La gestación por sustitución en el punto de mira de la bioética

Surrogate gestation is gestation agreed by means of a contract, with or without a price, in which a woman renounces the maternal filiation of the future child (the legal bond that unites mother and unborn child), in favour of the contracting party or a third party. Although this practice is null and void in Spain by Law 14/2006, of 26 May, on Assisted Human Reproduction Techniques, there are different international legislations that allow it in other countries. For this reason, it is important to carry out a bioethical analysis of the facts and values underlying this practice, such as commercialisation, mother-fetus bonds, the best interests of minors, as well as a global perspective with a gender and planetary perspective. This analysis will allow us to provide arguments from a bioethical point of view against a practice that undermines women's rights, harms the best interests of children and increases inequality on a planetary levelLa gestación por sustitución es la gestación convenida mediante un contrato, con o sin precio, en el que una mujer renuncia a la filiación materna del futuro hijo/a (vínculo jurídico que une a madre y nasciturus), a favor del contratante o de un tercero. A pesar de que esta práctica es nula de pleno derecho en España por la Ley 14/2006, de 26 de mayo, sobre Técnicas de Reproducción Humana Asistida, existen distintas legislaciones internacionales que la permiten en otros países. Por este motivo, es importante realizar un análisis con mirada bioética a los hechos y valores que subyacen bajo esta práctica, como la comercialización, los vínculos madre-feto, el interés superior de los/las menores así como una mirada global con perspectiva de género y planetaria. Este análisis nos va a permitir aportar argumentos desde el punto de vista bioético contra una práctica que entraña un menoscabo de los derechos de la mujer, un daño a los intereses superiores de los/las menores y un aumento de la desigualdad a nivel planetario

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine