O preparo bioético na graduação de Fisioterapia

Abstract

RESUMO: O desenvolvimento da Fisioterapia, aliado às mudanças na educação e na saúde, faz com que a autonomia e os dilemas éticos do fisioterapeuta sejam maiores a cada dia, expandindo seu papel no cuidado do paciente. Para além do Código de Ética, as noções de Bioética são centrais no preparo de graduandos para os desafios profissionais. Este estudo verificou a capacidade de tomar decisões éticas de alunos no último ano de Fisioterapia de duas universidades na cidade de São Paulo, das quais uma oferece no currículo a disciplina Bioética e a outra não. Cinqüenta alunos de cada universidade responderam a um questionário sobre dilemas éticos correspondentes a artigos do Código de Ética; cada questão oferecia três alternativas de resposta: uma bioética, outra referente ao Código e uma não-ética. As respostas foram analisadas estatisticamente. Os resultados mostraram um bom preparo ético em pouco mais de metade dos alunos das duas universidades, sugerindo que ambas oferecem preparo ético similar aos graduandos, independente da diferença curricular. No entanto, os alunos da universidade que oferece Bioética tiveram resultados significantemente melhores nos quesitos referentes à relação com outros profissionais da saúde, sugerindo que essa disciplina oferece melhores condições para o relacionamento interprofissional, fator importante tanto na prática clínica quanto para elevar o status da Fisioterapia. DESCRITORES: Bioética; Ética profissional; Fisioterapia/educação ABSTRACT: Physical therapy recent expansion, along with changes in education and health, enhance physical therapists' role in patient care, while increasing both their autonomy and the ethical challenges they face in daily clinic. In addition to knowledge of the professional ethical code, notions of Bioethics are thought to be central to students training. This study analysed the ability to make ethical decisions among 100 physical therapy undergraduate students at two universities in São Paulo, of which only one offers the discipline Bioethics. Fifty students of each university answered a questionnaire of dilemmas related to items of the Physical Therapy Code of Ethics; for each question there was a choice between three answers, bioethical, in accordance with the ethical code, or non-ethical. Answers were statistically analysed. About half the students of both universities seemed to be satisfactorily prepared to act ethically, thus suggesting that both offer similar ethical training, regardless of curricula differences. However, students from the university that offers Bioethics had significantly better results in questions concerning the relationship with other health providers, thereby suggesting that this discipline may provide better student training for inter-professional relationship, which is important both to clinical practice and to raise physical therapy status.

Interface entre fisioterapia, bioética e educação: revisão integrativa

“…In Brazil, the discipline "Ethics and Deontology" is mandatory within higher education courses in the health sciences 16 . However, physiotherapy courses still exist which do not incorporate the debate regarding moral and ethical judgments 29 in terms of the practical realities that are faced by recent graduates.…”

“…However, physiotherapy courses still exist which do not incorporate the debate regarding moral and ethical judgments 29 in terms of the practical realities that are faced by recent graduates. As a result, students face challenges in making decisions regarding the ethical dilemmas that arise during their clinical practice 16 . Deontology is the branch of ethics that deals with duties and standards, supplying its own moral codes to the professional classes, serving as behavioral norms that should be followed.…”

“…In a comparative study between two physiotherapeutic institutions, in which one included a bioethics course and the other did not, Alves et al 16 , its researchers demonstrated that no students from either institution regarded themselves as having knowledge of the professional code of ethics. Regarding the privacy and intimacy of the patients, each of the students revealed themselves to be sensitive to these aspects, referring to bioethical arguments.…”

“…Half of the students that participated in the study replied that they would not respect the patient's right to determine aspects regarding their own well beingv 16 . Many healthcare practitioners may adopt the justification of beneficence in order to defend paternalistic attitudes.…”

“…In other words, some healthcare professionals curtail the autonomy of the patient based on the belief they are benefiting others 31 . With respect to diagnoses and prognoses, the students of the university that did not study bioethics thought it better to discard such practices if they were to worsen the clinical situation of the patient, which seems to be a result of the Hippocratic tradition that is associated with non-maleficence 16 .…”