RESUMO
OBJECTIVES: This study attempts to analyse the ethical dilemmas arising from the microallocation of scarce health care resources, in terms of deontology and utilitarianism. METHODS: A group of 395 people were interviewed in the region of Diadema, greater San Paulo, Brazil, while visiting patients in the only state hospital in town. Each interviewee was given a list of eight simulated emergencies (see appendix). In each of the eight cases the interviewee had to choose which of the two patients described, both of whom suffered from exactly the same problem, should receive the only hospital bed currently available. The differences between the hypothetical patients were as follows: age, gender, family dependency, and lifestyle. Each interviewee was asked to justify one of their responses. These responses were then analysed. RESULTS: The results pointed to the co-existence of deontological and utilitarian orientations among the people interviewed. A tendency to give priority to the destitute was revealed throughout the research, contradicting the idea that society, valuing only productive people, wishes only such people to receive the most resources, thus maximising the benefits to be gained from resources. The results showed that people's disapproval of the alcoholic was stronger than that of the nicotine abuser.
Assuntos
Emergências/classificação , Tratamento de Emergência/estatística & dados numéricos , Ética , Alocação de Recursos para a Atenção à Saúde/normas , Valores Sociais , Adulto , Fatores Etários , Idoso , Brasil , Teoria Ética , Feminino , Humanos , Entrevistas como Assunto , Estilo de Vida , Masculino , Fatores SexuaisRESUMO
OBJECTIVE: To identify the social first-year and senior undergraduate students of a healthcare management course used for selecting patients who need emergency medical care. METHODS: A random sample of 64 first-year and 25 senior year students of a healthcare management course in São Paulo, Brazil, were studied. To collect data, a survey instrument was developed with nine hypothetical simulated case scenarios, including the social criteria involved in the patient selection process, such as age, sex, economical status, life-style, and social duty. RESULTS: There were significant differences in the two groups concerning criteria such as the patient's life-style and economic status. CONCLUSIONS: The results suggest that the respondents accept the inclusion of social criteria in the decision-making process in a situation of scarce resources.
Assuntos
Serviços Médicos de Emergência , Seleção de Pacientes , Adulto , Fatores Etários , Idoso , Criança , Serviços Médicos de Emergência/economia , Ética , Feminino , Humanos , Estilo de Vida , Masculino , Fatores Sexuais , Fatores SocioeconômicosRESUMO
It was carried out a study with the aim to analyse the autonomy of hospitalised elderly, based on the comprehension about their rights of information and the informed consent on proposals of diagnosis and therapeutics. The results showed patient's lack of information, dissatisfaction on the degree of information. It was also verified that the patient's family frequently acts as information intermediary between the health team and the patient. Therefore, autonomy process of decision making was compromised, as well as the informed consent of the elderly.
Assuntos
Idoso/psicologia , Hospitalização , Consentimento Livre e Esclarecido , Defesa do Paciente , Educação de Pacientes como Assunto/normas , Satisfação do Paciente , Comunicação , Feminino , Humanos , Masculino , Relações Profissional-Família , Inquéritos e QuestionáriosRESUMO
In an effort to better understand some of the ethical and legal dilemmas that health professionals face in their daily activities, this study identified and analyzed the opinions and expectations of medical and nursing students at the University of São Paulo, Brazil, regarding the autonomy of adolescents in receiving health care services. Over the 1995-1996 period, interviews were done with students in the first and last years of their programs in the School of Medicine and the School of Nursing of the University of São Paulo. The results from the first-year students were compared with those of the final-year students. The interview questions dealt with such issues as providing medical care to adolescents when a parent or guardian was not present, adolescents making their own decisions on health care services, the confidentiality of information that adolescents provide, the circumstances in which that information could be given to parents or guardians, and situations where there were conflicts between the decisions of parents and adolescents. Despite variations among the opinions and expectations of the students, the overall results suggest that most of the medical and nursing students do not accept the concept of "health adulthood" or autonomy for adolescents and that the students instead choose to rely on current legal definitions of adulthood.
Assuntos
Serviços de Saúde do Adolescente/normas , Estudantes de Medicina , Estudantes de Enfermagem , Adolescente , Fatores Etários , Bolívia , Tomada de Decisões , Atenção à Saúde , Feminino , Humanos , Masculino , Pais , Garantia da Qualidade dos Cuidados de Saúde , Qualidade da Assistência à SaúdeRESUMO
The ethical-juridical concepts related to the civil responsibility of medical activity in liberal practice are brought up to date. To this end, the arguments which guide the shaping up of the contractual relationship between the physician and the client are analysed, as also are the foundations on which the notion of guilt--an essential component of civil responsibility, whether relating to technical acts of to those within the field of medical humanism--are grounded. The answers presented for the solution of this question by European juridical systems are given.
Assuntos
Ética Médica , Jurisprudência , Relações Médico-Paciente , Prática Privada , Responsabilidade Social , Legislação MédicaAssuntos
Lactente , Pré-Escolar , Criança , Humanos , Masculino , Feminino , Ampicilina , Infecções RespiratóriasRESUMO
Os autores analisam 102 casos de criancas internadas no Instituto da Crianca com o diagnostico de septicemia, com base em dados clinicos e laboratoriais (hemoculturas positivas). Foram avaliados os seguintes parametros clinicos: sexo, idade, estado nutricional, internacao previa e evolucao. Em relacao a etiologia, destaca-se a alta incidencia de Salmonella sp (57,8%). O antibiograma foi avaliado para S. aureus e Salmonella sp: os achados diferem dos existentes na literatura