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Abortion has traditionally been a deeply controversial and sensitive public issue in Colombia. Although the Constitutional Court decriminalized abortion in 2006 in three specifi c circumstances, Colombian society is still polarized around the morality of abortion. However, the Court's decision is an opportunity to see how ethics, politics, and law can be rightly combined. Indeed, to differentiate each fi eld and to recognize their possibilities may be the key to coexisting peacefully even if ethical disagreements cannot be completely solved. ; Tradicionalmente el aborto en Colombia ha sido un tema sensible y bastante controvertido en el escenario público. Aunque la Corte Constitucional descriminalizó el aborto en 2006 en tres circunstancias específicas, la sociedad colombiana permanece polarizada alrededor de la moralidad del aborto. Sin embargo, esta decisión de la Corte es una oportunidad para ver como ética, política y derecho pueden ser en verdad combinados. De hecho, diferenciar cada campo y reconocer sus posibilidades puede ser la llave para convivir pacíficamente, incluso aunque en últimas los desacuerdos éticos no puedan resolverse completamente.

Abortion has traditionally been a deeply controversial and sensitive public issue in Colombia. Although the Constitutional Court decriminalized abortion in 2006 in three specifi c circumstances, Colombian society is still polarized around the morality of abortion. However, the Court's decision is an opportunity to see how ethics, politics, and law can be rightly combined. Indeed, to differentiate each fi eld and to recognize their possibilities may be the key to coexisting peacefully even if ethical disagreements cannot be completely solved. ; Tradicionalmente el aborto en Colombia ha sido un tema sensible y bastante controvertido en el escenario público. Aunque la Corte Constitucional descriminalizó el aborto en 2006 en tres circunstancias específicas, la sociedad colombiana permanece polarizada alrededor de la moralidad del aborto. Sin embargo, esta decisión de la Corte es una oportunidad para ver como ética, política y derecho pueden ser en verdad combinados. De hecho, diferenciar cada campo y reconocer sus posibilidades puede ser la llave para convivir pacíficamente, incluso aunque en últimas los desacuerdos éticos no puedan resolverse completamente.

Introduction: Currently, CRISPR-Cas9 is the most versatile tool in genetic engineering and, because of its low cost and ability to easily edit genomes is used by the scientific community. It offers considerable promises in every biological field, and in the biomedical community especially to cure diseases. However, despite the general support for its clinical use, there are ethical concerns, and efficacy and safety issues in the context of its use to edit the human genome. Objective: To review academic and lay literature about the concerns and implications to consider about the use of CRISPR-Cas9 in the human germline. Methods: The PubMed and Embase databases were searched using MeSH terms and free terms, as well as newspapers and books of high circulation. Results: 59 documents were selected according to the inclusion criteria and from them were created four chapters that review the technical limitations, the ethical concerns, the regulatory activity and political and judicial implications of using CRISPR-Cas9 in the human germline and the implications for Colombia. Conclusions: Atthough the technical limitations will be overcome by technological advances, the ethical concerns are permanent and have brought statements that go from ban or moratorium, to its use under strict conditions. Colombia should take seriously the ethical and regulatory challenges trying to strengthening the institutional capacities and the public debate. ; Introducción: CRISPR-Cas9 es actualmente la herramienta más versátil en la ingeniería genética y, por su bajo costo y habilidad para editar genomas fácilmente, es usada por toda la comunidad científica. Ofrece promesas considerables en todo campo biológico y especialmente en la comunidad biomédica para curar enfermedades. Sin embargo, a pesar del apoyo general para su utilización clínica, existen preocupaciones éticas y, sobre todo, respecto a su eficacia y seguridad en el contexto de su uso para editar el genoma humano. Objetivo: Revisar la literatura académica y popular sobre los problemas y las implicaciones a considerar sobre el uso de CRISPR-Cas9 en la línea germinal humana. Métodos: Búsqueda en las bases de datos PubMed y Embase con términos indexados y libres, periódicos y libros de alta circulación. Resultados: Se seleccionaron 59 documentos según los criterios de inclusión y a partir de ellos, se crearon cuatro capítulos que revisan las limitaciones técnicas, las implicaciones éticas, la actividad regulatoria e implicaciones políticas y jurídicas respecto del uso de CRISPR-Cas9 en la línea germinal humana, así como las implicaciones para Colombia. Conclusiones: Aunque las limitaciones técnicas se superarán con avances tecnológicos, las preocupaciones éticas son permanentes y han llevado a declaraciones que van desde la prohibición o la moratoria, hasta su uso bajo condiciones estrictas. Colombia debe abordar los retos éticos y regulatorios intentando fortalecer sus capacidades institucionales y el debate público

El presente artículo pretende proporcionar una mirada a las consideraciones y reflexiones desde la ética de la investigación enfocada a la investigación socio jurídica. La literatura en éste campo se ha ocupado de reflexionar sobre la ética de la investigación en las ciencias sociales, dentro de la que se encuentra la investigación socio jurídica. Este tipo de investigación en el campo del derecho presenta sus consideraciones teóricas propias, que aquí nos permiten encontrar una aproximación a la problemática de la definición misma de este tipo de investigación. Para efectos de presentar el análisis desde la ética de la investigación, se revisaron 10 artículos de resultado de investigación socio jurídica desde la perspectiva ética, tomando como punto de partida las consideraciones de la ética de la investigación con sujetos humanos del área de la biomedicina. En los artículos referidos se encontró que en efecto este tipo de investigaciones toman en consideración diferentes pautas éticas – no establecidas formalmente - que buscan el respeto a los derechos de los participantes, con las particularidades propias de la investigación socio jurídica que merecen ser tomadas en cuenta. El artículo concluye con algunas sugerencias desde lo práctico y lo metodológico en relación con la ética de la investigación socio- jurídica.

Background: In Colombia, recent legislation regarding end-of-life decisions includes palliative sedation, advance directives and euthanasia. We analysed which aspects influence health professionals´ decisions regarding end-of-life medical decisions and care for cancer patients. Methods: Qualitative descriptive–exploratory study based on phenomenology using semi-structured interviews. We interviewed 28 oncologists, palliative care specialists, general practitioners and nurses from three major Colombian institutions, all involved in end-of-life care of cancer patients: Hospital Universitario San Ignacio and Instituto Nacional de Cancerología in Bogotá and Hospital Universitario San José in Popayan. Results: When making decisions regarding end-of-life care, professionals consider: 1. Patient's clinical condition, cultural and social context, in particular treating indigenous patients requires special skills. 2. Professional skills and expertise: training in palliative care and experience in discussing end-of-life options and fear of legal consequences. Physicians indicate that many patients deny their imminent death which hampers shared decision-making and conversations. They mention frequent ambiguity regarding who initiates conversations regarding end-of-life decisions with patients and who finally takes decisions. Patients rarely initiate such conversations and the professionals normally do not ask patients directly for their preferences. Fear of confrontation with family members and lawsuits leads healthcare workers to carry out interventions such as initiating artificial feeding techniques and cardiopulmonary resuscitation, even in the absence of expected benefits. The opinions regarding the acceptability of palliative sedation, euthanasia and use of medications to accelerate death without the patients´ explicit request vary greatly. 3. Conditions of the insurance system: limitations exist in the offer of oncology and palliative care services for important proportions of the Colombian population. Colombians ...

BACKGROUND: In Colombia, recent legislation regarding end-of-life decisions includes palliative sedation, advance directives and euthanasia. We analysed which aspects influence health professionals´ decisions regarding end-of-life medical decisions and care for cancer patients. METHODS: Qualitative descriptive–exploratory study based on phenomenology using semi-structured interviews. We interviewed 28 oncologists, palliative care specialists, general practitioners and nurses from three major Colombian institutions, all involved in end-of-life care of cancer patients: Hospital Universitario San Ignacio and Instituto Nacional de Cancerología in Bogotá and Hospital Universitario San José in Popayan. RESULTS: When making decisions regarding end-of-life care, professionals consider: 1. Patient's clinical condition, cultural and social context, in particular treating indigenous patients requires special skills. 2. Professional skills and expertise: training in palliative care and experience in discussing end-of-life options and fear of legal consequences. Physicians indicate that many patients deny their imminent death which hampers shared decision-making and conversations. They mention frequent ambiguity regarding who initiates conversations regarding end-of-life decisions with patients and who finally takes decisions. Patients rarely initiate such conversations and the professionals normally do not ask patients directly for their preferences. Fear of confrontation with family members and lawsuits leads healthcare workers to carry out interventions such as initiating artificial feeding techniques and cardiopulmonary resuscitation, even in the absence of expected benefits. The opinions regarding the acceptability of palliative sedation, euthanasia and use of medications to accelerate death without the patients´ explicit request vary greatly. 3. Conditions of the insurance system: limitations exist in the offer of oncology and palliative care services for important proportions of the Colombian population. Colombians ...