Bioethics and the Law in Mexico
| Autor | Bernardo Garcia Camino, Robert T. Hall |
| Cargo | Profesor de Tiempo Completo. Miembro de la Unidad de Bioética de la Facultad de Filosofía, Integrante del Comité Institucional de Ética de la Investigación, Universidad Autónoma de Querétaro (México)/Co-Director, Unidad de Bioética, Universidad Autónoma de Querétaro (México) |
| Páginas | 107-123 |
Bioethics and the Law in Mexico Bernardo García Camino, Robert T. Hall
Rev Bio y Der. 2020; 49: 107-123
www.bioeticayderecho.ub.edu - ISSN 1886-5887
| 108
The results of an empirical study (Hall, 2017) show that, taken as a group, physicians in Mexico
do not know what is legal and what is not legal with respect to certain areas of clinical practice. A
number of legal cases are cited showing the ways i n which the legal system is ineffective with
respect to providing guidance on bioethical issues. We conclude that physicians in Mexico do not
know what is legal and what is illegal with respect to bioethics because they cannot know (the law
is unclear) and because they do not need to know (there is no effective legal precedent or
enforcement). We suggest that the way forward must be through institutional policies
establishing standards that depend only upon the traditional contract for medical care.
Keywords: bioethics; law; Mexico; palliative care.
Los resultados de un estudio empírico (Hall, 2017) muestran que, tomados como grupo, los
médicos en México no saben qué es legal y qué no lo es con respecto a ciertas áreas de la práctica
clínica. Se citan varios casos legales que muestran las formas en que el sistema legal es inefectivo
con respecto a proporcionar orientación sobre cuestiones bioéticas. Concluimos que los médicos
en México no saben qué es legal porque no pueden saberlo (la ley no es clara) y porque no
necesitan saberlo (no existe un sistema legal efectivo). Sugerimos que el camino a seguir debe ser
a través de políticas institucionales que establezcan estándares que dependan únicamente del
contrato tradicional para la atención médica.
Palabras clave: bioética; derecho; México; cuidados paliativos.
Els resultats d'un estudi empíric (Hall, 2017) mostren que, considerats com a g rup, els metges a
Mèxic no saben què és legal i què no ho és pel que fa a certes àrees de la pràctica clínica. Se citen
diversos casos legals que mostren les formes en què el sistema legal és inefectiu pel que fa a
proporcionar orientació sobre qüestions bioètiques. Concloem que els metges a Mèxic no saben
què és legal perquè no poden saber-ho (demostrem diverses maneres en què la llei no és clara) i
perquè no necessiten saber-ho (el sistema legal no proporciona una aplicació efectiva). Suggerim
que el camí a seguir ha de ser a través de polítiques institucionals que estableixin estàndards que
depenguin únicament del contracte tradicional per a l'atenció mèdica.
Paraules clau: bioètica; dret, Mèxic; cures pal·liatives.
Bioethics and the Law in Mexico Bernardo García Camino, Robert T. Hall
Rev Bio y Der. 2020; 49: 107-123
www.bioeticayderecho.ub.edu - ISSN 1886-5887
| 109
The addition of a section on palliative c are to the General Health Law of Mexico in 2009 and an
official Agreement (ACUERDO) by Consejo de Salubridad General (2014) by which the General
Health Council elaborated an Obligatory Comprehensive Management Scheme for Palliative Care
have paved the way for the improvement of health care at the end of life. However, in the same
year, 2014, the international organization Human Rights Watch published a report confirming a
common complaint in Mexico: the article Mexico: unnecessary suffering at the end of life
documented the lack of access for many patients to medications to relieve pain and other types
of palliative care (Human Rights Watch, 2014).
Suspecting that there is some confusion about the legality as well as differences of opinion
on the ethical acceptability of the different types of medical care, we carried out an empirical study
to discover what physicians know about the legality of common practices regarding palliative care
and what they really think about the morality of the same practices.
1.1. Materials and methodology
We used a brief survey of a convenience sample of 89 physicians i n the modern industrial city of
Querétaro. The inclusion criterion was that the respondent was a registered physician with a
practice relevant to palliative care. The survey included six brief clinical cases. In each case, we
asked about the legality and the ethical acceptability of the practice in question. We present one
example directly from our survey; details can be found at http://unidadbioetica.com. Since this
group of doctors was not a random sample, we cannot affirm that the results can be statistically
generalizable to all doctors of the state much less to all of Mexico. However, we believe that this
convenience sample was appropriate and that the results are representative and relevant to our
conclusions.
1.2. Results
Case: The refusal of surgery and a request to remove a ventilator
A patient is dying, a victim of multiple sclerosis. The condition of this lady has deteriorated, to
such a degree that she has recently lost total control of her bodily functions and she cannot move
at all without help. U nexpectedly and very quickly, the condition of the patient deteriorated and
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