Bioética en tiempo real: El Límite de la viabilidad en los recién nacidos
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Universidad Industrial de Santander
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Introducción: los avances en la medicina perinatal en sociedades con mayor desarrollo industrial, han generado reducción en las tasas de mortalidad neonatal con una gradual disminución en la edad gestacional con posibilidades de supervivencia. Objetivo: analizar los elementos bioéticos considerados en la toma de decisiones para establecer los límites de viabilidad en el recién nacido. Metodología: se realizó una búsqueda bibliográfca en distintas fuentes y bases de datos electrónicas sobre los aspectos éticos, legal y humanista en relación con el límite de la viabilidad en los recién nacidos. Resultados y conclusiones: se describen dos escenarios clínicos, que son la plataforma para ejemplifcar e iniciar el análisis del dilema ético que condiciona el límite de la viabilidad; se discute la zona gris de la neonatología de acuerdo a tasas de sobrevivencia y tasas de mortalidad en distintos países con diferentes características, dividiéndolos en países desarrollados o subdesarrollados. Se realiza el análisis bioético del dilema, en base a las teorías éticas y modelos de discernimiento: teorías utilitarista, deontológica y aretológica. (MÉD UIS.2013;26(3):23-31)
Advances in perinatal medicine over the past decades have led to reduced rates in neonatal mortality with a gradual decrease in gestational age with chances of survival. The aim of this review is to analyze the elements considered in bioethical decision making to establish the limits of viability in the newborn infant. A literature search was conducted in diferent sources and electronic databases on diferent ethics, legal and humanitarian aspects in relation to the limit of neonatal viability. We describe two clinical scenarios, which are the platform to start the analysis of the ethical dilemma that determines the limit of viability. We discuss the “gray zone” of neonatology according to survival and mortality rates in diferent countries with distinctive characteristics, dividing them into developed and developing countries. Bioethical analysis is performed of the dilemma, based on ethical theories and models of judgment: utilitarian, deontological and aretological theories. (MÉD UIS.2013;26(3):23-31)
Advances in perinatal medicine over the past decades have led to reduced rates in neonatal mortality with a gradual decrease in gestational age with chances of survival. The aim of this review is to analyze the elements considered in bioethical decision making to establish the limits of viability in the newborn infant. A literature search was conducted in diferent sources and electronic databases on diferent ethics, legal and humanitarian aspects in relation to the limit of neonatal viability. We describe two clinical scenarios, which are the platform to start the analysis of the ethical dilemma that determines the limit of viability. We discuss the “gray zone” of neonatology according to survival and mortality rates in diferent countries with distinctive characteristics, dividing them into developed and developing countries. Bioethical analysis is performed of the dilemma, based on ethical theories and models of judgment: utilitarian, deontological and aretological theories. (MÉD UIS.2013;26(3):23-31)
Keywords
Fetal viability, Ethics, Premature newborns, Viabilidad Fetal, Ética, Recién Nacidos, Prematuros