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Bibliographic Details
Main Author:	Jorge Luis Manzini
Format:	Artículo científico
Language:	es
Published:	Universidad de Chile 2005
Subjects:	Filosofía bioética prescripción salud pública industria farmacéutica
Online Access:	https://www.redalyc.org/articulo.oa?id=55411209
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Ética de la prescripción médica en un país pauperizado Jorge Luis Manzini Filosofía bioética prescripción salud pública industria farmacéutica Este artículo hace una sucinta revisión de los aspectos éticos de la prescripción a nivel micro, el de larelación terapéutica, con fundamento en la teoría de los principios (de Georgetown), y en los aspectos técnicos de lacorrecta prescripción según la lex artis, sustentada en la denominada medicina basada en la evidencia y en lasrecomendaciones y publicaciones de la OMS.Luego, se aborda el tema de la prescripción médica en tanto problema de salud pública. Se comenta su impacto socialy las presiones indebidas que sufren los médicos para prescribir, especialmente por parte de la industria farmacéutica.Se provee a continuación un marco jurídico, centrado en el llamado Derecho Internacional de los Derechos Humanos.Se considera que podría lograrse el acceso universal a los medicamentos, entendidos como bien social, de fundamentalimportancia para efectivizar el Derecho a la Asistencia Sanitaria. Se revisan las distintas justificaciones éticas quesostienen este derecho, especialmente la teoría de la justicia de John Rawls. 2005 artículo científico 0717-5906 https://www.redalyc.org/articulo.oa?id=55411209 es http://www.redalyc.org/revista.oa?id=554 Acta Bioethica application/pdf Universidad de Chile Acta Bioethica (Chile) Num.2 Vol.11

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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