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Marian Araujo Yaselli.}{\f1\fs24 \par }{\f1 C\'e1tedra Educaci\'f3n y Comunicaci\'f3n. Escuela de Nutrici\'f3n y Diet\'e9tica. \par Facultad de Medicina, Universidad Central de Venezuela. \par }{\f1\fs24 \par }\pard \qj \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 \par \par De las necesidades humanas b\'e1sicas, donde se incluyen: la libertad, la recreaci\'f3n, el trabajo, la vivienda, el vestuario, el afecto, la salud, la educaci\'f3n; la alimentaci\'f3n juega un papel fundament al, vital para la subsistencia como seres vivos. A trav\'e9s del estado nutricional de nuestra poblaci\'f3n, como un indicador v\'e1lido para aproximarnos a la calidad de vida, podemos determinar las posibilidades de desarrollo de un pa\'ed s. Es por esto y mucho m\'e1s que lo alimentario-nutricional est\'e1 inmerso y vinculado con todas las esferas del quehacer nacional. No es de extra\'f1ar entonces, las m\'faltiples y complejas aplicaciones de la Bio\'e9tica en esta \'e1 rea del conocimiento. \par \par Hace ya unos seis a\'f1os atr\'e1s, inici\'e9 una l\'ednea de investigaci\'f3n sobre Bio\'e9tica y Nutrici\'f3n, estudiando art\'edculos publicados y bibliograf\'eda con data de la d\'e9cada de los setenta hasta la actualidad. Fue fruct\'edfera la b\'fa squeda, se encontraron publicaciones que aplicaban conceptos bio\'e9ticos en las \'e1reas de: responsabilidad profesional, praxis y gremio profesional; tendencias filos\'f3ficas, religi\'f3n y costumbres alimentarias; ingenier\'eda gen\'e9 tica y biotecnolog\'eda alimentaria; disciplinas deportivas y suplementos nutricionales; educaci\'f3n en nutrici\'f3n, entre otras. En lo que concierne a este Congreso, las \'e1reas de mayor inter\'e9s ser\'edan: la nutrici\'f3 n como derecho humano y la pol\'edtica alimentaria-nutricional nacional; los derechos de los enfermos y la investigaci\'f3n en nutrici\'f3n; los derechos del consumidor y la publicidad y etiquetado nutricional, y finalmente el \'e1rea de la nutrici\'f3 n cl\'ednica-asistencial, donde la mayor\'eda de los art\'edculos se refieren a la indicaci\'f3n o suspensi\'f3n de soporte nutricional parenteral y enteral, las implicaciones de justicia distributiva y la administraci\'f3n de recursos escasos. \par }\pard\plain \s17\qj \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \b\f1\fs24\lang8202\langfe3082\cgrid\langnp8202\langfenp3082 {La nutrici\'f3n como derecho humano y la pol\'edtica alimentaria-nutricional nacional: \par }{\b0 Pensar la nutrici\'f3n como un derecho humano ser\'eda como pensar en el derecho de respirar aire puro, o en el derecho a vivir. \'bfAcaso es necesario declarar que tenemos derecho a comer? Pareciera que si, y la reflexi\'f3 n acerca de algo tan obvio toma car\'e1cter universal, cuando vemos como comunidades enteras son desbastadas por la hambruna y la desnutrici\'f3n extrema al otro lado del mundo, y c\'f3mo en nuestros propios pa\'ed ses y casi frente a nuestros propios ojos, la inseguridad alimentaria va en aumento y los casos de malnutrici\'f3n por exceso o por d\'e9ficit y el hambre oculta nos van rodeando. \par \par El UNICEF (1995) }{\i\fs20\super (1)}{\b0 public\'f3 un libro sobre los derechos del ni\'f1o, en donde se dedica todo un cap\'edtulo para la exposici\'f3n y an\'e1lisis de la nutrici\'f3n como derecho humano. Por su parte, la FAO (1996) }{\i\fs20\super (2)}{\b0 convoc\'f3 a una Cumbre Mundial sobre la Alimentaci\'f3n, celebrada en Roma. El resultado de ambos esfuerzos: llegar a un consenso universal sobre la necesidad inmediata de que cada naci\'f3n se haga responsable de fijar unos m\'ed nimos morales a trav\'e9s de sus metas nutricionales, las cuales deber\'edan concretarse dentro de las Pol\'edticas, Planes de la Naci\'f3n y en sus Programas subsecuentes, teniendo como norte la seguridad alimentaria, la viabilidad y sustentabilidad de los programas, y la aceptabilidad por la poblaci\'f3n, al respetar y proteger sus costumbres alimentarias positivas. \par \par Hasta hace poco, la tendencia era la de asociar la desnutrici\'f3n con falta de alimento, siendo esta una postura reduccionista ante una problem\'e1tica de mayor trascendencia. La pol\'edtica de estado no puede circunscribirse a s\'f3 lo programas de suplementaci\'f3n y donaci\'f3n de alimentos, debe ir m\'e1s all\'e1 y abarcar desde la producci\'f3 n y disponibilidad de alimentos hasta la biodisponibilidad de nutrientes, el estado de pobreza y la marginalidad misma. En Venezuela la mayor\'eda de los programas alimentarios han fracasado principalmente por falta de componentes educati vos, de control y seguimiento, pero sobre todo porque no se ha trabajado en lo que el UNICEF propone como \'93people\'b4s empowerment\'94 , es decir, la comunidad organizada, participativa que junto con el apoyo del estado, se apoderan de sus problemas, procurando su soluci\'f3n y el desarrollo de la comunidad, bajo el enfoque de desarrollo de Amartya Sen, como \'93proceso de expansi\'f3 n de las capacidades de la gente\'94. Hasta ahora, el estado paternalista con abundancia de recursos econ\'f3micos provenientes del petr\'f3leo, todo lo ha dado \'93gratis\'94 y \'93por intereses partidistas\'94 y \'93si se da\'f1 aba o se malgastaba le daba uno nuevo\'94, manteniendo e incrementando la sumisi\'f3n, el conformismo y la dependencia del pueblo. Basta entonces una leve crisis econ\'f3mica para que todo el sistema se caiga. Lamentablemente las decisiones pol\'ed ticas en materia alimentaria-nutricional no han sido prudentes ni justas. \par \par }{Los derechos del consumidor, la publicidad y el etiquetado nutricional: \par }{\b0 Otro tema de gran significaci\'f3n \'e9tica es la manipulaci\'f3n de la informaci\'f3n nutricional por parte de la industria farmac\'e9utica y de alimentos. Vemos con sorpresa como d\'eda a d\'eda, por los medios masivos de comunicaci\'f3n (televisi \'f3n, radio, prensa) nos \'93bombardean\'94 con productos o entrevistas a supuestos \'93expertos en nutrici\'f3n\'94 que no manejan informaci\'f3n veraz, sino que responden a intereses mercantilistas y de lucro particular. \par \par Todos estamos bajo la influencia de las modas y falacias sobre alimentos y suplementos nutricionales, y lo que es peor, muchas veces se indican suplementos vitam\'ednicos y de minerales, sin efectividad comprobada. \par \par Existen grupos de la poblaci\'f3n que son m\'e1s propensos al fraude, como por ejemplo: \par \par }{\b0\i\ul Los Obesos:}{\b0 ante la angustia y desesperaci\'f3n por perder peso corporal, toman cualquier pastilla o infusi\'f3n que se encuentre en el mercado para tal fin. O, a trav\'e9 s de anuncios publicitarios, se contactan con pseudo-profesionales que ofertan \'93dietas m\'e1gicas\'94, que hacen perder todo, hasta la vida\'85 \par }{\b0\i\ul Los Ancianos:}{\b0 otros en su deseo de retardar los procesos de envejecimiento, adquieren productos de alt\'edsimo costo y de resultados no comprobados. \par }{\b0\i\ul Los Deportistas:}{\b0 en su af\'e1n de destacarse r\'e1pidamente en una disciplina, sobretodo en las de multifuerza y f\'edsicoculturismo, los atletas y los principiantes toman sobrecargas de amino\'e1 cidos y otros suplementos que le proveen un medio ergog\'e9nico extra. Muchos de estos productos no advierten los efectos colaterales adversos, principalmente en las funciones endocrinas y metab\'f3licas del h\'edgado y ri\'f1\'f3n. \par }{\b0\i\ul Los Enfermos Cr\'f3nicos:}{\b0 Ciertas enfermedades cr\'f3nicas y degenerativas, como la diabetes y el c\'e1ncer, cuyo control y tratamiento en muchos casos son paliativos, conllevan a quienes las padecen, de ser v\'ed ctimas de los productos naturistas o a consultar terapias heterodoxas no estudiadas, no dosificadas y no comprobado el principio activo o curativo presente en algunos de ellos. \par \par Sin duda alguna que los principios bio\'e9ticos involucrados en estos casos son, la Justicia y la No-maleficencia, y el deber ser de los entes involucrados (Ministerio de Salud, Colegios Profesionales, Protecci\'f3 n al Consumidor, etc.), son la vigilancia sanitaria, control de los productos expendidos y servicios ofertados, y por supuesto, la educaci\'f3n en salud y en nutrici\'f3n que se debe impartir regularmente a todo nivel, porque consumidores, somos todos. \par \par }{La investigaci\'f3n en nutrici\'f3n y los derechos de los enfermos: \par }{\b0 Desde que se promulg\'f3 el C\'f3digo de Nuremberg (1947), hasta llegar a los m\'e1s recientes documentos del Consejo de Organizaciones Internacionales de Ciencias M\'e9 dicas (CIOMS, 1996), muchos han sido los encuentros y consensos mundiales a favor de los derechos de los enfermos y de los sujetos humanos que participan en una investigaci\'f3n biom\'e9dica. \par \par La \'e9tica del investigador juega un papel fundamental durante todas las fases de desarrollo del proyecto, sin embargo existen tres momentos cruciales en los que la base moral del investigador puede ser m\'e1s susceptible a influencias externas poco \'e9 ticas. Estos momentos son: durante el dise\'f1o metodol\'f3gico y la ejecuci\'f3n, al hacer uso de los resultados y al actuar como \'e1rbitro cient\'edfico. \par \par El Dr. Francisco J. De Abajo }{\i\fs20\super (3)}{\b0 , presenta en una tabla muy did\'e1ctica, los aspectos \'e9ticos principales de la investigaci\'f3n epidemiol\'f3gica y su asignaci\'f3n a los niveles correspondientes del esbozo moral seg\'fa n el Dr. Diego Gracia: \par }{\fs20\lang1024\langfe1024\noproof\langnp1033\langfenp1033 {\shp{\*\shpinst\shpleft-115\shptop233\shpright8957\shpbottom6185\shpfhdr0\shpbxcolumn\shpbxignore\shpbypara\shpbyignore\shpwr3\shpwrk0\shpfblwtxt0\shpz0\shplid1027 {\sp{\sn shapeType}{\sv 1}}{\sp{\sn fFlipH}{\sv 0}}{\sp{\sn fFlipV}{\sv 0}}{\sp{\sn fFilled}{\sv 0}}{\sp{\sn lineWidth}{\sv 12700}}{\sp{\sn fLine}{\sv 1}} {\sp{\sn fLayoutInCell}{\sv 0}}{\sp{\sn fLayoutInCell}{\sv 0}}}{\shprslt{\*\do\dobxcolumn\dobypara\dodhgt8192\dprect\dpx-115\dpy233\dpxsize9072\dpysize5952 \dpfillfgcr255\dpfillfgcg255\dpfillfgcb255\dpfillbgcr255\dpfillbgcg255\dpfillbgcb255\dpfillpat0\dplinew20\dplinecor0\dplinecog0\dplinecob0}}}}{\b0\fs20 \par }\pard \s17\qj \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b0\fs22 Nivel 1: }{\fs22 No Maleficencia \endash Justicia: \par }{\fs20 \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls2\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin1080\itap0 {\b0\fs22 Utilidad social de la investigaci\'f3n. \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls2\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin1080\itap0 {\b0\fs22 Correcci\'f3n t\'e9cnica del estudio. \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls2\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin1080\itap0 {\b0\fs22 Competencia del equipo investigador. \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls2\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin1080\itap0 {\b0\fs22 Selecci\'f3n equitativa de la muestra. \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls2\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin1080\itap0 {\b0\fs22 Relaci\'f3n beneficio/riesgo apropiada de las intervenciones del ensayo. (*) \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls2\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin1080\itap0 {\b0\fs22 Garant\'eda de }{\b0\i\fs22 Clinical Equipoise}{\b0\fs22 entre las intervenciones a comparar \par }\pard \s17\qj \fi720\li360\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin360\itap0 {\b0\fs22 (No-preferencia cl\'ednica o colectiva). * \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls3\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin1080\itap0 {\b0\fs22 Compensaci\'f3n por da\'f1os/Seguro. * \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls3\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin1080\itap0 {\b0\fs22 Interpretaci\'f3n rigurosa y veraz de los resultados y su publicaci\'f3n. \par }\pard \s17\qj \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b0\fs22 \par Nivel 2: }{\fs22 Autonom\'eda \endash Beneficencia: \par }{\fs20 \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls4\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls4\adjustright\rin0\lin1080\itap0 {\b0\fs22 Proceso de consentimiento informado. \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls4\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls4\adjustright\rin0\lin1080\itap0 {\b0\fs22 Especial protecci\'f3n de grupos vulnerables y decisiones de sustituci\'f3n. \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls4\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls4\adjustright\rin0\lin1080\itap0 {\b0\fs22 Preferencias de asignaci\'f3n. * \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls4\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls4\adjustright\rin0\lin1080\itap0 {\b0\fs22 Protecci\'f3n de la intimidad y confidencialidad de la informaci\'f3n. \par {\pntext\pard\plain\s17 \f3\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard \s17\qj \fi-360\li1080\ri0\widctlpar\jclisttab\tx1080{\*\pn \pnlvlblt\ilvl0\ls4\pnrnot0\pnf3\pnstart1\pnindent360\pnsp120\pnhang {\pntxtb \'b7}}\aspalpha\aspnum\faauto\ls4\adjustright\rin0\lin1080\itap0 {\b0\fs22 Continuaci\'f3n del tratamiento, o de la asistencia sanitaria, despu\'e9s de la investigaci\'f3n. \par }\pard \s17\qj \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b0\fs20 \par }{\b0\fs22 (*) Estos aspectos son m\'e1s propios de la investigaci\'f3n epidemiol\'f3gica experimental. \par }{\b0\fs16 Tomado de: De Abajo, Francisco. }{\fs16 Etica de la Investigaci\'f3n epidemiol\'f3gica.}{\b0\fs16 OPS-OMS. Cuadernos del Programa Regional de Bio\'e9tica para Am\'e9rica Latina y el Caribe 1996 Nov;3:7-28.}{\b0 \par \par La ciencia de la Nutrici\'f3n no escapa de estos preceptos. Vemos con asombro como la sociedad cient\'edfica discrimina positivamente aquellas investigaciones de car\'e1cter experimental; mientras m\'e1s alejada del ser y m\'e1s sub-especializada sea el \'e1rea de estudio, mejor. El positivismo y la tecnificaci\'f3n desmedida de las ciencias de la salud, han encontrado su contraparte en la Bio\'e9tica y los movimientos humanistas. Hoy m\'e1 s que nunca, los investigadores nacionales deben buscar la utilidad social de la investigaci\'f3n en nutrici\'f3n y tratar de dar respuesta a una diversidad de problemas de inter\'e9s com\'fan. \par }{La nutrici\'f3n cl\'ednica-asistencial: \par }{\b0 La Nutrici\'f3n bajo el contexto cl\'ednico nos circunscribe al ambiente hospitalario y al ambulatorio si del sector p\'fablico se trata, o, a la cl\'ednica y a la consulta privada si nos ubicamos en el sector privado de la atenci\'f3 n en salud. En cualquiera de los escenarios, nos encontraremos con una }{\b0\i Comunidad Interrelacionada}{\b0 , compleja, interactuante y sin\'e9rgica, donde cada uno de los entes que la componen debe ser considerado como }{\b0\i Persona Humana}{\b0 : sujeto espiritual, asiento de la vida moral de un ser humano; respetando sus caracter\'edsticas de ser intemporal, poseer libre albedr\'edo, interioridad y dignidad. Adem\'e1 s, la Regla de Oro, como norma fundamental de la conducta humana, que contiene la totalidad de las exigencias morales de las relaciones interpersonales de los seres humanos, deber\'eda ser la }{\b0\i Proyecci\'f3n Afectiva}{\b0 , que seg\'fa n el enunciado del Mahabharata expresa lo siguiente: \'93No hagas a ninguno lo que \'e9l no quiere que a \'e9l mismo le suceda\'94. Frase del todo sabia y que pretende respetar ante todo la autonom\'eda y la identidad en las relaciones personales. \par \par Esta antesala conceptual nos permite entonces iniciar el primer punto de discusi\'f3n: las }{\b0\i Relaciones del Profesional de la Nutrici\'f3n}{\b0 . \par \par Las Relaciones Profesionales del Nutricionista, al igual que las de otros profesionales de la salud, pueden agruparse en tres grandes bloques, cada uno con sus peculiaridades. La m\'e1s importante de ellas, tambi\'e9n la m\'e1 s discutida y donde realmente la profesi\'f3n como ciencia se transforma en arte, como vocaci\'f3n de servicio hacia el bienestar com\'fan, es la }{Relaci\'f3n con el Paciente-Usuario y sus Familiares}{\b0 , la cual muestra una tendencia hacia lo autonomista, sin embargo en nuestras sociedades latinas el patr\'f3n paternalista sigue siendo el imperante. Este proceso de transici\'f3n nos permite fusionar ambos modelos, tomar \'93lo bueno\'94 que ofrece cada uno y favorecer progresivamente la toma de conciencia sobre la responsabilidad y participaci\'f3n del ciudadano en la promoci\'f3n y mantenimiento de su estado de salud. En las otras relaciones: }{Relaci\'f3n en el \'e1mbito Interno }{ \b0 (Gremio Profesional, Colegas, Estudiantes de pre y postgrado, Auxiliares de Nutrici\'f3n, Empleados y Obreros) y }{Relaci\'f3n en el \'e1mbito Externo}{\b0 (M\'e9dicos, Enfermeras, Bioanalistas, Soci\'f3logos, Psic\'f3 logos, Trabajadores Sociales, Religiosos, Estudiantes de otras carreras, Personal Administrativo, entre otros), las principales cualidades a cultivar, desarrollar y optimizar ser\'edan la solidaridad y la comunicaci\'f3n. \par \par Estas relaciones profesionales planteadas bajo el contexto de las teor\'edas \'e9ticas actuales, toman sustento moral al incorporar de las }{Eticas Comunitaristas}{\b0 , los conceptos de Consenso Social, Bienes Comunitarios e Historia de la Comunidad; de las }{Eticas Discursivas}{\b0 : La teor\'eda de la Acci\'f3n Comunicativa, propuesta por Habermas, donde la simetr\'eda, la no-exclusi\'f3 n y la no-violencia son los principios del proceso comunicativo y de las }{Eticas de Responsabilidad}{\b0 , la Bio\'e9tica. \par \par \'bfC\'f3mo participa la Bio\'e9tica en el entorno cl\'ednico? Como \'e9tica de la responsabilidad, la Bio\'e9tica conjuga lo deontol\'f3gico (a priori), determinado por los principios, con lo teleol\'f3 gico (a posteriori), subordinado a las consecuencias. De esta forma, ante el hecho moral, la persona toma una decisi\'f3n aut\'f3noma, racional, bajo un proceso civil, pluralista, universal y sobre todo deliberativo, a trav\'e9s de Comit\'e9s de Bio\'e9 tica que se formen en cada instituci\'f3n. \par \par Este breve par\'e9ntesis conceptual me permite introducir los principios bio\'e9ticos, planteados por Beauchamp y Childress, aplic\'e1ndolos a la Nutrici\'f3n Cl\'ednica. \par \par Al hablar de }{Justicia}{\b0 , necesariamente abordamos el \'e1rea de la administraci\'f3 n de recursos escasos y aunque parezca exagerado pensar los alimentos como recurso escaso, la crisis presupuestaria por la que atraviesan nuestros hospitales, obliga a que se revise y eval\'fa e la eficiencia y eficacia de todos los servicios que conforman el Departamento de Nutrici\'f3n. Por ejemplo, el Servicio de Nutrici\'f3n Normal y Dietas Terap\'e9uticas, donde se preparan todas las dietas de los pacientes hospitalizados, debie ra estudiar cu\'e1nto del presupuesto se pierde en residuos por bandeja de alimentos que no fueron consumidos, porque estaban fr\'ed os, mal presentados o por hiporexia del paciente. Otros servicios que trabajan con productos especializados importados y de alto costo, como el Servicio de Soporte Nutricional Parenteral y Enteral, donde muchas veces las tomas nocturnas de nutrici\'f3 n enteral quedan refrigeradas sin ser suministradas al paciente, o en otros casos se adquieren productos con indicaci\'f3n muy especializada en mayor cantidad de la requerida y se vencen sin haber sido consumidos. En el Servicio de F\'f3rmulas L\'e1 cteas se preparan gran cantidad de biberones con suced\'e1neos de Leche Materna, en vez de fomentar y propiciar la pr\'e1ctica de la Lactancia Materna y crear un Banco de Leche Humana. La iniciativa del UNICEF de \'93Hospitales amigos de los ni\'f1 os y de la Madre\'94 ha ayudado a mejorar la relaci\'f3n costo/beneficio significativamente. \par \par La }{No Maleficencia}{\b0 puede ser vulnerada cuando incurrimos en malpraxis, ya sea por incompetencia, impericia, negligencia o iatrogenia. Una situaci\'f3n realmente alarmante es la de la alta tasa de desnutrici\'f3 n intrahospitalaria, es decir, de pacientes que se desnutren dentro del hospital, adem\'e1s de la patolog\'eda de base con que ingresan, adquieren otra dentro del hospital, repercutiendo negativamente en el pron\'f3stico y recuperaci\'f3 n de su estado de salud general. \'bfQu\'e9 est\'e1 pasando? Ni siquiera el m\'ednimo moral de No Maleficencia se est\'e1 cumpliendo. Ante esta indiferencia parecieran intervenir al menos dos factores: }{1)}{\b0 la vocaci\'f3 n profesional, en especial la de los nutricionistas, que no est\'e1 claramente definida, seg\'fan Claudio Schuftan (1983) }{\i\fs20\super (4)}{\b0 , nos hace falta m\'e1s }{\b0\i nutricionistas radicales}{\b0 , con conciencia social m\'e1 s alta y sobretodo orientados hacia la acci\'f3n y a ser protagonistas, en cambio, los }{\b0\i nutricionistas liberales}{\b0 discuten mucho y hacen poco. Es tambi\'e9n como propone James Drane (1991) }{\i\fs20\super (5)}{\b0 , nos hacen falta m\'e1 s profesionales con expresiones de una \'e9tica de la virtud y del car\'e1cter, que adem\'e1s de practicar una buena t\'e9cnica, sean t\'e9cnicos buenos. }{2)}{\b0 Sentido de pertenencia y referencia en nuestro quehacer profesional, vinculado a la visi \'f3n del centro de salud como comunidad. \par \par La }{Beneficencia}{\b0 se refiere a una atenci\'f3n adecuada y de alta calidad, en donde la educaci\'f3n en nutrici\'f3n que se imparta al paciente y familiares tiene gran significaci\'f3n, especialmente en aquellos enfermos con enfermedades cr\'f3 nicas como diabetes y obesidad; en aquellos con trastornos alimentarios como anorexia y bulimia, y sobretodo en aquellos con enfermedades carenciales producto de deprivaciones alimentarias y sociales. \par \par El principio de }{Autonom\'eda}{\b0 se hace presente al hablar de los derechos del enfermo }{\i\fs20\super (6)}{\b0 , a trav\'e9s de su consentimiento informado al acceder o no a alg\'fan r\'e9gimen diet\'e9tico, al respetar sus h\'e1 bitos y costumbres alimentarias vinculadas o no a creencias religiosas, como en los casos de vegetarianos estrictos y jud\'edos. \par \par Dentro de las situaciones cl\'ednicas donde la Autonom\'eda ha sido m\'e1s irrespetada, encontramos la indicaci\'f3n de nutrici\'f3n parenteral y enteral, por esto requiere una menci\'f3n especial, adem\'e1s de ser el tema con m\'e1s art\'ed culos publicados, el de mayor controversia y pol\'e9mica. \par \par Diversos autores }{\i\fs20\super (7-12)}{\b0 , argumentan que el soporte nutricional parenteral y enteral (SNPE) es una forma de alimentaci\'f3 n artificial (no natural), y que por lo tanto se pueden aplicar las normas dispuestas para las medidas extraordinarias de mantenimiento artificial de la vida. El paciente competente es aut\'f3 nomo para decidir sobre el inicio o continuidad del SNPE y se requiere su consentimiento para proceder. \par \par Ante todo \'93primum non nocere\'94. El equipo humano de SNPE debe tener claro que el principio que rige este tipo de terapia es el de No Maleficencia, seguido por el de Autonom\'eda y el de Beneficencia, entendi\'e9ndose por beneficio una extensi\'f3 n de la vida o una mejor\'eda en la calidad de esta. Si los productos para SNPE son escasos, la norma que se deber\'e1 seguir es la de dar prioridad a aquellos pacientes recuperables, considerando que si un paciente pudiese fallecer por desnutrici\'f3 n y no por otra causa, es un candidato para recibir SNPE. \par Ha sido minuciosa la revisi\'f3n expuesta y, a\'fan as\'ed ning\'fan tema se ha agotado, al contrario, se presentan nuevos horizontes en los cuales aplicar la Bio\'e9tica a la ciencia de la Nutrici\'f3 n. Solo quisiera concluir con dos reflexiones, una sobre la \'e9tica, motivo que nos reuni\'f3 y otra sobre la asistencia al desvalido. \par \par \'93Para lo \'fanico que sirve la \'e9tica es para intentar mejorarse a uno mismo\'85 y lo \'fanico seguro que sabe la \'e9tica es que t\'fa, yo y los dem\'e1s estamos hechos, de uno en uno, con amorosa diferencia\'94. \tab \tab \tab \tab }{\cf15 Fernando Savater. \par }{ \par }{\b0 \'93El primer acto de tratamiento es el acto de dar la mano al paciente\'94. }{\cf15 Von Leyden.}{\b0\cf15 \par }{\b0 \par }\pard \s17\qc \li0\ri0\sl360\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {REFERENCIAS BIBLIOGRAFICAS:}{\b0\fs22 \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 01)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 UNICEF. }{\fs22 Implementing the convention on the rights of the child. Resource mobilization in low-income countries.}{\b0\fs22 Himes JR, editor. Martunus Nijhoff Publishers. Netherlands, 1995. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 02)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 FAO. }{\fs22 Alimentos para todos. Cumbre mundial sobre la alimentaci\'f3n.}{\b0\fs22 Roma 13-17 Nov 1996. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 03)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 De Abajo, Francisco. }{\fs22 Etica de la Investigaci\'f3n epidemiol\'f3gica.}{\b0\fs22 OPS-OMS. Cuadernos del Programa Regional de Bio\'e9tica para Am\'e9 rica Latina y el Caribe 1996 Nov;3:7-28. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 04)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Schuftan, Claudio. }{\fs22 Ethics and ideology in the battle against malnutrition.}{\b0\fs22 Cap\'edtulo 7 en: Nutrition in the Community. Ed. D.S. McLaren. John Wiley & Sons Ltd., 1983. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 05)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Drane, James. }{\fs22 El SIDA y la \'e9tica.}{\b0\fs22 In: Aspectos de la \'e9tica y el derecho al estudio del SIDA. Publicaci\'f3n Cient\'edfica No. 530. OPS-OMS, 1991. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 06)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Le\'f3n Cechini, Augusto. }{\fs22 El enfermo y sus derechos.}{\b0\fs22 Publicaciones de la Revista de la Fundaci\'f3n Jos\'e9 Mar\'eda Vargas. Caracas, 1980. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 07)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Mora, Rafael. }{\fs22 Cap\'edtulo 3: Principios de soporte nutricional.}{\b0\fs22 In: Soporte nutricional especial. Bogot\'e1: Panamericana, 1992: 53-4. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 08)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Garc\'eda Sainz, Mauricio. }{\fs22 C\'e1ncer, apoyo nutricio y \'e9tica.}{\b0\fs22 In: Robles Gris, J; Ochoa, F. Apoyo nutricio en c\'e1ncer. M\'e9 xico:Interamericana Mc Graw Hill. 1era. Edici\'f3n. 1995. Cap\'edtulo 29. P.302-305. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 09)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Souchon, Eduardo. }{\fs22 Cuando no deben aplicarse medidas de nutrici\'f3n parenteral o enteral.}{\b0\fs22 En: Castillo, A; Mugarra, X. Etica, pol\'ed tica, derecho y situaciones de muerte. Caracas: Ediciones Rectorado, Universidad Central de Venezuela. 1991. P.95-99. \par {\pntext\pard\plain\s17 \b\f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 10)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\fs22 Ethical and legal issues in specialized nutrition support.}{\b0\fs22 Section IX. ASPEN Board of Directors 1993 Jul-Aug (17)4S:50SA-52SA. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 11)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Emanuel, Ezekiel. }{\fs22 A review of the ethical and legal aspects of terminating medical care.}{\b0\fs22 The american journal of medicine 1988 feb;84:291-301. \par {\pntext\pard\plain\s17 \f1\fs22\lang8202\langfe3082\langnp8202\langfenp3082 \hich\af1\dbch\af0\loch\f1 12)\tab}}\pard \s17\qj \fi-504\li504\ri0\widctlpar\jclisttab\tx510{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0{\pntxta )}} \aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin504\itap0 {\b0\fs22 Rabbi Schostak, Zev. }{\fs22 Jewish ethical guidelines for resuscitation and artificial nutrition and hidration of the dying elderly.}{\b0\fs22 Journal of medical ethics 1994;20:93-100.} {\b0 \par }\pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \fs20\lang8202\langfe3082\cgrid\langnp8202\langfenp3082 { \par }\trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Nombre del Autor\cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par MARIAN M. ARAUJO YASELLI\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Instituci\'f3n que represento\cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par }\pard\plain \s1\qj \li0\ri0\keepn\widctlpar\intbl\aspalpha\aspnum\faauto\outlinelevel0\adjustright\rin0\lin0 \b\f1\fs24\lang8202\langfe3082\cgrid\langnp8202\langfenp3082 { UNIVERSIDAD CENTRAL DE VENEZUELA \par }\pard\plain \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs20\lang8202\langfe3082\cgrid\langnp8202\langfenp3082 {\b\f1\fs24 Facultad de Medicina \par Escuela de Nutrici\'f3n y Diet\'e9tica \par C\'e1tedra de Educaci\'f3n y Comunicaci\'f3n \par \par CENTRO NACIONAL DE BIOETICA \par CENABI \endash Venezuela \par \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv \brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par T\'edtulo del Trabajo\cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par BIOETICA Y NUTRICION EN SALUD PUBLICA\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr \brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Resumen \cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Se presentan diversos aspectos del \'e1rea alimentaria-nutricional vistos bajo una perspectiva bio\'e9tica. La nutrici\'f3n como derecho humano y la pol\'edtica alimentaria-nutricional nacional; los derechos de los enfermos y la investigaci\'f3 n en nutrici\'f3n; los derechos del consumidor, la publicidad y el etiquetado nutricional, y finalmente el \'e1rea de la nutrici\'f3n cl\'ednica-asistencial, donde la mayor\'eda de los art\'edculos se refieren a la indicaci\'f3n o suspensi\'f3n de sopo rte nutricional parenteral y enteral, las implicaciones de justicia distributiva y la administraci\'f3n de recursos escasos.\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108 \trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Palabras Claves\cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Bio\'e9tica, Alimentaci\'f3n, Nutrici\'f3n, Salud P\'fablica.\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb \brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Direcci\'f3n de Habitaci\'f3n\cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Colinas de Los Ruices, Av. Alfarer\'eda, Qta. Myriam, \par Caracas 1071, Venezuela.\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh \brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt \clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Tel\'e9fonos\cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Hab. 058-2-2571378 / Cel. 058-16-8043328 \par Ofic. 058-2-6053530 / 6053506 \par Telefax. 058-2-6937139\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh \brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt \clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr \brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par Correo Electr\'f3nico\cell }\pard \qj \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \par }{\field\flddirty{\*\fldinst {\b\f1\fs24 HYPERLINK mailto:araujom@camelot.rect.ucv.ve }{\b\f1\fs24 {\*\datafield 00d0c9ea79f9bace118c8200aa004ba90b02000000170000001c00000061007200610075006a006f006d004000630061006d0065006c006f0074002e0072006500630074002e007500630076002e00760065000000e0c9ea79f9bace118c8200aa004ba90b460000006d00610069006c0074006f003a006100720061007500 6a006f006d004000630061006d0065006c006f0074002e0072006500630074002e007500630076002e0076006500000000}}}{\fldrslt {\cs15\f1\fs24\ul\cf2 araujom@camelot.rect.ucv.ve}}}{\b\f1\fs24 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\b\f1\fs24 \trowd \trgaph108\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trpaddl108\trpaddr108\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth2628 \cellx2520\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl \brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth6430 \cellx8950\row }\pard \qj \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs24 \par }\pard\plain \s17\qj \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \b\f1\fs24\lang8202\langfe3082\cgrid\langnp8202\langfenp3082 {\b0 \par \par }}