Boletín de la Oficina Sanitaria Panamericana. Pan American Sanitary Bureau
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Bol Oficina Sanit Panam · May 1996
Review[Non-communicable chronic diseases in Brazil: from risk factors to social impact].
The current epidemiologic profile of Brazil includes both the diseases of underdevelopment and those associated with modern life. Consequently, the country faces the difficult task of carrying out health promotion and protection activities aimed at controlling communicable diseases as well as noncommunicable chronic diseases (NCDs). This study sought to describe the epidemiologic situation of Brazilian adults with regard to NCDs and to present available data on the quality of care provided for these diseases and their social impact. ⋯ Premature mortality, as measured by productive years of life lost, reflects the poor quality of medical care and the absence of targeted control programs. These data, combined with other sources of information, such as consents for treatment and pensions paid for illness, give some idea of the impact of NCDs on the society. The authors point to the basic research that could be done in all the country's regions to serve as a basis for planning and implementing populational strategies to reduce risk factors and to treat and control chronic noncommunicable diseases in Brazil.
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The objective of this cross-sectional study was to estimate mortality and morbidity from asthma in Mexico by federative entity (state) of residence, age, and sex during the period between 1960 and 1988. Statistics published by the National Institute of Statistics, Geography, and Information Science were reviewed, as were vital statistics and information from other sources. Data were selected on mortality, hospital admissions, and outpatient visits, as well as population by federative entity, age, and sex. ⋯ From 1960 up to the 1990s, the highest rates of hospitalization and outpatient visits were registered among those under 4 and those over 60. The states with the highest asthma hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango, and Tamaulipas. It is concluded that asthma mortality in Mexico is showing a downward trend, while morbidity is increasing considerably, especially among adolescents.
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It has been suggested that the Hippocratic oath is no longer relevant in the context of modern morals and current medical practice and that it continues to be administered simply out of blind adherence to tradition. Such judgments may be the result of too superficial an analysis of the oath. The substance of the oath is its ethical content, while the style is shaped by its cultural and historical roots and its literary form. This article carefully examines the Hippocratic oath in order to elucidate the ethical values it contains and consider whether or not these continue to have relevance for contemporary physicians.
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Bol Oficina Sanit Panam · May 1990
Review[Relationship between autonomy and integrity in medical ethics].
The emergence of autonomy as a sociopolitical, legal, and moral concept has had a profoundly influenced medical ethics. It has shifted the center of decision-making from the physician to the patient and reoriented the physician-patient relationship so that it is more open and frank, and more respectful of the dignity of the person of the patient. In general, the ascendance of autonomy has protected patients against the grosser violations of their autonomy and integrity, so widely accepted as ethically permissible in the past. ⋯ As a foundation for medical relationships, the concept of integrity is richer, more fundamental, and more closely tied to what it is to be a whole human person--corporeally, psychologically, and axiologically. The moral implications of integrity are more demanding albeit more difficult to capture in legal language or in the procedures of informed consent. Yet, for the reasons outlined in this paper, we should deepen our grasp of the notion that autonomy depends upon preserving the integrity of persons--and that both depend on the physician being a person of integrity.