A importancia da bioética e do biodireito na sociedade atual

Considering the dynamics observed in bioethics conceptualization and its projection at the current society, this work, initially, provides a retrospective on the transformation of society over the centuries and, consequently on the emergence of new branches of scientific knowledge. Besides, offers a distinction between law, morality and ethics as a way to make the approximation of a definition of biolaw and bioethics, central theme of this study. Finally, emphasizes the importance of the use of bioethics and biolaw in the solution of conflicts of interest involving the so-called "actuality society law", all aimed at providing better protection for the current society, and particularly to guarantee the protection of fundamental rights for the citizen.

As trevas da razão esclarecida e as pesquisas em seres humanos em Tuskegee e na Guatemala: um caso de bioética

This work is aimed at examining the paradox of modernity, from the opposition between Enlightenment ideals and historical events that followed, especially during the twentieth century, as well as to study the impact of mismatch on Bioethics, adopting as a reference epistemological critical theory of the Frankfurt School. Bioethics presents itself as a shaky science, devoid of references, and primarily impacted by the emptying of ethics. The reason desubjectivation established by and exacerbated by modern enlightenment, was able to erect dark scary for humanity and promote barbaric practices in the name of a science that promises order and progress. This paradox and the fallacy of reason enlightened by scientific advances are wide open, always accompanied by ethical and moral returns scary. Some examples are the surveys conducted in Tuskegee and Guatemala, and treated in this study, which show how far modern rationality and all its consequences

Pesquisas em animais: uma reflexão bioética

Animal models are an important tool in scientific research. It is known that this practice must be based on bioethical principles in order to impose limits about pain and suffering, or for inspecting proceedings and research site. This study has as aim to evaluate and present current legislation ruling animal research in Brazil, comparing it with other countries, as well as fostering bioethical reflection about this issue. For this, we present current Brazilian legislation and we have carried out international literature review and discussion. The articles were searched in PubMed data base, using the key words "bioethics" and "animal welfare". Nineteen articles from 1997 to 2013 were included. It was concluded the evident contribution of animal research for scientific research in several fields. It is morally relevant for humans, as rational beings, to secure humane treatment to animals contributing to research. The safest way to follow this path is establishing clear norms and studies well designed, involving society for assigning ethical norms. Thus, animal welfare would be guarantee.

Violence against children and adolescents: awareness and attitudes of Brazilian dentists

Violence against children and adolescents, ranging from negligence to sexual abuse, is an imperative public health problem. The ill treatments are considered as nonaccidental traumas, actions or omissions against children, who suffer physical or emotional violence. The main perpetrators are fathers, mothers, guardians, family, friends or the children‘s primary caretaker. It is very important to identify abuse cases, because this allows proper medical and legal intervention. In Brazil, the law n. 8.069, of July 13, 1990, known as the ECA -Statute for Children and Adolescents (SCA), stipulates the obligation to report suspected or confirmed cases of ill treatment against a child or adolescent to the Guardianship Council of the respective locality. The health professionals play a crucial role with regard to identifying cases of violence, collecting information, making early diagnosis of suspect cases and reporting such cases to the authorities. The dentists can contribute significantly, as most injuries occur in the orofacial region. Bite marks, burns, bruising, among others, are easily identified during a dental consultation. The aim of this work was to verify the awareness and attitudes of Brazilian dentists concerning violence against children and adolescents. This research was approved by the Research Ethics Committee of the Faculty of Dentistry of Araraquara – São Paulo State University (FOAr – UNESP). Sixty-three dentists answered an open and closed questionnaire concerning their formation, knowledge, experience and attitudes towards ill-treated children and adolescents. Among other results, thirty-nine dentists (61.9%) affirmed to have the means to identify illtreatment cases, 13 (20.6%) reported having some experience on this matter, but only 8 reported the cases to the Council of Guardianship, as determined by Brazilian law. Twenty percent of the reasons presented for not notifying the Council were fear of reprisal, and 60.0% were uncertain concerning the ethical and legal implications. Physical violence was the most reported form of identified violence (76.9%), followed by negligence (38.5%). Among the 13 professionals that had experience with violence cases, in 10 cases the perpetrators were identified – in 70.0% of the cases, the parents were the originators of such violence. It was concluded that further formation and orientation are necessary, in order to prepare dentists to act correctly when, during their professional activities, they encounter cases of violence against children and adolescents.

Health professionals ethical and legal liability on patient’s inadequate clarification in order to obtain free and informed consent

It is required that patients are provided information about therapeutic possibilities, showing the risks, benefits, prognosis and costs of each possible and indicated alternative. This is an ethical and legal resolution. However, health professionals possess the clinical/technical/scientific knowledge and determine what information will be (or not) provided. The patient in question decides to undergo a treatment, providing his/her free and informed consent on the basis of the data presented. Unfortunately, some professionals may not provide all the information necessary for making an informed decision or, after obtaining the consent of the patient, may provide him information that causes the patient to give up on the treatment initially accepted. Such information, if relevant, and not a supervening fact, should have been provided initially. However, the information may not be entirely true, and bring the patient, for instance, to decide based on inadequately presented risks. The craniofacial rehabilitation of the temporomandibular joint (TMJ) by means of TMJ prosthesis, is indicated in many situations. Often, patients in need of such prostheses have aesthetic and functional problems and the rehabilitation expectations run high. This work presents a case and discusses ethical and legal issues, including the liability of partial and inadequate information to a patient.

Violence against children and adolescents: the importance of knowledge of the spectrum of bruise colors in its diagnosis

Introduction: One of the violence types more observed against children is the physical abuse, which produces many types of traumatic injuries. Contusions are common trauma signs and may indicate aggression when frequently present in locations where accidental injuries are rare. Contusions in skin undergo color changes with the passage of time, and such change in color is called “spectrum of bruise colors of Legrand du Saulle”. Thus, it is possible to estimate the age of the lesion based on the evaluation of color. Injuries caused by child abuse often reach regions of head, face and neck, because they are exposed and easily accessible. Therefore, the dentist is responsible with regard to the diagnosis and the actions to be undertaken against the cases of child abuse. Objective: To present and discuss the significance of the spectrum of bruise colors as a considerable visible trace in suspicion of violence against children and adolescents, during dentists’ clinical routine. Literature review: The study of the “spectrum of bruise colors of Legrand du Saulle” refers to the estimation of the age of the injury, in respect to the color change. The application of this study is of great value for identify if a lesion occurred from a single incident or from multiple incidents, especially in cases where it occurs in the same region of the body, indicative of repetitive trauma. Conclusion: The spectrum of bruise colors is very important for health professionals, such as dentists, for the identification or suspicion of cases of abuse against children and adolescents. As great part of the lesions originated of abuse involve the areas of head and neck, it is unacceptable that these professionals are unaware of the basic signs to help in early diagnosis, which is the case of the colors of the lesions. However, concerning the chronology of the spectrum of bruise colors, it is not possible to establish rigorous times.

O debate bioético e jurídico sobre as diretivas antecipadas de vontade

Pós-graduação em Direito - FCHS

Home care: uma análise

Pós-graduação em Direito - FCHS

Perception of the informed consent form by participants in clinical trials

To understand the perception of the participants in controlled clinical trials (CCTs) about the informed consent and describe the meaning of their participation in the research. Qualitative study using the focus group technique. The sample was composed of 19 patients who participated in clinical trials about hypertension and coronary disease in a specialized cardiologic hospital located in the city of Sao Paulo. The methodological framework used was the content analysis. Some of the participants were aware of the real objective of these studies while others had misperceptions. The reading of the informed consent is not always done and, when it is done, the patient does not understand it. The lack of understanding about the term ''placebo'' was mentioned by some participants. The motivation to participate was the personal benefit. This study shows that obtaining the informed consent in CCTs is complex and that there is the need to adapt the structure and application of this document, in order to protect the participants and improve the quality of clinical trials performed in the country.

Vivendo com HIV/AIDS: estudos da ocorrência de discrimição nos serviços de saúde

Introduction: The discrimination experienced by people with HIV / AIDS, not only by society but also by health professionals is one of the major problems observed relative the epidemic. Objective: To verify and to analyze the occurrence of discriminatory attitudes in the assistance to the health of people living with HIV/AIDS. Methods: It was a quantitative research was carried out with the participation of sixty-eight HIV-positive individuals from four Brazilian cities. The participants answered auto-administrate questionnaires that contained open and closed questions including the considered subject. Results: 41.2% of the total participants, HIV + people, said they had been discriminated against by health professionals. Among the discriminatory situations experienced by HIV patients, 34.2% nursing professionals were involved, in 34.2% dentists and in 31.6% doctors were involved. Those who have suffered discrimination, 78.6% said they had been discriminated against in public health service. Conclusion: The occurrence of discrimination in the assistance to the health of HIV-positive patients was high. The majority of discrimination situations occurred in the public health service. It is necessary the institution of strategies aiming at human attendance to these patients.

Actitud de los docentes de las facultades de Odontologia Brasilenas ante los aspectos bioeticos, eticos y legales del tratamiento odontológico

The study consist on an analysis of attitude by professors of Brazilian Dental Schools before the aspects bioethical, ethic and legal dental treatment aspects. The data collect occurred by semi-structured questioners send by e-mail and correspondence. It was applied the content analysis, by categorical analysis technique, according to Bardin. About bioethical aspects, 94,6% cited that the decision of treatment should be realized between professional and patient, because it don t interfere on negative form (100%). Everybody consider important the interaction professional/patient, because it establishes the respect and mutual agreement between them (61,8%). Tangent at ethic aspects, 95,5% show all alternatives for determined case, even knowing that can lost patient, explaining on the technique and laical form to clear doubts(61,9%). About legal aspects, 82,4% allege that dental surgeon should treat his patient like consumer whereas offer techniques, materials and know through profession. And, like legal prove on occasional lawsuit, 57,1% mentioned that professional don t need of contract necessarily, but a good documentation about patient and e assigned by him. It concluded that these aspects should be teached always to Dentistry academics, whereas they re inherent at profession, to not stay vulnerable at future ethic, judges and other problems.

Construção e validação de um questionário para análise de concepções bioéticas

In this paper we describe the stages of a quantitative questionnaire development that allows the investigation of conceptions about bioethical values inherent to the scientific activity. This questionnaire was statistically and semantically validated and developed according to the Likert scale. The relevance of this instrument is given by the fact that, unlike what happens in European countries, quantitative research in Brazil has little educational traditions. Therefore, this work is intended to subsidize the use of quantitative methods in Education research that lack such tools.

Bioética para estudantes de ciências biológicas: investigação sobre os fundamentos que compõem ou deveriam compor a área

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

As patentes de genes humanos sob a perspectiva do biodireito e da bioética

Pós-graduação em Direito - FCHS

Motivos da recusa à doação de órgãos apontados familiares de pessoas com morte encefálica

Purpose: Study aiming to understand the reasons for the refusal to donate organs by relatives of potential donors living in the Mid-Western region of the São Paulo state. Method: Qualitative study performed after data collection by the Organ Procurement Organization (OPO) Division of a reference hospital in the region. Relatives were contacted to participate in a semi-structured interview, and after the subjects in the study were characterized, four guiding questions were presented; their respective answers were recorded to be transcribed later. The Analysis of Content method proposed by Bardin was used to organize the speeches. Results: From 2006 to 2008, 30 (35.3%) families contacted by OPO have refused to agree with the organ donation. From that universe, 16 family members were interviewed. Data was systematized in three major themes: The experience of being informed on a family member’s brain death, decision concerning to the organ donation and aspects that would facilitate the decision to agree with the organ donation. Conclusion: the identification of reasons for the refusal and the suggestions presented has provided subsidies to improve the organ donation for transplantation process.