Edmund Pellegrino: moralidade médica e a teoria do consenso moral

Abstract

The authors present and comment on the ideas of Edmund Pellegrino, a bioethics specialist born in New Jersey, USA, regarding the existence of a morality intrinsic to medicine, related to the inherent goal of the medical art, that is, the cure of the patient, as well as the existence of a morality external to medicine, which concerns all other aspects of medical activity whose ultimate purpose is not the cure of the patient. The authors also present the comments of other ethicists, for or against the arguments presented by Pellegrino, and compare aspects of this external morality to the moral consensus theory previously developed by the authors. Keywords: Ethics medical. Consensus. Morals. Medicine. Bioethics. Ethicists. Resumo Edmund Pellegrino: moralidade médica e a teoria do consenso moralOs autores apresentam e comentam as ideias de Edmund Pellegrino, bioeticista nascido em New Jersey, Estados Unidos, acerca da existência de moralidade interna à medicina, relacionada ao fim inerente à arte médica, ou seja, a cura do paciente, assim como a moralidade externa à medicina, que diz respeito a todos os outros aspectos da atividade médica cujo propósito final não seja a cura do paciente. Apresentam também os comentários de outros eticistas, contra ou a favor dos argumentos apresentados por Pellegrino, e comparam aspectos da referida moralidade externa à teoria do consenso moral desenvolvida anteriormente pelos autores. Palavras-chave: Ética médica. Consenso. Princípios morais. Medicina. Bioética. Eticistas. ResumenEdmund Pellegrino: moralidad médica y la teoría del consenso moral Los autores presentan y comentan las ideas de Edmund Pellegrino, bioeticista nacido en New Jersey, Estados Unidos, acerca de la existencia de una moralidad interna de la medicina, relacionada con el fin inherente al arte médico, es decir, la cura del paciente, así como sobre la existencia de una moralidad externa a la medicina, que se relaciona con todos los demás aspectos de la actividad médica, cuyo propósito final no sea la cura del paciente. Presentan también los comentarios de otros eticistas, en contra o a favor de los argumentos presentados por Pellegrino, y comparan aspectos de la mencionada moralidad externa con la teoría del consenso moral desarrollada anteriormente por los autores.

Considerations about ethical and legal aspects at the end of life during the COVID-19 pandemic

“…In these conditions, moved by your good principles and a spirit of compassion, after obtaining consent from them, you decide to give a dose of lethal injection, with the sole purpose of shortening the suffering of the individual. This action is called active consent euthanasia ( 6 ).…”

“…However, it may be that your patient is in a state of unconsciousness or semi-consciousness, which does not allow them to give proper consent and still, you decide to give them the same lethal injection. In this case, the action is called active non-consenting euthanasia ( 6 ).…”

“…And, just for the sake of illustration, at that moment you decide not to take any additional therapeutic measures, knowing that there is nothing more to do for the patient in terms of prognosis. Some authors refer to this act as passive euthanasia ( 6 ).…”

“…On the other hand, one can adopt another type of conduct. Due to pressure from family members, or by the conviction of what your “doctor’s duty” is, you can subject the patient to some form of renal dialysis, you can increase the number of vasoactive drugs, and in this case, this attitude of maintaining life at any cost, prolonging the patient’s suffering with useless measures, is called dysthanasia ( 6 ).…”

Aspectos epidemiológicos e deontológicos da mortalidade no trânsito em Roraima

“…The essence of medical ethics is action on behalf of the patient, taken as an end -not as a means -of professional performance, always through free and informed consent 51 . By establishing a relationship of mutual trust, the doctor must seek beneficence and avoid harm, respecting patient autonomy and treating him/ her with fairness and respect, according to the principles of principlist bioethics.…”