Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964 |
Resumo: | In the Portuguese National Health Service, little attention has been paid to oral health care. The almost nonexistence of a dentistry network raises concern about accessibility to services, and justifies the need to call on a predominantly private provision of services. The coexistence between the public and private settings is not always easy, especially when services need to interact and actively collaborate in order to find answers to the patient’s problems. Dental implant procedures and the need to perform a previous maxillofacial computerized tomography to study the bone bed where osseointegrated dental implants are placed are a common situation. The current governmental regulation, blinded to the clinical context, may limit the accessibility to the tests. Based on this scenario, we discuss the possible options from an ethical point of view, framing the patient’s and the physician’s perspective and the relation between both.We conclude that the medical decision can’t be disregarded from the clinical evaluation, in the intimacy of the medical consultation. This is an ethical duty that overrules the administrative and bureaucratic constraints. A good management of this apparent dichotomy may enhance better health and greater empowerment for the patient. |
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Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental ImplantsA Transcrição de Exames na Consulta de Medicina Geral e Familiar: Perspetiva Ética Sobre o Caso do Pedido de Tomografia Computorizada Maxilofacial para Realização de Implantes DentáriosDental ImplantsPhysician-Patient RelationsPractice PatternsPhysiciansPrimary Health CarePrivate SectorPublic SectorReferral and ConsultationTomographyX-Ray ComputedCuidados de Saúde PrimáriosEncaminhamento e ConsultaImplantes DentáriosPadrões de Prática MédicaRelações Médico-DoenteSector PrivadoSector PúblicoTomografia ComputorizadaIn the Portuguese National Health Service, little attention has been paid to oral health care. The almost nonexistence of a dentistry network raises concern about accessibility to services, and justifies the need to call on a predominantly private provision of services. The coexistence between the public and private settings is not always easy, especially when services need to interact and actively collaborate in order to find answers to the patient’s problems. Dental implant procedures and the need to perform a previous maxillofacial computerized tomography to study the bone bed where osseointegrated dental implants are placed are a common situation. The current governmental regulation, blinded to the clinical context, may limit the accessibility to the tests. Based on this scenario, we discuss the possible options from an ethical point of view, framing the patient’s and the physician’s perspective and the relation between both.We conclude that the medical decision can’t be disregarded from the clinical evaluation, in the intimacy of the medical consultation. This is an ethical duty that overrules the administrative and bureaucratic constraints. A good management of this apparent dichotomy may enhance better health and greater empowerment for the patient.A saúde oral tem sido pouco cuidada no contexto do Serviço Nacional de Saúde em Portugal. A quase inexistência de uma rede de medicina dentária levanta problemas de acessibilidade que condicionam a necessidade de complementar os serviços públicos com uma oferta predominantemente privada. Mas esta coexistência não é sempre fácil, sobretudo quando há necessidade dos serviços se cruzarem e colaborarem ativamente na resolução dos problemas do doente. Uma situação comum é a colocação de implantes dentários e a necessidade de realizar uma tomografia computorizada maxilofacial prévia para estudo de leito para colocação de implantes dentários osteointegrados, onde a aplicação de regulação governamental desenquadrada do contexto clínico pode condicionar a acessibilidade aos tratamentos. Com base neste cenário, discutem-se as opções do ponto de vista ético, na perspetiva do doente, do médico e da relação entre ambos. Conclui-se que a decisão médica não pode ser desenquadrada de uma avaliação clínica que apenas o ambiente de intimidade da consulta médica pode proporcionar. É um imperativo ético que se sobrepõe aos constrangimentos administrativos e burocráticos e que se bem gerido é potenciador de uma melhor saúde e de maior capacitação da pessoa.Ordem dos Médicos2019-06-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964oai:ojs.www.actamedicaportuguesa.com:article/11964Acta Médica Portuguesa; Vol. 32 No. 6 (2019): June; 415-418Acta Médica Portuguesa; Vol. 32 N.º 6 (2019): Junho; 415-4181646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964/5712https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964/11195Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessSantos, Paulo2022-12-20T11:06:27Zoai:ojs.www.actamedicaportuguesa.com:article/11964Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:06.992830Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants A Transcrição de Exames na Consulta de Medicina Geral e Familiar: Perspetiva Ética Sobre o Caso do Pedido de Tomografia Computorizada Maxilofacial para Realização de Implantes Dentários |
title |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants |
spellingShingle |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants Santos, Paulo Dental Implants Physician-Patient Relations Practice Patterns Physicians Primary Health Care Private Sector Public Sector Referral and Consultation Tomography X-Ray Computed Cuidados de Saúde Primários Encaminhamento e Consulta Implantes Dentários Padrões de Prática Médica Relações Médico-Doente Sector Privado Sector Público Tomografia Computorizada |
title_short |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants |
title_full |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants |
title_fullStr |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants |
title_full_unstemmed |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants |
title_sort |
Diagnostic Test Requests in the Family Medicine Consultation: An Ethical Perspective Concerning Requests for Maxillofacial Computerized Tomography Scan Prior to Dental Implants |
author |
Santos, Paulo |
author_facet |
Santos, Paulo |
author_role |
author |
dc.contributor.author.fl_str_mv |
Santos, Paulo |
dc.subject.por.fl_str_mv |
Dental Implants Physician-Patient Relations Practice Patterns Physicians Primary Health Care Private Sector Public Sector Referral and Consultation Tomography X-Ray Computed Cuidados de Saúde Primários Encaminhamento e Consulta Implantes Dentários Padrões de Prática Médica Relações Médico-Doente Sector Privado Sector Público Tomografia Computorizada |
topic |
Dental Implants Physician-Patient Relations Practice Patterns Physicians Primary Health Care Private Sector Public Sector Referral and Consultation Tomography X-Ray Computed Cuidados de Saúde Primários Encaminhamento e Consulta Implantes Dentários Padrões de Prática Médica Relações Médico-Doente Sector Privado Sector Público Tomografia Computorizada |
description |
In the Portuguese National Health Service, little attention has been paid to oral health care. The almost nonexistence of a dentistry network raises concern about accessibility to services, and justifies the need to call on a predominantly private provision of services. The coexistence between the public and private settings is not always easy, especially when services need to interact and actively collaborate in order to find answers to the patient’s problems. Dental implant procedures and the need to perform a previous maxillofacial computerized tomography to study the bone bed where osseointegrated dental implants are placed are a common situation. The current governmental regulation, blinded to the clinical context, may limit the accessibility to the tests. Based on this scenario, we discuss the possible options from an ethical point of view, framing the patient’s and the physician’s perspective and the relation between both.We conclude that the medical decision can’t be disregarded from the clinical evaluation, in the intimacy of the medical consultation. This is an ethical duty that overrules the administrative and bureaucratic constraints. A good management of this apparent dichotomy may enhance better health and greater empowerment for the patient. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-06-28 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964 oai:ojs.www.actamedicaportuguesa.com:article/11964 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/11964 |
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por |
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por |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964/5712 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11964/11195 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2019 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa |
eu_rights_str_mv |
openAccess |
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application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 32 No. 6 (2019): June; 415-418 Acta Médica Portuguesa; Vol. 32 N.º 6 (2019): Junho; 415-418 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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