https://doi.org/10.4081/mem.2009.257

Il Parere del Comitato Nazionale per la Bioetica su rifiuto e rinuncia consapevole al trattamento sanitario

V. 58 N. 1 (2009)
Pubblicato: febbraio 28, 2009
Consenso informato, rifiuto delle cure, principio di autonomia, rapporto medico-paziente / Informed consent, treatment refusal, principle of autonomy, physician- patient relationship
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Autori

Marina Casini
marina.casini@rm.unicatt.it
Ricercatore, Italy.
Emma Traisci
Dottoranda di ricerca, Italy.
Fabio Persano
Dottorando di ricerca, Istituto di Bioetica, Facoltà di Medicina e Chirurgia "A. Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy.
Il presente lavoro costituisce un'analisi e un commento del Parere del Comitato Nazionale per la Bioetica (CNB) dal titolo "Rifiuto e rinuncia consapevole al trattamento sanitario nella relazione paziente-medico", approvato il 24 ottobre 2008. La prima parte del contributo descrive sinteticamente la struttura e il contenuto del documento, il cui oggetto, secondo le parole dello stesso CNB, è così individuato: "rifiuto o rinuncia consapevole, totale o parziale, a trattamenti sanitari non iniziati o già intrapresi manifestata da un paziente informato e pienamente capace di intendere e di volere, e rivolta al medico (o all'èquipe medica), titolare di fondamentali obblighi giuridici e deontologici e sotto la cui responsabilità il trattamento è in atto". Operata questa prima delimitazione, la successiva importante distinzione che viene effettuata è tra un paziente autonomamente in grado di sottrarsi alla terapia indesiderata e un paziente che si trova in condizioni di dipendenza tali da rendere necessario l'intervento di un altro soggetto (il medico) per realizzare l'interruzione della cura. L'ultima parte del Parere presenta le "Conclusioni" che sintetizzano le riflessioni svolte ed espongono i profili di convergenza all'interno del Comitato. Gli Autori del contributo procedono quindi ad un'analisi critica del Parere a partire da queste "Conclusioni", concentrando in particolare l'attenzione sulla distinzione, già messa in risalto, tra autonomia e dipendenza. Viene così evidenziato, da una parte, in relazione alla prima situazione, l'autentico fondamento dell'agire medico, anche in rapporto al consenso informato; dall'altra parte, riguardo alla situazione di dipendenza, si riafferma il valore giuridico del bene "vita" ed il ruolo dell'operatore sanitario per la tutela di essa.
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The present work constitutes of analysis and comment on the Advice of the Council on Bioethics entitled: "Conscious refusal and renunciation to medical care in the physician-patient relation", approved on October 24th, 2008. The first part of this work describes synthetically the structure and the contents of the Advice, the object of which, according to the words of the same CNB, is: "The conscious refusal and renunciation, totally or partially, of medical care not started or already started by an informed and capable patient and directed to a physician, holder of fundamental legal obligation and medical ethics under whose responsibility the medical care is already in progress". After this first delimitation, the succeeding important distinctions that come into effect between a patient who autonomously refuses the undesired therapy and a patient who is found in a state of dependence which requires the intervention of another subject (the doctor) to realize the interruption of the cure. The last part of the work presents the conclusions which synthesize the reflections made and the areas of overlap inside the Committee. The Authors proceed therefore to a critical analysis of the document apart from the conclusion, concentrating particular attention on the distinction already made between autonomy and dependence. They furthermore, in relation to the first situation, emphasize the authentic foundation of the medical act as it relates to informed consent; from another part, regarding the situation of dependence, they reaffirm the importance of life and the role of the physician in preserving it.

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Come citare

Casini, M., Traisci, E., & Persano, F. (2009). Il Parere del Comitato Nazionale per la Bioetica su rifiuto e rinuncia consapevole al trattamento sanitario. Medicina E Morale, 58(1). https://doi.org/10.4081/mem.2009.257

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