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)

It is unknown whether hospital-based medical professionals in Spain educate patients about advance directives. The objective of this research was to determine the frequency of hospital-based physicians’ and nurses’ engagement in AD discussions in the hospital and which patient populations merit such efforts. A short question-and-answer-based survey of physicians and nurses taking care of inpatients was conducted at a university hospital in Madrid, Spain. In total, 283 surveys were collected from medical professionals, of whom 71 per cent were female, with (...) an average age of thirty-four years. Eighty-four per cent had never educated patients about ADs because of lack of perceived responsibility, time, or general knowledge of ADs. Patient populations that warranted AD discussions included those with terminal illnesses, chronic diseases, and elderly patients. Regarding degree of AD understanding in medical professionals: 57 per cent of medical professionals claimed sufficient general knowledge of ADs, 19 per cent understood particulars regarding AD document creation, and 16 per cent were aware of AD regulatory policies. Engagement in AD discussions was considered important by 83 per cent of medical professionals, with 79 per cent interested in participating in such discussions themselves. The majority of hospital physicians and nurses do not educate their patients about ADs, despite acknowledging their importance. Patient populations of highest priority included those with terminal diseases or chronic illness or who are of advanced age. (shrink)

El objetivo principal de este trabajo es dar a conocer las reflexiones del filósofo alemán Robert Spaemann en torno al concepto de dignidad humana. Para ello, nos detendremos a considerar qué van antes, si los derechos humanos o la dignidad; los tipos de dignidad: ontológica y moral; así como los problemas que lleva consigo el concepto de dignidad humana. A continuación, abordaremos la argumentación de Robert Spaemann en torno a la dignidad en tres apartados: la capacidad de autotrascendencia del ser (...) humano, el ser potencialmente moral, y el poder representar a lo Absoluto. (shrink)

We discuss the effectiveness of mediated communication (internet communication via a computer tablet) and tacit engagement in a Project on mental health. The project is aimed at improving the wellbeing of adult women living with chronic mental disorders in long-term psychiatric internment. The computer tablets act as "portals" to provide access and conatct with the outside world for patients who have poor (if any) external social support. This support includes a patient-centred psycho-social care, and accompanying clinical and pharmaceutical treatment. Both (...) patients and their relatives accepted the benefits of internet mediation, for very different reasons. For the patient, this is a flash of contact with humanity, and for the relatives the internet communication this proved to be an alternative to the need for physical proximity. As some patients had no relatives or friends to communicate (even remotely) with the outside world, and because there is a school next door to the clinic, we visualized that the communication between these two communities could provide both a therapeutic and poetic act of learning and compassion. The electronic portal could serve as a virtual bridge between two forbidden domains. Although awareness of students of the nearby school was raised about mental health, the use of internet mediation devoid of physical proximity made the students suspicious of the goal of the mediation. From the patient's side, however, each contact was an instance of joy. Several issues were raised from this exercise. (shrink)

We discuss the effectiveness of mediated communication (internet communication via a computer tablet) and tacit engagement in a Project on mental health. The project is aimed at improving the wellbeing of adult women living with chronic mental disorders in long-term psychiatric internment. The computer tablets act as "portals" to provide access and conatct with the outside world for patients who have poor (if any) external social support. This support includes a patient-centred psycho-social care, and accompanying clinical and pharmaceutical treatment. Both (...) patients and their relatives accepted the benefits of internet mediation, for very different reasons. For the patient, this is a flash of contact with humanity, and for the relatives the internet communication this proved to be an alternative to the need for physical proximity. As some patients had no relatives or friends to communicate (even remotely) with the outside world, and because there is a school next door to the clinic, we visualized that the communication between these two communities could provide both a therapeutic and poetic act of learning and compassion. The electronic portal could serve as a virtual bridge between two forbidden domains. Although awareness of students of the nearby school was raised about mental health, the use of internet mediation devoid of physical proximity made the students suspicious of the goal of the mediation. From the patient's side, however, each contact was an instance of joy. Several issues were raised from this exercise. (shrink)

The notion that the application of basic rights requires “balancing” is widely and increasingly accepted. Balancing judgments are ever more frequently used in judicial decisions, particularly in constitutional courts and especially in contemporary supra-national human-rights courts. Many jurists deem that balancing is the only possible method to arrive to a rational decision in cases of conflict between basic rights. I assert that this kind of conflict between principles has the same structure of moral conflicts. And, as is the case with (...) moral conflicts, the way conflicts are solved will depend on the underlying concept of practical reasoning. I describe the two basic patterns that practical reasoning may follow in situations of conflict between moral principles in general and argue against the idea that balancing is the most appropriate procedure to cope with the conflict, either in general terms or in juridical argumentation in particular. (shrink)

Após fazer considerações gerais sobre o uso estendido do juízo de ponderação nas decisões judiciais envolvendo conflitos entre direitos, o artigo, em primeiro lugar, caracteriza as duas formas básicas que o raciocínio prático pode assumir nos casos de conflito entre princípios morais em geral e argumenta contra a ideia de que a ponderação seja o procedimento mais apropriado para lidar com o conflito. Em segundo lugar, no caso específico do conflito entre direitos, revisa e defende a concepção dos direitos de (...) Dworkin como uma alternativa genuína à ponderação.After constating the spreading use of balancing in judicial decisions involving conflicts of rights, two basic forms of practical reasoning in cases of conflict of moral principles are distinguished and it is argued against the idea of balancing as the most adequate way of resolve the conflict. In the specific case of conflicts of rights, it is revised and defended Dworkin´s conception of rights as a genuine alternative to balancing. (shrink)

The present work attempts to evaluate in what manner the Marian virtues marked out throughout the Middle Ages with respect to women, contribute powerfully to the dignification of women and their redemption from the traditional accusations that they are a perverting influence on humanity.

Computational simulations are now useful tools in experimental life. Their novelty and continuous development make it very difficult to understand their epistemic relevance. In this paper a first evaluation of them is presented through a parallel between thought experiments and computational simulations. Both simulations that play the role of actual experiment and also simulations that are part of experiments will be under scrutiny, since both of them are important in the understanding of contemporary experiments. But simulations as parts of actual (...) experiments can especially show a new face in the complex relation theory-experiment. (shrink)

Las imágenes de san Francisco de Asís se multiplican en Europa con la función de servir de modelo a los frailes menores y despertar la veneración de los fieles mediante el conocimiento de los episodios más significativos de su hagiografía. Para comprender el significado último de estas representaciones es necesario recordar dónde fueron realizadas, aunando aspectos formales y fuentes literarias que sir­vieron de inspiración a los pintores de la Baja Edad Media. En las siguientes líneas veremos el importante papel de (...) los franciscanos como comitentes, la difusión de las biografías de Tomás de Celano y san Buenaventura y su recepción en las imágenes, especialmente, a partir de los frescos de Giotto di Bondone en Asís. Estos constituyen un punto de inflexión en la evolución de los repertorios franciscanos, por su renovación e incidencia en la consoli­dación de símbolos parlantes y fórmulas de representación de carácter narrativo en la iconografía franciscana. No es objeto de este trabajo la catalogación de imágenes, sino reseñar las principales variables de la imagen de san Francisco desde el siglo xiii al xv a partir de piezas muy elocuentes respecto a su origen y evolución posterior. (shrink)

El presente trabajo busca establecer una relación entre el marcado carácter masculino que durante siglos ha tenido la actividad política y el veto a la mujer en el acceso a los estudios de Derecho. Partiendo de la explicación de la regla prohibitiva y el recuerdo de las juristas parlamentarias pioneras de principios del siglo xx, el estudio se centra en las juristas parlamentarias de la Transición, en concreto, en las que formaron parte de las Cortes Constituyentes de 1977-1979. El objetivo (...) último es reconocer el valor de las aportaciones de todas aquellas mujeres que, en unos años difíciles en España, se enfrentaron no solo al reto de realizar unos estudios con limitadas salidas profesionales para ellas, sino que participaron en aquella legislatura con la esperanza de recuperar y consolidar la democracia. (shrink)

Neste artigo avalio criticamente as diferentes tentativas de Mi-chael Smith e Bernard Williams de defender uma versão plausível da teo-ria da motivação humeana. Contra Smith, mantenho que a concepção disposicional dos desejos que defende não é apropriada, e que seu argu-mento fracassa porque ignora o papel que desempenham as condições da racionalidade nas explicações intencionais. Em relação a Williams, sustento que embora coloque corretamente um desafio contra qualquer perspectiva “racionalista” sobre a razão prática, seus argumentos não provam que a motivação (...) só possa ser entendida segundo esse modelo humeano melhorado que ele defende, e que sua posição não consegue dar conta plenamente do caráter normativo da motivação. Na parte final, desenvolvo as implicações dos argumentos de Smith e de Williams para a motivação moral e coloco em questão a plausibilidade de alguns de seus supostos básicos. (shrink)