-Por la Dra. Lida Sanmartín-
La Organización Panamericana de la Salud describe este momento decisorio y documentado de la relación asistencial encuadrándolo dentro del concepto de «buenas prácticas» definiéndolo como «el proceso mediante el cual un sujeto confirma voluntariamente su deseo de participar en un estudio en particular después de haber sido informado sobre todos los aspectos de éste que sean relevantes para que tome la decisión de participar. El consentimiento informado se documenta por medio de un formulario de consentimiento informado escrito, firmado y fechado .»
El nuevo Código CyC distingue dentro del consentimiento informado entre el que refiere a investigación en ser humanos (investigaciones clínicas o pruebas científicas) y el acto médico en concreto.
En los artículos 58 y 59 no pueden ser entendidos por separado, son el resumen preceptos que ya imperaban en la actividad de médicos y profesionales afines, así como en la investigación clínica, por ello en principio se puede sostener que no traerán aparejados grandes cambios para quienes llevaban a cabo sus actividades dentro de lo normado por esos principios rectores.
«ARTÍCULO 58.- Investigaciones en seres humanos.(también aplicable a todo acto médico) Inc. f. contar con el consentimiento previo, libre, escrito, informado y específico de la persona que participa en la investigación, a quien se le debe explicar, en términos comprensibles, los objetivos y la metodología de la investigación, sus riesgos y posibles beneficios; dicho consentimiento es revocable;…»
El inc. «F» prevé el Consentimiento Informado (CI) condición «sine quanon» de todo lo que seguirá una vez aprobada un protocolo de investigación en seres humanos. Si bien no lo define establece como debe obtenérselo (previo), que requisitos debe cumplir (libre, escrito sobre cada participante en particular), y qué recaudos deben quedar acreditados (informado, explicar comprensiblemente los objetivos, métodos, riesgos y beneficios) por lo que entendemos es una obligación de cumplimiento exclusiva de los profesionales de la salud.
Sostenemos que este es el documento más importante para el paciente, será en el que refleje su decisión y el fundamento de la misma. Es además -a nuestro entender- el momento en que el paciente (sujeto a investigación) sopesará su estado de salud con la información propia de la investigación donde deberá encontrar respuestas a interrogantes tales como: sobre qué, de qué manera, por quienes, con que propósito y con qué expectativa, o qué resultados se espera de la misma.
El consentimiento informado para actos medico. Alcance y revocabilidad.
El artículo 59 del nuevo Código Civil nos coloca frente al documento rector en todo acto médico e investigaciones clínicas: El Consentimiento informado.
El artículo es redactado en un intento de sistematizar la normativa especial procurando un marco normativo orgánico e integrado. Se inspira en las leyes de Derechos del Paciente.
El consentimiento, como ya hemos afirmado, es de vital importancia en la relación del médico con su paciente, pues conlleva para el médico -y demás profesionales de la salud- además de la prestación del servicio profesional, el consecuente trato digno y respetuoso, la información sanitaria, preservar su intimidad y confidencialidad. Estos derechos del paciente son esenciales y no se acota en el accionar del médico sino que se extiende en la relación entre profesionales de la salud, los efectores, los seguros médicos y el paciente. Y la observancia de estos valores en la relación tratado- tratantes será la fuente de éxitos o responsabilidades frente a los tratamientos y actos médicos indicados.
«ARTÍCULO 59.- Consentimiento informado para actos médicos e investigaciones en salud. El consentimiento informado para actos médicos e investigaciones en salud es la declaración de voluntad expresada por el paciente, emitida luego de recibir información clara, precisa y adecuada, respecto a:
- su estado de salud;
- el procedimiento propuesto, con especificación de los objetivos perseguidos;
- los beneficios esperados del procedimiento;
- los riesgos, molestias y efectos adversos previsibles;
- la especificación de los procedimientos alternativos y sus riesgos, beneficios y perjuicios en relación con el procedimiento propuesto;…»
Entendemos que el legislador en este artículo no soslaya el proceso pero se refiere más concretamente al documento que suscribirá el paciente cuando dice » es la declaración de voluntad expresada» es decir rubricada luego del proceso de información y decisión.
Lo que queda claro es que el legislador ha sido tajante sobre la obligatoriedad del consentimiento informado como base de cualquier práctica en salud al decir: «Nadie puede ser sometido a exámenes o tratamientos clínicos o quirúrgicos sin su consentimiento libre e informado, excepto disposición legal en contrario.»
El artículo es muy concreto y surge indiscutible que para llevar adelante todo acto médico (exámenes o tratamientos diagnósticos, clínicos o quirúrgicos) deberá estarse a su cumplimiento.
Referencias de la autora
Abogada. Asesora. Derecho Universitario. Derecho a la Salud. Facilitadora en temas de derecho Sanitario. Especialista en Administración del Sector Público. Asesora de la Secretaría Asistencial de APUBA. Consultoría de Trabajadores y trabajadoras universitarios del área asistencial. Estudio comparativo, planificación y proyección de reglamentaciones. Capacitación sector Asistencial. Ex Directora de Personal Universidad de Buenos Aires, Facultad de Ciencias Médicas. Dirección de Personal. Áreas de dependencia: DG Administración y Secretaria de Hacienda.
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The new Zune browser is shockingly constructive, still not as positive as the iPod’s. It operates effectively, but is just not as quick as Safari, and contains a clunkier interface. If yourself sometimes software on utilizing the web browser that’s not an issue, but if you might be planning to read through the internet alot versus your PMP then the iPod’s more substantial display and far better browser might be substantial.
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If you are nonetheless on the fence: grab your favorite earphones, brain down to a Simplest Invest in and inquire towards plug them into a Zune then an iPod and look at which just one sounds superior in the direction of your self, and which interface tends to make you smile further. Then you may recognize which is immediately for your self.
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I am going to products this evaluate in the direction of Two types of us residents: existing Zune owners who are taking into consideration an update, and These making an attempt in the direction of make a decision amongst a Zune and an iPod. (There are other players truly worth taking into consideration out there, including the Sony Walkman X, yet I anticipate this presents you adequate information and facts in direction of deliver an mindful conclusion of the Zune vs gamers other than the iPod line as properly.)
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Apple presently incorporates Rhapsody as an app, which is a exceptional get started, nevertheless it is already hampered through the incapacity in the direction of retail outlet locally on your iPod, and includes a dismal 64kbps little bit cost. If this changes, then it will fairly negate this usefulness for the Zune, but the 10 audio for each thirty day period will still be a significant as well as within Zune Pass’ choose.
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Apple by now incorporates Rhapsody as an app, which is a Good begin, nevertheless it is previously hampered via the inability in the direction of shop regionally upon your iPod, and contains a dismal 64kbps little bit value. If this alterations, then it will rather negate this benefit for the Zune, however the Ten new music per month will still be a massive plus inside of Zune Pass’ want.
The Zune concentrates upon currently being a Portable Media Player. Not a internet browser. Not a activity machine. Potentially in just the foreseeable future it’s going to do even superior within just those areas, yet for at this time it truly is a Great course to set up and listen in direction of your music and movies, and is without the need of peer inside that regard. The iPod’s benefits are its website browsing and apps. If all those good far more powerful, probably it is your perfect final decision.
Concerning me and my partner we have owned even further MP3 players previously mentioned the yrs than I can count, including Sansas, iRivers, iPods (classic & touch), the Ibiza Rhapsody, and so on. But, the final handful of yrs I’ve settled down in direction of one particular line of avid gamers. Why? Given that I was joyful in the direction of locate how well-designed and exciting in the direction of seek the services of the underappreciated (and widely mocked) Zunes are.
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This is getting to be a little bit additional subjective, nonetheless I significantly prefer the Zune Marketplace. The interface is colourful, includes excess aptitude, and some neat attributes like ‘Mixview’ that allow for by yourself out of the blue view identical albums, new music, or other consumers very similar toward what you are listening in direction of. Clicking on 1 of these will centre upon that product, and one more preset of «neighbors» will arrive into feeling, allowing for on your own towards navigate above looking into via equivalent artists, new music, or customers. Speaking of people, the Zune «Social» is on top of that Terrific enjoyment, permitting oneself locate some others with shared tastes and getting close friends with them. Your self then can pay attention toward a playlist crafted primarily based upon an amalgamation of what all your friends are listening towards, which is too thrilling. Individuals concerned with privateness will be relieved toward notice yourself can stay clear of the general public against looking at your unique listening patterns if on your own consequently opt for.
Palms down, Apple’s application keep wins through a mile. It is a massive number of all kinds of purposes vs a quite unsatisfied preference of a handful for Zune. Microsoft incorporates Options, primarily inside the realm of online games, still I am not confident I might need to have towards wager upon the potential if this characteristic is sizeable towards your self. The iPod is a significantly much better conclusion within that situation.
The Zune concentrates on remaining a Transportable Media Player. Not a world-wide-web browser. Not a video game machine. Quite possibly in just the long run it’ll do even greater in just those areas, yet for already it can be a excellent route toward organize and pay attention to your songs and flicks, and is without peer inside that respect. The iPod’s advantages are its internet visiting and apps. If those good a lot more compelling, quite possibly it is your least difficult option.
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Zune and iPod: Optimum humans review the Zune in direction of the Touch, yet soon after watching how slim and remarkably minor and light it is, I think about it in direction of be a fairly special hybrid that brings together properties of the two the Contact and the Nano. It’s Really colourful and attractive OLED exhibit is somewhat lesser than the touch screen, but the participant by itself feels rather a bit smaller and lighter. It weighs over 2/3 as considerably, and is noticeably scaled-down within width and height, though getting simply a hair thicker.
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