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      Comités de ética asistencial: de los grandes dilemas a los nuevos desafíos Translated title: Health Care Ethics Committees: from great dilemmas to new challenges Translated title: Comitês de ética assistencial: dos grandes dilemas aos novos desafios

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          Abstract

          Resumen Los avances científico-tecnológicos revolucionaron la historia de la medicina. En este artículo, procuramos realizar un breve análisis de los principales dilemas éticos que han surgido como consecuencia del desarrollo tecnológico a partir de la mitad del siglo XX, y procuramos focalizar en el estudio acerca de cómo han abordado estas cuestiones los primeros comités de bioética del mundo. Empeza por la Comisión de Seattle hasta considerar las propuestas sobre la autonomía del paciente, se destaca la creciente toma de conciencia sobre los nuevos escenarios en que se desarrolla la relación médico-paciente, la cual paulatinamente ha dejado de ser diádica para dar cabida a la participación de diversos actores.

          Translated abstract

          Abstract Scientific and technological advances have revolutionized the history of medicine. In this article, we aim to provide a brief analysis of the major ethical dilemmas that have emerged since the middle of the twentieth century as a result of technological developments, and analyze the way in which the first bioethics committees approached these issues. Beginning with the Seattle Committee and continuing to consider proposals regarding patient autonomy, we highlight the growing awareness of doctors and patients of new scenarios in which the patient-doctor relationship is no longer dyadic but has expanded to allow the participation of other actors.

          Translated abstract

          Resumo Os avanços científicos e tecnológicos revolucionaram a história da medicina. Neste trabalho, propomos fazer uma breve análise dos principais dilemas éticos que surgiram como resultado do desenvolvimento tecnológico desde meados do século XX e nos concentramos em um estudo de como os primeiros comitês de bioética no mundo tinham abordado estas questões. Começando com a Comissão de Seattle até considerar as propostas sobre a autonomia do paciente, chamamos a atenção para a crescente conscientização de médicos e pacientes sobre novos cenários em que a relação médico-paciente se desenvolve, tendo em conta que já não é uma relação diádica, mas tem sido estendida para permitir a participação de novos atores.

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          Fundamentos d. Bioética

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            Deciding to forego lifesustaining treatment: a report on the ethical, medical, and legal issues in treatment decsions

            (1983)
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              The Early Years of Chronic Dialysis:The Seattle Contribution

              Long-term hemodialysis for chronic renal failure first became possible with development of the Teflon shunt by Belding Scribner and coworkers at the University of Washington, Seattle, in 1960. Over the next 4 years, many of the advances in dialysis occurred in Seattle. These included recognition and treatment of complications such as malignant hypertension, gouty episodes due to uric acid accumulation, subcutaneous calcification, anemia, iron overload, and peripheral neuropathy. Technical advances included improving the shunt, and in collaboration with Professor A.L. Babb, development of a proportioning system to make dialysate from concentrate and water and the first automated home hemodialysis machine. Dr. Boen and Dr. Tenckhoff developed automated peritoneal dialysis equipment and peritoneal access devices. The world’s first outpatient dialysis center, the Seattle Artificial Kidney Center, was established in 1962, and used an anonymous lay committee to select from medically suitable patients those to be treated by the center. This triage was an important step in the development of biomedical ethics, and in 1964, Scribner’s presidential address to the American Society for Artificial Internal Organs discussed the problems of patient selection, termination of treatment, patient suicide, death with dignity, and selection for transplantation.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                bioet
                Revista Bioética
                Rev. Bioét.
                Conselho Federal de Medicina
                1983-8034
                April 2016
                : 24
                : 1
                : 91-97
                Affiliations
                [1 ] Argentina
                [2 ] Argentina
                [3 ] Universidad de Buenos Aires Argentina
                Article
                S1983-80422016000100091
                10.1590/1983-80422016241110
                65274fd8-c68f-4e95-83e6-c29074d1e5fa

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1983-8042&lng=en
                Categories
                ETHICS
                MEDICAL ETHICS

                General medicine,Ethics
                Comités de ética clínica,Bioética,Ciencia-Crecimiento y desarrollo,Committees,Bioethics,Scientific advances,Comitê de ética clínica,Ciência-Crescimento e desenvolvimento

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