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      CONFLICTOS ÉTICOS QUE SE PRESENTAN A MÉDICOS DE TRES CENTROS HOSPITALARIOS DE BOGOTÁ, COLOMBIA Translated title: ETHICAL CONFLICTS PRESENTED TO DOCTORS IN THREE HOSPITALS IN BOGOTÁ, COLOMBIA Translated title: CONFLITOS ÉTICOS APRESENTADOS AOS MÉDICOS DE TRÊS CENTROS HOSPITALARES DE BOGOTÁ, COLÔMBIA

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          Abstract

          La transformación del sistema de salud colombiano a partir de la Ley 100/1993 planteó nuevos conflictos éticos a los médicos. Como parte de una tesis doctoral cuyo objetivo general era comprender las tensiones que emergen entre los tipos de clima ético organizacional y los conflictos éticos que se presentan a médicos y enfermeros en tres instituciones prestadoras de salud (IPS) de Bogotá, se propuso identificar y describir los conflictos éticos que se presentan a los médicos y la manera como los resuelven, para que fuera posible indagar si desde los comités de ética pueden resolverse estos conflictos, como ha sido sugerido por algunos bioeticistas. Para ello se realizaron 23 entrevistas a médicos que laboraban en tres centros hospitalarios con servicios de alta complejidad de Bogotá: uno público, uno privado y uno de un régimen especial. Los resultados sugieren la presencia de conflictos de interés, por una parte, y conflictos de obligación que se expresan como dilemas éticos y angustia moral, por otra. Con base en ello, se formulan recomendaciones para la formación profesional, la investigación y los comités de ética hospitalarios.

          Translated abstract

          The transformation of the Colombian health system from the 100/1993 law raised new ethical conflicts to physicians. As a part of a doctorate thesis oriented to understand emerging tensions among ethical climate and ethical conflicts faced by physicians and nurses in three hospitals located in Bogota, it was proposed to identify and describe the ethical conflicts presented to physicians and the way they are faced. In order to achieve this goal, 23 interviews were carried out with physicians who worked in three hospitals located in Bogota: one private, one public and one with a special regime. The results suggest the presence of interest conflicts on the one hand, and commitment conflicts expressed as ethical dilemmas and moral distress on the other. Based on these results, recommendations to physicians education, research and committees of ethics are suggested.

          Translated abstract

          A transformação do sistema de saúde colombiano a partir da Lei 100/1993 levantou novos conflitos éticos para os médicos. Como parte de uma tese de doutorado cujo objetivo geral foi compreender as tensões que surgem entre os tipos de clima ético organizacional e os conflitos éticos apresentados aos médicos e enfermeiros em três instituições de saúde (IPS) em Bogotá, propôs-se a identificar e descrever os conflitos éticos apresentados aos médicos e como eles os resolvem, para que seja possível pesquisar si a partir dos comitês de ética esses conflitos podem se resolver, como foi sugerido por alguns bioeticistas. Para isso foram realizadas 23 entrevistas com médicos que trabalhavam em três centros hospitalares com serviços de alta complexidade de Bogotá: um público, um privado e um de regime especial. Os resultados sugerem da presença de conflitos de interesses, por um lado, e conflitos de obrigação que são expressos como dilemas éticos e sofrimento moral, do outro lado. Com base nisso, são formuladas recomendações para a formação profissional, a investigação e os comitês de ética hospitalares.

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          Making Sense of Intimate Partner Violence in Late Life: Comments From Online News Readers

          The purpose of this study was to gain insight into public awareness of intimate partner violence (IPV) in late life by how individuals respond to incidents of IPV reported in the newspaper.
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            Nurse moral distress and ethical work environment.

            This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity.
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              Verbal and physical abuse against nurses in Turkey.

              This study of verbal and physical abuse against nurses in Turkey aimed to describe prevalence, sources, important effects on work, family and social life of the nurses, coping methods and factors. A sample of 622 nurses working in eight hospitals located in the capital city of Turkey was surveyed using verbal and physical abuse questionnaires. The prevalence of verbal and physical abuse against nurses in the sample of this study were found to be as 91.1% and 33.0% respectively. Colleagues were found to be the most important source of verbally abusive behaviours while patients and patients' relatives were the important sources of physically abusive behaviours. Disturbed mental health, decreased job performance and headache were the more frequently reported negative effects of verbal and physical abuses on nurses. The most common reactions against abusive behaviours were anger, helplessness, humiliation and depression. It is interesting to find that 'did nothing' was the most reported coping method with verbal abuse. The findings also suggested that working in inpatient units and increasing work experience in the nursing profession were statistically significant variables increasing the likelihood of being abused physically. All the results on sources, negative effects, feelings and coping methods on verbally and physically abusive behaviours lead us to discuss that lower working status and power of the nurses at the work, poor working conditions in healthcare settings and insufficient administrative mechanisms as well as law and regulations against the abusers are the important factors forcing the nurses to work in an inappropriate work environment in Turkey.
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                Author and article information

                Contributors
                Role: ND
                Journal
                rlb
                Revista Latinoamericana de Bioética
                rev.latinoam.bioet.
                Universidad Militar Nueva Granada (Bogotá )
                1657-4702
                January 2015
                : 15
                : 1
                : 108-119
                Affiliations
                [1 ] Universidad Nacional de Colombia Colombia
                Article
                S1657-47022015000100010
                65d54187-ec1b-4fad-9367-f738fa393df4

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Colombia

                Self URI (journal page): http://www.scielo.org.co/scielo.php?script=sci_serial&pid=1657-4702&lng=en
                Categories
                MEDICAL ETHICS

                General medicine
                Ethical conflicts,ethical dilemma,moral distress,bioethics, and medicine ethics,Conflito ético,dilema ético,sofrimento moral,bioética,ética médica,Conflicto ético,angustia moral

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