Principialismo, bioética personalista y principios de acción en medicina y en servicios de salud Principialismo, bioética personalista e princípios de ação em medicina e serviços de saúde Since there is a gap and differences between bioethical concepts and other principles of action arising from the practice of modern medicine, their comparison is reasonable. Modern medicine has created principles of action based on evidence and principles of quality in medicine, and bioethical argumentation frequently resorts to principlism or personalist bioethics. This article (...) intends to illustrate the characteristics of the relationships between these concepts and their potential mutual enrichment. A simple, practical comparison matrix is proposed to compare the relationship between principles. These concepts have a significant overlap; however, both in the history of ideas and in their formulation, they are very dissimilar. Emphasis is placed on the contextual value of this analysis given by global health trends and some implications for medicine from personalist bioethics. Para citar este artículo / To reference this article / Para citar este artigo Insua JT. Principialismo, bioética personalista y principios de acción en medicina y en servicios de salud. pers. bioét. 2018; 22: 223-246. DOI: 10.5294/pebi.2018.22.2.3. (shrink)

Rare disease are those pathologies that affect a reduced proportion of the population. For this reason, the research on their causes and mechanisms, which is essential to find a way to treat or prevent them, is insufficient. This causes that the patients report a lack of coverage by the health system and the social discrimination that suffering one of these pathologies entails. Among rare diseases, we find the so-called prion diseases or transmissible spongiform encephalopathies. Although they are relatively well-known due (...) to the health crisis provoked by the “mad cow disease” at the end of the last century, there are still many uncertainties about these disorders that affect both animals and humans. This monograph aims at bringing to light the fascinating history and the diversity of prion diseases, which shook the foundations of the biology known before the 1980s by bringing out a new and puzzling type of infectious agent: prions. (shrink)

En más de 100 conflictos bélicos que se han producido en los últimos diez años, más del 80 por ciento de las víctimas son civiles. Se ha producido un desarrollo acelerado en las investigaciones concernientes a las consecuencias psico-sociales de la guerra en la población civil, la cual es el blanco principal de las víctimas en la guerra contemporánea. Este trabajo constituye una revisión bibliográfica sobre la guerra como desastre, acerca de los conceptos “modernos” de “guerra total”, desastre y las (...) consecuencias psicológicas de la guerra en la población civil, la utilización de los niños como soldados lo cual acarrea desórdenes mentales marcados y se aborda el problema de la violencia sexual como arma de guerra. Las mujeres, las jóvenes, e incluso niñas, son a menudo sometidas, violadas, secuestradas y forzadas a la esclavitud sexual o cualquier tipo de abuso sexual; son vejadas, humilladas y dañadas en lo más profundo de sus sentimientos psicológicos, y valores morales, lo que también trasciende al grupo social, comunidad, clase social o etnia a la que pertenecen. El deterioro o la destrucción de la infraestructura económica, social y política de las naciones en conflicto impide la atención de las necesidades básicas de la población. El trastorno por estrés postraumático es la entidad nosológica más frecuente en las víctimas de la guerra, pero existen otros trastornos mentales que hay que tener en cuenta In over 100 war conflicts that have occurred in the last 10 years, m ore than 80 percent of the victims were civilians. The scope of recent studies has been increasingly focused on psychological and social effects among civilians who are the target and main victims of contemporary wars. This article is an explanation of why war is considered a disaster, a revision of modern terms for war, disaster and the psychological effects of war on civilians, the training of children as soldiers, and the resulting mental disorders. It touches upon sexual violence problem as a war weapon. Women, adolescents and young children are often violated and forced into sexual slavery or any other type of sexual abuse, causing humiliation and psychological, ethical and moral damage, which can affect social groups, communities, social classes, or races. The deterioration or destruction of the economic, social and political infrastructure of the countries in conflict hinders the satisfaction of the citizens' basic needs. The most common psychological effect among war victims is posttraumatic stress, but there are also other mental disorders which must be taken into consideration. (shrink)

Sin lugar a duda, reflexiones sobre lanaturaleza de la mente han preocupado apensadores a lo largo de los siglas. Hoy en dia, laFilosofia de la Mente enfoca e! fenómeno de lomental principalmente desde un punto de vistafisicalista. Esta quiere decir que todos losprocesos mentales de una u otra manera sondescriptibles en términos de lo que ocurre en e!cerebro a nivel neuronal. Parece que estaapreciación se aleja considerablemente deiconcepto de lo mental en la Edad Media. De estamanera pareceria que en Tomás (...) de Aquino lomental queda relegado a una descripción dualistaque afirma una diferencia esencial entre lo mentaly lo corporal. Quisiera entonces, en estacomunicación, presentar una imagen un tantodistinta, según la cual los procesos mentalessegún e! Aquinate no se limitan al intelecto. Setendrá que incluir la teoria de los sentidosinteriores, los que representan facultadascognitivas que llevan a los ser sensibles, ytambién a seres humanos, a reconocer su mundocircundante de una manera no trivial. Un análisísde esas capacidades mentales demostrará queson necesartos crtterios fisicalistas para poder asiradecuadamente lo mental en la teoria de Tomásde Aquino. (shrink)

Según el criterio tradicional, la epistemología de Tomás de Aquino explica el conocimiento diferenciado e intencional de la realidad en términos de una doctrina del intelecto. En oposición a esta tendencia, se puede constatar la existencia de otro tipo de conocimiento complejo que se realiza a través de la actividad de los sentidos. Un análisis de la teoría tomasiana de los sensibles revelará una posición sorprendentemente cercana a la teoría moderna de la psicología del sentido común, es decir, una teoría (...) que describe la percepción y la conducta de los animales y los seres humanos de la experiencia cotidiana de objetos singulares. (shrink)

En este articulo se analiza la noción de circunstancia en la filosofía moral de Tomás de Aquino, para lo cual se presenta en primer lugar el marco teórico, introduciendo los conceptos de voluntad, objeto y fin. En un segundo paso se indaga acerca de la ontología de la circunstancia como accidente del acto, y en un tercer paso se analiza su poder explicativo con respecto a las acciones voluntarias. Se concluye primeramente que la ontología de las circunstancias contiene dificultades, en (...) tanto que pueden alterar la sustancia del acto, a pesar de ser accidentes. No obstante esta dificultad, se puede considerar que la teoría de las circunstancias constituye un intento valioso para analizar las acciones voluntarias en contextos concretos. (shrink)

In Aristotle's system there is an important ambiguity between his religious positions or, if they could be so called, his religious ideas, and his theological thought. The first aspect makes room to popular beliefs and can be seen in some philosophically unimportant documents like his will, but also in some philosophically relevant writings like his Metaphysics and his treatise On The Heavens. The second aspect, his theological position, is in flagrant opposition to the first one. On the contrary, in Aquinas (...) there is no contradiction between the object of faith in religion and his theological thought. Furthermore, religion entails ethical duties which can entirely be justified theologically, which is not the case with Aristotle. Natural law is the main concept that links the religious with the theological level in his thought. (shrink)

Se glosa el método poliano del abandono del limite mental como un 'trascendimiento' de la presencia - la cual detiene el inteligir objetivante y como actualidad lo separa de la actuosidad y dinamismo reales-. Se excluye así la extrapolación de la actualidad presencial como forma del ente sustancial tanto como su reducción a determinación efectiva a manera de modalidad del juicio asertivo. De donde se interpreta la distinción real de la esencia potencial con respecto al acto de ser creado que (...) la trasciende - sin separación- como el inherente distinguirse de posibilidades temporalmente desplegado por este acto, y se averigua la real distinción entre la primalidad radical que compete al acto de ser principal - extramental- y al intrínsecamente dual- personal humano-. (shrink)

Os prólogos dos comentários de Tomás de Aquino às obras de Aristóteles são de suma importância, porque neles o autor apresenta o que se poderia denominar “o marco conceptual” do trabalho que está empreendendo. No caso do Comentário à Política, o conceito fundamental é o conceito de natureza. A afirmação de que existe uma “imitação da natureza” significa, para Tomás, muito mais do que representou para seus antecessores. PALAVRAS-CHAVE – Tomás de Aquino. Comentário. Política. Natureza. Imitação. ABSTRACT The prologs of (...) Thomas Aquinas to the works of Aristotle are of main importance, because in these prologs the author presents what could be called “the conceptual mark” of the tasks he is undertaking. In the case of the Comments to the Politics, the fundamental concept is the concept of nature. The statement that there is an “imitation of nature” means, for Thomas, much more that it had represented for his antecessors. KEY WORDS – Thomas Aquinas. Comment. Politics. Nature. Imitatio. (shrink)

En varios tratados españoles del siglo XVI, la esclavitud como fenómeno social y comercial adquirió una importancia teórica cada vez mayor con respecto al estatus legal y moral de los seres humanos. El presente trabajo trata de esbozar algunos de los argumentos con respecto al comercio de esclavos y sus implicaciones morales y legales de acuerdo los autores Tomás de Mercado (1530-1576) y Bartolomé Frías de Albornoz (s. XVI), mostrando cómo la discusión se encaminó hacia la expresión de derechos individuales, (...) sin, no obstante, superar el tradicional apego al concepto de esclavitud legal. (shrink)

In Aristotle’s system there is an important ambiguity between his religious positions or, if they could be so called, his religious ideas, and his theological thought. The first aspect makes room to popular beliefs and can be seen in some philosophically unimportant documents like his will, but also in some philosophically relevant writings like his Metaphysics and his treatise On The Heavens. The second aspect, his theological position, is in flagrant opposition to the first one. On the contrary, in Aquinas (...) there is no contradiction between the object of faith in religion and his theological thought. Furthermore, religion entails ethical duties which can entirely be justified theologically, which is not the case with Aristotle. Natural law is the main concept that links the religious with the theological level in his thought. (shrink)

Saint Thomas Aquinas commences his study distinguishing the types of order that exist and with these he determines that moral philosophy studies, on one hand, the order of voluntary acts and, on the other hand, the human acts as ordered together and as orderd towards an end. The social character of the human being and the type of help he gives and receives in the order of the whole and the part is attended, and this leads to Aquinas dividing moral (...) philosophy in three parts: the monastic, which orders the acts towards an end; the economic, which orders the acts of the domestic multitude; and the politic, which orders the acts of the civil multitude. (shrink)

Saint Thomas Aquinas establishes why is it that logic is the directive art of the act of reason and why is it convenient to divide it in correspondence with the operations of the intelect. Thus, the Posterior Analytics are related with the act of reason which goes from one thing which is known to other thing that is unknown. By analogy with the process of necessity of nature, in which she can not fail, Aquinas explains that truth can not fail (...) in the demonstrative syllogism, which has the certainty of science, and that this act of reason is founded in the Posterior Analytics. The rest of saint Thomas Aquinas' exposition focuses on determining to which books of logic does each act or process of reason corresponds. (shrink)

Saint Thomas Aquinas explains that, according to the method followed by the Philosopher in metaphysics, it is convenient in science to treat first the determinations in the most common and general fashion in order to attend later to what is proper to each species. And it is in these sense that, according to Aquinas, the De Anima studies the most general and common affairs of the animated realities in order to treat later, in other books, about what is proper of (...) the animated in particular. (shrink)

Saint Thomas Aquinas explains how is it that certain animals seem to possess prudence in some degree, according to Aristotle, thanks to the memory that they have, because it allows them to consider past facts besides the present ones. Thus, De Memoria et Reminiscentia treats about memory, which is common to man and perfect animals, and reminiscence, which is proper to man.

Saint Thomas Aquinas explains that in the science of mobiles, when descending to the living, each one of the species of the animals and plants are attended specifying what is proper to each of them, and here is where De Sensu et Sensato is found. Aquinas enumerates the diverse types of living beings according to the parts of soul and enlists the books that have a relation with them, deducing that De Sensu et Sensato corresponds to the exterior act that (...) occurs when feeling. (shrink)

Saint Thomas Aquinas explains how is it that there must be among sciences one which is the most perfect and orders all of them, and that may be therefore trully called wisdom. This science has for its object the common entity and studies simultaneously the first causes, the most universal principles and the separated substances. Aquinas sustains that this science receives three different names: theology or divine science, for it treats separated substances; metaphysics, for it studies the entity and the (...) transphysical things that follow it; and first philosophy, for it studies the first causes of things. (shrink)

Saint Thomas Aquinas distinguishes three operations of the intelect and explains that the one which treats about composition and divition, or the affirmative and negative sentence, belongs to the book Peri Hermeneias. Thus, Aquinas proceeds to comment why the verb, the name and the statement are interpretations or voices with meaning and why this book focuses on the enuntiative sentence for the truth and the false are found in it.

By the notion of imitation, Saint Thomas Aquinas distinguishes between the cognoscitive approach towards nature and the productive approach towards art. From these relation arises the possibility of reason ordering the multitude of men who conform a community. Thus, Saint Thomas Aquinas explains how is it that the city is the most important whole that reason can know and produce directing it towards an end. Aquinas continues annotating that politics belong to the genre of practical and moral sciences, not mechanical (...) or productive, and that in these genre it is the most worthy and perfect science of them all. (shrink)

El artículo considera el recorrido necesario en el proceso de lectura de los textos proféticos a fin de que hoy sigan teniendo sentido como palabra de Dios. Toma como modelo de estudio el libro del profeta Jeremías, por ser el que más claramente evidencia este proceso. Primero trata la relación e..

Se analiza el concepto de libre albedrío a la luz de los teólogos Tomás de Aquino, quien lo defiende, y Juan Calvino, quien lo impugna. Se muestran los dos sentidos de la libertad que se derivan de ello y cómo el individualismo cristiano ha sido el fundamento conceptual para la democracia liberal. Pero si la doctrina cristiana tiene elementos que compensan su radical individualismo, las sociedades descristianizadas carecen de tales elementos y corren peligro de convertirse en individualismos exacerbados.

La grabación con teléfonos móviles de las masivas movilizaciones estudiantiles del año 2011 y del terremoto-tsunami del 27 de febrero de 2010 en Chile, y la divulgación de estos acontecimientos por Internet -especialmente a través de imágenes de YouTube-, permite la reflexión sobre la incorporación de las Tecnologías de la Información y las Comunicaciones (TICs) a los procesos de registro de memorias. En este caso se toma como referencia el imaginario “marino” de la navegación en el ciberespacio, con los respectivos (...) campos semánticos que ofrece la metáfora de una “sociedad líquida”. En este contexto se aborda la utilización del patrimonio digital -el acervo virtual y universal de imágenes- como fuente de memorias y de vestigios históricos: mensajes aislados, registrados por individuos y colectivos, que componen un archipiélago de culturas. (shrink)

El artículo realiza una lectura de Rey Lear desde el punto de visa del nomadismo filosófico, introduciendo elementos que permiten evaluar la relación entre los aspectos políticos y poéticos de la obra. Para ello, se toma como eje de análisis a los personajes principales del drama, en cuya relación dialéctica, se evidencia una ascética cristiana que, basada en el concepto de razón sensible, pone en juego las categorías propias de la moral. A partir de este análisis, el artículo indaga en (...) la relación dialéctica que se establece entre categorías tales como lo poético-lo político, el bien-el mal, moral paternal-moral política, y muestra cómo Shakespeare se sirve de ella para dar cuenta de la naturaleza del ser humano en toda su amplitud. (shrink)

Este texto se recomprende la noción escolástica de verdad como adecuatio intellectus et rei a la luz de la la interpretación heideggeriana como ¿develación¿. Para ello se siguen tres momentos al hilo de tres preguntas: ¿en qué consiste esta adecuación?, ¿en qué sentido el intelecto y la cosa pensda se parecen? y ¿cuál es la esencia de la verdad?

Esta reflexión gira alrededor del problema del estatus de los combatientes no estatales en las guerras posmodernas y del comportamiento de los distintos bandos en este tipo de guerras. La atención sobre estos asuntos proviene de lo que me parece que son dos descuidos en la reflexión contemporánea sobre la guerra: el primero es la desatención, cuando no invisibilización, a los combatientes por cuenta de una colonización de la esfera de la guerra por parte del derecho penal, por la cual (...) lo único que se toma en cuenta son las figuras del victimario y la víctima. El segundo descuido se refiere a la persistencia en los discursos normativos, políticos y jurídicos que extrapolan sin más los presupuestos de la teoría política moderna que entiende a los agentes políticos solo bajo los atributos de las entidades estatales. [Fragmento]. (shrink)

La racionalidad crítica es una actitud que hay que desarrollar de manera preferencial en esta época signada por la incertidumbre. Un ejemplo de lo que ella significa lo encontramos en los filósofos presocráticos, en su modo de enfrentar y resolver problemas de orden epistemológico. Contraejemplos históricos lo representan los desarrollos de la filosofía socrática platónica y aristotélica. En la filosofía medieval, se puede ilustrar este mismo caso con lo que desarrollaron los seguidores principalmente de Santo Tomás. Está probado que la (...) lealtad a ultranza a una filosofía, una hipótesis, una idea, se constituye en un suicidio para el investigador o para el filósofo. Sólo la crítica razonable permite la escogencia de la mejor opción. La invitación por lo tanto es a ejercer esta actitud con responsabilidad, con la confianza en que por esta vía encontraremos las soluciones – provisionales – a los problemas que nos acotan. Pero es también una actitud que exige del compromiso serio de quien investiga: su ejercicio es la salvaguarda contra actitudes fanáticas e intolerantes. (shrink)

Prevosti Vives, Xavier. “La liber-tad en santo Tomás de Aquino. Estudio del libre albedrío según santo Tomás y aproximación a su fundamento onto-lógico.”.

RESUMEN El artículo examina el consuelo como una cuestión filosófica en cuanto que concreción de la solicitud, y muestra los recursos que aporta para comprender al ser humano como sujeto sufriente y respondiente. Se analiza el consuelo en cuanto que fenómeno de acceso a otras dimensiones constitutivas del ser humano, como la afectividad, la apelación y el cuidado. ABSTRACT The article examines consolation as a philosophical issue insofar as it is a materialization of attentiveness, and explains the resources it offers (...) to understand human beings as suffering and caring subjects. It analyzes consolation as a phenomenon that provides access to other constitutive dimensions of the human being, such as affectivity, appeal, and care. (shrink)

Attention is a cognitive phenomenon that, for its multiple functions and its permeability to emotional and cultural aspects, it’s a phenomenon with difficult definition. At the same time, the reasons that difficult its definition makes it a fundamental piece to understand the human behaviour, particularly the way that it interacts with its environment. In this article, we want to review the role of attention in the awareness process that allow the subject an adequate adaptation to the environment, and, through it, (...) set his perspective of reality, his own «world». / La atención es un fenómeno cognitivo que, debido a sus múltiples funciones y a su permeabilidad a aspectos emocionales y culturales, resulta un fenómeno de difícil definición. Al tiempo, eso que por una parte dificulta su aprehensión, por otra la convierte en una pieza fundamental para comprender el comportamiento humano, particularmente el modo en que interactúa con su medio. En el presente artículo queremos revisar el papel de la atención en los procesos de toma de conciencia que permiten al sujeto una adecuada adaptación al medio y cómo, a través de ella, configurar su perspectiva de la realidad, su «mundo». (shrink)

Ante ciertos modelos causales del agente libre inspirados en Tomás de Aquino, resulta interesante atender al modelo causal presentado por Tomás mismo, especialmente en un texto a partir del cual se puede rastrear la exposición de la acción libre como el efecto de los cuatro sentidos causales aristotélicos. Se trata de la cuestión sobre los actos imperados (ST I–II, q. 17); en cuyos primeros cuatro artículos –y en sus textos paralelos– determina que la voluntad es causa agente; la razón práctica, (...) causa ordenadora; y el imperium de ambas (razón y voluntad) se relaciona con el acto imperado como lo formal con lo material. (shrink)

In this chapter, we discuss a selection of current views of the neural correlates of consciousness (NCC). We focus on the different predictions they make, in particular with respect to the role of prefrontal cortex (PFC) during visual experiences, which is an area of critical interest and some source of contention. Our discussion of these views focuses on the level of functional anatomy, rather than at the neuronal circuitry level. We take this approach because we currently understand more about experimental (...) evidence at this coarse level and because these results are appropriate for arbitrating between current theoretical frameworks. We discuss the Two-Visual-Systems Hypothesis (Milner & Goodale 1995; 2006), Local Recurrency (Lamme 2010; Lamme 2006), Higher Order (Lau 2008; Lau & Rosenthal 2011) and Global Workspace theories (Baars 1997; Baars 2005; Dehaene & Naccache 2001; Dehaene 2014). Despite the apparent stark differences between conscious and unconscious perceptual processing, available evidence suggests that their neural substrates must be largely shared. This indicates that the difference in neural activity between conscious and unconscious perceptual processing is likely to be subtle and highly specialized. We argue that current experimental evidence about the involvement of specific activity in prefrontal cortex supports the higher order neural theory of consciousness. In consequence, imaging techniques that focus only on marked differences between conscious and unconscious level of activity are likely to be insensitive to the relevant neural activity patterns that underlie conscious experiences. Finally, it follows from the evidence we discuss that the functional advantages of conscious over unconscious perceptual processing may be more limited than commonly thought. (shrink)

When a circular coin is rotated in depth, is there any sense in which it comes to resemble an ellipse? While this question is at the center of a rich and divided philosophical tradition (with some scholars answering affirmatively and some negatively), Morales et al. (2020, 2021) took an empirical approach, reporting 10 experiments whose results favor such perspectival similarity. Recently, Burge and Burge (2022) offered a vigorous critique of this work, objecting to its approach and conclusions on both philosophical (...) and empirical grounds. Here, we answer these objections on both fronts. We show that Burge and Burge’s critique rests on misunderstandings of Morales et al.’s claims; of the relation between the data and conclusions; and of the philosophical context in which the work appears. Specifically, Burge and Burge attribute to us a much stronger (and stranger) view than we hold, involving the introduction of “a new entity” located “in some intermediate position(s) between the distal shape and the retinal image.” We do not hold this view. Indeed, once properly understood, most of Burge and Burge’s objections favor Morales et al.’s claims rather than oppose them. Finally, we discuss several questions that remain unanswered, and reflect on a productive path forward on these issues of foundational scientific and philosophical interest. (shrink)

Arguably the most foundational principle in perception research is that our experience of the world goes beyond the retinal image; we perceive the distal environment itself, not the proximal stimulation it causes. Shape may be the paradigm case of such “unconscious inference”: When a coin is rotated in depth, we infer the circular object it truly is, discarding the perspectival ellipse projected on our eyes. But is this really the fate of such perspectival shapes? Or does a tilted coin retain (...) an elliptical appearance even when we know it’s circular? This question has generated heated debate from Locke and Hume to the present; but whereas extant arguments rely primarily on introspection, this problem is also open to empirical test. If tilted coins bear a representational similarity to elliptical objects, then a circular coin should, when rotated, impair search for a distal ellipse. Here, nine experiments demonstrate that this is so, suggesting that perspectival shapes persist in the mind far longer than traditionally assumed. Subjects saw search arrays of three-dimensional “coins,” and simply had to locate a distally elliptical coin. Surprisingly, rotated circular coins slowed search for elliptical targets, even when subjects clearly knew the rotated coins were circular. This pattern arose with static and dynamic cues, couldn’t be explained by strategic responding or unfamiliarity, generalized across shape classes, and occurred even with sustained viewing. Finally, these effects extended beyond artificial displays to real-world objects viewed in naturalistic, full-cue conditions. We conclude that objects have a remarkably persistent dual character: their objective shape “out there,” and their perspectival shape “from here.”. (shrink)

Consciousness and confidence seem intimately related. Accordingly, some researchers use confidence ratings as a measure of, or proxy for, consciousness. Rosenthal discusses the potential connections between the two, and rejects confidence as a valid measure of consciousness. He argues that there are better alternatives to get at conscious experiences such as direct subjective reports of awareness (i.e. subjects’ reports of perceiving something or of the degree of visibility of a stimulus). In this chapter, we offer a different perspective. Confidence ratings (...) in general, and metacognitive measures in particular, may offer important advantages over subjective ratings. The arguments we offer here are supported by empirical, practical and socio-strategic considerations. However, we do not suggest consciousness and confidence are interchangeable. We recognize the limitations of confidence ratings in some experimental designs and for some research questions. Nevertheless, we also address a potential conceptual link between consciousness and confidence that stems from Rosenthal’s very own work on mental quality space theory. (shrink)