Resumen:El objetivo del artículo es destacar las limitaciones del cientificismo a la hora de dar cuenta de la vivencia humana en toda su significación y correlativamente afirmar la necesidad de concebir al ser humano desde una perspectiva comprensiva, vía apropiada para un encuentro intercultural fecundo. Para ello se acude al enfoque de Charles Taylor. En primer lugar, se recala en la diferencia sustantiva entre las “ciencias naturales” y las “ciencias sociales”. En segundo lugar, se incide en la importancia de una (...) metodología hermenéutica en las ciencias sociales, a fin de superar el doble riesgo de etnocentrismo y de la tesis relativista de la incorregibilidad cultural. Por último, se presenta el dialogo intercultural como vía adecuada hacia una autocrítica de las culturas y una comprensión ampliada entre los seres humanos.Palabras clave: ciencias sociales; cosmovisión; hermenéutica; etnocentrismo; interculturalidad. (shrink)

Resumen El objetivo de este artículo es repensar el tipo de epistemología más adecuada para entender otras culturas. Para ello se acude al enfoque de Charles Taylor. En primer lugar, se analiza la epistemología moderna mediacional y se destacan las deficiencias que comporta para dar razón del vínculo de las personas y las sociedades con el mundo. En segundo lugar, se pone de manifiesto la deficiencia que implica este modelo epistemológico para dar cuenta del entendimiento mutuo entre las personas. Más (...) en concreto, se incide en la deficiencia en términos atomistas y monologistas que dicha imagen representacional comporta a la luz del argumento holístico del trasfondo. Por último, ahondando en el argumento holístico del trasfondo se propone un modelo alternativo de epistemología basada en la concepción del agente encarnado en la cultura. Un modelo que conjuga realidad y pluralidad y se propone superar tanto el realismo clásico como el relativismo. Abstract The aim of this article is to rethink the most appropriate type of epistemology to understand other cultures. For this, the approach of Charles Taylor is used. In the first place, we discuss modern mediational epistemology and the deficiencies it entails to account for the link between people and societies with the world. Secondly, the deficiency that this epistemological model implies to account for the mutual understanding between people. More specifically, it focuses on the deficiency in atomistic and monologistic terms that representational image entails considering the holistic argument of background. Finally, delving into the holistic argument of the background, an alternative model of epistemology based on the conception of the agent embodied in culture is proposed. A model that combines reality and plurality and aims to overcome both classical realism and relativism. (shrink)

This article examines the emerging possibility of “brain-state transitioning,” in which one brain state is prompted through manipulating the dynamics of the active brain. The technique, still in its infancy, is intended to provide the basis for novel treatments for brain-based disorders. Although a detailed literature exists covering topics around brain-machine interfaces, where targets of brain-based activity include artificial limbs, hardware, and software, there is less concentration on the brain itself as a target for instrumental intervention. This article examines some (...) of the science behind brain-state transitioning, before extending beyond current possibilities in order to explore philosophical and ethical questions about how transitions could be seen to impact on assessment of responsibility and personal identity. It concludes with some thoughts on how best to pursue this nascent approach while accounting for the philosophical and ethical issues. (shrink)

Movies can serve valuable didactic purposes teaching clinical ethics to medical students. However, using film sequences as means to develop critical thinking is not a straightforward task. There is a significant gap in the literature regarding how to analyse the ethical content embedded in these clips systematically, in a way that facilitates the students’ transition from anecdotal reflections to abstract thinking. This article offers a pedagogical proposal to approach the ethical analysis of film sequences in a systematic fashion. This structured (...) stepwise method encourages students to identify the main ethical problem of a selected scene and to reflect on the theoretical principles involved, emphasizing the application of these norms and values in a contextually situated analysis. We believe this method in film studies both reinforces the students’ comprehension of the theoretical framework of an ethical topic, and casts light on its pertinence and limitations under the circumstances of the scene, thus proving a constructive tool to strengthen the bridge between the theoretical teaching of clinical ethics and clinical practice. (shrink)

Background Ethical conflicts generate difficulties in daily clinical activity. Which methods of ethical advice are most frequently used to resolve them among Spanish doctors has not been studied. The objective of this study is to describe what methods hospital internal medicine physicians in Spain use to resolve their ethical doubts and which they consider most useful. Design A cross-sectional observational study was conducted through a voluntary and anonymous survey and distributed through an ad hoc platform of the Spanish Society of (...) Internal Medicine. Measures We measured methods by which to resolve doubts, types of tools sought, frequency of consulting the Clinical Ethics Committees, and satisfaction with resolution of ethical issues. Results Of 261 internists surveyed, 86 per cent resolve their ethical doubts with assistance, the most frequently used method being consultation with colleagues (58.6 per cent), followed by using specific protocols or guides (11.8 per cent) and consultation with experts in bioethics (9.6 per cent). The most preferred tools are the creation of protocols (30.3 per cent) and the establishment of a consultant/expert in bioethics (27.8 per cent). Conclusions Internists in Spain usually seek assistance to resolve their ethical doubts. Consulting colleagues is the most frequently adopted method. The majority regard tools to resolve ethical conflicts as necessary, seeking above all protocols and consultants/experts in bioethics. (shrink)

Eight focus groups were conducted in four public hospitals in Madrid to explore healthcare professionals’ perceptions of advance directives in order to improve the understanding of their lack of success among physicians and patients. A purposive sample of sixty healthcare professionals discussed ADs and reasons for their infrequent use. Three main themes were identified: perceptions about their meaning, appraisals of their use in clinical practice, and decision-making about them. Healthcare professionals perceived a lack of clarity about their definition and implementation. (...) There is insufficient awareness of their efficacy in improving the quality of clinical relationships and decision-making, and they are often perceived only as a bureaucratic procedure. Advance directives are not integrated in the clinical practice of Madrid’s healthcare specialist services because their application is exceedingly complex, because of insufficient education about them, and because of lack of procedural clarity. Consequently, healthcare professionals are not aware of how ADs could improve clinical decision-making, of when and for whom their use is appropriate, and of who has responsibility for providing ADs-related information to patients. These circumstances contribute to patients’ lack of interest in completing these documents and to physicians’ sceptical views about their usefulness. (shrink)

Background During the first weeks of March 2020 in Spain, the cases of severe respiratory failure progressively increased, generating an imbalance between the clinical needs for advanced life support (ALS) measures and the effective availability of ALS resources. To address this problem, the creation of triage committees (TC) was proposed, whose main function is to select the best candidates to receive ALS. The main objective of our study is to describe the clinical characteristics of the patients evaluated by the TC (...) of the Alcorcón Foundation University Hospital (AFUH) during the first wave of SARS CoV-2. Other objectives are to determine if there are differences between the patients considered candidates / not candidates for ALS and to analyze the functioning of the TC. Methods Retrospective observational study of all patients assessed by the AFUH TC. Results There were 19 meetings, in which 181 patients were evaluated, 65.4% male and with a mean age of 70.1 years. 31% had some degree of functional dependence, the Barthel median was 100 and Charlson 4. 58.5% were not considered a candidate for ALS at that time. The patients considered candidates to receive ALS were younger (72 vs 66; _p_ Conclusions The patients evaluated by the TC had a mean age of 70 years, high comorbidity and almost a third had some degree of functional dependence. More than half were not considered candidates for ALS at that time, these patients being older, with more comorbidity and a worse previous functional situation. TC decisions, based on objective clinical criteria, were almost always respected. Public institutions must get involved in triage procedures, which should and in our opinion must include the creation of TC in health centers. The implementation of Anticipated Decision programs (ADP) would help enable patients affected by triage decisions to participate in them. (shrink)