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Erro clínico
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Orientador(es)
Resumo(s)
A Medicina, pela sua natureza incerta, fundada em probabilidades, não é isenta de riscos e eventos adversos. A essa particularidade acresce o facto de estar sujeita a erro, à semelhança de qualquer outra actividade na dependência da acção do Homem (particularmente se a operar no seio de sistemas organizacionais complexos), e, mais recentemente, também dos – falíveis, não obstante notáveis – contributos proporcionados pelos avanços científico, técnico e tecnológico.
A importância de que o “erro clínico” se reveste, a par da ressonância que cada vez mais tem tido na sociedade – evidente através da crescente atenção de que tem sido alvo, e do espaço de debate que lhe tem sido cedido, na esfera pública –, tornam-no uma problemática por demais relevante nos dias de hoje. A sua complexidade inevitavelmente implica transdisciplinaridade, com particular destaque para o domínio do Direito.
Assim, é desígnio deste trabalho a descrição de casos clínicos classificados sob o lato conceito de “erro clínico”, a cujo propósito, através de revisão narrativa da literatura, da legislação e da doutrina aplicáveis, será convocada a perspectiva do Direito da Medicina caracterizado pelo método transdisciplinar jurídico-médico, compreendendo nomeadamente: acto médico; leges artis; consentimento informado; dicotomia obrigação de meios/obrigação de resultado; taxonomia dos erros e eventos em Medicina; responsabilidade médica – civil, criminal e disciplinar. Esses diferentes planos serão mobilizados na medida da sua relevância para a fundamentação da análise dos casos clínicos. Serão também abordadas as circunstâncias conducentes à emergência do erro clínico enquanto problemática, as consequências que dele decorrem e possíveis vias para o minorar e melhor gerir.
Medicine, as a result of its uncertain nature, founded on probabilities, is not free from risks and adverse events. Adding up to that particular feature is the fact that it is subject to error, as any other activity that depend upon human action (particularly when operating within complex organizational systems) and, more recently, also upon – fallible, nevertheless remarkable – contributions provided by scientific, technical and technological advances. The importance of the “clinical error”, along with the rising resonance that it has been having in society – which has been made clear by the growing attention it has been receiving, and the space for debate it has been given, in the public eye –, makes it a quite relevant problem nowadays. Its complexity inevitably implies transdisciplinarity, with particular emphasis on the Law field. As such, the purpose of this final paper is to describe clinical cases classified under the umbrella term “clinical error”, in which context the perspective of Medical Law characterized by the juridical-medical transdisciplinary method will be called upon, through narrative review of the literature, law and doctrine, comprehending: medical act; leges artis; informed consent; obligations of means/obligations of result dichotomy; taxonomy of errors and events in Medicine; medical responsability – civil, criminal and disciplinary. Those different layers will be mobilized to the extent of its relevante to the reasoning of the clinical cases’ analysis. The circumstances leading to the emergence of clinical error as a problem, the consequences that result from it and possible ways to minimize and better manage it will also be adressed.
Medicine, as a result of its uncertain nature, founded on probabilities, is not free from risks and adverse events. Adding up to that particular feature is the fact that it is subject to error, as any other activity that depend upon human action (particularly when operating within complex organizational systems) and, more recently, also upon – fallible, nevertheless remarkable – contributions provided by scientific, technical and technological advances. The importance of the “clinical error”, along with the rising resonance that it has been having in society – which has been made clear by the growing attention it has been receiving, and the space for debate it has been given, in the public eye –, makes it a quite relevant problem nowadays. Its complexity inevitably implies transdisciplinarity, with particular emphasis on the Law field. As such, the purpose of this final paper is to describe clinical cases classified under the umbrella term “clinical error”, in which context the perspective of Medical Law characterized by the juridical-medical transdisciplinary method will be called upon, through narrative review of the literature, law and doctrine, comprehending: medical act; leges artis; informed consent; obligations of means/obligations of result dichotomy; taxonomy of errors and events in Medicine; medical responsability – civil, criminal and disciplinary. Those different layers will be mobilized to the extent of its relevante to the reasoning of the clinical cases’ analysis. The circumstances leading to the emergence of clinical error as a problem, the consequences that result from it and possible ways to minimize and better manage it will also be adressed.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Leges artis Erro clínico Eventos adversos Segurança dos doentes Responsabilidade médica