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Abstract(s)
Introdução: A COVID-19 representa uma séria ameaça à sustentabilidade dos sistemas de
saúde, que não se encontravam preparados para o elevado número de doentes necessitados
de hospitalização, surgindo a necessidade de criar um sistema de triagem.
Objetivos: Rever pareceres de sociedades de bioética europeias, que estabeleceram
recomendações e critérios a ter em conta na triagem, publicadas até fevereiro de 2021.
Realizar uma revisão sistemática da literatura relevante, de forma a enquadrar o tema e por
último recolher a opinião dos alunos de Medicina da Universidade da Beira Interior sobre
os critérios que consideram mais relevantes.
Metodologia: Foi realizada uma pesquisa manual no Google e em websites
governamentais de vários países e uma revisão sistemática da literatura relevante sobre o
tema nas bases de dados Pubmed, Scopus e Web of Science, entre setembro de 2020 e
fevereiro de 2021. Foi criado um questionário enviado através de email institucional para os
alunos do 4º, 5º e 6º anos de Medicina da Universidade da Beira Interior.
Resultados: Foram incluídos 21 documentos pertencentes a 14 países - Alemanha,
Áustria, Bélgica, Espanha, Estónia, França, Grécia, Irlanda, Israel, Itália, Portugal, Reino
Unido, Suécia e Suíça - que convergiam na maximização do benefício, papel do prognóstico,
recusa da discriminação, proteção dos profissionais de saúde, autonomia do doente e
importância dos cuidados paliativos. Após aplicação dos critérios estabelecidos foram
incluídos 43 artigos. O questionário obteve 103 respostas, nas quais os alunos expressaram
preferência pela maximização do número de vidas salvas e priorização dos doentes mais
graves e com melhor prognóstico.
Conclusão: a maioria dos países segue uma abordagem utilitarista de maximização do
benefício, de forma a salvar o maior número possível de vidas, utilizando como principal
critério o prognóstico e gravidade clínica. O idadismo e a discriminação contra portadores
de deficiência continuam presentes na Europa. A comparação com os princípios expressos
na Declaração de Barcelona revela que estes foram respeitados, com algumas exceções. As
respostas obtidas no questionário dirigido aos alunos vão ao encontro dos princípios
expressos nos documentos analisados.
Introduction: COVID-19 represents a serious threat to the sustainability of health systems, which were not prepared for the high number of patients in need of hospitalization, and the need to create a triage system arose. Objectives: Review documents of European bioethics societies, which set recommendations and criteria to be taken into account in the triage, published until February 2021. Carry out a systematic review of the relevant literature, in order to introduce the theme and finally collect the opinion of the medical students from University of Beira Interior on the criteria they consider most relevant. Methodology: A manual search was carried out on Google and government websites in several countries and a systematic review of the relevant literature on the topic in the databases Pubmed, Scopus and Web of Science, between September 2020 and February 2021. A questionnaire was created and sent via institutional email to students of the 4th, 5th and 6th years of Medicine at the University of Beira Interior. Results: 21 documents from 14 countries were included - Germany, Austria, Belgium, Spain, Estonia, France, Greece, Ireland, Israel, Italy, Portugal, United Kingdom, Sweden and Switzerland - that converged on maximizing benefit, role of the prognosis, refusal of discrimination, protection of health professionals, patient autonomy and the importance of palliative care. After applying the established criteria, 43 articles were included. The questionnaire obtained 103 responses, in which the students expressed a preference for maximizing the number of lives saved and prioritizing the most serious patients with the best prognosis. Conclusion: most countries follow a utilitarian approach of maximizing benefit, in order to save as many lives as possible, using prognosis and clinical severity as the main criteria. Ageism and discrimination against people with disabilities are still present in Europe. The comparison with the principles expressed in the Barcelona Declaration reveals that they were respected, with some exceptions. The answers obtained in the questionnaire addressed to students are in line with the principles expressed in the analyzed documents.
Introduction: COVID-19 represents a serious threat to the sustainability of health systems, which were not prepared for the high number of patients in need of hospitalization, and the need to create a triage system arose. Objectives: Review documents of European bioethics societies, which set recommendations and criteria to be taken into account in the triage, published until February 2021. Carry out a systematic review of the relevant literature, in order to introduce the theme and finally collect the opinion of the medical students from University of Beira Interior on the criteria they consider most relevant. Methodology: A manual search was carried out on Google and government websites in several countries and a systematic review of the relevant literature on the topic in the databases Pubmed, Scopus and Web of Science, between September 2020 and February 2021. A questionnaire was created and sent via institutional email to students of the 4th, 5th and 6th years of Medicine at the University of Beira Interior. Results: 21 documents from 14 countries were included - Germany, Austria, Belgium, Spain, Estonia, France, Greece, Ireland, Israel, Italy, Portugal, United Kingdom, Sweden and Switzerland - that converged on maximizing benefit, role of the prognosis, refusal of discrimination, protection of health professionals, patient autonomy and the importance of palliative care. After applying the established criteria, 43 articles were included. The questionnaire obtained 103 responses, in which the students expressed a preference for maximizing the number of lives saved and prioritizing the most serious patients with the best prognosis. Conclusion: most countries follow a utilitarian approach of maximizing benefit, in order to save as many lives as possible, using prognosis and clinical severity as the main criteria. Ageism and discrimination against people with disabilities are still present in Europe. The comparison with the principles expressed in the Barcelona Declaration reveals that they were respected, with some exceptions. The answers obtained in the questionnaire addressed to students are in line with the principles expressed in the analyzed documents.
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Keywords
Alocação de Recursos Bioética Covid-19 Justiça Distributiva Triagem