Nedy Maria Branco Cerqueira Neves

Uso de substâncias psicoativas entre estudantes de Medicina de Salvador (BA)

Background: Studies have shown that medical students consume psychoactive substances at the same rates as the same age youth on general population, despite their predictable knowledge about drugs effects. Objective: To analyze the local pattern of psychoactive substances use among medical students and contribute for the formulation of preventive activities. Methods: The frequency of psychoactive substances use was evaluated by a self-administered anonymous questionnaire that also asked the main reasons for that use. Four hundred and four students in the first to sixth year from the two biggest medical schools in Salvador answered the questionnaire. Results: The lifetime use was bigger for alcohol (92.8%) and inhalant (46.2%). Alcohol use was constant for the students from first to sixth year of course, but it was not statistically significant (p > 0.05). However, tobacco, inhalants and tranquilizers use had a significant increase at the last two years of course students (p < 0.05). It was verified a bigger drugs use by the male gender. “Fun” was shown as the first main reason for psychoactive substances (58.7% of the valid answers). Conclusion: Psychoactive substances consume rates by medical students from Salvador are as high as the ones shown on other scientific researches about this subject.

Conhecimento e interesse em ética médica e bioética na graduação médica

OBJECTIVES: To evaluate the interest and knowledge about Medical Ethics and Bioethics in medical graduation. METHODS: Transversal and descriptive study. Two different questionnaires were applied with questions about the interest in Medical Ethics and Bioethics and the knowledge about the Brazilian Code of Medical Ethics (CME), one to professors and the other to students. RESULTS: One hundred and one professors and 331 students answered the questionnaires. The Brazilian CME had been read by 86.2% of the teachers and by 100% of the students. The importance given to the discipline Medical Ethics, on a scale from 1 to 5, was similar among teachers and students (4.7 ± 0.7 vs. 4.5 ± 0.8; p = 0.086); however the self-evaluation on knowledge about this subject was higher in the first group (3.4 ± 0.9 vs. 3.2 ± 0.7; p = 0.017). In a block with 9 questions, the right answer was given by 5,0 ± 1.9 of teachers and 5.9 ± 1.5 of students (p < 0,001); the mean of correct answers were related to the reading of the CME. CONCLUSIONS: The present study presents unpublished data about the perception of medical teachers and students about medical ethics and bioethics and can be useful for improving the teaching of these disciplines in our medical schools.

Análise do erro médico em processos ético-profissionais: implicações na educação médica

The objective of this work was to evaluate the characteristics of Professional Ethics Investigations with denouncement of a medical error and to discuss the importance of medical education for its prevention. The main article of the Brazilian Code of Medical Ethics characterizing the medical error is article 29. In this descriptive study we reviewed all investigations carried out in the Regional Council of Medicine of the State of Bahia (Cremeb) from 2000 to 2004. From the 372 doctors investigated by the Cremeb during the period, 42.7% (n = 159) were denounced according to article 29. From these, most were male (78.6%) and the medium age was of 44 years. The most frequent specialties were: Gynecology-obstetrics (24.8%), General Surgery (9.4%) and Anesthesiology (7.4%). Most of the accusations referred to medical errors occurred in public services (80.1%, n = 109) and were related to surgical interventions (66.0%, n = 97). Negligence was identified in 67.3% (n = 107) of the accusations, imprudence in 23.3% (n = 37) and inability in 8.8% (n = 14). Only 23.9% (n = 38) were considered guilty as charged while 31.4% (n = 50) were absolved due to lack of proofs and 44.0% (n = 70) for proven innocence. We conclude that medical errors, mostly due to negligence, are a frequent cause of accusations against doctors at Cremeb, a fact showing the need of this subject being more discussed and valued in the medicine course.

Reflexões sobre os juramentos utilizados nas faculdades médicas do Brasil

PURPOSE: Evaluate the graduation oaths (GO) administered in Brazilian medical schools. METHODS: Descriptive study covering graduations in Brazilian medical schools up to the year 2004. A questionnaire was sent to the dean of each university using three different attempts of contact: mail, fax and e-mail. RESULTS: From a total of 96 contacted universities, 48 (51,1%) answered to the questionnaire, 25 of which (52,1%) public institutions. All medical schools administer some oath during the course. In relation to the text used: 44 universities (91,7%) used the Hippocratic Oath or updated versions. Thirty eight answers to the questionnaire (79,2%) forwarded the entire text of the oath allowing to analyze its content. The most frequently mentioned principles were beneficence, non-maleficence (94,7%) and confidentiality (97,4%). Only one oath expressed the principle of autonomy of the patient and none of them the principle of justice. CONCLUSIONS: The use of the GO is very common in Brazilian medical schools. However, unlike to what is observed in other countries, the greater part of texts are still based on the Hippocratic Oath and do not address current relevant ethical and bioethical principles.

Reflexões bioéticas sobre a eutanásia a partir de caso paradigmático

Bioethical reflections on euthanasia: analysis of a paradigmatic case Recently, a fact that occurred in the city of Curitiba/PR caused a huge national impact and raised questions about euthanasia, a controversial topic that is rarely discussed by the population, what led the realization of this article. The objective of this work is to analyze bioethical aspects involved in death process: euthanasia, orthotanasia and the principle of autonomy. This is a reflective literature review based on an article published in the media that shows the point of view of medical students on this topic. The euthanasia is considered an illegal practice according to national legislation and goes against the medicine principles, since the professio nals in this field are trained to work for the maintenance of life. Orthotanasia should not be confused with that practice, and it seems to be the best way to be adopted by patients with terminal diseases and intense mental and physical pain.

Bioethical reflections on euthanasia: analysis of a paradigmatic case

Bioethical reflections on euthanasia: analysis of a paradigmatic case Recently, a fact that occurred in the city of Curitiba/PR caused a huge national impact and raised questions about euthanasia, a controversial topic that is rarely discussed by the population, what led the realization of this article. The objective of this work is to analyze bioethical aspects involved in death process: euthanasia, orthotanasia and the principle of autonomy. This is a reflective literature review based on an article published in the media that shows the point of view of medical students on this topic. The euthanasia is considered an illegal practice according to national legislation and goes against the medicine principles, since the professio nals in this field are trained to work for the maintenance of life. Orthotanasia should not be confused with that practice, and it seems to be the best way to be adopted by patients with terminal diseases and intense mental and physical pain.

Reflexiones bioéticas acerca de la eutanásia a partir de un caso paradigmático

Bioethical reflections on euthanasia: analysis of a paradigmatic case Recently, a fact that occurred in the city of Curitiba/PR caused a huge national impact and raised questions about euthanasia, a controversial topic that is rarely discussed by the population, what led the realization of this article. The objective of this work is to analyze bioethical aspects involved in death process: euthanasia, orthotanasia and the principle of autonomy. This is a reflective literature review based on an article published in the media that shows the point of view of medical students on this topic. The euthanasia is considered an illegal practice according to national legislation and goes against the medicine principles, since the professio nals in this field are trained to work for the maintenance of life. Orthotanasia should not be confused with that practice, and it seems to be the best way to be adopted by patients with terminal diseases and intense mental and physical pain.