Suchergebnisse

This was the first report in Spain about bioethical concerns on patients in the SARS-CoV-2 crisis. It was sent to several political and bioethical institutions to warn of critical situations that could come.

6 figures, 3 tables.-- Supplementary material under CC-BY license https://creativecommons.org/licenses/by/4.0/ ; Fuel reformulation through the use of oxygenated compounds e.g. dimethyl carbonate (DMC) is a potential option both to reduce the harmful soot emissions and to overcome the dependence on fossil fuels since many of them are bio-derived fuels. DMC presents a relative high oxygen content as compared with other additives and suitable characteristics to be used in combustion systems. The different fundamental aspects of the DMC combustion process including its oxidation behavior its tendency to produce soot and the role of the NO presence in the reaction system were studied. Experiments were conducted under well controlled conditions using specifically designed flow reactor systems. Results demonstrated the low tendency of DMC to form soot compared to other oxygenates and its capacity to contribute to NO reduction under specific fuel-rich conditions. Modeling calculations successfully reproduce reasonably well the experimental trends observed and emphasized the sensitivity of the results to the thermodynamic data of DMC and DMC derived species. ; Authors acknowledge the Aragón Government and the European Social Fund, GPT group, and MINECO and FEDER (Project CTQ2015-65226-R) for financial support. Dr. M. Abián acknowledges the MINECO and Instituto de Carboquímica (ICB-CSIC) for the post-doctoral grant awarded (FPDI-2013-16172).

Objectives: Each new wave of the COVID-19 pandemic invites the possible obligation to prioritize individuals' access to vital resources, and thereby leads to unresolved and important bioethical concerns. Governments have to make decisions to protect access to the health system with equity. The prioritization criteria during a pandemic are both a clinical and legal-administrative decision with ethical repercussion. We aim to analyse the prioritization protocols used in Spain during the pandemic which, in many cases, have not been updated. Method: We carried out a narrative review of 27 protocols of prioritization proposed by healthcare ethics committees, scientific societies and institutions in Spain for this study. The review evaluated shared aspects and unique differences and proffered a bioethical reflection. Results: The research questions explored patient prioritization, the criteria applied and the relative weight assigned to each criterion. There was a need to use several indicators, being morbidity and mortality scales the most commonly used, followed by facets pertaining to disease severity and functional status. Although age was initially considered in some protocols, it cannot be the sole criterion used when assigning care resources. Conclusions: In COVID-19 pandemic there is a need for a unified set of criteria that guarantees equity and transparency in decision-making processes. Establishing treatment indications is not the aim of such criteria, but instead prioritizing access to care resources. In protocols of prioritization, the principle of efficiency must vary according to the principle of equity and the criteria used to guarantee such equity.

Objectives: Each new wave of the COVID-19 pandemic invites the possible obligation to prioritize individuals' access to vital resources, and thereby leads to unresolved and important bioethical concerns. Governments have to make decisions to protect access to the health system with equity. The prioritization criteria during a pandemic are both a clinical and legal-administrative decision with ethical repercussion.We aim to analyse the prioritization protocols used in Spain during the pandemic which, in many cases, have not been updated. Method: We carried out a narrative review of 27 protocols of prioritization proposed by healthcare ethics committees, scientific societies and institutions in Spain for this study. The review evaluated shared aspects and unique differences and proffered a bioethical reflection. Results: The research questions explored patient prioritization, the criteria applied and the relative weight assigned to each criterion. There was a need to use several indicators, being morbidity and mortality scales the most commonly used, followed by facets pertaining to disease severity and functional status. Although age was initially considered in some protocols, it cannot be the sole criterion used when assigning care resources. Conclusions: In COVID-19 pandemic there is a need for a unified set of criteria that guarantees equity and transparency in decision-making processes. Establishing treatment indications is not the aim of such criteria, but instead prioritizing access to care resources. In protocols of prioritization, the principle of efficiency must vary according to the principle of equity and the criteria used to guarantee such equity. ; post-print ; 204 KB