Distorções acerca do testamento vital no Brasil (ou o porquê é necessário falar sobre uma declaração prévia de vontade do paciente terminal)

Abstract

ARTÍCULODistorções acerca do testamento vital no Brasil (ou o porquê é necessário falar sobre uma declaração prévia de vontade do paciente terminal)Distortion on living will in Brazil (or why it is necessary to talk about a prior declaration of will of terminal patient) AbstractThis article aims to analyze the panorama of the Brazilian discussion concerning to the living will, focusing at the controversial issues, and the very often divergent views about the subject. First, it focuses at the question of terminality, demonstrating why it has to rename the institute for prior declaration of will of the terminal patient, and then working specifically the issues about the content of this document, the improprieties that have happened on it and, finally, to work the difference between terminality and persistent vegetative state and the implications of this difference at making the statement.

Diretivas Antecipadas de Vontade: percepção acerca da aplicabilidade no contexto neonatal e pediátrico

“…Patience Self Determination Act (PSDA), traduzido como Lei de Autodeterminação do Paciente, sendo que, a partir desta legislação emergiram debates, tanto públicas, como privadas, que forçaram a confrontar as decisões de final de vida 2 . Apesar do Brasil ainda não ter uma legislação federal normatizando as DAV, em 31 de agosto de 2012 o Conselho Federal de Medicina (CFM) aprovou a Resolução n° 1.995, na qual se atesta a vontade do paciente em fim de vida sobre os tratamentos médicos, a designação de um interlocutor para tal fim, além do dever do médico em cumprir o desejo do paciente terminal.…”

Testamento vital na prática médica: compreensão dos profissionais

“…Patient must have met his desires and aspirations, as well a manifestation of respect to his autonomy and dignity when he is not capable of expressing them clearly and sensibly. In the other hand, should be guaranteed to doctor that, when attending expressly patient's will, he won't be able to suffer sanctions in legal framework or by his professional entity 32 . Patient's right of expressing and having satisfied his desires must be linked to immunity warranty to medical staff as agreeing in suspending disproportional or futile therapeutic measures intended for terminally ill patients without recovering perspectives, so following expressly patient's will.…”

“…So, the criminal imputability guarantee must be clearly and formally discriminated even in medical profession code or in any other laws referring to this subject 32 . Regarding to this matter, another study suggests the adoption of actions to offer a death worthy to patient: respect to his will, criminal immunity to medical staff, decriminalization of any aid for dying and punishment for therapeutic obstination.…”

Desafios da implementação das diretivas antecipadas de vontade à prática hospitalar

“…However, this resolution does not resolve a number of controversies that relate to this subject: the applicability of ADW; the expectation that final decisions will correspond to peoples' wishes; the insertion of health professionals into the ADW process; and whether the patients' decisions can be changed, among other questions (6) . Studies in Brazil have shown that doctors have difficulty respecting a patient's will, even when it is written, if the family opposes that will (7) .…”