Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?

Detalhes bibliográficos
Autor(a) principal: Azevedo, Geysa Adriana Soares
Data de Publicação: 2022
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
Texto Completo: https://tede2.pucrs.br/tede2/handle/tede/10678
Resumo: The Covid-19 Pandemic surprised by the rapid contagion between people and the way national and international institutions dealt with the problem. The medical crisis that followed this pandemic made it difficult to organize medical and health in the most different orders. One of the main consequences was the high impact of administering drugs of different species for the treatment of a disease of profound scientific uncertainty. The text that is presented understands that there is an ethical duty to pay attention and support to the most vulnerable people affected by the disease. Given this circumstance, the problem that guides this research is: should the question of the analysis of informed consent in the assessment of the physician's civil liability undergo some variation in the context of the use of off-label medicines in the Covid-19 pandemic? As a central hypothesis, it starts from the idea that if the new structures caused by the Covid-19 Pandemic are understood within a health crisis perspective, then informed consent is closely linked to the promotion of fundamental rights related to health, such as right to medical information, free personality development and autonomy. Faced with the problem outlined and the hypotheses raised, a legal-dogmatic method is used, associated with hypothetical-deductive reasoning, based on bibliographic and documentary research. In order to structure this research, it is necessary to reach a measure of analyzing how the principle of informed consent is presented as a fundamental instrument in the assessment of the physician's civil liability in the use of off-label medicines in the context of the Covid-19 pandemic. First, to investigate the concept, characteristics and historical evolution of informed consent, as well as its role in the pandemic context, based on the principle of human dignity and soon after, to categorize the elements and assumptions of informed consent and medical responsibility. Finally, medical civil liability and the duty of information to the patient in the Covid-19 pandemic are analyzed. It is understood that the Brazilian legal system, despite not expressly disciplining the use of off-label drugs, allows, from a systematic interpretation, to corroborate health resolutions that guide their prescription according to the fundamental social right to health and the right to science. Thus, off-label prescription should only occur when there is scientific evidence indicating that it is an apparently effective and beneficial therapy for the patient. In this way, the off-label use of hydroxychloroquine associated with azithromycin in the treatment of Covid-19 reached a short window of legality, determined by Didier Raoult's research and consequent releases for emergency use by regulatory agencies, ending with the publication of studies proving its ineffectiveness, and consequent revocation by the Food and Drug Administration, as well as the World Health Organization.
id P_RS_d1c001cacd6d72fb5ff95a7d19b8ec8b
oai_identifier_str oai:tede2.pucrs.br:tede/10678
network_acronym_str P_RS
network_name_str Biblioteca Digital de Teses e Dissertações da PUC_RS
repository_id_str
spelling Facchini Neto, Eugêniohttp://lattes.cnpq.br/6714748405905770http://lattes.cnpq.br/2974252298322429Azevedo, Geysa Adriana Soares2023-03-27T19:34:02Z2022-11-23https://tede2.pucrs.br/tede2/handle/tede/10678The Covid-19 Pandemic surprised by the rapid contagion between people and the way national and international institutions dealt with the problem. The medical crisis that followed this pandemic made it difficult to organize medical and health in the most different orders. One of the main consequences was the high impact of administering drugs of different species for the treatment of a disease of profound scientific uncertainty. The text that is presented understands that there is an ethical duty to pay attention and support to the most vulnerable people affected by the disease. Given this circumstance, the problem that guides this research is: should the question of the analysis of informed consent in the assessment of the physician's civil liability undergo some variation in the context of the use of off-label medicines in the Covid-19 pandemic? As a central hypothesis, it starts from the idea that if the new structures caused by the Covid-19 Pandemic are understood within a health crisis perspective, then informed consent is closely linked to the promotion of fundamental rights related to health, such as right to medical information, free personality development and autonomy. Faced with the problem outlined and the hypotheses raised, a legal-dogmatic method is used, associated with hypothetical-deductive reasoning, based on bibliographic and documentary research. In order to structure this research, it is necessary to reach a measure of analyzing how the principle of informed consent is presented as a fundamental instrument in the assessment of the physician's civil liability in the use of off-label medicines in the context of the Covid-19 pandemic. First, to investigate the concept, characteristics and historical evolution of informed consent, as well as its role in the pandemic context, based on the principle of human dignity and soon after, to categorize the elements and assumptions of informed consent and medical responsibility. Finally, medical civil liability and the duty of information to the patient in the Covid-19 pandemic are analyzed. It is understood that the Brazilian legal system, despite not expressly disciplining the use of off-label drugs, allows, from a systematic interpretation, to corroborate health resolutions that guide their prescription according to the fundamental social right to health and the right to science. Thus, off-label prescription should only occur when there is scientific evidence indicating that it is an apparently effective and beneficial therapy for the patient. In this way, the off-label use of hydroxychloroquine associated with azithromycin in the treatment of Covid-19 reached a short window of legality, determined by Didier Raoult's research and consequent releases for emergency use by regulatory agencies, ending with the publication of studies proving its ineffectiveness, and consequent revocation by the Food and Drug Administration, as well as the World Health Organization.A Pandemia de Covid-19 surpreendeu pelo rápido contágio entre pessoas e pela forma como as instituições nacionais e internacionais lidaram com o problema. A crise médica que se seguiu ao lado desta pandemia tornou dificultosa a organização médica e sanitária nas mais variadas ordens. Uma das consequências principais foi o alto impacto na administração de medicamentos de espécies diferentes para o tratamento de uma doença de profunda incerteza científica. O texto que se apresenta compreende que exista um dever ético de prestar atenção e sustento às pessoas mais vulneráveis acometidas pela doença. Diante de tal circunstância, o problema que guia esta pesquisa é: se a questão da análise do consentimento informado na aferição da responsabilidade civil do médico deve sofrer alguma variação no contexto da utilização de medicamentos off-label na pandemia do Covid-19? Como hipótese central parte-se da ideia de que caso sejam compreendidas as novas estruturas provocadas pela Pandemia de Covid-19 dentro de uma perspectiva de crise sanitária, então o consentimento informado está intimamente ligado com a promoção de direitos fundamentais relativos à saúde, tais como direito à informação médica, livre desenvolvimento da personalidade e autonomia. Diante do problema delineado e das hipóteses levantadas, lança-se mão de método jurídico-dogmático, associado à raciocínio hipotético-dedutivo, com lastro em pesquisas bibliográfica e documental. Para conseguir estruturar esta pesquisa, deve-se alcançar uma medida de analisar de que modo o princípio do consentimento informado se apresenta como instrumento fundamental na aferição da responsabilidade civil do médico na utilização de medicamentos off-label no contexto na pandemia do Covid-19. Primeiramente, perquirir o conceito, características e evolução histórica do consentimento informado, bem como seu papel no contexto pandêmico, baseado no princípio da dignidade humana e logo após, categorizar os elementos e pressupostos do consentimento informado e da responsabilidade médica. Por fim, analisa-se a responsabilidade civil médica e o dever de informação ao paciente na pandemia da Covid-19. Compreende-se que o ordenamento jurídico brasileiro, apesar de não disciplinar expressamente a utilização de medicamentos off-label, permite, a partir de interpretação sistemática, corroborar resoluções sanitárias que balizam sua prescrição conforme o direito fundamental social à saúde e o direito à ciência. Assim, a prescrição off-label só deverá ocorrer quando houver lastro científico indicando se tratar de terapêutica aparentemente eficaz e benéfica ao paciente. Dessa forma, a utilização off-label de hidroxicloroquina associada à azitromicina no tratamento da Covid-19 alcançou curta janela de licitude, determinada pelas pesquisas de Didier Raoult e consequentes liberações para uso emergencial de agências reguladoras, findando com a publicação de estudos comprovando sua ineficácia e a consequente revogação por parte da Food and Drug Administration, bem como da Organização Mundial da Saúde.Submitted by PPG Direito (ppgdir@pucrs.br) on 2023-03-23T13:45:06Z No. of bitstreams: 1 GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf: 964106 bytes, checksum: 1bb4254084717b5cd07944969d49e94c (MD5)Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2023-03-27T19:26:52Z (GMT) No. of bitstreams: 1 GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf: 964106 bytes, checksum: 1bb4254084717b5cd07944969d49e94c (MD5)Made available in DSpace on 2023-03-27T19:34:02Z (GMT). No. of bitstreams: 1 GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf: 964106 bytes, checksum: 1bb4254084717b5cd07944969d49e94c (MD5) Previous issue date: 2022-11-23application/pdfhttps://tede2.pucrs.br/tede2/retrieve/186843/GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em DireitoPUCRSBrasilEscola de DireitoConsentimento InformadoPrescrição Off-LabelPandemia da COVID-19.Informed ConsentOff-Label PrescriptionCovid-19 PandemicCIENCIAS SOCIAIS APLICADAS::DIREITOConsentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisTrabalho não apresenta restrição para publicação-81189034825801997565005005004512033976268881925-7277407233034425144info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILGEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.jpgGEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.jpgimage/jpeg5757https://tede2.pucrs.br/tede2/bitstream/tede/10678/4/GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.jpg5d335b4a22387906ae6ed4b2522de38aMD54TEXTGEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.txtGEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.txttext/plain381700https://tede2.pucrs.br/tede2/bitstream/tede/10678/3/GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.txt75e06db5bcdd2afafa024d2ba0567621MD53ORIGINALGEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdfGEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdfapplication/pdf964106https://tede2.pucrs.br/tede2/bitstream/tede/10678/2/GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf1bb4254084717b5cd07944969d49e94cMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590https://tede2.pucrs.br/tede2/bitstream/tede/10678/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/106782023-03-27 20:00:16.795oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2023-03-27T23:00:16Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false
dc.title.por.fl_str_mv Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
title Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
spellingShingle Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
Azevedo, Geysa Adriana Soares
Consentimento Informado
Prescrição Off-Label
Pandemia da COVID-19.
Informed Consent
Off-Label Prescription
Covid-19 Pandemic
CIENCIAS SOCIAIS APLICADAS::DIREITO
title_short Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
title_full Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
title_fullStr Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
title_full_unstemmed Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
title_sort Consentimento informado em tempos de pandemia : como a incerteza da ciência pode atender à necessidade de informações seguras por parte do paciente?
author Azevedo, Geysa Adriana Soares
author_facet Azevedo, Geysa Adriana Soares
author_role author
dc.contributor.advisor1.fl_str_mv Facchini Neto, Eugênio
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6714748405905770
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/2974252298322429
dc.contributor.author.fl_str_mv Azevedo, Geysa Adriana Soares
contributor_str_mv Facchini Neto, Eugênio
dc.subject.por.fl_str_mv Consentimento Informado
Prescrição Off-Label
Pandemia da COVID-19.
topic Consentimento Informado
Prescrição Off-Label
Pandemia da COVID-19.
Informed Consent
Off-Label Prescription
Covid-19 Pandemic
CIENCIAS SOCIAIS APLICADAS::DIREITO
dc.subject.eng.fl_str_mv Informed Consent
Off-Label Prescription
Covid-19 Pandemic
dc.subject.cnpq.fl_str_mv CIENCIAS SOCIAIS APLICADAS::DIREITO
description The Covid-19 Pandemic surprised by the rapid contagion between people and the way national and international institutions dealt with the problem. The medical crisis that followed this pandemic made it difficult to organize medical and health in the most different orders. One of the main consequences was the high impact of administering drugs of different species for the treatment of a disease of profound scientific uncertainty. The text that is presented understands that there is an ethical duty to pay attention and support to the most vulnerable people affected by the disease. Given this circumstance, the problem that guides this research is: should the question of the analysis of informed consent in the assessment of the physician's civil liability undergo some variation in the context of the use of off-label medicines in the Covid-19 pandemic? As a central hypothesis, it starts from the idea that if the new structures caused by the Covid-19 Pandemic are understood within a health crisis perspective, then informed consent is closely linked to the promotion of fundamental rights related to health, such as right to medical information, free personality development and autonomy. Faced with the problem outlined and the hypotheses raised, a legal-dogmatic method is used, associated with hypothetical-deductive reasoning, based on bibliographic and documentary research. In order to structure this research, it is necessary to reach a measure of analyzing how the principle of informed consent is presented as a fundamental instrument in the assessment of the physician's civil liability in the use of off-label medicines in the context of the Covid-19 pandemic. First, to investigate the concept, characteristics and historical evolution of informed consent, as well as its role in the pandemic context, based on the principle of human dignity and soon after, to categorize the elements and assumptions of informed consent and medical responsibility. Finally, medical civil liability and the duty of information to the patient in the Covid-19 pandemic are analyzed. It is understood that the Brazilian legal system, despite not expressly disciplining the use of off-label drugs, allows, from a systematic interpretation, to corroborate health resolutions that guide their prescription according to the fundamental social right to health and the right to science. Thus, off-label prescription should only occur when there is scientific evidence indicating that it is an apparently effective and beneficial therapy for the patient. In this way, the off-label use of hydroxychloroquine associated with azithromycin in the treatment of Covid-19 reached a short window of legality, determined by Didier Raoult's research and consequent releases for emergency use by regulatory agencies, ending with the publication of studies proving its ineffectiveness, and consequent revocation by the Food and Drug Administration, as well as the World Health Organization.
publishDate 2022
dc.date.issued.fl_str_mv 2022-11-23
dc.date.accessioned.fl_str_mv 2023-03-27T19:34:02Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://tede2.pucrs.br/tede2/handle/tede/10678
url https://tede2.pucrs.br/tede2/handle/tede/10678
dc.language.iso.fl_str_mv por
language por
dc.relation.program.fl_str_mv -8118903482580199756
dc.relation.confidence.fl_str_mv 500
500
500
dc.relation.department.fl_str_mv 4512033976268881925
dc.relation.cnpq.fl_str_mv -7277407233034425144
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Pontifícia Universidade Católica do Rio Grande do Sul
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Direito
dc.publisher.initials.fl_str_mv PUCRS
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Escola de Direito
publisher.none.fl_str_mv Pontifícia Universidade Católica do Rio Grande do Sul
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS
instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
instacron:PUC_RS
instname_str Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
instacron_str PUC_RS
institution PUC_RS
reponame_str Biblioteca Digital de Teses e Dissertações da PUC_RS
collection Biblioteca Digital de Teses e Dissertações da PUC_RS
bitstream.url.fl_str_mv https://tede2.pucrs.br/tede2/bitstream/tede/10678/4/GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.jpg
https://tede2.pucrs.br/tede2/bitstream/tede/10678/3/GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf.txt
https://tede2.pucrs.br/tede2/bitstream/tede/10678/2/GEYSA_ADRIANA_SOARES_AZEVEDO_dis.pdf
https://tede2.pucrs.br/tede2/bitstream/tede/10678/1/license.txt
bitstream.checksum.fl_str_mv 5d335b4a22387906ae6ed4b2522de38a
75e06db5bcdd2afafa024d2ba0567621
1bb4254084717b5cd07944969d49e94c
220e11f2d3ba5354f917c7035aadef24
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
repository.mail.fl_str_mv biblioteca.central@pucrs.br||
_version_ 1799765359964717056