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Blasco Igual, Clara
Añón Roig, María José (dir.) Departament de Filosofia del Dret Moral i Politic |
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Aquest document és un/a tesi, creat/da en: 2015 | |
In recent decades, patients’ rights have evolved significantly. The emergence of these rights is difficult to determine. However, unquestionably the recognition of human rights is a crucial advance in acknowledging patients’ rights. Therefore, the aforementioned situation comes to link the deployment of the former with the development of the latter. The Universal Declaration of Human Rights was a landmark document that has brought global recognition of individuals’ inherent rights. From that moment, the dignity as a foundation, and liberty and equality as values, have formed the basis for the consolidation of the rights of individuals, including those of patients. No doubt this achievement was the result of the continuous adoption of covenants, charters and other legal instruments that have promoted the progressive inclusion of the same domestically in many countries, as in the case of ...
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In recent decades, patients’ rights have evolved significantly. The emergence of these rights is difficult to determine. However, unquestionably the recognition of human rights is a crucial advance in acknowledging patients’ rights. Therefore, the aforementioned situation comes to link the deployment of the former with the development of the latter. The Universal Declaration of Human Rights was a landmark document that has brought global recognition of individuals’ inherent rights. From that moment, the dignity as a foundation, and liberty and equality as values, have formed the basis for the consolidation of the rights of individuals, including those of patients. No doubt this achievement was the result of the continuous adoption of covenants, charters and other legal instruments that have promoted the progressive inclusion of the same domestically in many countries, as in the case of SpainSince then there have been many changes. In the health context, the most significant transformation was changing the clinical care relationship since traditionally, the health profession has followed the so-called paternalistic model and overall the regulatory developments prioritize a model based on the respect for individual autonomy. Thus, the dominant relationship in the past has changed substantially in terms of its configuration, as the dominant paternalism has been gradually redirected towards a more egalitarian system rooted in a shared responsibility between the health professional and the patient or user.So, the fact that personal self-determination is enshrined as one of the fundamental pillars in the main documents on international human rights, along with government commitment in this regard, have meant that one of the most important aspects of the clinical care relationship is decision making. Moreover, at present, the legal concept of informed consent has certainly become one of the main features.In Spain, the significant legislative progress and the consolidation of informed consent occurs with the entry into force of Act 41/2002, of 14 November, regulating patient autonomy and rights and obligations regarding clinical information and documentation, also known as the law of patient autonomy. This law not only recognizes such institution, but also introduces and guarantees the rights, duties and obligations relating to the clinical care relationship at the state level.Informed consent in minors is regulated in the law on patient autonomy, which, in our legal system introduces a new figure, namely, the "mature minor". This refers to the person who, without having reached the adult age, has enough capacity to decide on matters concerning their health. However, the wording of the law has led to various interpretations regarding giving informed consent. And this situation leads us to consider the following keys questions: what is the framework for informed consent when the subject of a treatment or intervention is a minor? And in the specific case, who is responsible for decision making when the patient is a minor?El reconocimiento de los derechos de los pacientes constituye un logro relativamente reciente y aunque su nacimiento es de difícil determinación, es incuestionable que desde la aprobación de la Declaración Universal de los Derechos Humanos en 1948, se constata un avance importante en el desarrollo y protección de tales derechos. Gracias a ello se han producido numerosas transformaciones. La más significativa en el contexto sanitario se ha manifestado en el cambio de relación médico asistencial puesto que tradicionalmente, la profesión sanitaria ha seguido el denominado modelo paternalista y a través de la aprobación progresiva de la normativa específica en esta materia se ha dado prioridad a un modelo basado en el respeto de la autonomía individual. En este sentido, la relación preponderante en el pasado ha sido reconducida, pues, hacia una relación igualitaria que hunde sus raíces en una corresponsabilidad entre el profesional de la salud y el paciente. Así las cosas, el hecho de que el respeto de la autodeterminación personal se consagre como uno de los pilares fundamentales en los principales textos internacionales de los derechos humanos junto con el compromiso de los Estados en la materia, ha propiciado que uno de los aspectos más importantes de la relación clínico asistencial sea la toma de decisión. Es más, en la actualidad, se puede afirmar que la figura jurídica del consentimiento informado ha pasado a ser uno de los principales protagonistas. En España, la norma que regula el consentimiento informado es la Ley Orgánica 41/2002, de 14 de noviembre, básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica. Esta norma, regula por primera vez en este campo las cuestiones concernientes a la toma de decisión en el periodo de la infancia. Ahora bien, los términos en los que se expresa el articulado ha suscitado diversas interpretaciones. Esto es porque en lo que respecta al paciente menor de edad la ley introduce en el sistema una figura novedosa, la del menor maduro. La expresión, menor maduro, se utiliza para identificar a quienes legalmente son menores de edad, pero tienen una capacidad suficiente para involucrarse en la toma de decisiones atinentes a su persona. Y el tenor literal de la legislación sanitaria en combinación con la legislación civil, ha hecho que la inclusión de la figura del menor maduro genere diversas interpretaciones en torno a la emisión del consentimiento informado en este periodo de la vida. Precisamente de ahí, surge el interés en este estudio; en la conveniencia de identificar el marco de ejercicio del consentimiento informado en el periodo de la infancia y de plantear soluciones a los problemas prácticos que presentan los supuestos particulares en la toma de decisión sobre la salud de los niños.
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