Case-Report: Autonomy and Self Determination of an Elderly Population in South Brazil

Abstract

Some elderly members of a small community in the state of Rio Grande do Sul, Brazil were victims of fraudulent behavior by a group of criminals. It happened shortly before the development of a research project that evaluated quality of life and decision-making capacity. Such a crime was a significant trauma for the victims and, as a result, the participants of the research refused to sign the Informed Consent Form. This case serves as background for supporting the distinction -sometimes confused in the literature -of emerging issues in the field of bioethics: ´autonomy` and ´self -determination`. Ironically, although they had autonomy to decide to take part in the research, they were in fact not fully prepared to exercise their self-determination, since they were not able to sign a document to support their choice. Also, draws attention to the difficulties of obtaining scientific data from vulnerable populations.

Bioethics, Autonomy, and Self-Determination in Patients Admitted to a Teaching Hospital for Treatment of Substance Use Disorder

“…The results of our sample showed that all the patients' decision-making abilities were preserved, which is consistent with other studies involving vulnerable populations, such as older adults, research participants, and adoles-cents (37,40,41,45,47,48). This is also consistent with other studies which have shown that the moral-psychological development of individuals is not impacted by age and educational level(41).…”

“…In a case report based on a study of the elderly population of a municipality located in the state of Rio Grande do Sul, Bajotto and Goldim(47) demonstrated this distinction between autonomy and self-determination. Many of the elderly were deemed capable according to the administration of an assessment tool of moral-psychological development; however, in practice their ability to make autonomous decisions was impeded by other family members who took control of the decision-making process (47).…”

What is Vulnerability?” A Qualitative Study about the Perception of Vulnerability in Adults and Older Adults

“…In a study that sought to differentiate autonomy of selfdetermination, the authors from this paper, took as a starting point a community of seniors who had been temporarily discouraged to act without the consent of family to differentiate the concept of autonomy and self-determination. While the former refers to the ability to make decisions, the second term refers to the ability to put the decision into practice, denotes "action [21]".…”

Diretivas antecipadas de vontade em unidade de emergência hospitalar

“…A garantia do respeito à autodeterminaçãopoder expressar seus desejos e participar ativamente do planejamento dos seus cuidados de saúde -vem sendo progressivamente incorporada à prática dos profissionais da área 4 . É importante diferenciar autonomia, entendida como capacidade de decidir, e autodeterminação, como exercício de decisão 5 .…”