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Revista Brasileira de Educação Médica

versão impressa ISSN 0100-5502versão On-line ISSN 1981-5271

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MUGAYAR, Nalita Maria Hall Brum de Barros; CARRARO-EDUARDO, José Carlos  e  SA, Renato Augusto Moreira de. Maliandi’s Bioethics in Undergraduate Medicine Courses. Rev. Bras. Educ. Med. [online]. 2017, vol.41, n.4, pp.468-477. ISSN 1981-5271.  https://doi.org/10.1590/1981-52712015v41n3RB20160088.

This article points out the deficiency of medical courses in relation to Humanities and argues that the study of Bioethics — a discipline that seeks to integrate the Human and Biological Sciences — can help fill this harmful gap. We present the Convergent Bioethics of Ricardo Maliandi and Oscar Thüer as a valuable theoretical framework able to help physicians to solve or minimize ethical conflicts inherent to their professional practice, without undue unilateralism. Comparing its theoretical foundation with the well-known proposal of Beauchamp and Childress we point out the advantages of the former. We showcase its applicability with the analysis of potential ethical conflicts inferred from information obtained from medical records of a patient admitted tothe Intensive Care Unit of the Hospital Universitário Antônio Pedro. To that end, medical literature was studied in search of probabilistic data about the disease in question (esophageal cancer with fistula, complicated by pulmonary septic shock), noting that these data can help toward gaining a better understanding of the prognosis, but cannot be used by the medical team as support for unilateral decisions about therapeutic limitations. Reading Azoulay's work regarding patients with diseases with poor prognosis who eventually find themselves in intensive care, we highlight his proposal for difficult cases from an ethical point of view, recognizing and demonstrating its compatibility with the Convergent Bioethics of Maliandi and Thüer. This is a theoretical essay on therapeutic limitation, in which we seek to link the literature's foundation to real-case applicability of a critical patient. We believe that this article could be a starting point for the dissemination of Convergent Ethics — developed by the philosopher Ricardo Maliandi and explained with the aid of the physician Oscar Thüer as refers to bioethics — in medical courses, bringing more security and less loneliness in the difficult decision-making process inherent to the relationship between physicians and patient/family, particularly with regard to end of lifemedical care.

Palavras-chave : Bioethics; Education, Medical; Terminal Illness; Intensive Care; Palliative Care.

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