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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">A search in Scopus &#8211; the largest database of abstracts and citations in peer reviewed scientific journals in the world &#8211; shows that from 1990 to June 2018 the number of papers on the subject of consent for the publication of case reports &#40;CPCR&#41; amounted to 14 documents&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;14</span></a> Of this total&#44; only four were peer reviewed papers published in indexed journals&#44; as is shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Within the sample analysed&#44; such a small number of results clearly shows the relevance of the paper&#58; &#8220;<span class="elsevierStyleItalic">The Patient Information Sheet &#40;PIS&#41; and Informed Consent &#40;IC&#41; for case reports and case series&#58; Proposal for a standard model for presentations in congresses and other scientific publications</span>&#8221;&#44; published by Juana Cruz del R&#237;o&#44; Isabel Sastre Gerv&#225;s and Susana Romero Yuste&#44; &#42; in this edition of <span class="elsevierStyleItalic">Clinical Rheumatology</span>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The authors propose a digital format as the bioethical support for&#58; &#40;1&#41; the description of case reports and case series in conferences&#59; &#40;2&#41; publication in journals that lack their own model&#44; and &#40;3&#41; undertaking teaching activities in the health sector&#46; With their proposal the authors seeks to comply with the right to privacy and the protection of patient data used in research in Spain&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">This paper is not only relevant&#44; as it is also opportune given that several medical journals have gradually ceased to publish case reports&#46; They state that studies of this type affect levels of impact as they lack quality standards&#44; are quoted very infrequently and fail to comply with the ethical standards governing clinical research&#46; The work presented here aims to correct these deficiencies to a certain degree&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Some challenges for Latin America</span><p id="par0025" class="elsevierStylePara elsevierViewall">During the second half of the 20th century it became obligatory in several Western countries to revise the ethical aspects of experiments undertaken in human beings&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Until 1966 medical research was routinely performed without seeking any type of consent from the patients subjected to research&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> As a part of developments in the this field&#44; in 1996 the first paper and guides were published by the <span class="elsevierStyleItalic">International Committee of Medical Journal</span> Editors on CPCR&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In spite of the progress made since then many challenges remain in this field&#44; particularly in developing countries&#44; where research ethics committees either do not exist or are in a precarious situation&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Given that consent depends on the context&#44; this problem has to weigh sociocultural factors such as the age of participants&#44; their educational level&#44; language differences&#44; coercion and the influence of patriarchal or traditional societies&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The CPCR developed in Latin American countries also have to take into account the fact that sometimes researchers have to deal with highly vulnerable populations including children&#44; women&#44; the elderly&#44; individuals with mental development disorders&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> illegal immigrants and native populations&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Within all of these contexts&#44; guaranteeing the rights of research subjects who are illiterate&#44; disabled or speakers of native languages&#44; for example&#44; usually requires the additional presence of an independent witness&#44; a tutor or a translator to confirm that consent was given consciously and freely&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">All of these considerations have to be taken into account when obtaining a CPCR&#44; with the aim of minimising asymmetries between researchers and research subjects&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">The duty of rheumatologists to protect personal rights and dignity</span><p id="par0060" class="elsevierStylePara elsevierViewall">To summarise&#58; the CPCR&#44; which has the aim of protecting research subjects against possible harm and exploitation during the publication of a study&#44; must be contextualised within the sociocultural reality in each nation&#44; especially when research to be published consists of a case report or case series in rural&#44; marginalised or very poor communities&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In any case it must never be forgotten that in medical research projects undertaken by rheumatologists respect for the privacy&#44; rights and intrinsic dignity of individuals is expressed by components such as the CPCR&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The above considerations mean that constant&#44; respectful and fluid dialogue and communication are necessary between researchers&#44; patients and their associations&#44; regulatory bodies&#44; health institutions and scientific journals&#46; This has to be strengthened by suitable and solid bioethical training in undergraduate and graduate courses&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a></p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflict of interests</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#44; and they have received no financing&#46;</p></span></span>"
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