Perspectives""Advance Care Planning in Brazil

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTARDELLI, Natalia Rocha
dc.contributor.authorFORTE, Daniel Neves
dc.contributor.authorVIDAL, Edison Iglesias de Oliveira
dc.date.accessioned2024-02-15T14:55:57Z
dc.date.available2024-02-15T14:55:57Z
dc.date.issued2023
dc.description.abstractBrazil is a country of continental size marked by extreme social inequalities. Its regulation of Advance Directives (AD) was not enacted by law but within the scope of the norms that govern the relationships between patients and physicians, as a resolution of the Federal Medical Council without any specific requirement for notarization. Despite this innovative starting point, most of the debate regarding Advance Care Planning (ACP) in Brazil has been dominated by a legal transactional approach focused on making decisions in advance and the creation of AD. Yet, other novel ACP models have recently emerged in the country with a focus on the creation of a specific quality of relationship between patients, families, and physicians aiming at the facilitating future decision-making. Most of the education on ACP in Brazil happens in the context of palliative care courses. As such, most ACP conversations are performed within palliative care services or by healthcare professionals with training in that area. Hence, the scarce access to palliative care services in the country means that ACP is still rare and that those conversations usually happen late in the course of disease. The authors posit that the existing paternalistic healthcare culture is one of the most important barriers to ACP in Brazil and envision with great concern the risk that its combination with extreme health inequalities and the lack of healthcare professionals' education on shared decision-making could lead to the misuse of ACP as a form of coercive practice to reduce healthcare use by vulnerable populations.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.description.sponsorshipSao Paulo Research Foundation (FAPESP) [2022/14878-7]
dc.description.sponsorshipBrazilian National Council for Scientific and Technological Development (CNPq) [312499/2022-1]
dc.identifier.citationZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN, v.180, p.43-49, 2023
dc.identifier.doi10.1016/j.zefq.2023.04.010
dc.identifier.eissn2212-0289
dc.identifier.issn1865-9217
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58226
dc.language.isoeng
dc.publisherELSEVIER GMBHeng
dc.relation.ispartofZeitschrift Fur Evidenz Fortbildung und Qualitaet Im Gesundheitswesen
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright ELSEVIER GMBHeng
dc.subjectAdvance Care Planningeng
dc.subjectProactive health planningeng
dc.subjectAdvance directiveseng
dc.subjectBrazileng
dc.subjectRevieweng
dc.subject.otherphysician orderseng
dc.subject.otherlifeeng
dc.subject.otherpolsteng
dc.subject.otherendeng
dc.subject.otherlaweng
dc.subject.wosHealth Policy & Serviceseng
dc.titlePerspectives""Advance Care Planning in Brazileng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalTARDELLI, Natalia Rocha:Sao Paulo State Univ UNESP, Botucatu Med Sch, Internal Med Dept, Geriatr Div, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, Brazil
hcfmusp.author.externalVIDAL, Edison Iglesias de Oliveira:Sao Paulo State Univ UNESP, Botucatu Med Sch, Internal Med Dept, Geriatr Div, Av Prof Mario Rubens Guimaraes Montenegro S-N, BR-18618687 Botucatu, SP, Brazil
hcfmusp.citation.scopus4
hcfmusp.contributor.author-fmusphcDANIEL NEVES FORTE
hcfmusp.description.beginpage43
hcfmusp.description.endpage49
hcfmusp.description.volume180
hcfmusp.origemWOS
hcfmusp.origem.pubmed37380546
hcfmusp.origem.scopus2-s2.0-85163890335
hcfmusp.origem.wosWOS:001116845900001
hcfmusp.publisher.cityMUNICHeng
hcfmusp.publisher.countryGERMANYeng
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