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A presente Dissertação tem por finalidade a análise da realidade legislativa e jurisprudencial do tratamento dado ao instituto do consentimento informado no âmbito das instituições de saúde da rede hospitalar pública, no contexto da violência obstétrica. A escolha do tema decorre da relevância que o mesmo assume atualmente, considerando o aumento significativo de casos registados em Portugal. Optámos por não efetuar uma abordagem da temática sob o ponto de vista penal, visto que a presente investigação se insere no âmbito de uma especialização em Direito Administrativo. Numa primeira fase iremos proceder a uma breve contextualização histórica do direito ao consentimento, analisando as diversas fontes, quer nacionais quer internacionais, que o consagram. Seguidamente será feito um estudo mais aprofundado do conceito de direito ao consentimento, bem como dos elementos que o caracterizam. Tratando-se de um tema que só recentemente começou a ver a luz do dia. Com efeito, são poucos os casos de responsabilidade médica que, em Portugal, no âmbito da violência obstétrica, chegam à barra dos tribunais. Há um certo sentimento de corporativismo na atividade médica que torna mais complexa a resolução destes litígios. Ademais, a própria dificuldade de prova da culpa do agente e do nexo causal dificultam a tarefa de quem pretende ser ressarcido pelos danos de que foi vítima. A nossa vontade de tratar este tema deriva da necessidade de consciencialização para a importância do instituto do consentimento informado numa área tão sensível da medicina: a obstetrícia. O acesso a cuidados de saúde que possibilitem um parto e um nascimento condignos deve considerar-se um direito fundamental inviolável. No entanto, a realidade a que assistimos fomenta o paternalismo clínico, retirando a autonomia à parturiente no que respeita às decisões a tomar quanto ao seu próprio corpo, naquela que constitui a fase mais importante do processo reprodutivo: o parto.
The purpose of this Dissertation is to analyze the legislative and jurisprudential reality of the treatment given to the institute of informed consent within the scope of health institutions of the public hospital network, in the context of obstetric violence. The choice of theme stems from the relevance it currently assumes, considering the significant increase in cases registered in Portugal. We have chosen not to approach the subject from a criminal point of view, since the present investigation is part of a specialization in Administrative Law. In a first phase, we will proceed with a brief historical context of the right to consent, analyzing the various sources, both national and international, that consecrate it. A more in-depth study of the concept of the right to consent will then be carried out, as well as the elements that characterize it. As this is an issue that has only recently begun to surface, few cases of medical liability in Portugal, within the scope of obstetric violence, reach the courts. There is a certain feeling of corporatism in medical activity that makes the resolution of these cases more complex. In addition, the difficulty of proving the agent's guilt and the causal link makes the task very hard for those who intend to be compensated for the damages. Our desire to address this issue stems from the need to raise awareness of the importance of the institute of informed consent in such a sensitive area of medicine: obstetrics. Access to a decent delivery and birth is a fundamental and inviolable right. However, the reality we are witnessing encourages clinical paternalism, depriving the parturient of her autonomy to make the decisions to be taken regarding her own body, in one of the most important phases of her reproductive process: childbirth.
The purpose of this Dissertation is to analyze the legislative and jurisprudential reality of the treatment given to the institute of informed consent within the scope of health institutions of the public hospital network, in the context of obstetric violence. The choice of theme stems from the relevance it currently assumes, considering the significant increase in cases registered in Portugal. We have chosen not to approach the subject from a criminal point of view, since the present investigation is part of a specialization in Administrative Law. In a first phase, we will proceed with a brief historical context of the right to consent, analyzing the various sources, both national and international, that consecrate it. A more in-depth study of the concept of the right to consent will then be carried out, as well as the elements that characterize it. As this is an issue that has only recently begun to surface, few cases of medical liability in Portugal, within the scope of obstetric violence, reach the courts. There is a certain feeling of corporatism in medical activity that makes the resolution of these cases more complex. In addition, the difficulty of proving the agent's guilt and the causal link makes the task very hard for those who intend to be compensated for the damages. Our desire to address this issue stems from the need to raise awareness of the importance of the institute of informed consent in such a sensitive area of medicine: obstetrics. Access to a decent delivery and birth is a fundamental and inviolable right. However, the reality we are witnessing encourages clinical paternalism, depriving the parturient of her autonomy to make the decisions to be taken regarding her own body, in one of the most important phases of her reproductive process: childbirth.
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Keywords
Consentimento informado Responsabilidade civil Violência obstétrica Informed consent Civil responsibility Obstetric violence