Objeção da consciência e aborto previsto em lei : vivências em um serviço público de saúde

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem, 2015.

Análise bioética do uso de artes expressivas no cuidado oncológico infantil em hospital público de Pernambuco

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Bioética, 2015.

What can the philosophy of science contribute to the ethics of science and technology?

Nascida para permitir que seus criadores possam atender suas próprias necessidades, a técnica científica sempre desempenhou papel significativo na civilização humana. Este é o contexto em que podemos vislumbrar o advento da tecnociência moderna, que tem contribuído significativamente para o incremento do controle humano sobre a natureza. Este estudo tem por objetivo analisar, sob o enfoque da bioética, reflexões sobre como a filosofia da ciência entende a neutralidade da ciência e sua convergência com a racionalidade epistêmica, bem como relacionar essas reflexões ao processo de tomada de decisões na administração da tecnociência. O estudo levantou dúvidas sobre a capacidade do conhecimento tecnocientífico para legitimar e justificar as decisões no âmbito dos sistemas de ciência e tecnologia nacionais, sinalizando assim a necessidade de promover ligação entre a auto-regulação tecnocientífico e hetero-regulação bioética. ______________________________________________________________________________ ABSTRACT

Cuidados paliativo em crianças portadoras de malformações cerebrais

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Bioética, 2016.

Internação compulsória e o respeito à autonomia da população em situação de rua usuária de álcool e outras drogas sob o olhar da equipe do consultório na rua do Plano Piloto DF

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Bioética, 2016.

Financial incentives for living kidney donors: are they necessary?

In the face of the perceived failure of altruistic organ donation programs to generate sufficient kidneys to meet demand, introducing financial incentives for living donors is sometimes argued as the only effective strategy by which lives currently lost while awaiting kidney transplantation might be saved. This argument from life-saving necessity is implicit in many incentive proposals, but rarely challenged by opponents. The core empirical claims on which it rests are thus rarely interrogated: that the gap between supply of and demand for donor kidneys is large and growing, the current system cannot meet demand, and financial incentives would increase the overall supply of kidneys and thus save lives. We consider these claims in the context of the United States. While we acknowledge the plausibility of claims that incentives, if sufficiently large, may successfully recruit greater numbers of living donors, we argue that strategies compatible with the existing altruistic system may also increase the supply of kidneys and save lives otherwise lost to kidney failure. We conclude that current appeals to the life-saving necessity argument have yet to establish sufficient grounds to justify trials of incentives.

Implementation of China's new policies on organ procurement: An important but challenging step forward

In the last decade, health authorities in China have made a series of policy announcements concerning organ procurement programs and changes in practice have been intermittently reported (1). The international community of transplant professionals has followed these reports closely, preoccupied with one fundamental issue: the procurement of organs from executed prisoners, a practice that for many years has provided the majority of organs transplanted in China. Sharif et al. describe this practice as “ethically indefensible” (2), an evaluation that reflects the position embraced by the international community for more than two decades (3-5). Sharif et al. express concern that whilst some transplant programs in China have ceased using organs from executed prisoners, others continue to do so, and that all organs procured from the deceased may be allocated through a collective pool as part of the new China Organ Transplant Response System, effectively “laundering” organs obtained from prisoners. They also note that one of the new strategies to encourage deceased donation of organs among the Chinese public has involved financial incentives for donor families, another practice that has been strongly critiqued by the international professional community and global health authorities (6,7).

In China and in the United States, proponents of organ procurement from executed prisoners have argued that prisoners should not be denied the option to donate organs after their death if they so choose, as this may provide them or their families solace and an opportunity for moral, spiritual or social redemption (8,9). However, the predominant argument in favour of the practice appears to be essentially pragmatic: prisoners condemned to death represent an additional pool of potential “donors” with organs that will otherwise “go to waste” (10). In contrast, international professional societies and the World Health Organization among others have argued that the practice not only violates the core principles of medical ethics but also thereby undermines efforts to establish a sufficient supply of deceased donor organs. In this commentary, we reaffirm the ethics policy of The Transplantation Society (TTS) concerning organ procurement from executed prisoners (4), and briefly discuss the implications of this policy for international professional engagement with China at this time of significant evolution of Chinese organ procurement programs.

The Doha model of organ donation and transplantation: thinking beyond citizenship

This paper reviews the policy and practice of organ donation and transplantation in Qatar that has developed since January 2011. The important features of the Doha Model (the ‘Model’) are explored, including: (i) all legal residents of Qatar have an equal right to access deceased donor organs and transplantation regardless of their citizenship status; (ii) no prioritisation in organ allocation is given to Qatari citizens; (iii) a multilingual and multicultural education and promotional program about donation has been implemented to engage the diverse national communities resident within Qatar; (iv) financial incentives or fungible rewards for living or deceased donation are prohibited. The ethical framework of this policy will be examined in the light of the national self-sufficiency paradigm, which advocates reciprocity and solidarity among resident populations seeking to meet all needs for transplantation equitably. We review some preliminary evidence of the impact of the Model with respect to engagement of a highly diverse multinational population in a donation and transplantation program, and argue that the Model may inform policy and practice in other countries, particularly those with non-citizen resident populations.

National self-sufficiency in reproductive resources: an innovative response to transnational reproductive travel

Transnational reproductive travel is symptomatic of insufficient supplies ofreproductive resources, including donor gametes and gestational surrogacy services,and inequities in access to these within domestic health-care jurisdictions.Here, we argue that an innovative approach to domestic policy makingusing the framework of the National Self-Sufficiency paradigm represents thebest solution to domestic challenges and the ethical hazards of the global marketplacein reproductive resources.

The long road from the kidney bazaar: a commentary on Pakistan’s progress towards self-sufficiency in organ transplantation

The dark history of transplant tourism in Pakistan demonstrates the hazards of unregulated cross-border markets in human organs. Trading on existing national and international social inequities, ‘transplant tourism’ offers dubious benefits for transplant recipients and attractive profits to those facilitating the industry at the expense of the world’s poor. The impact of Pakistan’s 2007 Transplantation of Human Organs and Tissue Ordinance and the sustained efforts of transplant professionals and societal groups led by the Sindh Institute of Urology and Transplantation, show that organ trading can be effectively discouraged and equitable programs of organ procurement and transplantation pursued despite multiple challenges. In this paper, the factors that have contributed to Pakistan’s progress towards self-sufficiency in organ transplantation are identified and discussed. The case of Pakistan highlights the need for countries to protect their own organ and tissue providers who may be vulnerable in the global healthcare market. Pakistan provides an excellent example for other countries in the region and throughout the world to consider when regulating their own transplantation programs and considering the pursuit of national self-sufficiency.

Queer pedagogies out of place and time: redrawing the boundaries of youth, sexual and gender difference, and education

For this contribution to the "Cartographies" section of the special issue on "Mapping Queer Bioethics," the author focuses on the concept of spatialized time as made material in the location of historical places, in particular as it relates to a reconsideration of approaches to Australian queer/LGBT youth education. Accordingly, the author employs historical maps as illustrative examples of spatialized time, reflecting on the relationships between historical knowledge and queer youth education.

El rol de las redes de apoyo transnacional en la evolución del régimen de trata de personas en la región del mekong, 2004-2015

Con el fin de la unipolaridad no sólo se fortalecieron mecanismos de gobernanza global como los Regímenes Internacionales, sino también se fortalecieron actores no estatales. A pesar de la importancia que tomaron estos dos elementos aún no existe una teoría que explique exhaustivamente la relación que existe entre ellos. Es por lo anterior que, la investigación busca responder de qué manera el rol de las Redes de Apoyo Transnacional ha incidido en la evolución del régimen de tráfico de personas en la Región del Mekong. Asimismo tiene como objetivo comprender las relación entre el Régimen y las Redes de Apoyo Transnacional a través de la formulación de un caso de estudio basado en metodologías cualitativas, específicamente, en el análisis teórico-constructivista y el análisis de contenido de documentos producidos por actores estatales y no estatales.

EL ANÁLISIS DE LA INTERFASE ENTRE LA BIOÉTICA Y LOS DERECHOS HUMANOS

ResumenEste artículo tiene como objetivo profundizar los estudios concernientes a la interfase entre Bioética y Derechos Humanos, así como contribuir para la solidificación de la interconexión entre los dos campos de saber. Para ello, se investigaron los modos por los cuales la instancia de producción bioéticaque se insiere en el ámbito de la OMS – el Departamento de Ética, Equidad, Comercio y Derechos Humanos – construye la interfase entre Bioética y Derechos Humanos a partir del análisis de los sentidos identificados en los documentos de cuño general producidos por dicha instancia bioética.Para tal fin, se utilizó el abordaje teórico-metodológico que se fundamenta en la acepción de que los sentidos construidos socialmente pueden ser aprehendidos por medio del análisis de las prácticas discursivas. Tal elección metodológica se basó en la percepción de que los documentos producidospor organismos internacionales son prácticas discursivas cuyos sentidos pueden ser identificados mediante el examen de sus repertorios. Como conclusión, se observó que la interconexión entre Bioética y Derechos Humanos se forma de manera compleja, dado que el Departamento de Ética de la OMS al mismo tiempo que se aproxima a la temática, se aleja de ella pues hay elementos que evidencian la incorporación de los principios y normas de los Derechos Humanos en sus documentos y, paradójicamente, se constata la ausencia de la Bioética y sus normativas.Palabras clave: Bioética institucional, derechos humanos, Declaración Universal sobre Bioética y Derechos Humanos, Organización Mundial de la Salud.AbstractThis article aims at intensifying the studies concerning the interface between Bioethics and Human Rights, as well as at contributing to the solidification of the connection between these two fields of knowledge. In order to do so, we investigated the ways through which the instance of bioethics that is part of the scope of the World Health Organization – the Department of Ethics, Equity, Trade and Human Rights – builds the interface between Bioethics and Human Rights by means of the analysis of the meanings identified in the general documents produced by such instance of bioethics. For that end, we used the theoretical-methodological approach that is based on the assumption that the socially constructed meanings can be understood through the analysis of the discourse practices. The choice of such methodology was supported by the perceptionthat the documents elaborated by international organisms are discourse practices whose meanings can be identified through the examination of their repertoires. In sum, it was observed that the interconnection between Bioethics and Human Rights is complex, since the Ethics Department of the WHO deals with this theme by being close to it and far from it, simultaneously, as there are features that constitute evidence of the incorporation of Human Rights norms and principles into the WHO documents, but it is also observed the absence of Bioethics and its norms.Keywords: institutional Bioethics, Human Rights, Universal Declaration on Bioethics and Human Rights,World Health Organization.