It is necessary to recognize the child as an active moral subject in making decision process related to his health or his participation in research. The taking of informed consent as a communication process should tend to respect the autonomy and dignity of the child considered mature or not, taking their decisions seriously and not just an assent as a normative principle of mere legal aspect. It describes theoretical elements that can be used as tools to have an approach to the moral development of the child from the principle of responsibility according to the degree of emancipation. The objective is to provide a description of the most relevant aspects about the informed consent process in the mature child and their right to be informed to agree or consent. We searched the databases such as: PROQUEST, MEDLINE, LILACS and PUBMED, analyzing 51 articles. For the organization of the information, the SLIDING methodology was used: sort, label, integrate and prioritize. It was concluded that the ability to assent of the child considered mature or not should be evaluated under objective parameters and not simply under the perception of the doctor or researcher. Finally, it is necessary to design strategies to promote the autonomy, respect and dignity of the child based on the same practices at the time of informed consent.
INTRODUCTION: The cancellation of surgery represents a dilemma in establishing relatively adequate cancellation rates according to the factor, because each institution and surgical specialty have different dynamics. Objective: Describe the types of factors present for the cancellation of surgeries in a health institution. Colombia (2017-2018). METHODOLOGY: Descriptive, retrospective, cross-sectional study. We reviewed (3339) records of scheduled surgeries from January to December 2017. In 2018 they were reviewed (1733) between January and June. A total of (5072) records of a Third Level Health Institution of the Department of Cesar / Colombia were reviewed. The Neuronal Multilayer Perceptron Network model and the Gini coefficient were applied to determine the most important factor and therefore the inequality between them. RESULTS: In 2017, there was a surgical cancellation rate of 4% of the total number of scheduled surgeries (3339). For the year 2018, the rate was 3% of the total of scheduled surgeries (1733). The most important factor was due to the patient's adverse conditions. The surgical specialties that had the highest number of cancellations were general surgery followed by orthopedics. CONCLUSION: An evaluation of the factors for the cancellation of programmed surgeries with a high coefficient of inequality is described. In addition, the most important factor was related to the patient. Prospective studies by specialty are proposed for the design of solution and monitoring strategies to avoid surgical cancellations.
This article presents an analysis about meanings that clinicians and researchers have regarding the autonomy of the mature minor with autoimmune disease, which could lead to different power practices during the moment of taking the informed consent, keeping in mind the doctrine of the minor mature. Consequently, the role of clinicians and researchers in contributing to the moral development or autonomy of the child. The objective was to describe the meanings or perceptions of doctors and researchers, at the time of informed consent, in relation to the autonomy or moral development of the child with autoimmune disease, arising from their experiences, knowledge and prior conceptions of the child. The methodology used was of a qualitative nature with a subjectivist and interpretative approach and a transversal scope. Semi-structured interviews were applied to 21 people, researchers and doctors, who attend children with autoimmune diseases, whose data were analyzed through the Atlas Ti program. 8.0. In conclusion, the informed consent is a process of assertive communication ethical model that seeks the moral structuring of the child beyond what is perceived by the clinician or researcher, in addition the clinicians and researchers consider that to structure the minor is to perceive him as an autonomous subject; which is possible when it shows adherence to treatment and responsible care independently of the tutor's support.
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