Juan Pablo Beca | Universidad del Desarrollo (UDD) (original) (raw)
Papers by Juan Pablo Beca
Revista Medica De Chile, Mar 1, 2020
A proposal of the Chilean Academy of Medicine to improve organ procurement and transplantation in... more A proposal of the Chilean Academy of Medicine to improve organ procurement and transplantation in Chile The Chilean Academy of Medicine designated a group of specialists to evaluate the practice and to propose reforms for organ donation and transplantation, due to the general insufficiencies at the national level with these procedures. In the last six years the mean number of organ transplants in Chile was 340 cases per year while effective cadaveric donors ranged between 6 and 10 per million inhabitants. These averages remained stable during this period and are among the lowest in the region. Our analysis attributed these deficient results mainly to low organ donation and inefficient procurement due to lack of compliance with protocols and little accountability. The committee proposes several measures for improvement. These are a systematic and obligatory report of potential organ donors by all emergency and critical care centers, frequent evaluation of results, empowering of health authorities to correct insufficiencies in organ procurement, education programs for primary, secondary, technical and university students to improve their knowledge about the social significance and solidarity required for transplantation policies and specialized updated training of all health professionals involved. Organ donation and transplantation must be based on clear and fair ethical considerations in order to be accepted by the general public.
Revista médica de Chile, 2021
Opinion about clinical ethics consultation among intensivist physicians Background: Clinical ethi... more Opinion about clinical ethics consultation among intensivist physicians Background: Clinical ethics consultation services and their methods vary and they are seldom evaluated. Only one formal system of individual clinical ethics consultation has been reported in Chile, with a ten-year registry. Aim: To evaluate the opinion of intensivist physicians about the contribution of clinical ethics consultation. Material and Methods: An anonymous and voluntary questionnaire consulting their opinion about clinical ethics consultations was sent to 38 intensivist physicians. Results: The questionnaire was answered by 28 professionals. Eighty four percent of respondents considered that ethics consultation contributed to improve patients´ quality of care, 92% responded that this practice helps in decisions about limitation of treatments or life support, and 96% expressed that it also was a positive support for patients and their relatives. Seventy two percent of respondents considered that ethics consultations enhanced their ethical sensibility, 76% that they improved their understanding of clinical ethics topics, and 72% declared that it decreased their stress in complex decision-making. Conclusions: Clinical ethics consultation provides a positive support for improvements in clinical decision-making and in the quality of patients' care.
Global Child Health Advocacy, 2013
![Research paper thumbnail of [An ethics call to include pregnant women in research: Reflections from the Global Forum on Bioethics in Research]](https://attachments.academia-assets.com/109511840/thumbnails/1.jpg)
](Revista panamericana de salud publica = Pan American journal of public health, 2017
Revista médica de Chile, 2021
Clarifying concepts on euthanasia Euthanasia is a subject of permanent discussion everywhere, mai... more Clarifying concepts on euthanasia Euthanasia is a subject of permanent discussion everywhere, mainly about its ethical appropriateness and about its legalization in different countries. This debate includes many ethical, legal, social, political, spiritual, religious, and public health issues. A relevant problem is the frequent misunderstanding that many have about the meaning of the terms and concepts used in different ethical and clinical end of life settings. Many views and even texts are affected by such mistakes, rendering a constructive discussion almost impossible. The goal of this article is to contribute to an improvement of the social and legislative discussion about euthanasia through an elucidation of the main terms and notions linked to this topic. We present definitions and explanations for euthanasia, assisted suicide, withdrawal or foregoing of therapy, treatment rejection, palliative sedation, dignified death and others.
Revista Medica De Chile, 2020
Cadernos de Saúde Pública
Migrantes internacionales han sido reconocidos como población de riesgo en el contexto de la pand... more Migrantes internacionales han sido reconocidos como población de riesgo en el contexto de la pandemia de COVID-19. A nivel mundial se han desplegado diversas estrategias para la protección de esta población, como la habilitación de centros de recepción y cuarentena o aislamiento. El artículo da cuenta de los resultados de un estudio que exploró las experiencias de migrantes internacionales en residencias sanitarias dispuestas en Chile para la realización de cuarentenas seguras en el marco de la pandemia COVID-19, desde un enfoque de condiciones éticas para el cuidado. Se realizó un estudio cualitativo entre los años 2020-2021. Se efectuaron 30 entrevistas individuales semi-estructuradas en línea en las ciudades de Arica, Iquique, Antofagasta y Santiago a migrantes internacionales con experiencia de uso de residencias sanitarias; equipos de salud de residencias sanitarias; mánagers de dichos recintos; autoridades locales; y expertos nacionales. Se realizó análisis temático de la info...
Revista médica de Chile, 2016
The recent Ebola epidemic that affected several countries in Africa, with very high mortality and... more The recent Ebola epidemic that affected several countries in Africa, with very high mortality and a pandemic threat, posed problems of justice, public health, prevention, treatment and research, each of which has relevant ethical issues. Despite severe initial difficulties, an effective international response was achieved, whose outcome has left significant teachings to be considered in order to deal with future epidemics or pandemics. In this article, the authors analyze the main problems faced during the Ebola epidemic, including the unequal distribution of health resources between countries, the need for international collaboration, the requirement for a review of the ethical standards of clinical trials in emergencies, and the necessity of an organized global system of prevention and timely response to these outbreaks. Authors conclude that at the present time health is a global issue without borders, that insufficient healthcare resources in some countries poses risks and affects all countries and that the confrontation of the threats of epidemics requires a solution based in universal solidarity. At the same time, a moral duty to investigate should be acknowledged, seeking a balance between sense of urgency, scientific rigor and involvement of local communities.
Bioethics in the 21st Century, 2011
Revista chilena de enfermedades respiratorias, 2016
![Research paper thumbnail of [Role of medical students in the accompaniment of patients. Reflections about a true case]](https://attachments.academia-assets.com/88903780/thumbnails/1.jpg)
](We share the experience of a clinical relationship that arose between a medical student and a pat... more We share the experience of a clinical relationship that arose between a medical student and a patient hospitalized due to a SARS-CoV-2 pneumonia. The analysis of this experience and the discussion of medical students' possible role in patient care suggest that they should be included as members of the health care team during their clinical practice. This would mean a positive contribution for both the patients' care and the students' learning experience.
Revista chilena de pediatría, 2012
Se puede adquirir este libro en librerías médicas o en compras por internet en www. mediterraneo.cl
Revista chilena de pediatría, 1996
![Research paper thumbnail of [Hybrid embryos as a source of embryonic stem cells]](https://attachments.academia-assets.com/82113586/thumbnails/1.jpg)
](Revista medica de Chile, 2007
The HFEA (Human Fertilisations & Embryology Authority) recently accepted to perform research in h... more The HFEA (Human Fertilisations & Embryology Authority) recently accepted to perform research in hybrid embryos generated by transferring human somatic cell nucleus to cow enucleated oocytes, named cytoplasmatic hybrids. The aim is to obtain a source of embryonic stem cells without the use of human oocytes. The arguments for the approval are to avoid the risk of obtaining human oocytes and that these embryos will not be transferred to a female's womb for its development. Those who oppose the technique argue that it is a manipulation of the beginning of life and a disrespect to the dignity of human life because of the destruction of embryos. Nevertheless, the real nature of this new entity has not been established. Biologically it is an embryo with 99% of human genome and animal's cytoplasm, not generated from human gametes, it is not a new genome and it will be used only to cultivate stem cells. It does not seem possible to define its nature beyond any doubts. If it were cons...
![Research paper thumbnail of [Medical student-patient relationship: the students' perspective]](https://attachments.academia-assets.com/82113584/thumbnails/1.jpg)
](Revista medica de Chile, 2007
BACKGROUND The relationship between medical students and patients has special characteristics tha... more BACKGROUND The relationship between medical students and patients has special characteristics that require to be well understood to prepare both students and tutors. AIM To learn about medical students' thoughts and experiences once they start working with patients, how do they solve difficulties or problems and their perceptions about professional roles and patient rights. MATERIAL AND METHODS Qualitative study based on semi-structured interviews applied to 30 volunteer third year medical students who were beginning their clinical practice. The answers to open questions were transcribed and then analysed and grouped by topics and categories. RESULTS Helping others was the main motivation to go to medical school. Other reasons were scientific interest and social status. Students felt prepared to communicate with patients. However they felt anxious, stressful and fearful of not being competent or not being able to answer patients' questions. There were some differences betwee...
![Research paper thumbnail of [The debate about the right to die]](https://attachments.academia-assets.com/83839699/thumbnails/1.jpg)
](Revista medica de Chile, 2005
The Right to Die is a debatable issue and some basic notions need to be clarified to discuss it. ... more The Right to Die is a debatable issue and some basic notions need to be clarified to discuss it. Death needs to be recognized as part of human life. The goal of medicine is to avoid pain and alleviate suffering, to prevent premature death and when this is not possible, to let it occur peacefully. The concept of euthanasia is unclear, which increases the confusion on end-of-life topics. The term euthanasia should be used only when referring to medical acts performed to produce the patient's death, with the intention of terminating his/her suffering. It is what is usually called "active" euthanasia, which can be voluntary or involuntary. It is essential to understand the difference between producing and allowing death. This will permit timely decisions about limiting or withdrawing treatments, that can be disproportionate or that are only prolonging suffering. Limiting treatments does not mean to abandon the patient but rather to redefine his needs, such as pain treatmen...
![Research paper thumbnail of [Medicine in television. An ethical problem?]](https://attachments.academia-assets.com/83839703/thumbnails/1.jpg)
](Revista medica de Chile, 2004
Television programs where medical procedures are shown with progressive realism generate problems... more Television programs where medical procedures are shown with progressive realism generate problems that physicians need to know and analyze. The authors analyze this issue, based on the respect to patient's dignity and the principles of bioethics. Medical programs on TV present specific problems to the different agents involved in them: TV media, physicians, health organization, public and patients or relatives that are exposed. Physicians have the responsibility to educate the society using the most efficient methods of public communication, including television. The problem is not how much can be shown but how to do it, making sure that the dignity of patients, the privacy of their stories and their own and their relative's feelings are always strictly cherished. The respect towards the patient is accomplished through a valid informed consent, the reverence to his face as an expression of his personhood, and the way in which his body is exposed. The authors conclude that TV...
Revista Médica Clínica Las Condes
Revista Medica De Chile, Mar 1, 2020
A proposal of the Chilean Academy of Medicine to improve organ procurement and transplantation in... more A proposal of the Chilean Academy of Medicine to improve organ procurement and transplantation in Chile The Chilean Academy of Medicine designated a group of specialists to evaluate the practice and to propose reforms for organ donation and transplantation, due to the general insufficiencies at the national level with these procedures. In the last six years the mean number of organ transplants in Chile was 340 cases per year while effective cadaveric donors ranged between 6 and 10 per million inhabitants. These averages remained stable during this period and are among the lowest in the region. Our analysis attributed these deficient results mainly to low organ donation and inefficient procurement due to lack of compliance with protocols and little accountability. The committee proposes several measures for improvement. These are a systematic and obligatory report of potential organ donors by all emergency and critical care centers, frequent evaluation of results, empowering of health authorities to correct insufficiencies in organ procurement, education programs for primary, secondary, technical and university students to improve their knowledge about the social significance and solidarity required for transplantation policies and specialized updated training of all health professionals involved. Organ donation and transplantation must be based on clear and fair ethical considerations in order to be accepted by the general public.
Revista médica de Chile, 2021
Opinion about clinical ethics consultation among intensivist physicians Background: Clinical ethi... more Opinion about clinical ethics consultation among intensivist physicians Background: Clinical ethics consultation services and their methods vary and they are seldom evaluated. Only one formal system of individual clinical ethics consultation has been reported in Chile, with a ten-year registry. Aim: To evaluate the opinion of intensivist physicians about the contribution of clinical ethics consultation. Material and Methods: An anonymous and voluntary questionnaire consulting their opinion about clinical ethics consultations was sent to 38 intensivist physicians. Results: The questionnaire was answered by 28 professionals. Eighty four percent of respondents considered that ethics consultation contributed to improve patients´ quality of care, 92% responded that this practice helps in decisions about limitation of treatments or life support, and 96% expressed that it also was a positive support for patients and their relatives. Seventy two percent of respondents considered that ethics consultations enhanced their ethical sensibility, 76% that they improved their understanding of clinical ethics topics, and 72% declared that it decreased their stress in complex decision-making. Conclusions: Clinical ethics consultation provides a positive support for improvements in clinical decision-making and in the quality of patients' care.
Global Child Health Advocacy, 2013
Revista panamericana de salud publica = Pan American journal of public health, 2017
Revista médica de Chile, 2021
Clarifying concepts on euthanasia Euthanasia is a subject of permanent discussion everywhere, mai... more Clarifying concepts on euthanasia Euthanasia is a subject of permanent discussion everywhere, mainly about its ethical appropriateness and about its legalization in different countries. This debate includes many ethical, legal, social, political, spiritual, religious, and public health issues. A relevant problem is the frequent misunderstanding that many have about the meaning of the terms and concepts used in different ethical and clinical end of life settings. Many views and even texts are affected by such mistakes, rendering a constructive discussion almost impossible. The goal of this article is to contribute to an improvement of the social and legislative discussion about euthanasia through an elucidation of the main terms and notions linked to this topic. We present definitions and explanations for euthanasia, assisted suicide, withdrawal or foregoing of therapy, treatment rejection, palliative sedation, dignified death and others.
Revista Medica De Chile, 2020
Cadernos de Saúde Pública
Migrantes internacionales han sido reconocidos como población de riesgo en el contexto de la pand... more Migrantes internacionales han sido reconocidos como población de riesgo en el contexto de la pandemia de COVID-19. A nivel mundial se han desplegado diversas estrategias para la protección de esta población, como la habilitación de centros de recepción y cuarentena o aislamiento. El artículo da cuenta de los resultados de un estudio que exploró las experiencias de migrantes internacionales en residencias sanitarias dispuestas en Chile para la realización de cuarentenas seguras en el marco de la pandemia COVID-19, desde un enfoque de condiciones éticas para el cuidado. Se realizó un estudio cualitativo entre los años 2020-2021. Se efectuaron 30 entrevistas individuales semi-estructuradas en línea en las ciudades de Arica, Iquique, Antofagasta y Santiago a migrantes internacionales con experiencia de uso de residencias sanitarias; equipos de salud de residencias sanitarias; mánagers de dichos recintos; autoridades locales; y expertos nacionales. Se realizó análisis temático de la info...
Revista médica de Chile, 2016
The recent Ebola epidemic that affected several countries in Africa, with very high mortality and... more The recent Ebola epidemic that affected several countries in Africa, with very high mortality and a pandemic threat, posed problems of justice, public health, prevention, treatment and research, each of which has relevant ethical issues. Despite severe initial difficulties, an effective international response was achieved, whose outcome has left significant teachings to be considered in order to deal with future epidemics or pandemics. In this article, the authors analyze the main problems faced during the Ebola epidemic, including the unequal distribution of health resources between countries, the need for international collaboration, the requirement for a review of the ethical standards of clinical trials in emergencies, and the necessity of an organized global system of prevention and timely response to these outbreaks. Authors conclude that at the present time health is a global issue without borders, that insufficient healthcare resources in some countries poses risks and affects all countries and that the confrontation of the threats of epidemics requires a solution based in universal solidarity. At the same time, a moral duty to investigate should be acknowledged, seeking a balance between sense of urgency, scientific rigor and involvement of local communities.
Bioethics in the 21st Century, 2011
Revista chilena de enfermedades respiratorias, 2016
We share the experience of a clinical relationship that arose between a medical student and a pat... more We share the experience of a clinical relationship that arose between a medical student and a patient hospitalized due to a SARS-CoV-2 pneumonia. The analysis of this experience and the discussion of medical students' possible role in patient care suggest that they should be included as members of the health care team during their clinical practice. This would mean a positive contribution for both the patients' care and the students' learning experience.
Revista chilena de pediatría, 2012
Se puede adquirir este libro en librerías médicas o en compras por internet en www. mediterraneo.cl
Revista chilena de pediatría, 1996
Revista medica de Chile, 2007
The HFEA (Human Fertilisations & Embryology Authority) recently accepted to perform research in h... more The HFEA (Human Fertilisations & Embryology Authority) recently accepted to perform research in hybrid embryos generated by transferring human somatic cell nucleus to cow enucleated oocytes, named cytoplasmatic hybrids. The aim is to obtain a source of embryonic stem cells without the use of human oocytes. The arguments for the approval are to avoid the risk of obtaining human oocytes and that these embryos will not be transferred to a female's womb for its development. Those who oppose the technique argue that it is a manipulation of the beginning of life and a disrespect to the dignity of human life because of the destruction of embryos. Nevertheless, the real nature of this new entity has not been established. Biologically it is an embryo with 99% of human genome and animal's cytoplasm, not generated from human gametes, it is not a new genome and it will be used only to cultivate stem cells. It does not seem possible to define its nature beyond any doubts. If it were cons...
Revista medica de Chile, 2007
BACKGROUND The relationship between medical students and patients has special characteristics tha... more BACKGROUND The relationship between medical students and patients has special characteristics that require to be well understood to prepare both students and tutors. AIM To learn about medical students' thoughts and experiences once they start working with patients, how do they solve difficulties or problems and their perceptions about professional roles and patient rights. MATERIAL AND METHODS Qualitative study based on semi-structured interviews applied to 30 volunteer third year medical students who were beginning their clinical practice. The answers to open questions were transcribed and then analysed and grouped by topics and categories. RESULTS Helping others was the main motivation to go to medical school. Other reasons were scientific interest and social status. Students felt prepared to communicate with patients. However they felt anxious, stressful and fearful of not being competent or not being able to answer patients' questions. There were some differences betwee...
Revista medica de Chile, 2005
The Right to Die is a debatable issue and some basic notions need to be clarified to discuss it. ... more The Right to Die is a debatable issue and some basic notions need to be clarified to discuss it. Death needs to be recognized as part of human life. The goal of medicine is to avoid pain and alleviate suffering, to prevent premature death and when this is not possible, to let it occur peacefully. The concept of euthanasia is unclear, which increases the confusion on end-of-life topics. The term euthanasia should be used only when referring to medical acts performed to produce the patient's death, with the intention of terminating his/her suffering. It is what is usually called "active" euthanasia, which can be voluntary or involuntary. It is essential to understand the difference between producing and allowing death. This will permit timely decisions about limiting or withdrawing treatments, that can be disproportionate or that are only prolonging suffering. Limiting treatments does not mean to abandon the patient but rather to redefine his needs, such as pain treatmen...
Revista medica de Chile, 2004
Television programs where medical procedures are shown with progressive realism generate problems... more Television programs where medical procedures are shown with progressive realism generate problems that physicians need to know and analyze. The authors analyze this issue, based on the respect to patient's dignity and the principles of bioethics. Medical programs on TV present specific problems to the different agents involved in them: TV media, physicians, health organization, public and patients or relatives that are exposed. Physicians have the responsibility to educate the society using the most efficient methods of public communication, including television. The problem is not how much can be shown but how to do it, making sure that the dignity of patients, the privacy of their stories and their own and their relative's feelings are always strictly cherished. The respect towards the patient is accomplished through a valid informed consent, the reverence to his face as an expression of his personhood, and the way in which his body is exposed. The authors conclude that TV...
Revista Médica Clínica Las Condes