Sofia Salas - Academia.edu (original) (raw)
Papers by Sofia Salas
Revista médica de Chile, 2021
Revista médica de Chile, 2021
Aspectos éticos respecto de embriones humanos producidos en el laboratorio Ethical issues related... more Aspectos éticos respecto de embriones humanos producidos en el laboratorio Ethical issues related to human embryos produced in the laboratory correspondencia a: Dra. Sofía P. Salas. avda. las condes 12.461, torre 3, oficina 202. Santiago,
Revista chilena de infectología, 2020
Carta al Editor Consideraciones éticas respecto del "pasaporte" COVID-19 No hubo financiamiento. ... more Carta al Editor Consideraciones éticas respecto del "pasaporte" COVID-19 No hubo financiamiento. Conflicto de intereses: ninguno que declarar.
Revista médica de Chile, 2020
Revista médica de Chile, 2018
Experience in the global forum of bioethics in research. Challenges for the ethical review in Chi... more Experience in the global forum of bioethics in research. Challenges for the ethical review in Chile The Global Forum on Bioethics in Research annually convenes a number of researchers, bioethicists and stakeholders with a shared interest in the ethics of conducting research in low and middle-income countries (LMIC). It provides a useful platform to discuss ethical issues that affect research practice in different scenarios, promoting ethically conducted research, global development for health research ethics and partnerships between the global north and south. As participant of the last three meetings, in this article the author analyzes the main ethical issues that were discussed in this forum, namely "Emerging epidemic infections and experimental medical treatments" (Annecy, France, 2015); "Ethics of research in pregnancy" (Buenos Aires, Argentina, 2016), and "The ethics of alternative clinical trial designs and methods in LMIC research" (Bangkok, Thailand, 2017). Local research ethics committees are not well prepared to face the new ethical challenges associated with research conducted in emergency situations or in pregnant women, or to evaluate new methods, such as alternative clinical trial designs (cluster randomized trials, adaptive platforms, or controlled human infection models, among others). According to this scenario, research ethics committees should be trained to carefully assess the risks and benefits of approving this type of research. In this context, it is necessary to harmonize local regulations with the new international standards in research ethics.
Revista médica de Chile, 2019
The Chilean Law regulating the voluntary interruption of pregnancy, contemplates the possibility ... more The Chilean Law regulating the voluntary interruption of pregnancy, contemplates the possibility that health personnel may refrain from doing the procedure if they have stated that they are conscientious objectors (CO). There are numerous articles on the subject. However, the impact on medical training centers when a student or resident abstain from performing certain clinical procedures invoking CO, has seldom been analyzed. In this article, we explore the rights and duties of the CO students to perform an abortion or other clinical procedures for either religious or cultural reasons. Based on international experience, we recommend that all health care centers should have established and publicly known policies on this matter. Finally, we honor CO invoked by students, based on three general principles. First, the autonomy and moral integrity of the students should be respected. Second, an adequate ethical sensitivity is promoted. Third, it contributes to the necessary heterogeneity and diversity of students, promoting a desirable pluralism. However, certain interests and values, such as the well-being of patients, must be considered over and above accepting the CO requests.
Reproductive health, Jan 14, 2017
This paper explores the ethical implications of a randomized double-blind clinical trial aimed to... more This paper explores the ethical implications of a randomized double-blind clinical trial aimed to determine effectiveness and safety of an oxytocin receptor antagonist versus a betamimetic in the treatment of preterm labor, presented to a teaching hospital affiliated with a private university in Santiago, Chile. Though this trial protocol fulfills one of the conditions under which pregnant women could be enrolled in a clinical trial-the intervention has the potential to benefit the pregnant woman (by reducing adverse effects associated to salbutamol administration) and her fetus (if the new drug prolongs pregnancy)-there are some specific ethical issues raised. First, when to obtain consent is an important issue for clinical trials involving acute and unforeseen conditions that affect pregnant woman, e.g. preterm labor. Second, research must address the risk/benefit ratio for these two interdependent individuals, providing a good prospect of low risk and adequate benefit for both of...
Revista médica de Chile, 2018
Revista médica de Chile, 2020
Ethical arguments for and against the participation of the medical profession in assisted death: ... more Ethical arguments for and against the participation of the medical profession in assisted death: analysis of the Ethics Department of the Chilean Medical Association The discussion of a bill that allows medically assisted death (MAD) in Chile, revived the debate about the ethics of this practice. The Department of Ethics of the Chilean Medical Association herein analyzes arguments in favor or against the participation of the medical profession in MAD. Among the main arguments against the participation of physicians in this practice are that MAD conflicts with the basic ethical principles of medical practice, that it is contrary to the purposes of medicine and that it could erode the patients' and society's confidence in physicians. The arguments in favor are related to physician´s compassion and non-abandonment of patients during their illness, choosing palliative care and ushering them to the final instance. Additionally, there is social expectation that this practice will be carried out by trained physicians who can verify that the strict criteria established by the legislation are met, guarantee that it obeys to a repeated request of a fully capable patient, and who is able to deal with the complications of the procedure. In this document we aimed to represent the different perspectives about physicians' participation in MAD, offering arguments to colleagues and stimulating their participation in this important debate.
Revista médica de Chile, 2018
Every so often, in Chile there is a discussion about the role of physicians in the care of people... more Every so often, in Chile there is a discussion about the role of physicians in the care of people on hunger strike (HS). In this document, we review the ethical aspects of health care for persons in HS, aiming to provide guidelines to medical doctors who are required to attend them. First, we make an important distinction between HS and suicide, since the former is used as a protest and denunciation tool, while suicide seeks deliberately to end a life. Then we describe the three roles that the health professional can fulfill: as a treating doctor, as an expert or as an official of a prison. The respect for the autonomy and dignity of the person in HS must prevail whatever the role of the physician. Therefore, we maintain that under no circumstances, people who have autonomously decided to be in HS should be fed by force. Due to the complexity of the issue, we make special considerations about the management of minors and the non-competent persons in HS. In conclusion, we adhere to the principles that inspire the Declaration of Malta, which indicate that it would be preferable to "allow a person on hunger strike to die in dignity, rather than subjecting them to repeated interventions against their will".
![Research paper thumbnail of [Position paper from the Department of Ethics of the Chilean College of Physicians about conscientious objection]](https://attachments.academia-assets.com/104877521/thumbnails/1.jpg)
](Revista médica de Chile, 2016
The Chilean bill that regulates abortion for three cases (Bulletin Nº 9895-11) includes the possi... more The Chilean bill that regulates abortion for three cases (Bulletin Nº 9895-11) includes the possibility that health professionals may manifest their conscientious objection (CO) to perform this procedure. Due to the broad impact that the issue of C O had, the Ethics Department of the Chilean College of Physicians considered important to review this concept and its ethical and legal basis, especially in the field of sexual and reproductive health. In the present document, we define the practical limit s of CO, both for the proper fulfillment of the medical profession obligations, and for the due respect and non-discrimination that the professional objector deserves. We analyze the denial of some health institutions to perform abortions if it is legalize d, and we end with recommendations adjusted to the Chilean reality. Specifically, we recognize the right to conscientious objection that all physicians who directly participate in a professional act have. But we a lso recognize that p...
![Research paper thumbnail of [Conflicts of interest in nephrology]](https://attachments.academia-assets.com/104877513/thumbnails/1.jpg)
](Revista medica de Chile, 2016
Since doctors disposed of effective tools to serve their patients, they had to worry about the pr... more Since doctors disposed of effective tools to serve their patients, they had to worry about the proper management of available resources and how to deal with the relationship with the industry that provides such resources. In this relation-ship, health professionals may be involved in conflicts of interest that they need to acknowledge and learn how to handle. This article discusses the conflicts of interest in nephrology. Its objectives are to identify those areas where such conflicts could occur; to help to solve them, always considering the best interest of patients; and to help health workers to keep in mind that they have to preserve their autonomy and professional integrity. Conflicts of interest of professionals in the renal area and related scientific societies, with the industry producing equipment, supplies and drugs are reviewed. Dichotomy, payment for referral, self-referral of patients and incentives for cost control are analyzed. Finally, recommendations to help preserv...
Revista médica de Chile, 2008
The public dissemination of advances in biomedical research and clinical medicine generates sever... more The public dissemination of advances in biomedical research and clinical medicine generates several difficulties and problems. Mass media have the responsibility to report accurately and in a comprehensive way, and physicians and researchers mustprovide this information in ...
ARS MEDICA Revista de Ciencias Médicas, 2009
El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de e... more El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de estudios médicos humanísticos, actualmente incluido en el historial de Ars Medica Revista de ciencias médicas. El contenido del presente artículo, no necesariamente representa la actual línea editorial. Para mayor información visitar el siguiente vínculo:
ARS MEDICA Revista de Ciencias Médicas, 2008
El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de e... more El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de estudios médicos humanísticos, actualmente incluido en el historial de Ars Medica Revista de ciencias médicas. El contenido del presente artículo, no necesariamente representa la actual línea editorial. Para mayor información visitar el siguiente vínculo:
Pediatric Research, 1992
The fetus of sheep a species that evolved in lowlands, responds to hypoxemia (H) by maintaining c... more The fetus of sheep a species that evolved in lowlands, responds to hypoxemia (H) by maintaining cardiac output and umbilical-blood flow, increasing heart, brain and adrenal blood flow and decreasingittoother organs. The response to H of the fetus of the llama, thas has evolved in high altitudes, is not fully understood. We postulate that the systemic responses to H in the fetal llama are less marked and that the main adaptation occurs at the cellular and tissue levels. Our aim was to compare cardiac output and its distribution at 0 min (B) and after 20 min of fetal H (22-27% Sathb and 3-6 m102/dl in descending aorta) in-8 fetal sheep and 8 fetal llamas at 0.8 gestation. The results (x t SEM) were: Fetal Llama Fetal Sheep Basal Hypoxernia Basal Hyp~xemia Cardiac output (ml/minxkg)
Academic Medicine, 2007
The day after the graduation ceremony, the School of Medicine at the Pontificia Universidad Catól... more The day after the graduation ceremony, the School of Medicine at the Pontificia Universidad Católica de Chile traditionally invites the new doctors and the faculty members to a farewell party. Graduation takes place in January, which is summertime in the southern ...
Revista chilena de obstetricia y ginecología, 2015
Revista médica de Chile, 2021
Revista médica de Chile, 2021
Aspectos éticos respecto de embriones humanos producidos en el laboratorio Ethical issues related... more Aspectos éticos respecto de embriones humanos producidos en el laboratorio Ethical issues related to human embryos produced in the laboratory correspondencia a: Dra. Sofía P. Salas. avda. las condes 12.461, torre 3, oficina 202. Santiago,
Revista chilena de infectología, 2020
Carta al Editor Consideraciones éticas respecto del "pasaporte" COVID-19 No hubo financiamiento. ... more Carta al Editor Consideraciones éticas respecto del "pasaporte" COVID-19 No hubo financiamiento. Conflicto de intereses: ninguno que declarar.
Revista médica de Chile, 2020
Revista médica de Chile, 2018
Experience in the global forum of bioethics in research. Challenges for the ethical review in Chi... more Experience in the global forum of bioethics in research. Challenges for the ethical review in Chile The Global Forum on Bioethics in Research annually convenes a number of researchers, bioethicists and stakeholders with a shared interest in the ethics of conducting research in low and middle-income countries (LMIC). It provides a useful platform to discuss ethical issues that affect research practice in different scenarios, promoting ethically conducted research, global development for health research ethics and partnerships between the global north and south. As participant of the last three meetings, in this article the author analyzes the main ethical issues that were discussed in this forum, namely "Emerging epidemic infections and experimental medical treatments" (Annecy, France, 2015); "Ethics of research in pregnancy" (Buenos Aires, Argentina, 2016), and "The ethics of alternative clinical trial designs and methods in LMIC research" (Bangkok, Thailand, 2017). Local research ethics committees are not well prepared to face the new ethical challenges associated with research conducted in emergency situations or in pregnant women, or to evaluate new methods, such as alternative clinical trial designs (cluster randomized trials, adaptive platforms, or controlled human infection models, among others). According to this scenario, research ethics committees should be trained to carefully assess the risks and benefits of approving this type of research. In this context, it is necessary to harmonize local regulations with the new international standards in research ethics.
Revista médica de Chile, 2019
The Chilean Law regulating the voluntary interruption of pregnancy, contemplates the possibility ... more The Chilean Law regulating the voluntary interruption of pregnancy, contemplates the possibility that health personnel may refrain from doing the procedure if they have stated that they are conscientious objectors (CO). There are numerous articles on the subject. However, the impact on medical training centers when a student or resident abstain from performing certain clinical procedures invoking CO, has seldom been analyzed. In this article, we explore the rights and duties of the CO students to perform an abortion or other clinical procedures for either religious or cultural reasons. Based on international experience, we recommend that all health care centers should have established and publicly known policies on this matter. Finally, we honor CO invoked by students, based on three general principles. First, the autonomy and moral integrity of the students should be respected. Second, an adequate ethical sensitivity is promoted. Third, it contributes to the necessary heterogeneity and diversity of students, promoting a desirable pluralism. However, certain interests and values, such as the well-being of patients, must be considered over and above accepting the CO requests.
Reproductive health, Jan 14, 2017
This paper explores the ethical implications of a randomized double-blind clinical trial aimed to... more This paper explores the ethical implications of a randomized double-blind clinical trial aimed to determine effectiveness and safety of an oxytocin receptor antagonist versus a betamimetic in the treatment of preterm labor, presented to a teaching hospital affiliated with a private university in Santiago, Chile. Though this trial protocol fulfills one of the conditions under which pregnant women could be enrolled in a clinical trial-the intervention has the potential to benefit the pregnant woman (by reducing adverse effects associated to salbutamol administration) and her fetus (if the new drug prolongs pregnancy)-there are some specific ethical issues raised. First, when to obtain consent is an important issue for clinical trials involving acute and unforeseen conditions that affect pregnant woman, e.g. preterm labor. Second, research must address the risk/benefit ratio for these two interdependent individuals, providing a good prospect of low risk and adequate benefit for both of...
Revista médica de Chile, 2018
Revista médica de Chile, 2020
Ethical arguments for and against the participation of the medical profession in assisted death: ... more Ethical arguments for and against the participation of the medical profession in assisted death: analysis of the Ethics Department of the Chilean Medical Association The discussion of a bill that allows medically assisted death (MAD) in Chile, revived the debate about the ethics of this practice. The Department of Ethics of the Chilean Medical Association herein analyzes arguments in favor or against the participation of the medical profession in MAD. Among the main arguments against the participation of physicians in this practice are that MAD conflicts with the basic ethical principles of medical practice, that it is contrary to the purposes of medicine and that it could erode the patients' and society's confidence in physicians. The arguments in favor are related to physician´s compassion and non-abandonment of patients during their illness, choosing palliative care and ushering them to the final instance. Additionally, there is social expectation that this practice will be carried out by trained physicians who can verify that the strict criteria established by the legislation are met, guarantee that it obeys to a repeated request of a fully capable patient, and who is able to deal with the complications of the procedure. In this document we aimed to represent the different perspectives about physicians' participation in MAD, offering arguments to colleagues and stimulating their participation in this important debate.
Revista médica de Chile, 2018
Every so often, in Chile there is a discussion about the role of physicians in the care of people... more Every so often, in Chile there is a discussion about the role of physicians in the care of people on hunger strike (HS). In this document, we review the ethical aspects of health care for persons in HS, aiming to provide guidelines to medical doctors who are required to attend them. First, we make an important distinction between HS and suicide, since the former is used as a protest and denunciation tool, while suicide seeks deliberately to end a life. Then we describe the three roles that the health professional can fulfill: as a treating doctor, as an expert or as an official of a prison. The respect for the autonomy and dignity of the person in HS must prevail whatever the role of the physician. Therefore, we maintain that under no circumstances, people who have autonomously decided to be in HS should be fed by force. Due to the complexity of the issue, we make special considerations about the management of minors and the non-competent persons in HS. In conclusion, we adhere to the principles that inspire the Declaration of Malta, which indicate that it would be preferable to "allow a person on hunger strike to die in dignity, rather than subjecting them to repeated interventions against their will".
Revista médica de Chile, 2016
The Chilean bill that regulates abortion for three cases (Bulletin Nº 9895-11) includes the possi... more The Chilean bill that regulates abortion for three cases (Bulletin Nº 9895-11) includes the possibility that health professionals may manifest their conscientious objection (CO) to perform this procedure. Due to the broad impact that the issue of C O had, the Ethics Department of the Chilean College of Physicians considered important to review this concept and its ethical and legal basis, especially in the field of sexual and reproductive health. In the present document, we define the practical limit s of CO, both for the proper fulfillment of the medical profession obligations, and for the due respect and non-discrimination that the professional objector deserves. We analyze the denial of some health institutions to perform abortions if it is legalize d, and we end with recommendations adjusted to the Chilean reality. Specifically, we recognize the right to conscientious objection that all physicians who directly participate in a professional act have. But we a lso recognize that p...
Revista medica de Chile, 2016
Since doctors disposed of effective tools to serve their patients, they had to worry about the pr... more Since doctors disposed of effective tools to serve their patients, they had to worry about the proper management of available resources and how to deal with the relationship with the industry that provides such resources. In this relation-ship, health professionals may be involved in conflicts of interest that they need to acknowledge and learn how to handle. This article discusses the conflicts of interest in nephrology. Its objectives are to identify those areas where such conflicts could occur; to help to solve them, always considering the best interest of patients; and to help health workers to keep in mind that they have to preserve their autonomy and professional integrity. Conflicts of interest of professionals in the renal area and related scientific societies, with the industry producing equipment, supplies and drugs are reviewed. Dichotomy, payment for referral, self-referral of patients and incentives for cost control are analyzed. Finally, recommendations to help preserv...
Revista médica de Chile, 2008
The public dissemination of advances in biomedical research and clinical medicine generates sever... more The public dissemination of advances in biomedical research and clinical medicine generates several difficulties and problems. Mass media have the responsibility to report accurately and in a comprehensive way, and physicians and researchers mustprovide this information in ...
ARS MEDICA Revista de Ciencias Médicas, 2009
El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de e... more El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de estudios médicos humanísticos, actualmente incluido en el historial de Ars Medica Revista de ciencias médicas. El contenido del presente artículo, no necesariamente representa la actual línea editorial. Para mayor información visitar el siguiente vínculo:
ARS MEDICA Revista de Ciencias Médicas, 2008
El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de e... more El presente artículo corresponde a un archivo originalmente publicado en Ars Medica, revista de estudios médicos humanísticos, actualmente incluido en el historial de Ars Medica Revista de ciencias médicas. El contenido del presente artículo, no necesariamente representa la actual línea editorial. Para mayor información visitar el siguiente vínculo:
Pediatric Research, 1992
The fetus of sheep a species that evolved in lowlands, responds to hypoxemia (H) by maintaining c... more The fetus of sheep a species that evolved in lowlands, responds to hypoxemia (H) by maintaining cardiac output and umbilical-blood flow, increasing heart, brain and adrenal blood flow and decreasingittoother organs. The response to H of the fetus of the llama, thas has evolved in high altitudes, is not fully understood. We postulate that the systemic responses to H in the fetal llama are less marked and that the main adaptation occurs at the cellular and tissue levels. Our aim was to compare cardiac output and its distribution at 0 min (B) and after 20 min of fetal H (22-27% Sathb and 3-6 m102/dl in descending aorta) in-8 fetal sheep and 8 fetal llamas at 0.8 gestation. The results (x t SEM) were: Fetal Llama Fetal Sheep Basal Hypoxernia Basal Hyp~xemia Cardiac output (ml/minxkg)
Academic Medicine, 2007
The day after the graduation ceremony, the School of Medicine at the Pontificia Universidad Catól... more The day after the graduation ceremony, the School of Medicine at the Pontificia Universidad Católica de Chile traditionally invites the new doctors and the faculty members to a farewell party. Graduation takes place in January, which is summertime in the southern ...
Revista chilena de obstetricia y ginecología, 2015