Salud Mental

Background. Recently, the academic world has established a series of reconfigurations of emerging human rights, in order to safeguard the mental integrity of people exposed to neurotechnologies. The recommendations of different stakeholders and a literature review support regulation of these technologies. There are different proposals for regulation, some in soft law and others in objective law. The type of regulation chosen can have repercussions on clinical practice, research, and public policy. The constitutional enactment of neurorights in Chile has been criticized in the academic fields of neuroethics and law as having potential negative effects on mental health research. Objective. To analyze in light of the available literature whether the construction of neurorights could create ethical conflicts in the field of mental health, or if it could offer protection against the disruptive use of various neurotechnologies. Method. This analysis included a narrative review of studies included in the PsycInfo, Springer, JSTOR, Medline, Scopus, PubMed, CINALH, and Web of Science databases, without restrictions on language or year of publication. Results. The enactment of neurorights as hard law is found not to be detrimental to the field of mental health. Discussion and conclusion. This article argues that the regulation of neurorights does not threaten the framework of an ecosystem that uses neurotechnologies. On the contrary, such regulation offers protections to people within the complex system of neurotechnologies.

Objective. To reflect on ethical and social issues related to research on the genetics of mental health. Method. A narrative review was undertaken of 87 articles found in three databases: Medline, Scopus, and Scielo. Keywords were defined broadly to capture as many relevant publications as possible. Data were summarized by topic. Results. The following topics were identified regarding the application of genetic and genomic tools to mental health disorders: problems with diagnosis, proper informed consent procedures, protecting confidential data, providing participants with research results, risk-benefit balance, equity and access, commercialization of genotyping, and prenatal testing. Discussion and Conclusion. Although a promising field, there is still much research needed on genetic approaches to mental health to achieve clinical relevance and predictive value, and more so in developing countries where there is little available data. Cost-benefit studies thus do not recommend genetic diagnoses in underdeveloped settings. Instead, local approaches should be enhanced. One limitation of research on the genetics of mental health is that it seeks biological causes for mental illnesses. However, the etiology of most mental health disorders is multifactorial, limiting the predictive value of genetic tests. Still, understanding the genetic origins of the biological pathways that lead to mental illness is important to diagnosis and therapy. Other problems discussed are enhancement of the informed consent process and counseling, protection of the right to know and not to know, and how the geneticization of disease is related to stigma.

Introduction. Mental health services have been a focus of human rights advocates and recent legal reforms in some Latin American countries, which have called for a change from the paradigm of hospitalization to one of accompanying and supporting the person with mental health issues, which make it possible to apply the Advance Directives in Psychiatry (PADs). This change will require time, as well as economic, material, and human resources, and transformations in attitudes, culture, and society, but the implementation of PADs cannot be postponed: they must be used to protect the autonomy of the persons affected, within a bioethical framework. Objective. Identify possible bioethical conditions in the prevailing conventional hospital context in Latin America that allow for an implementation of PADs. Method. A participant-observer study was carried out in two psychiatric hospital services from June to September 2022. Results. A thematic analysis found three themes: 1) clinical care, 2) patient predisposition, and 3) medical-legal questions. This study considered part of theme 2, including the following sub-themes: a) patient self-perception, b) biography/narrative versus diagnostic classification, and c) negotiation. Discussion and conclusion. Prominent among the sub-themes discussed are recognition of the values of autonomy and its elements in all of the expressions of the person with mental illness, as well as actions of the physician or health care team in synergy with supported decision-making, a distinctive feature of the anticipatory process of the PAD.

The importance of biopsychosocial factors in the genesis and maintenance of disease is increasingly being recognized. Most illnesses should be studied from a multifactorial perspective to facilitate understanding and treating them. Many psychopathological processes involve factors such as loneliness, hopelessness, and lack of social cohesion. As early as the nineteenth century, J.M. Charcot defined those illnesses in which no organic lesion was visible as functional disorders. Today, the anthropological view of illness known as the Heidelberg School provides us with a more global and comprehensible assessment of illness. The anthropological approach is complemented by a bioethical one, a bioethics of daily life which, as a practical science, studies and evaluates the living conditions of individuals, seeking practical solutions and contributing its reflections with deliberation and care. In this paper, we aim to highlight the most important factors that have an impact on illness by providing an anthropological view of illness and bringing bioethics closer to everyday life.

This article applies the concept of normality, in both its descriptive and normative connotations, to the field of mental health, emphasizing its ethical undertones in different cultural and situational contexts. Ethics is defined as the linguistic justification of morals, and bioethics is characterized by arguments based on dialogical, discursive, and deliberative processes. Bioethical decision-making influences human relationships and has implications for diagnosis, prognosis, interventions, and evaluation of therapeutic results and outcomes. Normality in mental health should be reformulated on bioethical principles to avoid being a source of stigma and discrimination, at a time when human diversity and cultural change impose a redefinition of conceptual boundaries and depathologization of different forms of behavior and experience.