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Enfermos En Fase Terminal LA PROTECCIÓN DE LA PERSONA HUMANA ENFERMOS EN FASE TERMINAL © CORTE SUPREMA DE JUSTICIA INSTITUTO DE INVESTIGACIONES JURÍDICAS (IIJ) Alonso y Testanova, Piso 9, Torre Sur. Asunción - Paraguay Teléfono: +595 21 422 161 DIRECCIÓN EJECUTIVA JOSÉ RAÚL TORRES KIRMSER, Ministro Responsable CARMEN MONTANÍA CIBILS, Directora COMPILACIÓN CARMEN MONTANÍA CIBILS, Investigadora GLADYS ASTIGARRAGA PANIAGUA, Investigadora EQUIPO DE EDICIÓN COLABORACIÓN ESPECIAL OVIDIO M. AGUILAR, Diagramación HAYDEÉ CARMAGNOLA DE AQUINO, MIGUEL LÓPEZ, Diseño de tapa Asesora FELICIANO PEÑA PÁEZ, Corrector ANTONELLA FERNÁNDEZ LIPPMAN, Asistente jurisdiccional SADY FLEITAS, Técnico jurisdiccional P 346 PERSONAS COR CORTE SUPREMA DE JUSTICIA INSTITUTO DE INVESTIGACIONES JURÍDICAS (IIJ) “La Protección de la Persona Humana. Enfermos en Fase Terminal”. Asunción – Paraguay Primera edición. Año 2019. 500 ejemplares, p. 504 ISBN: 978-99953-41-60-2 Las opiniones vertidas en los artículos son de exclusiva responsabilidad de los autores. DERECHOS RESERVADOS. Queda prohibida cualquier forma de reproducción, trans- misión o archivo en sistemas recuperables, sea para uso privado o público por medios mecánicos, electrónicos, fotocopiadoras, grabaciones o cualquier otro sistema de archivo y recuperación de información total o parcial del presente ejemplar, con o sin finalidad de lucro, sin autorización expresa por escrito. EUGENIO JIMÉNEZ ROLÓN Presidente LUIS MARÍA BENÍTEZ RIERA Vicepresidente Primero GLADYS ESTER BAREIRO DE MÓDICA Vicepresidenta Segunda JOSÉ RAÚL TORRES KIRMSER MIRYAM PEÑA MANUEL DEJESÚS RAMÍREZ CANDIA ANTONIO FRETES CÉSAR GARAY ZUCCOLILLO Ministros ÍNDICE GENERAL Presentación .......................................................................................... 13 Prólogo ................................................................................................... 15 Siglas y abreviaturas ............................................................................ 17 DOCTRINA Aspectos Éticos del Final de la Vida: Los Principios de la Bioética y los Cuidados Paliativos para preservar la Dignidad de las Personas ...................................................................................... 21 Elena de Mestral de Giménez Limitación del Esfuerzo Terapéutico. LET. Conductas no res- petuosas de la Dignidad de la Persona ............................................. 37 Enrique de Mestral La Cultura de la Vida: Cuidados Paliativos ..................................... 49 Umberto Mazzotti Díez Introducción a los Cuidados Paliativos. Uso correcto de los opioides, su accesibilidad y sus beneficios ....................................... 63 Miriam Riveros Ríos Sedación Paliativa. Cuestiones Éticas y Principios Morales .......... 79 Paulina Taboada El Principio del Doble Efecto y el trato justo a los Enfermos en Fase Terminal ...................................................................................... 103 Alejandro Miranda Montecinos Fases de Adaptación del Paciente en situación de Terminali- dad y Comunicación Humanizada .................................................. 125 Gladys Moreira Decisiones Anticipadas. El Reto de comprender la Autonomía del Paciente .......................................................................................... 139 Rosalino Pinto Derechos y Deberes del Enfermo en Fase Terminal en la legis- lación chilena ....................................................................................... 149 Francisco Javier León Correa Directivas Anticipadas en materia de capacidad en el nuevo Código Civil y Comercial Unificado. Argentina ............................ 165 Jorge Nicolás Lafferriere y Carlos Muñiz Reflexiones acerca de la regulación de la Enfermedad Termi- nal en España ....................................................................................... 211 José Luis Llaquet de Entrambasaguas Aporte del Centro de Bioética, Persona y Familia al Comité de Derechos Humanos de la ONU en el marco de la consulta para el Comentario General al artículo 6 del Pacto de Derechos Civiles y Políticos ................................................................................ 239 María Inés Franck, Jorge Nicolás Lafferriere, Daniela Zabaleta y Leonardo Pucheta Asociación Paraguaya de Medicina y Cuidados Paliativos .......... 245 Hacer la Muerte más fácil hace la Vida más difícil ........................ 249 Richard Stith ANEXO I LEYES, RESOLUCIONES, CONVENIOS Y PROYECTOS DE LEYES Ley N° 1.246/1998 De Trasplantes de Órganos y Tejidos Anatómicos humanos. ............................................................................... 259 Ley N° 6.069/2018 Que modifica el Artículo 11 y el Numeral 2 del Artículo 12 de la Ley N° 4758/12 “Que crea el Fondo Nacional de Inversión Pública y Desarrollo (FONACIDE) y el Fondo para la Excelencia de la Educación y la Investiga- ción”. ...................................................................................... 281 Ley N° 6.170/2018 Que modifica varios artículos de la Ley N° 1.246/1998 “De Trasplantes de Órganos y Tejidos Anatómicos Hu- manos” y la Ley N° 4.758/2012 “Que crea el Fondo Na- cional de Inversión Pública y Desarrollo (FONACIDE) y el Fondo para la Excelencia de la Educación y la Inves- tigación” y su modificatoria Ley N° 6.069/2018. ............ 285 Ley 6.266/2018 De Atención Integral a las Personas con Cáncer. ............ 299 Resolución S.G. Nº 0438/2017 Por la cual se crea la Comisión Nacional de Bioética del Paraguay. ............................................................................... 311 Convenios y otros A-52: Protocolo adicional a la Convención Americana sobre Derechos Humanos en materia de Derechos Económicos, Sociales y Culturales, “Protocolo de San Salvador”. ..................... 323 Comité de Derechos Humanos de la ONU Observación general núm. 36 sobre el artículo 6 del Pacto Internacional de Derechos Civiles y Políticos, re- lativo al derecho a la vida ................................................... 341 Proyecto de Ley de la Cámara de Senadores 1. Proyecto de Ley “Atención de los Enfermos en Fase Terminal” ............................................................................... 373 Proyectos de Leyes de la Cámara de Diputados 1. Proyecto de Ley “Voluntad Anticipada de Pacientes Médicos” ................................................................................ 381 2. Proyecto de Ley “Proyecto de Ley de Cuidados Palia- tivos para Pacientes con Enfermedades Terminales” ..... 391 3. Proyecto de Ley “Proyecto de Ley de Bioética y que crea el Consejo Nacional de Bioética” ............................... 401 FALLOS INTERNACIONALES Fallo comentado: Corte Suprema de Justicia de la Nación ~ 2015-07-07 ~ D. M. A. s/ Declaración de Incapacidad .................. 411 Fallo comentado: Suprema Corte de Canadá ~ 2015-02-06 ~ Carter c. Canadá .................................................................................. 431 ANEXO II DISCURSOS Discurso de Cierre del Ciclo de Conferencias Edición 2017 ......... 459 José Raúl Torres Kirmser Presentación de la Primera Jornada Preparatoria .......................... 463 Carmen Montanía Discurso de apertura Protección de la Persona Humana Enfermos en Fase Terminal: Voluntad anticipada ......................... 465 Carmen Montanía ANEXO III PUBLICACIONES El Tribunal de Estrasburgo autoriza a dejar morir a un tetra- pléjico francés ...................................................................................... 471 Eutanasia no, tampoco ensañamiento terapéutico ........................ 475 Cuidados Paliativos ........................................................................... 477 IPS debe atender a asegurado ........................................................... 481 ANEXO IV Afiches ................................................................................................. 485 Fotos ..................................................................................................... 488 Datos de los autores ........................................................................... 497 u “Si no puedes hacer el bien, por lo menos no hagas daño”. Hipócrates PRESENTACIÓN La Corte Suprema de Justicia, por iniciativa del Instituto de Investigaciones Jurídicas, inició en el año 2015 un Ciclo de Confe- rencias que abarcaría el periodo 2015-2017 con el tema central de Protección de la Persona Humana, desde una perspectiva antropo- lógica, jurídica, científica y de diseño cultural. La edición 2017 del ciclo abordó el tema Enfermos en Fase Terminal que tuvo como objetivos crear espacios para analizar las implicancias relacionadas con la protección de las personas en es- tado terminal; y aportar conocimientos a los magistrados y a la co- munidad judicial sobre las propuestas para enfrentar la situación de los enfermos próximos a morir, conocimientos que pueden condu- cir a adoptar decisiones relativas al fin de la vida humana y a asumir con responsabilidad las consecuencias jurídicas y culturales de esas decisiones. Este material que ofrecemos al lector, es el segundo de una serie de publicaciones y está precedido por el de Personas por Na- cer. En ambos casos las ediciones incluyen ponencias de juristas, profesionales de la salud y bioeticistas nacionales y extranjeros, así como legislación y otros documentos incorporados en el curso de la investigación en el marco del ciclo. En las diferentes conferencias se plantearon temas relativos a los aspectos bioéticos al final de la vida, conductas no respetuosas de la dignidad de la persona, los cuidados paliativos,
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