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Advisor(s)
Abstract(s)
A tese que aqui apresentamos resulta do estudo desenvolvido no âmbito do
Doutoramento em Bioética do Instituto de Bioética da Universidade Católica Portuguesa. Esta
tese visa contribuir para a reflexão e construção de um entendimento claro e organizado da
vulnerabilidade na doença oncológica, para o reconhecimento dessa vulnerabilidade na
abordagem teórica e prática do princípio do respeito pela autonomia e vulnerabilidade da
pessoa com doença oncológica, para a valorização e implementação da metodologia inerente à
decisão bioética no contexto clínico, em oncologia, bem como para a sugestão de medidas
concretas para a promoção e desenvolvimento da decisão bioética em oncologia.
Organizámos esta tese em três partes distintas, nas quais, cada uma, apresenta
capítulos que propõem a ilustração da relação entre o tema central em estudo e os temas que
por ele são abraçados.
Inicia-se com o tema central da tese, abordando a vulnerabilidade na sua acessão
filosófica e conceptual. Prossegue-se com a descrição acerca da saúde, da doença e da
vulnerabilidade no processo de doença, descobrindo o caminho que permite descrever a
vulnerabilidade decorrente da doença oncológica, ou seja, as dimensões ou fatores de
vulnerabilidade, em análise, no contexto dos cuidados em oncologia. A formulação da ligação
entre a doença cancro, a oncologia e a bioética permite-nos a identificação dos fatores de
vulnerabilidade da pessoa, com doença oncológica, e a compreensão da imperiosidade da
bioética, como elemento essencial para a gestão do cuidar, nesta área de especialidade.
Na terceira parte analisamos a relação entre a vulnerabilidade e a autonomia, em
oncologia, identificando a forma com os fatores de vulnerabilidade influenciam a autonomia da
pessoa doente e, desse modo, a necessidade da gestão bioética da autonomia, em situação. A
doença oncológica só pode ser acolhida e adequadamente cuidada enquanto «fator social
total», o que coloca elevadas exigências, não só à pessoa doente, mas também aos
profissionais de saúde que delas cuidam. Integrar os múltiplos fatores de vulnerabilidade, da
doença oncológica, numa resposta que prescreve a ética, a responsabilidade, o
profissionalismo e a excelência do cuidar é o desafio de qualquer profissional de saúde a
trabalhar nesta área, por isso, assumindo essa premissa e no final do nosso estudo sobre
vulnerabilidade e autonomia, apresentamos a nossa proposta de uma ferramenta de apoio à
decisão (Bio)ética para o contexto dos cuidados em oncologia.
Terminamos a nossa tese com a proposta de um programa de formação para a decisão
bioética em oncologia.
The results presented in this thesis are the outcome of a study developed in the Bioethics PhD, at the Bioethics Institute of the Catholic University, Porto. This work aims to be a contribute to the reflexion and construction of a clear and organized understanding of vulnerability in oncology, to a recognizement of that vulnerability in the theoretical approach and exercise of the principles of autonomy and vulnerability of the person with oncologic illness, to increase the value of the bioethics decision-making in the clinical context, in oncology, to promote it as a methodology, and also to contribute with a set of measures to promote and develop the bioethical decision making, in oncology. We have organized this thesis in three distinct parts, each one presenting chapters that offer the illustration of the relationship between the main study focus and the themes by it embraced. Initially, it is done a philosophical and conceptual approach of vulnerability - the main theme. We precede with a description about health, illness and vulnerability in the illness process, unveiling the path that leads us to describe vulnerability in oncologic illness – the analysis of vulnerability dimensions in oncology. The connection between cancer, oncology and bioethics allows us, not only to identify the vulnerability elements of the person with oncologic illness, but also to understand the mandatory presence of bioethics as an essential element in caring, in this particular area. In the third part, we analyse the connection between vulnerability and autonomy, in oncology, identifying the influence of vulnerability elements in the autonomy of the ill person, which led us to the need of bioethics management of autonomy. One can only face the oncologic illness and receive adequate healthcare, if it is done holistically, and this demands a lot from the ill person, but also from the healthcare professionals. The challenge to any healthcare professional in this area is to combine the multiple vulnerability elements of the oncologic illness in an answer that prescribes ethics, responsibility, professionalism and excellence in caring. Therefore, taking that as a premise, and after our approach to vulnerability and autonomy, we bring our proposal of tool to support the (Bio)ethical decision making in oncology care. Finally, our thesis also presents a training program proposal in bioethics decision making, in oncology.
The results presented in this thesis are the outcome of a study developed in the Bioethics PhD, at the Bioethics Institute of the Catholic University, Porto. This work aims to be a contribute to the reflexion and construction of a clear and organized understanding of vulnerability in oncology, to a recognizement of that vulnerability in the theoretical approach and exercise of the principles of autonomy and vulnerability of the person with oncologic illness, to increase the value of the bioethics decision-making in the clinical context, in oncology, to promote it as a methodology, and also to contribute with a set of measures to promote and develop the bioethical decision making, in oncology. We have organized this thesis in three distinct parts, each one presenting chapters that offer the illustration of the relationship between the main study focus and the themes by it embraced. Initially, it is done a philosophical and conceptual approach of vulnerability - the main theme. We precede with a description about health, illness and vulnerability in the illness process, unveiling the path that leads us to describe vulnerability in oncologic illness – the analysis of vulnerability dimensions in oncology. The connection between cancer, oncology and bioethics allows us, not only to identify the vulnerability elements of the person with oncologic illness, but also to understand the mandatory presence of bioethics as an essential element in caring, in this particular area. In the third part, we analyse the connection between vulnerability and autonomy, in oncology, identifying the influence of vulnerability elements in the autonomy of the ill person, which led us to the need of bioethics management of autonomy. One can only face the oncologic illness and receive adequate healthcare, if it is done holistically, and this demands a lot from the ill person, but also from the healthcare professionals. The challenge to any healthcare professional in this area is to combine the multiple vulnerability elements of the oncologic illness in an answer that prescribes ethics, responsibility, professionalism and excellence in caring. Therefore, taking that as a premise, and after our approach to vulnerability and autonomy, we bring our proposal of tool to support the (Bio)ethical decision making in oncology care. Finally, our thesis also presents a training program proposal in bioethics decision making, in oncology.
Description
Keywords
Vulnerabilidade Autonomia Bioética Decisão ética e oncologia Vulnerability Autonomy Bioethics Ethical decision and oncology