Direito à boa morte como estratégia na promoção do cuidado em saúde

Abstract

Objective: to analyze in the scientific literature how good death/euthanasia and therapeutic co-responsibility are addressed in medical training. Methodology: This is an integrative literature review, focused on the themes of euthanasia, comprehensive health care, autonomy and medical education. The research was conducted on four platforms: Google Scholar, Scielo, Pubmed and Portal BVS. Results: 242 eligible titles were found, after applying the inclusion and exclusion criteria, 49 articles were included for the full reading of the studies that met the analysis criteria. Three thematic categories emerged, namely: Euthanasia, Comprehensive Health and Medical Education. Final considerations: The study shows the scarcity in the approach to the theme of euthanasia in medical education, as well as the difficulty of these professionals when dealing with the end of life, in addition to pointing out the need for a national policy that supports diverse scenarios, based on a model of good death that proposes to unconditionally welcome the patient, promoting a higher quality of life at a time of lower quality of life for these people. Although incipient, studies are unanimous in recognizing the right of individuals to decide the course of their lives and bodies, especially when in terminal conditions, shedding light on ethical principles of dignity and autonomy for a stance of non-omission in the face of human suffering during the most difficult phase of life, ensuring respect for self-determination. They also point out that the lack of autonomy causes suffering and that the production of comprehensive health care is a dialogical practice, which should be based on therapeutic co-responsibility. Therefore, it is essential to give centrality to the construction of good end-of-life practices and therapeutic co-responsibility/patient autonomy in all areas, especially in academic training, in order to overcome the paternalistic biomedical model focused on cure and to have comprehensive patient care as a therapeutic horizon.