos con (...) el cartesianismo, mantiene un carácter a-histórico insuficiente para la explicación de la conciencia humana. Finalmente, proponemos la adopción de una teoría explicativa de la conciencia humana que considere las relaciones existentes en ella, no sólo como interacciones sino también como interpenetraciones ontogénicas y filogenéticas.This article examines Neural Darwinism proposed as an explanation of evolution of human consciousness. His methodology is contrasted with that used by Richard Lewontin, Richard Levins, and Steven Rose, who made important contributions to the study of living systems from a dialectical point of view. We conclude that the interactionist explanation of the evolution of conscience put forward in ND overcomes many of the deficiencies proper to biological determinism. However, as ND also shares many of the foundations of the Cartesian approach, it maintains a non-historical character, insufficient for the account of human consciousness. We suggest the adoption of an alternative theory, able to fully explain human conscience which must consider the whole of existing relations in it, and, instead of merely considering them as interactions, they have to be observed as dialectical interpenetrations. (shrink)

La teoría “coaseana” del derecho, y el Análisis Económico del Derecho en general, asumen implícitamente la veracidad de dos premisas comportamentales: la “exogeneidad de la preferencia” y la “independencia de la referencia”. Este artículo señala algunas objeciones a estas premisas, luego evidencia algunas implicaciones acerca de: cómo el AED –desde un punto de vista positivo– pronostica los comportamientos de las personas y los efectos de las normas jurídicas entendidas como incentivos, y cómo, –desde un punto de vista normativo– la teoría (...) económica sugiere las decisiones del juez o del legislador. El artículo además presenta los desafíos a los que se enfrenta el AED al aceptarse la premisa comportamental de que las personas valoran los derechos individuales, no en términos absolutos, sino en términos relativos, comparados con un punto de referencia. (shrink)

O presente texto não pretende ser um artigo analítico sobre Bourdieu mas um ensaio escrito da perspectiva de uma cientista política sobre as possibilidades abertas pela teoria desenvolvida pelo sociólogo francês para o estudo dos fenômenos da política. Com este propósito trabalharei com as noções de campo e capitais.

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for a biomedical (...) understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothe- sis is that clinical understanding combines biomedical understanding of a disease or pathological condition with understanding illness, which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. (shrink)

There is increasing interest in determining what impact having women in management positions may have on corporate social responsibility initiatives. Various authors suggest that gender equality practices should be factored into the broader framework of CSR. This paper examines how the presence of women on corporate boards, in top and middle management and as heads of CSR departments, influences gender equality practices in the field of CSR. Using information collected from companies that have signed up to Women's Empowerment Principles in (...) Spain, we show that the presence of women in the aforesaid posts has a positive impact on CSR activities with gender equality objectives. We thus supplement the justice, business and moral arguments with further arguments in support of the incorporation of women into not only corporate boards but all management positions. Finally, we provide a view of how gender equality can be included in the broader framework of CSR. (shrink)

We sometimes fail unwittingly to do things that we ought to do. And we are, from time to time, culpable for these unwitting omissions. We provide an outline of a theory of responsibility for unwitting omissions. We emphasize two distinctive ideas: (i) many unwitting omissions can be understood as failures of appropriate vigilance, and; (ii) the sort of self-control implicated in these failures of appropriate vigilance is valuable. We argue that the norms that govern vigilance and the value of self-control (...) explain culpability for unwitting omissions. (shrink)

The importance of socio-economic impacts from the introduction and use of genetically modified crops is reflected in increasing efforts to include them in regulatory frameworks. Aiming to identify and understand the present knowledge on SEI of GM crops, we here report the findings from an extensive study of the published international scientific peer-reviewed literature. After applying specified selection criteria, a total of 410 articles are analysed. The main findings include: limited empirical research on SEI of GM crops in the scientific (...) literature; the main focus of the majority of the published research is on a restricted set of monetary economic parameters; proportionally, there are very few empirical studies on social and non-monetary economic aspects; most of the research reports only short-term findings; the variable local contexts and conditions are generally ignored in research methodology and analysis; conventional agriculture is the commonly used comparator, with minimal consideration of other substantially different agricultural systems; and there is the overall tendency to frame the research upon not validated theoretical assumptions, and to over-extrapolate small-scale and short-term specific results to generalized conclusions. These findings point to a lack of empirical and comprehensive research on SEI of GM crops for possible use in decision-making. Broader questions and improved methodologies, assisted by more rigorous peer-review, will be required to overcome current research shortcomings. (shrink)

Esta investigación se efectuó en ocho defensorías de la mujer (dos privadas y seis públicas) con el propósito de caracterizar los servicios que prestan las mismas y reflexionar sobre los mecanismos de prevención que efectúan contra de la violencia conyugal en el municipio de Sucre–Bolivia. La técnica de recolección de la información que se utilizó fue la entrevista semiestructurada. Los resultados del estudio giran en torno a tres grandes categorías: (1) servicios que brindan, (2) características de la población beneficiaria y (...) servicios que solicitan, y (3) características de las y los profesionales y de sus puestos de trabajo. (shrink)

El trabajo doméstico y de cuidados que es realizado en su gran mayoría por las mujeres es invisibilizado y no es reconocido en una sociedad que privilegia el trabajo remunerado en el espacio público realizado, en gran medida, por los hombres. Este desprecio por el cuidado del hogar y la familia ocasiona que las mujeres vayan acumulando grandes desventajas a lo largo de su vida por lo que, al llegar a la vejez, experimentan con mayor recrudecimiento las desigualdades.

The veins are cuticular structures that differentiate in precise patterns in insect wings. The genetic and molecular basis of vein pattern formation in Drosophila melanogaster is beginning to be unravelled with the identification and characterisation of the gene products that position the veins and direct their differentiation. Genes affecting the veins fall into two groups: transcriptional regulators that specify individual veins, and members of signalling pathways involved in patterning and differentiation of the veins. The elaboration of the vein pattern is (...) progressive in time and requires the coordinated activities of these signalling pathways and the transcription factors regulated by them. Although the network of genetic interactions that determine vein cell fate is well understood, very little is known about the cellular biology underlying the acquisition of vein histotype. BioEssays 25:443–451, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Nombreux sont les artistes qui, au cours des années soixante, ont écrit pour la revue Artforum, qui demeure, encore aujourd’hui, l’une des plus importantes publications artistiques. Certains de ces écrits s’inscrivent dans des formats journalistiques, quelques-uns sont des compositions faisant appel à des catégories littéraires, d’autres suivent les formes académiques de l’essai et de la dissertation et, enfin, s’ajoutent à ceux-ci des travaux conceptuels ayant le statut d’œuvres d’art. Cet article étudie la manière dont cette revue a contribué à rendre (...) visible la parole des artistes entre 1962 et 1967, du moment de son émergence jusqu’au numéro d’été où figurent des textes incontournables pour le monde de l’art, tels que « Notes on Sculpture » de Robert Morris, « Towards the Development of an Air Terminal Site » de Robert Smithson, ou encore « Paragraphs on Conceptual Art » de Sol LeWitt. D’après une analyse effectuée sur les cinq volumes parus au cours de cette période, un total de 36 % des articles a été rédigé par des artistes. (shrink)

I discuss the ontology and normativity of affordances by suggesting that their ontology can be dualist and that their normativity, although socioculturally shaped, has an affective biological value….

It is common to distinguish between “holist” and “reductionist” views of brain function, where the former envisions the brain as functioning as an indivisible unit and the latter as a collection of distinct units that serve different functions. Opposing reductionism, a number of researchers have pointed out that cortical network architecture does not respect functional boundaries, and the neuroanatomist V. Braitenberg proposed to understand the cerebral cortex as a “great mixing machine” of neuronal activity from sensory inputs, motor commands, and (...) intrinsically generated processes. In this paper, we offer a contextualization of Braitenberg’s point, and we review evidence for the interactions of neuronal activity from multiple sensory inputs and intrinsic neuronal processes in the cerebral cortex. We focus on new insights from studies on audiovisual interactions and on the influence of respiration on brain functions, which do not seem to align well with “reductionist” views of areal functional boundaries. Instead, they indicate that functional boundaries are fuzzy and context dependent. In addition, we discuss the relevance of the influence of sensory, proprioceptive, and interoceptive signals on cortical activity for understanding brain-body interactions, highlight some of the consequences of these new insights for debates on embodied cognition, and offer some suggestions for future studies. (shrink)

Our EcoDialogue Center is an educational space for human sustainability within the University of Veracruz. We propose that creating sustainable knowledge requires re-thinking how we conceive ourselves as human beings. This requires paying attention to what we call “the quality of being,” which means caring about and attending to the physical–emotional–mental–spiritual as the foundation of education. This way we can create a space where we can dialogue contemplatively where all dimensions of our lives interact; the physical, the emotional, the communitarian, (...) the social politic, the planetarium, and the spiritual being act with social–environmental responsibility. (shrink)

Neil Levy (2007) argues that empirical data shows that psychopaths lack the moral knowledge required for moral responsibility. His account is intriguing, and it offers a promising way to think about the significance of psychopaths for work on moral responsibility. In what follows we focus on three lines of concern connected to Levy's account: his interpretation of the data, the scope of exculpation, and the significance of biological explanations for anti-social behavior.

O escopo do artigo é examinar a tese hobbesiana de que todo efeito possui uma causa necessária, indicando como o filósofo a demonstra de modos diferentes, mas complementares: em primeiro lugar, tanto por meio da identificação entre causa integral, causa suficiente e causa necessária, como pela redefinição dos conceitos de potência e ato; em segundo, através da subordinação do princípio de bivalência à determinação necessária dos eventos; e, por fim, pela defesa de que só por meio de uma causa necessária, (...) causa que opera mecanicamente por meio de contato, é possível dar a razão pela qual os eventos possuem tais determinações espaciotemporais ao invés de outras, de modo que a causalidade mecânica necessária se estabelece como o único tipo legítimo de explicação dos fenômenos em Hobbes, transformando-se, então, na forma geral da inteligibilidade. (shrink)

O conceito de potentia possui uma pluralidade de sentidos na obra de Hobbes, sendo empregado na física, na antropologia, nas reflexões sobre o direito e sobre a política, bem como no discurso sobre Deus e seus atributos. Neste artigo, o exame será circunscrito ao conceito hobbesiano de potência (power) no Short Tract em seu diálogo com a tradição aristotélica da potência e do ato, isto é, ao conceito físico de potência por meio do qual os movimentos são explicados. O que (...) pretendo indicar é que já nessa obra esse conceito se forjou em oposição ao conceito aristotélico e à tradição escolástica, por mais que essa primeira formulação da noção de potência seja problemática. Hobbes fundamenta uma dupla fonte do determinismo no Short Tract, fonte que se tornará una com a reformulação do conceito de potência nos textos posteriores, como exporei na segunda parte do artigo. (shrink)

Moral psychology is the study of how human minds make and are made by human morality. This state of the art volume covers contemporary philosophical and psychological work on moral psychology, as well as notable historical theories and figures in the field of moral psychology, such as Aristotle, Kant, Nietzsche, and the Buddha. The volume’s 50 chapters, authored by leading figures in the field, cover foundational topics, such as character, virtue, emotion, moral responsibility, the neuroscience of morality, weakness of will, (...) and the nature of moral judgments and reasons. The volume also canvases emerging work in applied moral psychology, including adaptive preferences, animals, mental illness, poverty, marriage, race, bias, and victim blaming. (shrink)

This article addresses the relationships between dialectic and learning within the constellations of the conceptual universes of Adorno and Vygotsky. In that order, we proceed to analyze the set of links between the main dialectical categories that structure the dialectical approach that characterizes both representatives of the Marxist thought tradition (process, totality, mediation, fields of force, antagonism, praxis) and the communicating vessels that go from epistemology to aesthetics and that demonstrate the relevance of the tasks of thought in the face (...) of social transformation. Finally, the article addresses the question of an (im)possible analytical horizon that arises, from both thinkers, to emphatically think about social emancipation and its challenges today. (shrink)