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A alteridade como criterio fundamental e englobante da bioetica

Francisco de Assis Correia
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 03/09/1993 PT
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O objetivo deste é propor A Alteridade como Critério Fundamental e Englobante da Bioética. Dividido em três partes, na primeira, examina a origem e a conceituação da Bioética, suas principais características, e trata da chamada "trindade" bioética: beneficência, autonomia e iustiça, fazendo, para cada um destes critérios, uma abordagem conceitual e histórica, bem como demonstrando seus limites; na segunda parte, propõe e define a alteridade como critério fundamental e englobante da Bioética e estabelece a relação entre alteridade e beneficência, alteridade e autonomia e alteridade e iustiça. O marco referencial adotado é o conceito de alteridade de Enrique D. DUSSEL. A terceira parte aplica concretamente o critério de alteridade a duas dimensões da Bioética: ao meio ambiente e ao relacionamento médico-paciente, sendo que, para este último, se articula a relação quase didática de LAIN ENTRALGO com a alteridade segundo DUSSEL.; The objective of the present study was to propose otherness as a Fundamental and AII- Encompassing Criterion of Bioethics. The study was divided into three parts. The first examines the Origin and concept of. Bioethics and its major characteristics, and deals with the so-called bioethical "triad": beneficence...

Bancos de tecidos musculoesqueléticos no Brasil : análise à luz da bioética e da biossegurança

Bugarin Júnior, João Geraldo
Fonte: Universidade de Brasília Publicador: Universidade de Brasília
Tipo: Tese
PT_BR
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Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, 2007.; Introdução: Neste trabalho, apresenta-se uma análise dos bancos de tecidos ósseos no Brasil autorizados a funcionar pelo Sistema de Nacional de Transplantes, no que se refere às técnicas de obtenção, processamento, armazenagem e utilização de homoenxertos, relacionando os dados coletados aos critérios de biossegurança e analisando-os a luz das teorias da Bioética. Objetivo: Avaliar o estágio atual dos bancos de tecidos ósseos no Brasil, no que diz respeito a aspectos éticos, legais e de biossegurança, utilizando os referenciais teóricos da Teoria Bioética Principialista, o enfoque da beneficência proposto por Engelhardt e a Ética da Responsabilidade de Hans Jonas. Método: Foram realizadas entrevistas semi-estruturadas com os responsáveis pelos seis bancos de ossos, com roteiro pré-estabelecido, que consistiu em quinze perguntas para livre manifestação dos entrevistados e versaram sobre temas relacionados a: 1) Critérios de Biossegurança (princípio da não-maleficência); 2) Benefícios do Osso Humano (princípios da beneficência e justiça); 3) Dimensão da Responsabilidade (ética da responsabilidade). Os resultados colhidos foram submetidos à análise qualitativa pelo método de Análise de Conteúdo e contrapostos com as referências normativas sobre protocolos de bancos de tecidos musculoesqueléticos e com os referenciais teóricos da bioética. Resultados: Todos os entrevistados demonstraram conhecer e seguir adequadamente as exigências normativas atuais...

Estudo bioético sobre o desenvolvimento das pesquisas em células-tronco embrionárias no Brasil

Pereira, Claudia Severo Wanderley
Fonte: Universidade de Brasília Publicador: Universidade de Brasília
Tipo: Dissertação
POR
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Dissertação (mestrado)—Universidade de Brasília, Programa de Pós-Graduação em Bioética, 2011; Introdução – O progresso da ciência evoluiu em trajetória acelerada e possibilitou a criação de técnicas inovadoras que permitiram um crescente domínio sobre o mundo natural. Com isso, a ciência e a tecnologia conquistam cada vez mais espaço, penetram fundo na vida biológica, adquirindo poderes de manipular, alterar e transformar o organismo vivo. Nesse contexto, o limite do corpo humano deixou de ser uma característica pertinente à natureza do vivente e passou a ser uma falha orgânica evitável pela ação beneficente da ciência moderna. Entretanto, sabe-se que, no contexto das possibilidades beneficentes da tecnociência, surgem situações perigosas, das quais é difícil tratar os limites. Assim sendo, indaga-se se a aplicação dos novos recursos tecnológicos implicaria sempre um “bem” aos indivíduos. Para isso, a temática escolhida foi estudar o desenvolvimento das pesquisas em células-tronco embrionárias no Brasil, sob o ponto de vista teórico da bioética. Esse tema se tornou relevante por estar alinhado às perspectivas das situações emergentes do campo da bioética e aos possíveis conflitos que podem ser gerados pela aplicação de novas tecnologias na área da medicina regenerativa. Objetivo - Avaliar as pesquisas com embriões humanos...

Abordagens bioéticas e deontológicas do código de ética profissional para fisioterapeutas e terapeutas ocupacionais no Brasil

Figueiredo, Leandro Corrêa
Fonte: Universidade de Brasília Publicador: Universidade de Brasília
Tipo: Dissertação
POR
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Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ceilândia, Programa de Pós-Graduação em Ciências e Tecnologias em Saúde, 2013.; As condutas das classes trabalhadoras, pautadas pelos códigos de ética já não são capazes de prestigiar todos os conflitos enfrentados pelos profissionais, visto que foram concebidos em uma base deontológica. Fatores como o avanço tecnológico e genético, a medicalização na saúde, a deficiência na alocação de recursos, entre outros, alavancaram o surgimento da bioética, com princípios e conceitos que devem ser considerados na conduta e prática profissional. Recentemente o código de ética profissional para fisioterapeutas e terapeutas ocupacionais foi reformulado e novas versões em separado para cada profissional foram publicadas. Frente ao contexto histórico, o presente estudo teve por objetivo verificar a proporção de enfoque bioético presentes no antigo e novos códigos de ética destas profissões. Para isso, utilizou os conceitos de análise de conteúdo proposto por Bardin, porém para fonte documental. Foram fragmentadas unidades textuais em categorias do principialismo bioético (autonomia, beneficência, não maleficência e justiça), bem como nas categorias técnica e virtude consideradas de enfoque deontológico. Em seguida...

A bioética entre as convicções do doente e o avanço científico, na área da medicina transfusional

Viegas, Alzira Manuela da Rocha Gomes, 1957-
Fonte: Universidade de Lisboa Publicador: Universidade de Lisboa
Tipo: Dissertação de Mestrado
Publicado em //2010 POR
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Tese de mestrado, Bioética, Faculdade de Medicina, Universidade de Lisboa, 2010; O sangue motivou sempre um fascínio particular no ser humano desde as civilizações mais antigas até à sociedade moderna. Mas foi apenas no princípio do século XX que a prática da transfusão sanguínea se iniciou, tendo sido alvo de uma rápida evolução científica. Ligada a uma forte vertente sociocultural e cada vez mais dependente de complexas exigências técnicas e legais, a transfusão sanguínea faz actualmente parte da prática clínica, sendo impensável prescindir da sua utilização num número considerável de situações, como á o caso de grandes cirurgias e traumas, entre outras. Mas se para uns uma transfusão pode salvar uma vida, para outros ela pode fazer perder a alma. È assim que pensam as Testemunhas de Jeová, que como é do conhecimento geral recusam a administração de componentes sanguíneos. Por este motivo os profissionais de saúde enfrentam por vezes verdadeiros dilemas éticos, resultantes de conflitos entre os princípios hipocráticos da beneficência e da não maleficência e o respeito pelo moderno princípio da autonomia do doente. Este trabalho centraliza-se nos problemas bioéticos e técnicos que os profissionais de saúde enfrentam no caso de doentes que recusam transfusões...

Beneficence in general practice: an empirical investigation.

Rogers, W A
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1999 EN
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OBJECTIVES: To study and report the attitudes of patients and general practitioners (GPs) concerning the obligation of doctors to act for the good of their patients, and to provide a practical account of beneficence in general practice. DESIGN: Semi-structured interviews administered to GPs and patients. SETTING AND SAMPLE: Participants randomly recruited from an age and gender stratified list of GPs in a geographically defined region of South Australia. The sample comprised twenty-one general practitioners and seventeen patients recruited by participating GPs. RESULTS: In practice, acting for the good of the patient not only accommodates the views of patients and GPs on expertise and knowing best, but also responds to the particular details of the clinical situation. Patients had a complex understanding of the expertise necessary for medical practice, describing a contextual domain in which they were expert, and which complemented the scientific expertise of their GPs. General practitioners identified multiple sources for their expertise, of which experience was the most significant. The role of the GP included responding to individual patients and particular clinical problems and ranged from the assumption of responsibility through to the proffering of medical advice. CONCLUSION: This study found that GPs acting for the good of their patients covered a variety of GP actions and patient preferences. Beneficence was not justified by presumed patient vulnerability or the inability of patients to understand medical problems...

Not just autonomy--the principles of American biomedical ethics.

Holm, S
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1995 EN
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The Principles of Biomedical Ethics by Tom L Beauchamp and James F Childress which is now in its fourth edition has had a great influence on the development of bioethics through its exposition of a theory based on the four principles: respect for autonomy; non-maleficence; beneficence, and justice (1). The theory is developed as a common-morality theory, and the present paper attempts to show how this approach, starting from American common-morality, leads to an underdevelopment of beneficence and justice, and that the methods offered for specification and balancing of principles are inadequate.

Ethical theory, ethnography, and differences between doctors and nurses in approaches to patient care.

Robertson, D W
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /10/1996 EN
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OBJECTIVES: To study empirically whether ethical theory (from the mainstream principles-based, virtue-based, and feminist schools) usefully describes the approaches doctors and nurses take in everyday patient care. DESIGN: Ethnographic methods: participant observation and interviews, the transcripts of which were analysed to identify themes in ethical approaches. SETTING: A British old-age psychiatry ward. PARTICIPANTS: The more than 20 doctors and nurses on the ward. RESULTS: Doctors and nurses on the ward differed in their conceptions of the principles of beneficence and respect for patient autonomy. Nurses shared with doctors a commitment to liberal and utilitarian conceptions of these principles, but also placed much greater weight on relationships and character virtues when expressing the same principles. Nurses also emphasised patient autonomy, while doctors were more likely to advocate beneficence, when the two principles conflicted. CONCLUSION: The study indicates that ethical theory can, contrary to the charges of certain critics, be relevant to everyday health care-if it (a) attends to social context and (b) is flexible enough to draw on various schools of theory.

Marginally effective medical care: ethical analysis of issues in cardiopulmonary resuscitation (CPR)

Hilberman, M; Kutner, J; Parsons, D; Murphy, D J
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1997 EN
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Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposal for selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performing CPR when the outcomes are harmful or usage inappropriate. Additionally, policies which usurp good clinical judgment and moral responsibility, thereby contributing to inappropriate CPR usage, should be considered maleficent. Autonomy restricts CPR use when refused but cannot create a right to CPR. Justice requires that we define which medical interventions contribute sufficiently to health and happiness that they should be made universally available. This ordering is necessary whether one believes in the utilitarian standard or wishes medical care to be universally available on fairness grounds. Low-yield CPR fails justice criteria. Cardiopulmonary resuscitation should be performed when justified by the extensive outcomes literature; not performed when not desired by the patient or not indicated; and performed infrequently when relatively contraindicated.

Ethical implications of standardization of ICU care with computerized protocols.

Morris, A. H.; East, T. D.; Wallace, C. J.; Orme, J.; Clemmer, T.; Weaver, L.; Thomas, F.; Dean, N.; Pearl, J.; Rasmusson, B.
Fonte: American Medical Informatics Association Publicador: American Medical Informatics Association
Tipo: Artigo de Revista Científica
Publicado em //1994 EN
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Ethical issues related to the use of computerized protocols to control mechanical ventilation of patients with Acute Respiratory Distress Syndrome (ARDS) are identical to the ethical issues surrounding the use of any therapy or intervention. Four ethical principles must be considered: nonmaleficence, beneficence, autonomy, and distributed justice. The major ethical challenges to computerized protocol use as a specific application of clinical decision support tools are found within the principles of nonmaleficence and of beneficence. The absence of credible outcome data on which ARDS patient survival probabilities with different therapeutic options could be based is a constraint common to most ICU clinical decision making. Clinicians are thus deprived of the knowledge necessary to define benefit and are limited to beneficent intention in clinical decisions. Computerized protocol controlled decision making for the clinical management of mechanical ventilation for ARDS patients is ethically defensible. It is as well supported as most ICU therapy options.

Procreative beneficence and the prospective parent

Herissone‐Kelly, P
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /03/2006 EN
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Julian Savulescu has given clear expression to a principle—that of “procreative beneficence”—which underlies the thought of many contemporary writers on bioethics. The principle of procreative beneficence (PPB) holds that parents or single reproducers are at least prima facie obliged to select the child, out of a range of possible children they might have, who will be likely to lead the best life. My aim in this paper is to argue that prospective parents, just by dint of their being prospective parents, are in fact not obliged to act on PPB. That is, there is something about their filling the role of prospective parents that exempts them from selecting the child with the best life. I urge that it is more realistic to view prospective parents as bound by a principle of acceptable outlook, which holds that they ought not to select children whose lives will contain an unacceptable amount of suffering.

Critical reflections on the principle of beneficence in biomedicine

Munyaradzi, Mawere
Fonte: The African Field Epidemiology Network Publicador: The African Field Epidemiology Network
Tipo: Artigo de Revista Científica
Publicado em 18/02/2012 EN
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Medical ethics as a scholarly discipline and a system of moral principles that apply values and judgments to the practice of medicine encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, anthropology and sociology. As such there are a number of values in medical ethics such as autonomy, non-maleficence, confidentiality, dignity, honesty, justice and beneficence, among others. These values act as guidelines for professionals in the medical fraternity and are therefore used to judge different cases in the fraternity. For purposes of this work, this paper examines the principle of beneficence in biomedicine. Using both hypothetical cases and others in real life situations, the paper reflects on the implications of beneficence in biomedicine. It argues that the principle of beneficence is a prima facie obligation that should “always be acted upon unless it conflicts on a particular occasion with an equal or stronger principle”.

Upholding the Principles of Autonomy, Beneficence, and Justice in Phase I Clinical Trials

Owonikoko, Taofeek K.
Fonte: AlphaMed Press Publicador: AlphaMed Press
Tipo: Artigo de Revista Científica
EN
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This commentary discusses the importance of maintaining the three core principles of autonomy, beneficence, and justice in phase I clinical trials.

Patient autonomy in chronic care: solving a paradox

Reach, Gérard
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em 12/12/2013 EN
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The application of the principle of autonomy, which is considered a cornerstone of contemporary bioethics, is sometimes in obvious contradiction with the principle of beneficence. Indeed, it may happen in chronic care that the preferences of the health care provider (HCP), who is largely focused on the prevention of long term complications of diseases, differ from those, more present oriented, preferences of the patient. The aims of this narrative review are as follows: 1) to show that the exercise of autonomy by the patient is not always possible; 2) where the latter is not possible, to examine how, in the context of the autonomy principle, someone (a HCP) can decide what is good (a treatment) for someone else (a patient) without falling into paternalism. Actually this analysis leads to a paradox: not only is the principle of beneficence sometimes conflicting with the principle of autonomy, but physician’s beneficence may enter into conflict with the mere respect of the patient; and 3) to propose a solution to this paradox by revisiting the very concepts of the autonomous person, patient education, and trust in the patient–physician relationship: this article provides an ethical definition of patient education.

An analytic review of the doctor-patient relatyionship part I

Oprea, Liviu
Fonte: Coleguiul Medicilor Iasi Publicador: Coleguiul Medicilor Iasi
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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In this article I review of the bioethics and clinical models of doctor-patient relationship and analyze them with ethical lens. It has two parts. First I review the bioethics models of DPR and argue that they are normative and prescriptive in nature being derived from various ethical and social theories. Although they describe various processes through which they may promote either patients' autonomy or beneficence, these processes are not assessed empirically and therefore. it is not clear whether their implementation at the level of health systems may rich their goals. Second I review the clinical models of DPR and show that similar to the bioethics models of DPR they are normative and prescriptive in nature. In addition, similar to the bioethics models of DPR, they are instrumental for beneficence and patients' autonomy. However, the processes through which these models aim at promoting beneficence were comprehensively assessed from an empirical point of view. I outline this research and argue that there is evidence that the relationship centered care model of DPR may promote beneficence and patients' autonomy if implemented Finally, I compare the processes in the clinical models of DPR with those in the bioethics models and argue that the contractual models of DPR are likely to promote less beneficence and patients' autonomy as compared with relational models of DPR.

The Principle of Procreative Beneficence is Eugenic, but so what?

Hotke, ANDREW
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
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In response to the possibilities for selection created by reproductive technologies like IVF and Prenatal screening, Julian Savulescu has argued that parents have a moral obligation to employ selective technology in order to have the best child that they can possibly have. This idea, which Savulescu has called the Principle of Procreative Beneficence, appears reminiscent of historical eugenics. However, Savulescu has argued that this principle is not eugenic. In this paper I argue that there are good reasons to think that the Principle of Procreative Beneficence is eugenic. Specifically, I argue that this principle shares five common features with historical eugenics which justify the conclusion that it is eugenic. However, while I argue that this principle is eugenic, I argue that it is not morally problematic for that reason because the shared features of historical eugenics and the Principle of Procreative Beneficence, which justify the claim that the principle is eugenic, are not morally problematic.; Thesis (Master, Philosophy) -- Queen's University, 2012-10-08 22:23:59.333

Toward a Virtue-Centred Ethics of Reproduction

Wayne, KATHERINE
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
27.32%
When it comes to potential children, is to love them to leave them be (nonexistent)? I examine the possibility of virtuous reproduction, as well as some more basic theoretical issues surrounding the nature of moral goodness and obligation generally. Currently, there is a large body of literature in the field of reproductive ethics on questions of what considerations and practices ought to guide reproductive decision-making. The appropriate use of testing technologies to inform such decision-making, for instance, has been widely debated. Much smaller and less visible is the debate surrounding the prior question of whether reproduction itself is morally appropriate or desirable. I am particularly interested in how consequentialist strategies for including considerations of beneficence in reproductive decision-making have shaped moral approaches to reproduction. The principle of procreative beneficence (PPB), which mandates potential reproducers to select the best possible child, highlights the problematic nature of these strategies. The limited conceptual resources and problematic normative foundations of such strategies have stymied the development of a robust discussion on the ethics of reproduction itself. Other types of ethical approaches...

Beneficiência e autonomia

Rocha, Daiane Martins
Fonte: Universidade Federal de Santa Catarina Publicador: Universidade Federal de Santa Catarina
Tipo: Tese de Doutorado
POR
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17.32%
Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas, Programa de Pós-Graduação em Filosofia, Florianópolis, 2013; ; Abstract: Having seen the clarificatory task of philosophy pointed out by Wittgenstein in his book ?Tractatus?, this thesis assumes the goal of clarifying the concepts involved in the discussion between beneficence and autonomy in secular society, as well as the implications of each one of these bioethical approaches. These elucidations arises the notion of the patient?s welfare, which includes effectively what should be the end (telos) of Medicine. This conception of welfare is fully compatible with the model of beneficence-in-trust, supported by Pellegrino & Thomasma and partially compatible with the autonomist approach represented by the principle of permission, enunciated by Engelhardt. As beneficence-in-trust is identified as the model that better contributes to the patient?s welfare, it has practical consequences, as the defense of comprehensive and intensive palliative care, as well as more humanized medical practices, and also a criticism concerning to the practices that aim to anticipate the patients? death, such as medical assisted suicide, since this practice is not supported by the telos of medicine approach and by the concept of welfare defended here.

The Ownership Model of Business Ethics

Rodin, David
Fonte: Blackwell Publishing Ltd Publicador: Blackwell Publishing Ltd
Tipo: Artigo de Revista Científica
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This essay attempts to develop a new theoretical model for business ethics distinct from the two canonical business-ethics theories, the stakeholder theory and the shareholder value theory. Milton Friedman argued that because managers are agents of the company's owners, their sole moral responsibility is to maximize owner returns. Thomas Pogge has recently suggested that such a view involves a kind of moral incoherence and that we should reject the efficacy of social arrangements like the principal-agent relationship in altering moral obligations. Both views fail to give proper account of the dispersal of moral responsibilities in business contexts. We must distinguish "minimal moral obligations" (stemming from justice and rights) from "maximal moral obligations" (stemming from all other moral considerations, including duties of aid, beneficence, and the virtues). Minimal obligations apply to all persons, but maximal obligations can be effected by social arrangements like the ownermanager relationship. There may be moral obligations incumbent on owners that do not apply to managers. Understanding this distribution of responsibilities enables us to develop a new and attractive model of business ethics - "the ownership model" - which places greater emphasis on the rights and responsibilities of the owners of business than has been traditional in business ethics.

Ethics, justice and the sale of kidneys for transplantation purposes

Slabbert,M
Fonte: PER: Potchefstroomse Elektroniese Regsblad Publicador: PER: Potchefstroomse Elektroniese Regsblad
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2010 EN
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Living kidney donor transplantations are complex; add to that financial compensation to the donor and one enters an ethical maze. Debates on whether the buying and selling of kidneys should be allowed are mainly between utilitarians, deontologists and virtue ethicists as legal transplants are more common in the Western world. The pros and cons of each theory in relation to the sale of human organs are analysed, after which the foundational principles for all bio-ethical judgments; beneficence, non-maleficence, autonomy and justice are also scrutinised in seeking to justify the sale of human kidneys for transplantation purposes in a country with a human rights culture.