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Revista Colombiana de Gastroenterologia

Print version ISSN 0120-9957

Abstract

BLANCO AVELLANEDA, Camilo et al. First Colombian Consensus on the Practice of Endoscopy "Fundamental Agreement" : Part two: Ethics. Rev Col Gastroenterol [online]. 2013, vol.28, n.1, pp.27-44. ISSN 0120-9957.

Purpose: The practice of endoscopy involves theoretical, practical and ethical knowledge. The first two are given widespread distribution and great importance in education. Ethics is always mentioned, but is little studied or investigated. The Colombian Association of Digestive Endoscopy (ACED) devotes the second part of the "Fundamental Agreement" consensus to the ethical practice of gastrointestinal endoscopy. We approach this topic from an analysis of the resolution of real dilemmas that arise in endoscopic scenarios shaping our practice. This is the way of conceptually appropriating ethical principles and moral values that should permeate the practice of specialists who rely on endoscopy. It is important to note that the end result is not intended to standardize the conduct of doctors. To the contrary, we propose to carry out an ongoing reflection about the continuous conflicts that arise in our specialty which should not be resolved without profound ethical and moral consideration. Materials and methods: This consensus is a social research study. It uses a descriptive and cross-sectional approach which mixes qualitative and quantitative analysis and is based on the Delphi Method. The information used was obtained during the "Fundamental Agreement" event held on June 23, 2012 by the Colombian Association of Digestive Endoscopy (ACED). Qualitative data were taken from four roundtable discussions in which the 34 participants discussed the 21 proposed ethical dilemmas. Quantitative data used include the final voting, individual private electronic surveys. Consensus was defined as agreement of 75% or more of participants. Speech analysis was used for qualitative analysis. It was oriented around from five variables related to moral and ethical aspects of the practice of endoscopy. For quantitative analysis, basic descriptive statistics centered on percentages were used. Results: Some of the consensus obtained were: 80.65% agreed to consult with the group that they replace in a particular institution; 80.54% shared the opinion that the type of contract limited research, educational, institutional and even personal development; 78.12% agreed that recognition of group work prevails over recognition of individual work in intellectual production, 100% agreed every individual involved in writing and publication should receive individual credit for their work; 80.64% agreed that the relationship of the patient to the health system determined the kind of attention that is given, and 90.82% agreed that the quality of care was affected by the number of patients who require care. Conclusions: The Colombian consensus agrees that resolution of ethical dilemmas that arise in real-world scenarios in the practice of endoscopy should consider ethical and moral values specifically related to the particular situation faced by the specialist. Thus, conflicts related to contractual or employment issues have to consider the dignity of, and respect for, colleagues. Similarly, equality and justice as values and principles that prevail within these scenarios must be considered. Intellectual property rights require responsibility and honesty as guiding principles when situations of group or individual recognition are confronted. Endoscopists´ professional relationships with patients should be framed within values and ethics including prudence, humanity, truthfulness, and choosing the lesser evil. In turn, the specialist´s relations with her or his team should respect collegiality, autonomy, the right to an individual´s good name, dignity and equality. A culture that promotes ethics, responsibility, humanity and charity must prevail for ethical training

Keywords : Ethical principles; moral values; consensus on endoscopy; ethics in gastroenterology and endoscopy; training in ethics; medical ethics; Colombia.

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