PUBLICACIONES DEL COMITÉ DE BIOÉTICA

Perception of consultation length in cardiology and its ethical implications
Percepción de la duración de la consulta y sus implicancias éticas
Doval HC, Borracci RA, Darú VD, Giorgi MA, Samarelli M.
Rev Panam Salud Publica/Pan Am J Public Health 24(1), 2008

Objectives. This study considered whether the time employers allotted to medical consultations in many working environments in Argentina might be inadequate to carry out an interview. The objective was to conduct a survey to gather information on the length of cardiologic medical consultations in Argentina.

Methods. During 2007, a survey was carried out that included 816 cardiologists.

Results. Seventy-six percent of participants said they needed 20 to 30 minutes, and 14% considered that 15 minutes was sufficient, for an adequate consultation. On the other hand, 64% reported that their employer required that consultations be done in 10 to 15 minutes, and 86% cited limits of less than 20 minutes (P < 0.0001). This time was inadequate for 60% of physicians. With regard to ethics, 89% answered affirmatively that requiring that patients be attended in such a short time could be considered an ethical flaw of the employer; 75% acknowledged their own ethical flaw when agreeing to conduct the consultation in an inadequate amount of time. When opinions were grouped, 22% considered that an adequate consultation length was fundamental for a correct patient–physician relationship, 27% reported that this time depended on “pressures” of the system, 19% indicated that inadequate consultation length affected the quality of attention patients received, 17% thought that low fees forced employers to reduce this time with a resulting detriment in quality of care, and 15% said that consultation length was variable and depended on the patient.

Conclusions. This study showed that 60% of physicians perceived as insufficient the time their employers allotted for conducting an adequate consultation. Most believed that allotting such a short time for examining patients could be considered an ethical flaw.

Referencia: Doval HC, Borracci RA, Darú VD, Giorgi MA, Samarelli M. Perception of consultation length in cardiology and its ethical implications. Rev Panam Salud Publica. 2008;24(1):31–5. Descargar el artículo
 

Ethical Review and Informed Consent in Cardiovascular Research Reports in Argentina
Revisión ética y consentimiento informado en las comunicaciones de investigación cardiovascular
Raúl A. Borracci, Gustavo Calderón, Martín R. Seoane, Analía C. Perez, Hernán C. Doval
Research Area, Argentine Society of Cardiology, Ethical Board, Argentine Society of Cardiology, Dept. Drugs & Clinical Trial Evaluation, A.N.M.A.T., Argentina
Arq Bras Cardiol 2008; 90(5): 290-293

Background: Requirements for Institutional Review Board approval and informed consent for research involving human subjects have existed for more than 2 decades. However, evidence of fulfillment of these requirements is sometimes lacking in cardiovascular research reports in Argentina. Since ethical standards vary between committees, there may be some confusion among researchers regarding the need for an ethical review when conducting low risk research.

Objective: To examine the frequency of obtaining an ethical review and informed consent in cardiovascular research in Argentina.

Methods: Through a questionnaire, we contacted authors of 100 reports submitted to our annual scientific meeting during 2006.

Results: Thirty six per cent of questionnaires were resubmitted with confirmation of ethical review, 34% responded that ethical review was not obtained, 23% reported as being exempt and 7% were never resubmitted. Most articles obtaining ethical review were pharmacological trials or research involving assessment of new devices. On the other hand, most articles reporting lack of or exemption from ethical review come from epidemiological research or studies evaluating non-invasive methods. Sixty percent of phase IV pharmacological trials, research on cellular implantation or assessment of new devices met federal regulations requirements.

Conclusion: The rate of ethical review and use of informed consent in cardiovascular reports in Argentina vary among articles. Most research involving prospective observational studies and nearly 50% of protocols including intervention or invasive procedures do not report ethical review. This high proportion of articles ethical review suggests the presence of legal and ethical flaws which should be discussed and overcome.

Referencia Borracci RA, Calderón G, Seoane MR, Perez AC, Doval HC. Ethical review and informed consent in cardiovascular research reports in Argentina.
Arq Bras Cardiol 2008; 90(5): 290-293 Descargar el artículo