Cuadernos Médico Sociales

Medical prognosis and terminal illness

Miguel Kottow — 2025-04-04

Hipocrates wrote about the crucial importance of a well founded prognosis, which came fairle easy to him since his medical practice did not interfir whith the natural course of disease, letting the vis medicatrix naturae determine whether de patient would die or cure. Along medical history, the prognosis became an unreliable instrument in the hands of medical practitioners, only to regain its importance in contemporar medical practice, where sophisticated diagnostic and therapeutic instrumentation makes anticipation uncertain and unpredictable.

Euthanasia is often discussed and legislated for "terminal patients", putting the authorized practice in the straightjacket of time and the medical certification that death is inminent. Under these conditions, patients have few options to make decisions about medical interventions that will have personal existential consequences that may conflict with medical criteria.

"Individual prognoes are necessary in every medicaldecision and, beyond that, they even legitimize every medical act" Wiesemann, C. 1998), provided they resepct the patients' needs and interesets.

Editorial. Por un giro eto-biológico (ecológico) del pensamiento

Mirtha Parada Valderrama — 2025-04-04

El sendero de Rodrigo Moren: un homenaje

Diego Alfaro Palma — 2025-04-04

Darwin Vegetal

Yuri Carvajal Bañados — 2025-04-04

Cronistas de indias del siglo XX: Oda a la erosión en la Provincia de Malleco

Yuri Carvajal Bañados — 2025-04-04

What does bio mean in biodiversity and health?

Yuri Carvajal Bañados — 2025-04-04

We review the relationship between health and biodiversity, going through two perspectives. The first, a review and update of six relevant biological notions: sympoiesis, ethology, eco-.evo.-devo, epigenetics, plan and biome. Seeking to also localize the debate, we review four aspects of the future of the Anthropocene in the south of our continent.

Biodanza and health

Eylin Novoa Jara — 2025-04-04

Biodanza is presented as a Personal Development system focused on the study and strengthening of human potential through music, group communication exercises, and integrative experiences. It is recognized as a Body Practice, currently included in the Ministry of Health’s Complementary Medicine and Health Wellness Practices Policy. This article describes the origins and briefly the history of the development of Biodanza, its significance, and the effects and benefits this system brings at the physical, emotional, and neurological levels. It also outlines where Biodanza has been applied in the field of health, presenting some case studies.

Urgencia para la toma de decisiones en sitios contaminados y zonas de sacrificio en un contexto de cambios climáticos en Chile

Yuri Carvajal Bañados — 2025-04-04

Primer tratado que aborda la interacción entre la propiedad intelectual, los recursos genéticos y los conocimientos tradicionales

Cuadernos Médico Sociales — 2025-04-04

Bitácora del Simposio “Identidad y Pertenencia Sociocultural” Chiloé, noviembre 2024

Horacio Riquelme — 2025-04-04

Desafíos desde una mirada socio sanitaria y ciudadana: avanzar en una reforma a la salud

Jaime Sepúlveda Salinas — 2025-04-04

Public Spending on Primary Care: 35 years of democratic governments

Patricio Lagos Araya — 2025-04-04

This study will address the concepts of public spending in PHC: Contribution Law No. 19,378; PRAPS and Public Health Goods Programs. These programs are associated with direct spending on health care for the population. In the case of sectoral investment in PHC, in the short term, it requires a more in-depth investigation of the investment plans in each government period and the budgetary decisions associated with the financing and accrued execution of the expenditure in the portfolio of projects identified for each budget year. Constructing a 35-year series of public investment in PHC is a matter of greater complexity. The sources of information that will be cited in the article come from documents and statistics from MINSAL; FONASA; DIPRES and academic publications from universities.

Universal Primary Care: from Pioneering Program to State Policy

Osvaldo Artaza Barrios — 2025-04-04

There is consensus that Primary Health Care is the cornerstone for achieving universal health, as it is the primary tool for improving access to health services, contributing to equity, efficiency, promotion, and prevention, as well as providing a comprehensive and intersectoral approach to diverse health needs with the involvement of individuals and their communities. For this reason, the Government of Chile has launched a pioneering program for the Universalization of Primary Health Care in 28 municipalities, aiming to ensure that all individuals, regardless of the subsector to which they belong, can access this strategy. This article presents various aspects of the initiative and its initial results. It highlights the importance of establishing political agreements to transform this pilot program into a state policy that, beyond political cycles, can become the universal foundation of a mixed system for service delivery.

Universalization of Primary Health Care in Chile: regrettably regressive policy

Camilo Bass del Campo — 2025-04-04

The Universalization of Primary Health Care (PHC-U) in Chile has been presented as the “heart” of a future reform. However, it contains strategic, tactical and operational problems that generate regressive effects, mainly affecting the most vulnerable sectors of society. Objective: To evaluate PHC-U, considering financing, administration, access, human talent and community participation. Methods: Documentary analysis based on official reports and data on the development of PHC-U in pilot communities. Results: The financing of PHC-U establishes a cross-subsidy towards private insurers, returning to a situation that had been attempted to be overcome decades ago in our country. Furthermore, in the midst of tax regressivity, the poorest sectors end up subsidizing those who have better health and private insurance. In relation to administration, the vices of municipalization continue, generating territorial disparities and misuse of resources. Finally, in a scenario of low coverage and following the law of care in reverse, the implementation of this policy deepens inequality in care. Conclusion: Rather than generating equity, the APS-U perpetuates exclusion in health, disguising under a progressive discourse mechanisms that reinforce aporophobia, structural injustice and the lack of understanding of the private sector. Urgent structural changes are required in this policy.

Reflections and debate on the implementation of Universal Primary Care

Ingrid Kremser Ruíz — 2025-04-04

Reflections on the Universalization of Primary Health Care, a Ministry of Health program launched two years ago. This paper analyzes the challenges and expectations of the Universalization Process and the current problems faced.

Green shoots in Primary Care

Antonio Infante Barros — 2025-04-04

The author's view of the Primary Health Care scenario in Chile, along with a review of three promising developments regarding the comprehensive development of the PHC strategy: Universal PHC, ECICEP (Comprehensive Person-Centered Control Strategy), and Information for Social Management.

Revista de Libros y Revistas

Carolina Benítez Hernández — 2025-04-04

The Porous Body: a new concept for an integral perspective in Medicine, Bioethics, and Public Health

Reinaldo Bustos Domínguez — 2025-04-04

This article presents the original concept of the "porous body" as an integral and relational perspective in contrast to the traditional biomedical model in medicine, bioethics, and public health. Drawing on Spinoza's monism and the assemblages of Deleuze and Guattari, this notion characterizes the body as permeable, dynamic, and interdependent with its biological, social, and cultural environment. Historically, from magical-religious models to molecular biomedicine, it highlights how views of the body have evolved from the supernatural to more mechanistic and reductionist approaches. The porous body challenges this fragmentation, highlighting the influence of epigenetic and neuroscientific factors that demonstrate how environmental and social conditions affect human health. In bioethics, it promotes a relational ethic that values community interdependence over isolated individual autonomy. In public health, it emphasizes the importance of addressing social and environmental determinants through inclusive and equitable policies. Finally, it questions neoliberal logic in medicine, emphasizing health as a collective right, and proposes practical strategies to ensure more just and sustainable healthcare.

Dr. José Salas: the people’s first candidate for President of the Republic

Felipe Martínez Fernández — 2025-04-04

In early 1925, various social movements and political parties supported the presidential candidacy of Dr José Salas. Salas became a political leader who responded to new social demands, especially the need to modernize the state administration. On the occasion of the centenary of this event, this article reflects on his rise as a presidential candidate. It examines his medical career, with particular emphasis on his career in the military medical service. It then analyzes his participation in public life in the context of political changes driven by both military and civilian groups. Finally, it examines how his sexual orientation became an object of gossip, curiosity and political vilification.

Social participation in health five years after the social uprising in Chile

Camila Gallardo Gómez — 2025-04-04

This article analyzes social participation in health in Chile five years after the social outbreak of 2019, using the example of the citizen health councils in Valdivia and the emerging proposals from social mobilization. It concludes with the need for a progressive reform of the current dual health system based on the universalization of care and a Single Health Insurance. Furthermore, it proposes strategies to strengthen citizen participation through a governance model that ensures community influence in decision-making.

Editorial. Impulsar los cambios. Creatividad, asociación y liderazgo

Jorge Lastra Torres — 2025-04-04

Salud y Ambiente: formación médica en el Antropoceno

Departamento de Medio Ambiente. Colegio Médico de Chile A.G. — 2025-04-04