Página 397 - Dimensiones éticas de las regulaciones en salud

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ducted by the Bioethics program associated with different, institutions.
Details of these and other studies can be found athttp://www.paho.org/
bioetica
Lessons learned and future challenges
What should experts in public health know about bioethics?
Public health experts are health professionals whose training, practice and
world view are based on a population focus rather than individual practice
–assuring the availability of essential services using skills such as leader-
ship, management and education as well as clinical interventions.
Historically this has not been the emphasis of bioethical thinking, more
concerned with individuals than with groups. Public health and social
medicine demand bioethical competencies such as deliberation and di-
alog with different stakeholders in order to achieve results. Traditional
bioethical analysis applicable to individual healthcare and research must
be reformulated for use in public health(12,13). Its classical principles as
taught at medical schools should be reshaped, and this is part of ongoing
efforts(14,15).
The tension between individual needs and group demands, and the clash
between the local and the universal, are moral problems. Many proposed
investigation strategies for pandemic threat, for example, have unintended
(or undesirable) consequences such as adverse economic effects or restric-
tions of civil rights and liberties. The preeminence given to society over
individual interests must be supported by sound argument. Tensions also
exist between global beliefs and particular cultures, or between the power
of dominant nations or worldviews and local practices. Public health ex-
perts must be aware of the bioethical implications of globalization in its
different forms. In Latin America and the Caribbean this is particularly
relevant, given the ethnic diversity of the populations and the many forms
of vulnerability.