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Resumo(s)
Esta dissertação irá debruçar-se sobre o consentimento informado na obstetrícia, que assume
contornos específicos quando se trata de recusar procedimentos clínicos ou tratamentos que estão
previstos em protocolos e que, não raras vezes, não têm evidência científica que os sustente. Este
ato de recusa - o dissentimento - leva muitas vezes os médicos a agir de forma deontologicamente
reprovável para com as utentes que recusam certos procedimentos durante a gravidez, na medida
em que recusam também eles continuar o seguimento clínico daquela mulher, sem a encaminharem
para outro médico e sem a orientarem devidamente. No parto, o dissentimento é muitas vezes
desrespeitado e traz consequências potencialmente graves para as mulheres, tanto a nível físico
como psíquico, sem que os médicos sejam responsabilizados por agirem contra a vontade das
parturientes. Na sequência das más práticas médicas na gravidez, no parto e no pós-parto, surgem
iatrogenias, evitáveis através da melhoria global dos serviços de saúde obstétricos.
O objetivo desta dissertação será perceber quais as consequências práticas deste direito de recusa,
tanto para as mulheres grávidas como para os médicos e perceber o alcance jurídico-penal do
desrespeito do médico perante o dissentimento e perante as iatrogenias decorrentes das más
práticas em obstetrícia
This dissertation’s focus is on informed consent in obstetrics, taking specific contours when it comes to refusing clinical procedures or treatments provided in protocols which very often have no scientific evidence to support them. This act of refusal, called dissent, frequently leads physicians to act in a deontologically reproachable manner towards users who refuse certain procedures during pregnancy, in that they also refuse to continue the patient’s clinical follow-up without a referral to another doctor and also without proper guidance. In childbirth, dissent is often disrespected which can bear serious consequences for women, both physically and mentally and physicians are also seldom held accountable for acting against the mother’s will. Medical malpractices in pregnancy, childbirth and postpartum lead to iatrogenic complications, which can be prevented through an overall improvement of obstetric health services. The objective of this dissertation will be to understand the practical consequences of this right of refusal, for both pregnant women and physicians, and to understand the legal and penal scope of the doctor’s contempt when facing a dissent and the iatrogenic complications resulting from malpractices in obstetrics.
This dissertation’s focus is on informed consent in obstetrics, taking specific contours when it comes to refusing clinical procedures or treatments provided in protocols which very often have no scientific evidence to support them. This act of refusal, called dissent, frequently leads physicians to act in a deontologically reproachable manner towards users who refuse certain procedures during pregnancy, in that they also refuse to continue the patient’s clinical follow-up without a referral to another doctor and also without proper guidance. In childbirth, dissent is often disrespected which can bear serious consequences for women, both physically and mentally and physicians are also seldom held accountable for acting against the mother’s will. Medical malpractices in pregnancy, childbirth and postpartum lead to iatrogenic complications, which can be prevented through an overall improvement of obstetric health services. The objective of this dissertation will be to understand the practical consequences of this right of refusal, for both pregnant women and physicians, and to understand the legal and penal scope of the doctor’s contempt when facing a dissent and the iatrogenic complications resulting from malpractices in obstetrics.
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Palavras-chave
Consentimento Dissentimento Direito de recusa de tratamento Direito e saúde Obstetrícia Más práticas nos cuidados de saúde Boas práticas médicas Medicina baseada em evidência Gravidez Parto Latrogenias Consent Dissent Right to refuse treatment Health law Obstetrics Medical malpractice Good medical practice Evidence-based medicine Pregnancy Childbirth Latrogenesis