This article examines the complex relationship between culture, values, and ethics in mental health care. Cultural competence is a practical, concrete demonstration of the ethical principles of respect for persons, beneficence (doing good), nonmaleficence (not doing harm), and justice (treating people fairly)—the cornerstones of modern ethical codes for the health professions. Five clinical cases are presented to illustrate the range of ethical issues faced by mental health clinicians working in a multicultural environment, including issues of therapeutic boundaries, diagnosis, treatment choice, (...) confidentiality and informed consent, and the just distribution of limited health care resources. (shrink)
Background: The Directive 2001/20/EC was an important first step towards consistency in the requirements and processes for clinical trials across Europe. However, by applying the same rules to all types of drug trials and transposing the Directive’s principles into pre-existing national legislations, the Directive somewhat failed to meet its facilitation and harmonisation targets. In the field of ethics, the Directive 2001/20/EC conditioned the way of understanding and transposing the “single opinion” process in each country. This led to a situation in (...) which two models of research ethics committees organisation systems exist, being the model in which the “single opinion” is considered to be the decision made by a single ethics committee more effective and simpler in terms of administrative and logistic workload. Method: A survey was conducted in 10 European countries. Members of the European Clinical Research Infrastructures Network working party number 1, with expertise in the field of ethics, responded. Results: There is a major heterogeneity in the composition of ethics committees among the surveyed countries based on the number of members, proportion of experts versus lay members and expertise of the scientific members. A harmonised education of the ethics committees’ membership based in common curricula is recommended by the majority of countries. Conclusions: Despite the efforts for harmonisation of the European Clinical Trial Directive, from an ethical point of view, there remains a plurality of ethics committees' systems in Europe. It is important to comprehend the individual national systems to understand the problems they are facing. (shrink)
In recent years, discussion on evil as a philosophical problem has increased. However, there is a tendency to see this problem from an aesthetic point of view, to frame it in theodicy's plot, or even to suggest silence in front of those extreme forms of evil that are linked to specific episodes, such as totalitarianism or ethnic cleansing. This review article focuses on María Pía Lara's development of a postmetaphysical theory of evil in her book Narrating Evil. The main purpose (...) of Lara's theoretical effort is to show that critical recovery of historical episodes that have become paradigms of evil for us, has a narrative texture and intends to generate a discussion in the present time about the ways we can give reality to an idea of democratic justice, in the context of what Jürgen Habermas has called secular and postmetaphysical societies. Thus, learning from catastrophes — the term coined by Habermas and redefined by Lara — becomes a tool for mastering the past, but also constitutes a narrative device that allows us a critical approach to our present political reality. (shrink)
This work tries to give the possible most suitable vision of the Generation of 98 regarding the purposes and interest of the main authors: Azorín, Pío Baroja, Miguel Unamuno, Antonio Machado and José Ortega y Gasset.