The Chilean House of Representatives is discussing the bill on “Dignified death and palliative care”, which regulates the so-called medical assistance in dying or euthanasia. This paper will critically analyze the different aspects of the bill, particularly concerning four main dimensions, namely, the patient's condition at the time of requesting euthanasia; the doctor-patient relationship and respect for the autonomy of both parties; the idea of medicine involved in it; and the possible therapeutic alternatives to euthanasia. This critical analysis raises the need to discuss in more depth a project that has to do with such important decisions about our lives and that implies a radical change in the way of thinking and practicing medicine.

RESUMEN En este artículo discuto acerca de la polémica entre Harry Frankfurt y Susan Wolf respecto a si es o no es importante que aquello que amamos sea objetivamente valioso, y si una vida completamente inmoral es tan valiosa como otra vida moral. Sostengo que aunque Frankfurt tiene razón al decir que el solo hecho de amar ya es valioso, eso no basta para una praxis plena. Dado que nuestros fines determinan nuestras elecciones, aquello que amemos determinará el tipo de vida que tengamos y no cualquiera da igual.

ABSTRACT In this paper I discuss the controversy between Harry Frankfurt and Susan Wolf as to whether or not it is important that what we care about is objectively valuable, and whether a completely immoral life is as valuable as a moral life. I argue that although Frankfurt is right in saying that the mere act of caring is already valuable, that is not enough for a meaningful praxis. Given that our ends in life determine our choices, whatever we love will determine the kind of life we have, and different kinds of life are not equally valuable.

Resumen La disforia de género es una marcada incongruencia entre el sexo que se siente o expresa y el que se asigna al nacer, asociada a un malestar clínicamente significativo o deterioro en lo social, que puede darse en niños, adolescentes y adultos. En relación con los pacientes pediátricos, no existe actualmente consenso sobre su tratamiento, así como tampoco evidencia que apoye claramente un enfoque por sobre otro. En la literatura se describen principalmente tres tipos de abordaje en niños preadolescentes: modelo terapéutico, watchful waiting (espera atenta) y modelo afirmativo. En este trabajo se realiza una breve revisión de la literatura existente sobre la disforia de género, se describen los distintos abordajes en niños y se analizan las visiones antropológicas que los sustentan. Plantearemos que existen al menos dos modos de entender la identidad de género, lo que ha dado lugar, en gran medida, a las controversias en los tratamientos propuestos. Por ello, resulta de gran importancia comprender los supuestos antropológicos en que se fundamentan estos modelos, ya que a cada uno de ellos subyacen diferentes maneras de entender la relación sexo-género en la persona y, por tanto, el rol de la corporalidad y de la autoconsciencia en la identidad de género.

Abstract Gender dysphoria is a marked mismatch between the sex felt or expressed by an individual and that assigned to them at birth. It is associated with clinically significant discomfort or social impairment and can occur in children, adolescents, and adults. The literature mainly describes three approaches for preadolescents: therapeutic model, watchful waiting, and gender affirmative model. However, there is currently no consensus on its treatment nor any evidence that favors one approach over another. This paper provides a brief review of the existing literature on gender dysphoria, explains various approaches for children, and discusses the anthropological views behind them. We argue that at least two ways of understanding gender identity have given rise to disagreements over the proposed treatments. It is quite important to comprehend the anthropological assumptions on which these models are based since they underlie different conceptions of the person's sex-gender relationship and, therefore, the role of corporality and self-awareness in gender identity.

Resumo A disforia de gênero é uma marcada incongruência entre o sexo que se sente ou expressa e o que é designado ao nascer, associada a um malestar clinicamente significativo ou a uma deterioração no âmbito social, que pode ocorrer em crianças, adolescentes e adultos. Quanto aos pacientes pediátricos, não existe atualmente consenso em seu tratamento nem evidência que apoie com clareza uma abordagem sobre outro. Na literatura, são descritos três tipos de abordagem em crianças pré-adolescentes: modelo terapêutico, watchful waiting (observação vigilante) e modelo afirmativo. Neste trabalho, é realizada uma breve revisão da literatura sobre a disforia de gênero, são descritas as diferentes abordagens em crianças e são analisadas as visões antropológicas que as justificam. É provável que haja, pelo menos, dois modos de entender a identidade gênero, o que abre espaço a controvérsias nos tratamentos propostos. Por isso, é de grande importância compreender os pressupostos antropológicos nos quais esses modelos estão fundamentados, já que a cada um deles subjazem diferentes maneiras de entender a relação sexo-gênero na pessoa e, portanto, o papel da corporeidade e da autoconsciência na identidade de gênero.

The catastrophic emergency experienced by many countries with the COVID-19 pandemic emphasized the importance of bioethics for decision-making, both at the public health (equitable and effective policies) and at the clinical level. At the clinical level, the issues are the fulfillment of medical care demand with adequate health care teams, infrastructure, and supplies, and to cover critical care demands that surpass the available resources. Therefore, ethically correct approaches are required for the allocation of life sustaining resources. There are recommendations for the allocating life support during disasters based on multiple considerations, including ethical ones. However, the ethical criteria of existing guidelines are variable. Ethical principles usually considered are saving the greatest number of lives, saving the greatest number of years of life and the principle of the life cycle or the goal to give each individual equal opportunity to live through the various phases of life. However, the centrality of the human being and the search for the common good should be considered. Knowledge of public perspectives and moral benchmarks on these issues is essential. A successful assignment effort will require everyone's trust and cooperation. Decision making should be planned and discussed in advance, since in-depth deliberation will be extremely complex during the disaster. Our goal is to help the health care teams to wisely allocate resources in shortage periods.

Abstract The Scottish sentimentalist philosophers David Hume and Adam Smith suggest different strategies for restricting and accommodating human selfish tendencies. In spite of the obvious similarities of their moral proposals, Smith finds within the human being the capacity to transform his partial passions and to aspire to ideals of perfection. In contrast, Hume's sentimentalism does not allow for self-transformation, and must rely on social conventions to manipulate and redirect selfish impulses from without. Both attempts achieve their goal. However, while for Hume peaceful social interaction seems to be the only aim of morality; for Smith morality also opens a new dimension of development for the human being.

Resumen Los filósofos sentimentalistas escoceses David Hume y Adam Smith proponen dos estrategias distintas para restringir las tendencias egoístas de la naturaleza humana. A pesar de las evidentes similitudes de sus propuestas morales, Smith encuentra dentro del ser humano la capacidad para transformar sus pasiones parciales y aspirar hacia ideales de perfección. El sentimentalismo de Hume, en cambio, no permite la autotransformación de la persona, y debe apoyarse en convenciones sociales para manipular y redirigir los impulsos egoístas desde fuera. Ambos logran su objetivo. Pero mientras Hume se conforma con una moral funcional para la vida social, Smith abre una nueva dimensión de desarrollo para el ser humano.

ABSTRACT: In his Theory of Moral Sentiments, Adam Smith reconciles two moral paradigms that are usually considered incompatible: an ethics of virtue, with general guidelines and ideals of excellence, and an ethics with universal rules, which must be applied to all cases without exceptions. Smith makes this possible by shifting the perspective from which moral judgments are assessed to what I call the 'sympathetic-impartial' perspective, which stands for "the sympathetic feelings of an impartial and well-informed spectator". From this new standpoint, Smith is able to introduce some modern features into classic virtue ethics and provide a different justification for positive virtues, as well as to change the way 'universal norms or principles' are understood. Accordingly, Smith's theory accounts simultaneously, and within the same theoretical framework, for both ancient-like virtues and their ideals of excellence and for modern-like universal imperatives.

RESUMEN: En su Teoría de los Sentimientos Morales Adam Smith propone una ética que concilia dos paradigmas habitualmente considerados como incompatibles: una ética de virtudes, con normas orientativas e ideales de excelencia, y una ética con reglas universales que se aplican en todos los casos sin excepción. Smith lo hace cambiando el punto de vista desde el que se realiza el juicio moral, a una perspectiva que llamaré "simpatético-imparcial", y que corresponde a "los sentimientos simpatéticos de un espectador imparcial y bien informado". Este novedoso punto de vista le permite introducir características modernas a la ética clásica de la virtud para dar una nueva justificación a las virtudes positivas, así como cambiar el modo de entender las "reglas o principios universales". De este modo, Smith construye una ética capaz de dar cuenta, dentro del mismo marco teórico, tanto de los ideales de excelencia propios de la virtud, como de los imperativos universales modernos.

In this paper I propose that, when analyzed according to the teachings of the Church, both prenatal adoption and the so-called rescue of frozen embryos should be considered as morally impermissible. The good intentions of the rescuers and the tragic circumstances of the embryos don't change the intrinsic evil of the object of this action, i.e. a heterologous transfer. Unlike other commentators, my argument is not related to prudential reasons or the sanctity of marital intercourse, but exclusively to the violation of the embryo's dignity. This is one of the difficult cases in which respect for human dignity requires to respect its death rather than commit oneself to any means to save its life.

En este artículo postulo que, analizado a la luz de las enseñanzas del Magisterio de la Iglesia, tanto el llamado rescate como la adopción de embriones criopreservados abandonados debe considerarse una acción moralmente ilícita, al margen de la buena intención de las rescatistas y las trágicas circunstancias de los embriones. A diferencia de otros autores que se oponen por razones prudenciales o la relación de esta adopción con los bienes del matrimonio, yo propongo que el objeto de esta acción, la transferencia heteróloga de un embrión criopreservado, es en sí una violación a la dignidad del embrión y en cuanto tal un mal intrínseco. Este es uno de los difíciles casos en que el respeto a la dignidad de la persona obliga a respetar su muerte antes que empeñarse por cualquier medio por salvar su vida.

In recent decades, bioethics has become a crucial issue for the church. The dynamics of such study, which is self-propelled and advances independently of ethical criteria, is imminently threatening to human dignity. It is now possible to artificially produce human beings, even without the involvement of gametes. What still hasn't been established is an index that recognizes when a manipulated cell is still a cell -eventually pluripotent and therefore possessing great therapeutic promise- or when it has become a tot potent cell, a zygote, a human organism, namely a person. Science, philosophy and technology, as is shown in this paper, come together to reflect on bioethics in the urgent need to find these signs, given that biotechnology is still advancing and a position must be taken on its discoveries. The Church cannot remain silent as it beholds possible artificial production, instrumentalization and destruction of people who, despite being in the single-cell phase and having come to the world as artifacts, are still reflections of the face of God.

en las últimas décadas la bioética se ha vuelto un tema crucial para la Iglesia. La dinámica propia de la técnica, que se auto-propulsa y avanza con independencia de criterios éticos, amenaza de modo inminente la dignidad humana. En la actualidad ya existe la posibilidad de producir artificialmente seres humanos, incluso sin la mediación de gametos. Pero lo que no existe son los índices para reconocer cuándo una célula intervenida sigue siendo sólo una célula -eventualmente pluripotencial y por tanto con grandes promesas terapéuticas; o cuando ya es una célula totipotencial, un cigoto, un organismo humano: una persona. Ciencia, filosofía y teología, como se mostrará en este artículo, se unen en la reflexión bioética para encontrar de modo urgente esas señales; puesto que la biotecnología sigue avanzando, y hay de tomar posición sobre sus descubrimientos. La Iglesia no puede callar frente a una posible producción artificial, instrumentalización y destrucción de personas; que aunque estén en su fase unicelular y hayan llegado al mundo como artefactos, siguen siempre siendo el reflejo del Rostro de Dios.

Francis Hutcheson is known as a proto-utilitarian. Adam Smith, though, his most prominent student an successor on the Chair of Moral Philosophy in the University of Glasgow, focuses on some different trends of his teacher's ethics and founds, based on the same sentimentalism, a completely different theory of morals. On this paper I explore what aspects of Hutcheson s ethics -particularly those of 'sympathy' and the 'impartial spectator'- where already present in his theory, and how Smith develops those intuitions in order to introduce a moment of rationality in moral judgments, whereby he is able to construct a theory that includes practical reasoning, without betraying the Scottish sentimentalist tradition.

Francis Hutcheson es un reconocido proto-utilitarista. Sin embargo, Adam Smith, su discípulo más prominente y sucesor en la cátedra de Filosofía Moral de la Universidad de Glasgow, tomó otros aspectos de la ética sentimentalista de su maestro y fundó, sobre la base del mismo sentimentalismo, una teoría moral completamente distinta. En este trabajo exploraré qué rasgos de la ética de Smith -en particular, los de la simpatía y espectador imparcial- se encuentran ya en germen en la ética de Hutcheson y cómo Smith desarrolló esas intuiciones para, introduciendo una instancia de racionalidad en los juicios morales y sin traicionar la tradición sentimentalista, incluir también en su teoría moral elementos propios de la razón práctica.