Letter to the Editor
Another assessment in relation to the aid to die in Intensive Medicine Units
Otra valoración en relación a la Prestación de ayuda a morir (PAM) en Unidades de Medicina Intensiva
Alfonso Canabal
Universidad Francisco de Vitoria, Hospital Universitario La Princesa de Madrid, Calle Diego de León 62, 28006, Spain
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The “<span class="elsevierStyleItalic">social and professional debate</span>” has not occurred since no consultations were made. Medical professionalism,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> detailed reports from organisms in the field of ethics,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and communications from the Spanish Society of Palliative Medicine, exposing the generated risks,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> were lacking.</p><p id="par0010" class="elsevierStylePara elsevierViewall">As you rightly point out, diversity and moral values differ among people and cultures, though the mechanism for listening to all the implicated parties has not been used. The authors correctly adopted a position from the perspective of professional ethics, though here things are also debatable.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In answering the issues raised, references have been made to emotivism, compassion and autonomism, which seem unquestionable in today’s society, and which have replaced rationalism with desire, opinion and emotion, which occupy the entire philosophical debate.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Intensivists with ethical training fundamented good medical practice and the limitation of therapeutic effort, contributing conceptual and ethical development to it. We help patients to fulfill their will to not prolong their refractory terminal condition, without resorting to euthanasia practices.</p><p id="par0025" class="elsevierStylePara elsevierViewall">On the other hand, euthanasia is hard to regard as a medical act if we take medical deontology into account, as updated with a new code in 2022,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and which does not contemplate such practices. Likewise, it is not consistent with the definitions of the Hastings Center on the purposes of Medicine. These ethical codes are considered to evolve according to the interests and obligations that we as professionals assign to ourselves, though this has not been the case to date. Controversy is generated in view of the higher ranking of laws concerning the professional codes — a fact that also generates ethical conflicts.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Our involvement in the organ donation process after euthanasia extends beyond the possibilities of the article of the authors and also of my own observations. Such delicate and important issues should not be addressed in a summarized way. A deep, paused and constructive analysis is needed in order to improve upon what is being proposed.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Canabal A. Otra valoración en relación a la Prestación de ayuda a morir (PAM) en Unidades de Medicina Intensiva. Med Intensiva. 2023. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.medine.2023.10.010">https://doi.org/10.1016/j.medine.2023.10.010</span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La prestación de ayuda a morir en el ámbito de las unidades de medicina intensiva. ¿Cómo puede afectar a los profesionales?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Olga Rubio Sanchiz" 1 => "Nuria Masnou Burrallo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2023.03.004" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva" "fecha" => "2023" "volumen" => "47" "paginaInicial" => "468" "paginaFinal" => "470" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37059649" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Asamblea General: Posicionamiento del CGCOM ante la eutanasia y el suicidio asistido. May 2018, Consulted on the internet; <a target="_blank" href="https://www.cgcom.es/notas-de-prensa/asamblea-general-posicionamiento-del-cgcom-ante-la-eutanasia-y-el-suicidio-asistido">https://www.cgcom.es/notas-de-prensa/asamblea-general-posicionamiento-del-cgcom-ante-la-eutanasia-y-el-suicidio-asistido</a>." ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Comité de Bioética de España. Informe del Comité de bioética de España sobre el final de la vida y la atención en el proceso de morir, en el marco del debate sobre la regulación de la eutanasia: propuestas para la reflexión y la deliberación. October 2020. Consulted in August 2023 and available online: <a target="_blank" href="http://assets.comitedebioetica.es/files/documentacion/Informe%20CBE%20final%20vida%20y%20la%20atencion%20en%20el%20proceso%20de%20morir.pdf">http://assets.comitedebioetica.es/files/documentacion/Informe%20CBE%20final%20vida%20y%20la%20atencion%20en%20el%20proceso%20de%20morir.pdf</a>." ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Comunicado de SECPAL y AECPAL ante la ley orgánica de regulación de la euthanasia. Consulted in August 2023 and available on the internet: <a target="_blank" href="https://www.secpal.org/comunicado-de-secpal-y-aecpal-ante-la-ley-organica-de-regulacion-de-la-eutanasia/">https://www.secpal.org/comunicado-de-secpal-y-aecpal-ante-la-ley-organica-de-regulacion-de-la-eutanasia/</a>." ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Atención médica al final de la vida. Código de deontología médica. Guía de ética médica" ] ] "host" => array:2 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2022" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "https://www.cgcom.es/sites/main/files/minisite/static/828cd1f8-2109-4fe3-acba-1a778abd89b7/codigo_deontologia/index.html" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004800000002/v1_202401310654/S2173572723001704/v1_202401310654/en/main.assets" "Apartado" => array:4 [ "identificador" => "64604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004800000002/v1_202401310654/S2173572723001704/v1_202401310654/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572723001704?idApp=WMIE" ]
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