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Professional-patient relationship and bioethics: an ever-present discussion
CORRESPONDENCE
Professional-patient relationship and bioethics: an ever-present discussion FABIANO MALUF PhD Student in Health Sciences, Universidade de Brasília; Dental Surgeon, 1st Lieutenant ODT Ex HFA, Hospital das Forças Armadas, Brasília, DF, Brazil ©2012 Elsevier Editora Ltda. All rights reserved.
Unfortunately, human nature adapts to the environment. Acts command thoughts, molding them, and not otherwise. Just recently health professionals have been able to adapt or to ethically position themselves in situations that were imposed by the cultural and historical reality, and by the extraordinary and impressive technicalscientific advances experienced over the last 20 to 25 years. The starting point of this ethical awareness in the professional-patient relationship was the sordid combination of technological advancement with the shadow of fear wandering in the professional’s (un)conscious, worried by an eventual slip which might bring chagrin and embarrassment. But the slowness to adapt to the new reality we envision and that whips us is unforgivable... An instrument which allows us to walk safely towards this new reality is the Informed Consent, not only in the sense of being a concrete and tangible legal resource, but for a reflection about the competence and scientific knowledge, exercise of the equilibrium between moral and technical power, respect for the autonomy of another fragile human being and human compassion. This resource shows the professional and the patient not only a new right to be exerted; it also indicates a possibility for both of them to share victories and successes, pitfalls and difficulties, and ultimately, responsibilities. In general, the patient exchanges his/hers “restful position” of being blindly guided through an imposed treatment, and the professional exchanges the (un)comfortable situation of a tyrannic health dictator, for the advantages of dividing responsibilities.
It can be inferred that there are still some conflicts that health professionals must be alert of, concerning linguistics, autonomy, lack of real patient decision power, beneficence, and paternalistic attitudes capable of making mechanisms that can provide a horizontal and efficient communication unviable1. The important thing is to be alert in order to prevent the relationship from taking a unilateral, dominant characteristic. The professional must, without putting aside the conduct of procedures, considering the responsibility which is inherent to the exercise, give information in a clear and complete way to the patient, and allow, as much as possible – that is, within certain boundaries – that the patient interacts with him/her2. The right to information and choice between treatment alternatives is not merely an ethical recommendation, but is also dictated in the consumers’ rights legislation, which includes the provision of health services2. These should be the real advantages/benefits of an Informed Consent, having legal and juridical protection as a secondary function and perhaps unnecessary, whenever the health professional-patient relationship is well conducted, with excellent communication not only in the beginning but also during the whole treatment.
REFERENCES 1. 2.
Garrafa V, Prado MM, Bugarin Jr JG. Bioética e odontologia. In: Vieira TR, organizador. Bioética nas profissões. Petrópolis: Vozes; 2005. p.85-100. Primo WQSP, Garrafa V. Análise ética da revelação do diagnóstico e tratamento em pacientes com câncer genital ou mamário. Rev Assoc Med Bras. 2010;56(4):397-402.
Rev Assoc Med Bras 2012; 58(1):7
7
Professional-patient relationship and bioethics: an ever-present discussion FABIANO MALUF PhD Student in Health Sciences, Universidade de Brasília; Dental Surgeon, 1st Lieutenant ODT Ex HFA, Hospital das Forças Armadas, Brasília, DF, Brazil ©2012 Elsevier Editora Ltda. All rights reserved.
Unfortunately, human nature adapts to the environment. Acts command thoughts, molding them, and not otherwise. Just recently health professionals have been able to adapt or to ethically position themselves in situations that were imposed by the cultural and historical reality, and by the extraordinary and impressive technicalscientific advances experienced over the last 20 to 25 years. The starting point of this ethical awareness in the professional-patient relationship was the sordid combination of technological advancement with the shadow of fear wandering in the professional’s (un)conscious, worried by an eventual slip which might bring chagrin and embarrassment. But the slowness to adapt to the new reality we envision and that whips us is unforgivable... An instrument which allows us to walk safely towards this new reality is the Informed Consent, not only in the sense of being a concrete and tangible legal resource, but for a reflection about the competence and scientific knowledge, exercise of the equilibrium between moral and technical power, respect for the autonomy of another fragile human being and human compassion. This resource shows the professional and the patient not only a new right to be exerted; it also indicates a possibility for both of them to share victories and successes, pitfalls and difficulties, and ultimately, responsibilities. In general, the patient exchanges his/hers “restful position” of being blindly guided through an imposed treatment, and the professional exchanges the (un)comfortable situation of a tyrannic health dictator, for the advantages of dividing responsibilities.
It can be inferred that there are still some conflicts that health professionals must be alert of, concerning linguistics, autonomy, lack of real patient decision power, beneficence, and paternalistic attitudes capable of making mechanisms that can provide a horizontal and efficient communication unviable1. The important thing is to be alert in order to prevent the relationship from taking a unilateral, dominant characteristic. The professional must, without putting aside the conduct of procedures, considering the responsibility which is inherent to the exercise, give information in a clear and complete way to the patient, and allow, as much as possible – that is, within certain boundaries – that the patient interacts with him/her2. The right to information and choice between treatment alternatives is not merely an ethical recommendation, but is also dictated in the consumers’ rights legislation, which includes the provision of health services2. These should be the real advantages/benefits of an Informed Consent, having legal and juridical protection as a secondary function and perhaps unnecessary, whenever the health professional-patient relationship is well conducted, with excellent communication not only in the beginning but also during the whole treatment.
REFERENCES 1. 2.
Garrafa V, Prado MM, Bugarin Jr JG. Bioética e odontologia. In: Vieira TR, organizador. Bioética nas profissões. Petrópolis: Vozes; 2005. p.85-100. Primo WQSP, Garrafa V. Análise ética da revelação do diagnóstico e tratamento em pacientes com câncer genital ou mamário. Rev Assoc Med Bras. 2010;56(4):397-402.
Rev Assoc Med Bras 2012; 58(1):7
7