Adolescência, sigilo médico e exposição ”“ Revisão bibliográfica
DOI:
https://doi.org/10.26512/rbb.v15.2019.29724Palavras-chave:
Sigilo médico, Adolescência, Mídias sociais, Relação médico-pacienteResumo
Ao associar três temas relevantes e recorrentes na atualidade, com a prática médica e seus aspectos bioéticos sobre o atendimento, busca-se entender para prover uma assistência médica de qualidade e que respeite a confidencialidade e o pudor de pacientes adolescentes. A exposição nas redes sociais impacta a vida desses jovens de maneiras positivas e negativas. Os pais desempenham também um papel-chave quando se trata de atendimentos médicos. A garantia de sigilo nos atendimentos e repercussões clínicas de cada quadro, é o principal motor que impulsiona os jovens a buscarem auxílio médico, caso contrário negligenciam seu estado de saúde, por receio de que a confidencialidade possa ser quebrada. Há situações, nas quais o médico deverá levar em conta a segurança da vida do adolescente e considerar os alicerces bioéticos da profissão ao justificar o rompimento do sigilo.
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Referências
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Bourke J, Wessely S. Confidentiality. The BMJ. 2008; 336:888.
Brasil. Conselho Federal De Medicina. Código de Ética Médica. Resolução CFM nº 2.217, de 27/09/2018, modificada pelas Resoluções CFM nº 2.222/2018 e 2.226/2019/ Conselho Federal de Medicina ”“ Brasília: Conselho Federal de Medicina, 2019 (versão de bolso). 108 p. 15 cm.
Brasil. Ministério da Justiça. Lei nº 8.069, de 13/07/1990. Dispõe sobre o Estatuto da Criança e do Adolescente e dá outras providências. Brasília: Legislativo; 13/07/1990.
Braverman PK, Adelman WP, Alderman EM, Breuner CC, Levine DA, Marcell AV, O’Brien R. The adolescent's right to confidential care when considering abortion. Pediatrics. 2017; 139(2). Acessível em https://pediatrics.aappublications.org/content/pediatrics/139/2/e20163861.full.pdf
Burrows J, Echeverría CB, Goic AG, Herrera CC, Quintana CV, Rojas AO, Ruiz-Esquide G, Salinas RR, Serani AM, Taboada PR, Vacarezza RY El respeto a la intimidad del paciente. Revista médica de Chile 2014; 142(4): 506-511. Acessível em https://scielo.conicyt.cl/pdf/rmc/v142n4/art13.pdf
Chacko MR. Contraception: Issues specific to adolescents. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/contraception-issues-specific-to-adolescents?search=bioetica%20adolescentes&topicRef=5459&source=see_link
Chassiakos YR, Radesky J, Christakis D, Moreno MA, Cross C. Children and Adolescents and Digital Media. Pediatrics. 2016; 138(5). Acessível em https://pediatrics.aappublications.org/content/pediatrics/138/5/e20162593.full.pdf
Conti AA. From informed consent to informed dissent in health care: historical evolution in the twentieth century. Acta Biomed 2017; 88(2): 201-3. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166155/pdf/ACTA-88-201.pdf
Copen CE, Dittus PJ, Leichliter JS. Confidentiality concerns and sexual and reproductive health care among adolescents and young adults aged 15”“25. NCHS (National Center for Health Statistics) data brief 2016; 266. Acessível em https://www.cdc.gov/nchs/data/databriefs/db266.pdf
Coyne SM, Radesky J, Collier KM, Gentile DA, Linder JR, Nathanson AI, Rasmussen EE, Reich SM, Rogers J. Parenting and Digital Media. Pediatrics 2017; 140(2):112-6. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S112.full.pdf
Dake JA, Price JH, Maziarz L, Ward B. Prevalence and Correlates of Sexting Behavior in Adolescents. American Journal of Sexuality Education 2012; 7-1: 1-15. Acessível em https://www.tandfonline.com/doi/full/10.1080/15546128.2012.650959?scroll=top&needAccess=true
Eleuteri S, Saladino V, Verrastro V. Identity, relationships, sexuality, and risky behaviors of adolescents in the context of social media, Sexual and Relationship Therapy 2014; 32(3-4): 354-65.
Elster A. Guidelines for adolescent preventive services. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/guidelines-for-adolescent-preventive-services
Fortenberry JD. Sexually transmitted infections: Issues specific to adolescents. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/sexually-transmitted-infections-issues-specific-to-adolescents#H1
Gilbert AL, McCord AL, Ouyang F, Etter DJ, Williams RL, Hall JA, Tu W, Downs SM, Aalsma MC. Characteristics Associated with Confidential Consultation for Adolescents in Primary Care. The Jornal of Pediatrics. 2018; 199: 79-84. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063778/pdf/nihms945680.pdf
Gillespie SL. The adolescent with HIV infection. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/the-adolescent-with-hiv-infection
Hornberger LL and AAP Committee On Adolescence. Diagnosis of Pregnancy and Providing Options Counseling for the Adolescent Patient. Pediatrics. 2017;140(3)
Kayaalp M. Patient Privacy in the Era of Big Data. Balkan Medical Journal. 2018; 35(1):8-17. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820452/pdf/BMJ-35-8.pdf
Kennebeck S, Bonin L. Suicidal ideation and behavior in children and adolescents: Evaluation and management. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-children-and-adolescents-evaluation-and-management?source=related_link
Klosky JL, Flynn JS, Lehmann V, Russell KM, Wang F, Robin N. Hardin RN, Eddinger JR, Zhang H, Schenck LAM, Schover LR. Parental influences on sperm banking attempts among adolescent males newly diagnosed with cancer. Fertility and Sterility 2017; 108(6):1043”“9. Acessível em https://www.fertstert.org/article/S0015-0282(17)31904-0/pdf
LeBourgeois MK, Hale L, Chang AM, Akacem LD, Montgomery-Downs HE, Buxton OM. Digital Media and Sleep in Childhood and Adolescence. Pediatrics 2017; 140(2): 92-96. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658795/pdf/PEDS_20161758J.pdf
Lippman JR, Campbell SW. Damned If You Do, Damned If You Don't…If You're a Girl: Relational and Normative Contexts of Adolescent Sexting in the United States, Journal of Children and Media 2014; 8(4):371-86. Acessível em https://www.tandfonline.com/doi/pdf/10.1080/17482798.2014.923009?needAccess=true
Middleman AB, Olson KO. Confidentiality in adolescent health care. Upto Date. Dec 2019. Acessível em https://www.uptodate.com/contents/confidentiality-in-adolescent-health-care?search=bioetica%20adolescentes&topicRef=107&source=related_link
Miller E, Wiemann CM. Adolescent relationship abuse including physical and sexual teen dating violence. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/adolescent-relationship-abuse-including-physical-and-sexual-teen-dating-violence
Nicholas S, Stephens R. Implications of consent for medical practice. British Journal of Hospital Medicine, June 2017; 78(6).
Olson KA, Middleman AB. Consent in adolescent health care. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/consent-in-adolescent-health-care?search=bioetica%20adolescentes&topicRef=106&source=related_link
Ouytsel JV, Gool EV, Walrave M, Ponnet K, Peeters E. Sexting: adolescents’ perceptions of the applications used for, motives for, and consequences of sexting, Journal of Youth Studies 2016; 20(4): 446-70. Acessível em https://www.tandfonline.com/doi/full/10.1080/13676261.2016.1241865?scroll=top&needAccess=true
Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL, Wartella E. Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics 2017; 140(2): 97-101. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S97.full.pdf
Romer D, Moreno M. Digital Media and Risks for Adolescent Substance Abuse and Problematic Gambling. Pediatrics 2017; 140(2):102-6. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S102.full.pdf
Taquette SR, Vilhena MM, Silva MM, Vale MP. Conflitos éticos no atendimento à saúde de adolescentes. Caderno de Saúde Pública 2005; 21(6):1717-25, Acessível em http://www.scielo.br/pdf/csp/v21n6/09.pdf
Timimi FK. Medicine, morality and health care social media. BMC Medicine 2012; 10:83. Acessível em https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/1741-7015-10-83
Uhls YT, Ellison NB, Subrahmanyam K. Benefits and Costs of Social Media in Adolescence. Pediatrics 2017; 140(2):67-70. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S67.full.pdf
Vanderhoven E, Schellens T, Valcke M, Raes A. How Safe Do Teenagers Behave on Facebook? An Observational Study. PLoS ONE. 2014; 9(8). Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146465/pdf/pone.0104036.pdf
Velden MVD, Emam KE. "Not all my friends need to know": a qualitative study of teenage patients, privacy, and social media. Journal of the American Medical Informatics Association. 2013; 20(1):16-24. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555319/pdf/amiajnl-2012-000949.pdf
Wilson J, Ogeil RP, Lam T, Lenton S, Lloyd B, Burns L, Aiken A, Gilmore W, Chikritzhs T, Mattick R, Lubman DI, Allsop S. Re-thinking pre-drinking: Implications from a sample of teenagers who drink in private settings. International Journal of Drug Policy 2018; 52:20-4. Acessível em https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0955395917303535/first-page-pdf
Bittencourt ALP, França LG, Goldim JR. Adolescência vulnerável: fatores biopsicossociais relacionados ao uso de drogas. Revista de bioética 2015; 23(2): 311-9.
Bourke J, Wessely S. Confidentiality. The BMJ. 2008; 336:888.
Brasil. Conselho Federal De Medicina. Código de Ética Médica. Resolução CFM nº 2.217, de 27/09/2018, modificada pelas Resoluções CFM nº 2.222/2018 e 2.226/2019/ Conselho Federal de Medicina ”“ Brasília: Conselho Federal de Medicina, 2019 (versão de bolso). 108 p. 15 cm.
Brasil. Ministério da Justiça. Lei nº 8.069, de 13/07/1990. Dispõe sobre o Estatuto da Criança e do Adolescente e dá outras providências. Brasília: Legislativo; 13/07/1990.
Braverman PK, Adelman WP, Alderman EM, Breuner CC, Levine DA, Marcell AV, O’Brien R. The adolescent's right to confidential care when considering abortion. Pediatrics. 2017; 139(2). Acessível em https://pediatrics.aappublications.org/content/pediatrics/139/2/e20163861.full.pdf
Burrows J, Echeverría CB, Goic AG, Herrera CC, Quintana CV, Rojas AO, Ruiz-Esquide G, Salinas RR, Serani AM, Taboada PR, Vacarezza RY El respeto a la intimidad del paciente. Revista médica de Chile 2014; 142(4): 506-511. Acessível em https://scielo.conicyt.cl/pdf/rmc/v142n4/art13.pdf
Chacko MR. Contraception: Issues specific to adolescents. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/contraception-issues-specific-to-adolescents?search=bioetica%20adolescentes&topicRef=5459&source=see_link
Chassiakos YR, Radesky J, Christakis D, Moreno MA, Cross C. Children and Adolescents and Digital Media. Pediatrics. 2016; 138(5). Acessível em https://pediatrics.aappublications.org/content/pediatrics/138/5/e20162593.full.pdf
Conti AA. From informed consent to informed dissent in health care: historical evolution in the twentieth century. Acta Biomed 2017; 88(2): 201-3. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166155/pdf/ACTA-88-201.pdf
Copen CE, Dittus PJ, Leichliter JS. Confidentiality concerns and sexual and reproductive health care among adolescents and young adults aged 15”“25. NCHS (National Center for Health Statistics) data brief 2016; 266. Acessível em https://www.cdc.gov/nchs/data/databriefs/db266.pdf
Coyne SM, Radesky J, Collier KM, Gentile DA, Linder JR, Nathanson AI, Rasmussen EE, Reich SM, Rogers J. Parenting and Digital Media. Pediatrics 2017; 140(2):112-6. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S112.full.pdf
Dake JA, Price JH, Maziarz L, Ward B. Prevalence and Correlates of Sexting Behavior in Adolescents. American Journal of Sexuality Education 2012; 7-1: 1-15. Acessível em https://www.tandfonline.com/doi/full/10.1080/15546128.2012.650959?scroll=top&needAccess=true
Eleuteri S, Saladino V, Verrastro V. Identity, relationships, sexuality, and risky behaviors of adolescents in the context of social media, Sexual and Relationship Therapy 2014; 32(3-4): 354-65.
Elster A. Guidelines for adolescent preventive services. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/guidelines-for-adolescent-preventive-services
Fortenberry JD. Sexually transmitted infections: Issues specific to adolescents. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/sexually-transmitted-infections-issues-specific-to-adolescents#H1
Gilbert AL, McCord AL, Ouyang F, Etter DJ, Williams RL, Hall JA, Tu W, Downs SM, Aalsma MC. Characteristics Associated with Confidential Consultation for Adolescents in Primary Care. The Jornal of Pediatrics. 2018; 199: 79-84. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063778/pdf/nihms945680.pdf
Gillespie SL. The adolescent with HIV infection. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/the-adolescent-with-hiv-infection
Hornberger LL and AAP Committee On Adolescence. Diagnosis of Pregnancy and Providing Options Counseling for the Adolescent Patient. Pediatrics. 2017;140(3)
Kayaalp M. Patient Privacy in the Era of Big Data. Balkan Medical Journal. 2018; 35(1):8-17. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820452/pdf/BMJ-35-8.pdf
Kennebeck S, Bonin L. Suicidal ideation and behavior in children and adolescents: Evaluation and management. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-children-and-adolescents-evaluation-and-management?source=related_link
Klosky JL, Flynn JS, Lehmann V, Russell KM, Wang F, Robin N. Hardin RN, Eddinger JR, Zhang H, Schenck LAM, Schover LR. Parental influences on sperm banking attempts among adolescent males newly diagnosed with cancer. Fertility and Sterility 2017; 108(6):1043”“9. Acessível em https://www.fertstert.org/article/S0015-0282(17)31904-0/pdf
LeBourgeois MK, Hale L, Chang AM, Akacem LD, Montgomery-Downs HE, Buxton OM. Digital Media and Sleep in Childhood and Adolescence. Pediatrics 2017; 140(2): 92-96. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5658795/pdf/PEDS_20161758J.pdf
Lippman JR, Campbell SW. Damned If You Do, Damned If You Don't…If You're a Girl: Relational and Normative Contexts of Adolescent Sexting in the United States, Journal of Children and Media 2014; 8(4):371-86. Acessível em https://www.tandfonline.com/doi/pdf/10.1080/17482798.2014.923009?needAccess=true
Middleman AB, Olson KO. Confidentiality in adolescent health care. Upto Date. Dec 2019. Acessível em https://www.uptodate.com/contents/confidentiality-in-adolescent-health-care?search=bioetica%20adolescentes&topicRef=107&source=related_link
Miller E, Wiemann CM. Adolescent relationship abuse including physical and sexual teen dating violence. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/adolescent-relationship-abuse-including-physical-and-sexual-teen-dating-violence
Nicholas S, Stephens R. Implications of consent for medical practice. British Journal of Hospital Medicine, June 2017; 78(6).
Olson KA, Middleman AB. Consent in adolescent health care. UptoDate. Dec 2019. Acessível em https://www.uptodate.com/contents/consent-in-adolescent-health-care?search=bioetica%20adolescentes&topicRef=106&source=related_link
Ouytsel JV, Gool EV, Walrave M, Ponnet K, Peeters E. Sexting: adolescents’ perceptions of the applications used for, motives for, and consequences of sexting, Journal of Youth Studies 2016; 20(4): 446-70. Acessível em https://www.tandfonline.com/doi/full/10.1080/13676261.2016.1241865?scroll=top&needAccess=true
Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL, Wartella E. Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics 2017; 140(2): 97-101. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S97.full.pdf
Romer D, Moreno M. Digital Media and Risks for Adolescent Substance Abuse and Problematic Gambling. Pediatrics 2017; 140(2):102-6. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S102.full.pdf
Taquette SR, Vilhena MM, Silva MM, Vale MP. Conflitos éticos no atendimento à saúde de adolescentes. Caderno de Saúde Pública 2005; 21(6):1717-25, Acessível em http://www.scielo.br/pdf/csp/v21n6/09.pdf
Timimi FK. Medicine, morality and health care social media. BMC Medicine 2012; 10:83. Acessível em https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/1741-7015-10-83
Uhls YT, Ellison NB, Subrahmanyam K. Benefits and Costs of Social Media in Adolescence. Pediatrics 2017; 140(2):67-70. Acessível em https://pediatrics.aappublications.org/content/pediatrics/140/Supplement_2/S67.full.pdf
Vanderhoven E, Schellens T, Valcke M, Raes A. How Safe Do Teenagers Behave on Facebook? An Observational Study. PLoS ONE. 2014; 9(8). Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146465/pdf/pone.0104036.pdf
Velden MVD, Emam KE. "Not all my friends need to know": a qualitative study of teenage patients, privacy, and social media. Journal of the American Medical Informatics Association. 2013; 20(1):16-24. Acessível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555319/pdf/amiajnl-2012-000949.pdf
Wilson J, Ogeil RP, Lam T, Lenton S, Lloyd B, Burns L, Aiken A, Gilmore W, Chikritzhs T, Mattick R, Lubman DI, Allsop S. Re-thinking pre-drinking: Implications from a sample of teenagers who drink in private settings. International Journal of Drug Policy 2018; 52:20-4. Acessível em https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0955395917303535/first-page-pdf
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2020-06-23
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Navascués Rodrigues, T., & Rosa Fernandes, J. (2020). Adolescência, sigilo médico e exposição ”“ Revisão bibliográfica. Revista Brasileira De Bioética, 15, 1–18. https://doi.org/10.26512/rbb.v15.2019.29724
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