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Aula de Bioética sobre Transplante de Órgãos

  • 1. %LRpWLFD H GRDomR GH yUJmRV QR %UDVLO DVSHFWRV pWLFRV QD DERUGDJHP j IDPtOLD GR SRWHQFLDO GRDGRU -XOLDQD 'LDV 5HLV 3HVVDODFLD 9DQHVVD )DULD RUWHV $OED 2WWRQL 5HVXPR (VWH DUWLJR FRQVLVWH HP UHÁH[mR WHyULFD TXH SUHWHQGH LGHQWLÀFDU TXHVW}HV pWLFDV TXH SRGHULDP LQÁXHQFLDU QDV WD[DV GH FRQVHQWLPHQWR GH IDPLOLDUHV HP UHODomR j GRDomR GH yUJmRV ,GHQWLÀFRXVH FRPR SULQFLSDO TXHVWmR pWLFD D IDOWD GH HVFODUHFLPHQWRV GXUDQWH R SURFHVVR GH REWHQomR GR FRQVHQWLPHQWR MXQWR DR IDPLOLDU VHQGR LGHQWLÀFDGDV FRPR GHÀFLHQWHV DV LQIRUPDo}HV DFHUFD GR GLDJQyVWLFR GH PRUWH HQFHIiOLFD D DSDUrQFLD H D GHVÀJXUDomR GR FRUSR 7DPEpP VH FRQVWDWRX TXH RXWURV DVSHFWRV pWLFRV SRGHP LQÁXHQFLDU QHVWH SURFHVVR WDLV FRPR R UHVSHLWR DR PRPHQWR TXH R IDPLOLDU YLYHQFLD jV VXDV FUHQoDV H YDORUHV EHP FRPR R DFROKLPHQWR H D GLVSRQLELOLGDGH SRU SDUWH GR HQWUHYLVWDGRU H D JDUDQWLD GH TXH R IDPLOLDU WHQKD HVFROKLGR D DOWHUQDWLYD PDLV DGHTXDGD SDUD D VLWXDomR 3RUWDQWR UHVVDOWDVH D LPSRUWkQFLD GH SURÀVVLRQDLV GH VD~GH FDSDFLWDGRV SDUD D DERUGDJHP DR IDPLOLDU YLVDQGR FRP LVWR PDLRU DFHLWDomR H XPD DVVLVWrQFLD SDXWDGD QD pWLFD 3DODYUDVFKDYH 7UDQVSODQWH GH yUJmRV %LRpWLFD 5HODo}HV SURÀVVLRQDOIDPtOLD -XOLDQD 'LDV 5HLV 3HVVDODFLD *UDGXDGD HP (QIHUPDJHP SHOD )DFXOGDGH GH 0HGLFLQD GH 6mR -RVp GR 5LR 3UHWR GRXWRUD HP (QIHUPDJHP SHOD (VFROD GH (QIHUPDJHP GH 5LEHLUmR 3UHWR ((53
  • 3. SURIHVVRUD DGMXQWD GR DPSXV HQWUR 2HVWH 'RQD /LQGX GD 8QLYHUVLGDGH )HGHUDO GH 6mR -RmR 'HO 5HL 8)6-
  • 4. 0LQDV *HUDLV %UDVLO 'RDomR H WUDQVSODQWH FRQVWLWXHP XP FRPSOH[R SURFHVVR TXH VH LQLFLD FRP D LGHQWLILFDomR H SDVVD SHOD DYDOLDomR H PD QXWHQomR GR SRWHQFLDO GRDGRU GLDJQyVWLFR GH PRUWH HQFHIi OLFD DERUGDJHP j IDPtOLD GRFXPHQWDomR GR GLDJQyVWLFR GH PRUWH HQFHIiOLFD ORJtVWLFD GR SURFHVVR UHPRomR GRV yUJmRV H WHFLGRV GLVWULEXLomR H ILQDOPHQWH R WUDQVSODQWH 2 SURJUHVVR WHFQROyJLFR R DSHUIHLoRDPHQWR GDV WpFQLFDV FLU~UJLFDV R GHVHQYROYLPHQWR GH LPXQRVVXSUHVVRUHV H D FRPSUHHQVmR LPXQROyJLFD GD FRPSDWLELOLGDGH H UHMHLomR SRVVLELOLWDUDP D WUDQVIRUPDomR GD FODVVLILFDomR GR WUDQV SODQWH GH WUDWDPHQWR H[SHULPHQWDO SDUD R GH WHUDSrXWLFD VHJXUD H HILFD] QR FRQWUROH GDV LQVXILFLrQFLDV WHUPLQDLV GH DOJXQV yUJmRV H IDOrQFLD GH DOJXQV WHFLGRV 1R HQWDQWR R FRQVHQWLPHQWR GD IDPtOLD GRV SDFLHQ WHV FRQVLGHUDGRV GRDGRUHV HP SRWHQFLDO p DWXDOPHQWH D PDLRU OLPLWDomR QR VXFHVVR GH WUDQVSODQWHV GH yUJmRV QR %UDVLO $VVLP p LPSRUWDQWH GLVFXWLU HQWUH RXWUDV 5HY ELRpW ,PSU
  • 5. 9DQHVVD )DULD RUWHV *UDGXDGD HP (QIHUPDJHP SHOD 8QLYHUVLGDGH )HGHUDO GR 5LR GH -DQHLUR 8)5-
  • 6. GRXWRUD HP %LRTXtPLFD SHOD 8)5- SURIHVVRUD DGMXQWD GR DPSXV HQWUR2HVWH 'RQD /LQGX GD 8QLYHUVLGDGH )HGHUDO GH 6mR -RmR 'HO 5HL 8)6-
  • 7. 0LQDV *HUDLV %UDVLO $OED 2WWRQL *UDGXDGD HP (QIHUPDJHP SHOD 8QLYHUVLGDGH )HGHUDO GH 0LQDV *HUDLV 8)0*
  • 8. GRXWRUDQGD HP ,QIHFWRORJLD H 0HGLFLQD 7URSLFDO SHOD 8)0* SURIHVVRUD DVVLVWHQWH GR DPSXV HQWUR2HVWH 'RQD /LQGX GD 8QLYHUVLGDGH )HGHUDO GH 6mR -RmR 'HO 5HL 8)6-
  • 9. 0LQDV *HUDLV %UDVLO TXHVW}HV RV DVSHFWRV pWLFRV HQYROYLGRV QD DERUGDJHP DR IDPLOLDU GR SRWHQFLDO GRDGRU 6RE WDLV SUHPLVVDV R SUHVHQWH DUWLJR FRQVLVWH HP XPD UHIOH[mR WHyULFD TXH SUHWHQGH LGHQWLILFDU TXHVW}HV pWLFDV TXH SRGHULDP LQ IOXHQFLDU QDV WD[DV GH FRQVHQWLPHQWR GH IDPLOLDUHV HP UHODomR j GRDomR GH yUJmRV $VSHFWRV JHUDLV VREUH D GRDomR H R WUDQVSODQWH GH yUJmRV 2 WUDQVSODQWH GH yUJmRV KXPDQRV H HP HVSHFLDO D GRDomR GH yUJmRV VmR WHPDV SROrPLFRV TXH YrP GHVSHUWDQGR LQWH UHVVH H GLVFXVV}HV $ IDOWD GH HVFODUHFLPHQWR GD SRSXODomR RV QRWLFLiULRV VHQVDFLRQDOLVWDV VREUH WUiILFR GH yUJmRV D DX VrQFLD GH SURJUDPDV HIHWLYRV YROWDGRV SDUD D FRQVFLHQWL]DomR GD SRSXODomR H R LQFHQWLYR j FDSWDomR GH yUJmRV FRQWULEXHP SDUD D DWXDO VLWXDomR GH Q~PHUR LQVXILFLHQWH GH GRDGRUHV H VLJQLILFDWLYD SHUGD GH SRWHQFLDLV GRDGRUHV SURORQJDQGR R VRIULPHQWR GH SDFLHQWHV TXH GHSHQGHP GD GRDomR $OpP GD IDOWD GH FRQKHFLPHQWR DFHUFD GR WHPD R WUDQV SODQWH GH yUJmRV DLQGD p XPD WHUDSrXWLFD RQHURVD H LQDFHV VtYHO D JUDQGH SDUWH GD SRSXODomR EUDVLOHLUD 7UD] FRQVLJR GLOHPDV OHJDLV KXPDQLWiULRV H FXOWXUDLV TXH LQIOXHQFLDP GHFLVLYDPHQWH QD YLGD GR UHFHSWRU QR IXWXUR GD FLrQFLD EDVHDGD HP DYDQoRV QDV WHQWDWLYDV GH GHVFREHUWDV GR SUR FHVVR GH FXUD H GH DOWHUQDWLYDV GH WUDWDPHQWR GDV PDLV GLYHUVDV GRHQoDV RP UHODomR DR WLSR GH WUDQVSODQWH H[LVWH XPD VpULH GH FODVVLILFDo}HV GHQWUH HODV R DORWUDQV SODQWH R TXDO FRQVLVWH HP WUDQVSODQWH HQWUH GLIHUHQWHV PHPEURV GD PHVPD HVSpFLH H R [HQRWUDQVSODQWH TXH p R WUDQVSODQWH HQWUH GLIHUHQWHV HVSpFLHV 4XDOTXHU SDFLHQWH FXMD WHUDSrXWLFD IRL DYDOLDGD FRPR LQHILFD] RX D PRUWH HQFHIiOLFD p LPLQHQWH RX Mi RFRUUHX FRQVWLWXL XP GRDGRU HP SRWHQFLDO RQWXGR UHVVDOWDVH TXH D TXHVWmR GR GRDGRU FDGiYHU FRP PRUWH HQFHIiOLFD WUD] PXLWRV FRQIOLWRV QDV UHODo}HV KXPDQDV HQWUH D IDPtOLD GR GRDGRU RV SURILVVLR %LRpWLFD H GRDomR GH yUJmRV QR %UDVLO DVSHFWRV pWLFRV QD DERUGDJHP j IDPtOLD GR SRWHQFLDO GRDGRU
  • 10. QDLV HQYROYLGRV H R UHFHSWRU DEH GHVWDFDU TXH DWXDOPHQWH D PDLRULD GRV yUJmRV SDUD WUDQVSODQWHV VmR SURYHQLHQWHV GH GRDGRUHV FD GiYHUHV H TXH FRP HOHV QmR VH FRQVHJXH VXSULU D GHPDQGD KDMD YLVWD TXH R Q~PHUR GH SDFLHQ WHV IDOHFLGRV FRP TXDGUR GH PRUWH HQFHIiOLFD p EDVWDQWH UHGX]LGR 1R %UDVLO D OHJLVODomR p FODUD H UHTXHU R FRQVHQWLPHQWR GD IDPtOLD SDUD UHPRYHU RV yUJmRV H WHFLGRV SDUD WUDQVSODQWH RX VHMD D GRDomR VRPHQWH DFRQWHFH DSyV DXWRUL]D omR GR UHVSRQViYHO OHJDO 2 WUDQVSODQWH GH yUJmRV H WHFLGRV p UHJXODPHQWDGR SHOD /HL GH GH IHYHUHLUR GH TXH SUH YLX D GRDomR SUHVXPLGD VDOYR PDQLIHVWDomR H[SOtFLWD HP FRQWUiULR SHOR 'HFUHWR GH GH MXQKR GH H SHOD 3RUWDULD GH GH DJRVWR GH GR 0LQLVWpULR GD 6D~GH 06
  • 11. 3RVWHULRUPHQWH R JRYHUQR IHGHUDO HGLWRX PHGLGD SURYLVyULD UHYRJDQGR D GRDomR SUHVXPLGD $VVLP IL FRX HVWDEHOHFLGR TXH D GRDomR GH yUJmRV GHSHQGH GD YRQWDGH GRV IDPLOLDUHV $ WH UDSrXWLFD GH WUDQVSODQWH GH yUJmRV Vy SRGH VHU UHDOL]DGD SRU KRVSLWDLV H HTXLSHV PpGL FDV SUHYLDPHQWH FUHGHQFLDGDV SHOR 6LVWHPD ÔQLFR GH 6D~GH 686
  • 12. RPR GHVFULWR HPERUD Mi UHJXODPHQWDGR H HPEDVDGR SRU WpFQLFDV DYDQoDGDV R WUDQV SODQWH GH yUJmRV H WHFLGRV HQWUH VHUHV KXPD QRV DLQGD HQFRQWUD IRUWHV OLPLWDo}HV SDUD R SOHQR VXFHVVR H XPD GDV SRWHQWHV EDUUHLUDV SDUD HVVH GHVHQYROYLPHQWR p D UHFXVD IDPL OLDU $QWH WDO TXDGUR WRUQDVH UHOHYDQWH GLVFXWLU DVSHFWRV YROWDGRV SDUD R SURFHVVR GH REWHQomR GR FRQVHQWLPHQWR GR IDPLOLDU GR SRWHQFLDO GRDGRU LGHQWLILFDQGRVH DV TXHV W}HV pWLFDV TXH SHUPHLDP HVWH SURFHVVR 3URFHVVR GH REWHQomR GR FRQVHQWLPHQWR SDUD GRDomR GH yUJmRV 2 FRQVHQWLPHQWR WHP UHSUHVHQWDGR LPSRU WDQWH DYDQoR QDV TXHVW}HV HQYROYHQGR R UHV SHLWR j DXWRQRPLD GD SHVVRD H QDV UHODo}HV TXH WDQJHP DV SUiWLFDV FOtQLFDV 1HVVH VHQ WLGR VXD UHOHYkQFLD WHP VLGR LQFRQWHVWiYHO FRQWXGR D SROrPLFD DSDUHFH TXDQGR VH DQD OLVD D IRUPD GH DERUGDJHP GRV VXMHLWRV SDUD D REWHQomR GR PHVPR 8P FRQVHQWLPHQWR REWLGR EXURFUDWLFDPHQWH FRP DVVLQDWXUD H WHVWHPXQKDV WRUQDVH PHUD ILJXUD FDUWR ULDO SHUGHQGR VHX VHQWLGR PDLRU H SRGHQGR VHU YLVWR FRP GHVFRQILDQoD ² SLRUDQGR DR LQYpV GH PHOKRUDU WDLV UHODo}HV 'LIHUHQWH GLVVR p R FRQVHQWLPHQWR RX PHVPR D UHFX VD
  • 13. TXH HPHUJH GH DPSOD H UHVSHLWRVD DQiOLVH HQWUH DV GXDV SDUWHV 8P FRQVHQWLPHQWR QmR SRGH VHU XP IULR GRFXPHQWR GDGR DR VXMHLWR SDUD DVVLQDU (OH GHYH VHU XP FRQMXQWR GH LQIRUPDo}HV FODUDV H REMHWLYDV HP OLQJXDJHP TXH SRVVD VHU HQWHQGLGD PLQXFLRVDPHQWH H[SOLFDGR DR SDFLHQWH RX IDPLOLDU 2 H[HUFtFLR GR FRQ VHQWLPHQWR WHP FRPR SUHVVXSRVWRV D MXQ omR GH HOHPHQWRV WDLV FRPR D DXWRQRPLD D FDSDFLGDGH D YROXQWDULHGDGH D LQIRUPDomR H R HVFODUHFLPHQWR 5HVVDOWHVH TXH GHQWUH HVVHV HOHPHQWRV D LQIRUPDomR VHMD XP GRV PDLV LPSRUWDQWHV H SRU LVVR GHYH VHU FODUD H REMHWLYD HP OLQJXDJHP FRPSDWtYHO FRP R HQWHQGLPHQWR LQGLYLGXDO GH FDGD VXMHLWR 5HY ELRpW ,PSU
  • 14. RQVLGHUDQGRVH R FRQWH[WR GD GRDomR GH yU JmRV QR %UDVLO FDEH GHVWDFDU TXH D UHFXVD IDPL OLDU RX R QmR FRQVHQWLPHQWR IDPLOLDU WHP VLGR D SULQFLSDO UD]mR SDUD D QmR FDSWDomR GH yUJmRV GH SRWHQFLDLV GRDGRUHV $SUR[LPDGDPHQWH PHWDGH GDV IDPtOLDV DERUGDGDV TXDQWR j GRDomR QRV (VWDGRV 8QLGRV GLVVHUDP QmR 1R %UDVLO D WD[D GH UHFXVD FKHJD D QDV UHJL}HV PH QRV GHVHQYROYLGDV GR SDtV 1RVVR VLVWHPD GH GRDomR GH yUJmRV RSHUD GH IRUPD DOWUXtVWLFD H YROXQWiULD QD TXDO RV SD FLHQWHV RX VXDV IDPtOLDV SRGHP HVFROKHU HQ WUH GRDU RX QmR RV yUJmRV DSyV D PRUWH (P FRQWUDVWH FRP R VLVWHPD EUDVLOHLUR YiULRV SDtVHV HXURSHXV WUDWDP GD GRDomR GH yUJmRV EDVHDGRV QR SULQFtSLR GR FRQVHQWLPHQWR SUH VXPLGR RQGH WRGR LQGLYtGXR PRUWR p FRQVL GHUDGR FRPR SRWHQFLDO GRDGRU D PHQRV TXH HP YLGD WHQKD RSWDGR SRU QmR R VHU 0HVPR HP SDtVHV RQGH YLJRUDP OHLV GH FRQVHQWLPHQWR SUHVXPLGR RX TXDQGR R SDFLHQWH p SRUWDGRU GH XP FDUWmR GH GRDGRU HTXLSHVGHFDSWDomRGRPXQGRLQWHLUREXVFDPR FRQVHQWLPHQWR GDV IDPtOLDV SDUD D UHWLUDGD GRV yUJmRV 1HVVD SHUVSHFWLYD FDEH GLVFXWLU TXDLV VmR RV DVSHFWRV pWLFRV TXH SHUPHLDP D SUiWLFD GR FRQVHQWLPHQWR SDUD D GRDomR GH yUJmRV FRQVLGHUDQGRVH TXH QR FRQWH[WR EUDVLOHLUR D DERUGDJHP LQDGHTXDGD DRV IDPLOLDUHV UHSHUFXWH QR DXPHQWR GD WD[D GH UHFXVD GRV PHVPRV $ERUGDJHP j IDPtOLD GR SRWHQFLDO GRDGRU GH yUJmRV DVSHFWRV pWLFRV $ DERUGDJHP j IDPtOLD GHYH VHU IHLWD SRU SURILVVLRQDLV FDSDFLWDGRV PpGLFRV HQIHU PHLURV SVLFyORJRV RX PHVPR DVVLVWHQ WHV VRFLDLV 8P HVWXGR DSRQWRX FRPR IDWRUHV GHWHUPL QDQWHV SDUD D GRDomR GH yUJmRV SHOD IDPt OLD TXHVW}HV VRFLRFXOWXUDLV WDLV FRPR HWQLD FUHQoDV UHOLJLRVDV QtYHLV VRFLRHFRQ{PLFR H GH LQIRUPDomR VREUH GRDomR H WUDQVSODQWHV FRQKHFLPHQWR GR VWDWXV GH GRDGRU GR PRU WR H[SHULrQFLD SUpYLD GD IDPtOLD FRP GRD omR RX WUDQVSODQWH FUHGLELOLGDGH QR VLVWHPD GH WUDQVSODQWH H GLVWULEXLomR GH yUJmRV JUDX GH VDWLVIDomR FRP R DWHQGLPHQWR PpGLFR H GH HQWHQGLPHQWR VREUH D PRUWH HQFHIiOLFD FRQGLo}HV H R PRPHQWR GD DERUGDJHP GD IDPtOLD JUDX GH WUHLQDPHQWR GR HQWUHYLV WDGRU H[SOLFDo}HV VREUH FXVWRV H R IXQHUDO OHJLVODomR GH FRQVHQWLPHQWR SUHVXPLGR H FDPSDQKDV HGXFDFLRQDLV 6HJXQGR DV 'LUHWUL]HV EiVLFDV SDUD D FDS WDomR H UHWLUDGD GH P~OWLSORV yUJmRV H WHFLGRV GD $VVRFLDomR %UDVLOHLUD GH 7UDQVSODQWH GH ÐUJmRV $%72
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