Juan López

Previamente a la realización de una intervención médica, el paciente tiene derecho a expresar su libre conformidad con ésta. Para ello, dicha conformidad debe ir precedida de la información pertinente que le permita decidir según sus intereses. Como correlato de este derecho surge la obligación del médico de informar al paciente y de recabar su consentimiento antes de llevar a cabo su actividad. De esto se trata el consentimiento informado, que se ha convertido en un derecho consolidado y con plena vigencia en la mayoría de Estados democráticos. Desde hace algunas décadas, su reconocimiento ha producido que, a nivel europeo y particularmente en España, se aprecie un incremento notable de las reclamaciones judiciales por defectos de información en la asistencia sanitaria. Hoy en día, el consentimiento informado es el argumento principal de las demandas. En esta obra se lleva a cabo un estudio detallado de la figura del consentimiento informado, acudiendo a diferentes disciplinas como la Historia, la Bioética y el Derecho comparado. Se hace especial énfasis en su naturaleza jurídica y sus elementos característicos, sin perder de vista los problemas que pueden presentarse en la práctica diaria. También se centra en determinar las consecuencias jurídicas que surgen de la vulneración de este derecho desde la perspectiva de la responsabilidad civil, prestando gran interés a la relación de causalidad y al posible daño moral que se pueda generar.

Este artículo pretende realizar un análisis semiótico del rito dancístico del pascol, el cual se distingue por ser una de las prácticas culturales más importantes de los indígenas rarámuri que radican en la región de barrancas de la sierra occidental del noroeste de México. A través del análisis de la semiosis de este rito dancístico intentaremos mostrar cómo es el proceso de significación interpretativa que le otorgan los rarámuri para explicar su cosmovisión. Se tendrá como finalidad dar cuenta que esta práctica cultural es un símbolo esencial del proceso de la asociación de signos cuya acción o influencia compone una parte sustantiva de la cosmovisión de este grupo étnico, que tiene entre sus principales funciones mantener algunos preceptos socioculturales para la estabilidad futura de las familias y la comunidad.

Aquí, su autor, el antiguo Jefe del estado Mayor del Aire (1997-2001), desarrolla de forma clara las características fundamentales del Poder Aéreo, sus cometidos y misiones principales y ciertas consideraciones en el empleo del mismo. Para ello, se da a conocer el papel que desempeña el Poder Aéreo como componente estratégico principal de la acción de los Ejércitos, estudiando los aspectos claves, político, estratégico y operativo de cualquier campaña militar, así como las características fundamentales, cometidos y misiones más usuales del Poder Aéreo. Todo lo anterior desde la óptica del puesto en el que le ha tocado vivir las actuaciones del Poder Aéreo en los últimos años, le lleva a la conclusión de que éste es un instrumento sumamente flexible y rentable para su utilización en cualquier tipo de crisis, desde las acciones humanitarias hasta los conflictos abiertos.

La vida en el futuro a corto plazo será revolucionada por el efecto creciente de tecnología multidisciplinaria en todas las dimensiones: social, económico, político, y personal. La revolución de disponibilidad de la información y utilidad seguirá afectando en profundidad el mundo en todas estas dimensiones. Los resultados serán asombrosos. Los efectos pueden incluir mejoras significativas de la calidad de vida, las altas tarifas de volumen de ventas industrial, la globalización continuada, la amalgamación cultural o la epidemia de aislamiento de los individuos, así como el aislamiento personal en una tentativa de hacerse más abiertos mundialmente. La realización real de estas posibilidades dependerá de un número de factores, incluyendo la aceptación local de cambio tecnológico, niveles de inversiones de infraestructura y tecnología. El paso rápido de desarrollo tecnológico y brechas hace la previsión difícil, pero la revolución de la tecnología a escala mundial parece significativa y muy probable.Life in the short-term future will be revolutionized by the growing effect of multidisciplinary technology across all dimensions of life: social, economic, political, and personal. The revolution of information availability and utility will continue to profoundly affect the world in all these dimensions. The results will be astonishing. Effects may include significant improvements in human quality of life, high rates of industrial turnover, continued globalization, cultural amalgamation or invasion of individuals’ privacy, as well as personal isolation in an attempt to become more open worldwidely. The actual realization of these possibilities will depend on a number of factors, including local acceptance of technological change, levels of technology and infrastructure investments. The fast pace of technological development and breakthroughs makes foresight difficult, but the technology revolution seems globally significant and quite likely

In this article we are concerned with an analysis of «methodological individualism » that is on the ground of weberian work, as himself states in “Die «Objetivität» sozialwissenschaftlicher und sozialpolitischer Erkenntnis”. This individualism means, not only a scientific methodology , but a accurate subjectivity scheme: the subject is constrained in its ability to provide a thorough meaning to life. Also, this study claims that the German Methodensreit was a central discusión in the weberian theory. The global aim of this article is to emphasize the value of methodological individualism as a way of understanding the society in the scheme of the social action drawn by Max Weber

The aim of this paper is to prove how what is apparently a mistake made by Plutarch, wheter deliberate or not, in his reference to the arson attack of Caesar´s soldiers in Alexandria as the end of the famous Library, show us the common sense of the term “bibliotheke” from that time up to now. Coming to this conclusion has required a detailed analysis of the Library of Alexandria since its birth applying Aristotelian doctrine to its configuration not only as an organized space for books but also as an imaginary reading room from which the helenistic world of relations is established. In a second approach, we focus the attention on the change occurred in this collection with the introduction of alphabetical order and, then, with the philological activity of Callimachus. As a result of his Pinakes, the platonic concept of daimon, “guide”, became the first characteristic o a philologist or librarian. Using the information ordered in the Pinakes anybody could be a librarian and find a library anywhere. The old megále bibliotheke of Alexandría remains only with the idea of the conservation of original papyrus. This is de reason of the enigmatic sentence of Plutarch announcing the end of this situation caused by the action of the fire

Dentro del Humanismo Cristiano se da un concepto preciso de lo que sea la naturaleza humana. El hombre es una unidad intrínseca cuerpo-espíritu; por ello es un ser abierto a todo tipo de realidad, tanto material como espiritual o divina. Ha de construir su propia vida en vista de esta realidad si quiere salvarse individualmente y como especie. Actúa de acuerdo al modelo de vida que escoje y al fin que desea alcanzar. Los modelos de sociedad que construye, las instituciones y normas por las que se rigen las diferentes sociedades responden a ese modelo de vida elegido. Por ello, B. Arias Montano y X. Zubiri, al coincidir en el mismo concepto de hombre, coinciden también en una explicación antropológica y filosófica de los actos humanos y los diferentes modelos de sociedad aparecidos a lo largo de la historia

In lieu of an abstract, here is a brief excerpt of the content:Anthropological Perspectives in Psychiatric NosologyJuan J. López-Ibor Jr. (bio) and María-Inés López-Ibor (bio)KeywordsDSM, etiology, Aristotelian causes, social dramasPsychiatry and clinical psychology, as we learn in this paper, are disciplines in need of an ontological perspective. Very few branches of contemporary learning share this characteristic. Probably only theoretical physic and theology—as the rest have long ago given up trying to define and understand the essence of their object, for example, life in the case of biology or mind in psychology. Consequently, the paper by Pérez-Álvarez, Sass and García-Montes, “The Ontology of Mental Disorders in Constructivist Perspective,” (2008) should be welcomed and indeed included in the reading lists for trainees in psychiatry and clinical psychology.The authors propose an approach to the understanding of mental disorders that is extremely attractive and well articulated, and which also has practical implications for clinicians. It is not just another “philosophical divertimento” devoid of scientific and practical importance. Let us analyze the article in an orderly way.Less DsmThe authors of the target paper disapprove of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III/IV approach to defining illnesses by starting from the symptoms that are present—on the grounds that this may lead clinicians to assume that their sole role is to identify, fight, and suppress the symptoms by whichever procedure. They propose an alternative that is dear to myself because it follows the path of the so-called “anthropological” psychiatry of Binswanger, von Gebsattel, Erwin Strauss, Zutt, López-Ibor, Sr., and others. In essence, this is a phenomenological approach to the meaning of mental diseases, one that emphasizes how the illness is revealed to the patient him- or herself.The target article’s criticism of DSM should be considered in the context of the abuses committed on its behalf. The DSM is not a textbook of psychiatric disorders, nor does it contain a definition of the diseases. The DSM does not tell what a disease is (Klerman et al. 1984)—something that is impossible with a classification system based on the manifestations of the diseases, the signs and symptoms. The DSM, as its title states, is just a diagnostic and statistical manual, which does not contain anything about the origin of [End Page 259] any disease nor an explanation of why it exists or what it means. The DSM is, in fact, just a tool to determine whether a disease is present, and therefore to facilitate communication between professionals and with other individuals, without saying anything about the disease’s aitia—a key term (associated with notions of essence as well as cause) to be discussed below. In theory, most clinicians should understand these limitations; it may be, however, that this is not really the case for many who read or use the DSM. In the world there are around 200,000 psychiatrists; since 1980 the number of DSM copies sold is in the order of several hundred thousand.The misuse of a classification system is even more noticeable in the International Classification of Diseases (ICD)-10 Research Version. The instructions for the use of this version recommend that the first step is to make an inventory of all the symptoms present, and then to construct a diagnosis based on them. This how all computer-assisted systems work. This procedure can, however, only be valid if the clinician has already reached a diagnostic conclusion by other means—a diagnosis then to be confirmed for research purposes. It may be that this is one of the reasons why the ICD-10 Research Version has almost never actually been used for research.Furthermore, the concept of symptoms in psychiatry applies only to organic mental disorders (Schneider 1959), conditions in which the patient’s attitude and way of experiencing the symptoms do not play the kind of role that they play in schizophrenia and other mental disorders. The quotation from the important paper by Sass and Parnas in this context is most appropriate. It is indeed that case that “subjective experience can play an important causal role in the progressive experiential transformations of a developing schizophrenic illness...

In lieu of an abstract, here is a brief excerpt of the content:Creativity Belongs to the Person, not to DiseaseJuan J. López-Ibor Jr. (bio) and María-Inés López-Ibor (bio)Keywordscreativity, patho-biography, Saint Teresa, visionsIn the paper, “From the Visions of Saint Teresa of Jesus to the Voices of Schizophrenia,” Cangas, Sass, and Pérez-Álvarez (2008) take an original approach to patho-biography that is very welcome.The temptation to designate historical individuals or characters of fiction as suffering from mental disease has always produced disagreeable feelings in me. This sort of abuse of psychiatry and of the people in question is parallel to the abuse by the media or lay citizens when they describe, say, an especially violent murderer as a schizophrenic—forgetting that the vast majority of people with schizophrenia are not in the least violent. Having read Santa Teresa’s writings during my adolescence, well before I even considered entering medicine, I reacted to comments about her alleged psychiatric illnesses with uneasiness, to put it mildly. The Santa Teresa of La Vida de la Santa Madre Teresa de Jesús (her autobiography), of the Camino de Perfección, and of the El Castillo Interior was surely not a mental patient, it seemed to me. The same would apply to San Juan de La Cruz, Jean D’Arc, Don Quijote, Sancho Panza, Edipus, and Clitemnestra, to mention a few. Even van Gogh’s paintings did not seem to me the productions of a patient with schizophrenia or epilepsy. Of course all of them may have suffered, at certain periods of life, symptoms attributable to a mental disorder, but their creativity rested elsewhere, and was often manifest during healthy periods of their lives. After years spent fighting the stigma of mental diseases, and after organizing several exhibitions of works of art of people with mental diseases, we came to the conclusion that creativity and singularity belong to the person, not to the illness. Some of the diseases of these individuals may have being accidents (van Gogh’s hallucinations and psychotic symptoms, for example, were most probably due to intoxications with absinthe, then rich in hallucinogenic alkaloids such as tujone), or, together with other life circumstances, may have had unspecific influences on the person’s condition. In contrast with many other psychiatric disorders that are represented in ancient Greek and Roman literature, there are no descriptions of individuals with schizophrenia in the Greek and Roman literature dating from the fifth century bc to the beginning of the second century Ad (Evans et al. 2003), and several authors have speculated that schizophrenia did not exist before the eighteenth century (Ellard 1987).Caution is important when dealing with mental health and religious issues in contrast with creativity. The creativity of people suffering from bipolar disorders is well recognized (Jamison 1993) and [End Page 277] the same applies to alcohol and drug intoxication. Tellenbach (1986) has also written on the creativity of depressed persons, although he refers more to the disposition of mood (Schwermut) than to clinical depression as such. The link between melancholia and genius put forward by Aristotle has often been misinterpreted. The philosopher was considering the melancholic temperament and not the melancholic illness as we would understand it today. Of the four temperaments, it is in his view only the melancholic that is gifted with creativity. The sanguine person seeks the immediate pleasures of life, the choleric one considers himself powerful and dedicates himself to manifesting this power, and the phlegmatic individual is disconnected from life and seeks to live without effort or pleasure. The melancholic temperament leads to creativity because of the predominance of doubt, reflection, and dissatisfaction with the miseries of life.Freud’s notion of religiosity as a collective obsessive neurosis is totally mistaken, in my view. The three main themes of obsessions are cleanliness, order, and guilt. In none of these cases is the theme the goal of the action; rather, it is a strategy to contain anxiety. As a consequence, patients with obsessions and compulsions about dirt and cleanliness tend to be dirty themselves, because the real purpose of their compulsions is not in fact to be clean but rather to satisfy a ritual. When order...