De Oliveira Reinaldo Ayer, Oselka Gabriel, Cohen Cláudio, Costa Sérgio ibiapina Ferreira
São Paulo University Faculty of Medicine, São Paulo, Brazil.
J Int Bioethique. 2008 Mar-Jun;19(1-2):157-64, 204.
Clinical bioethics was born out of the need to introduce different ethical values involved in the relationships among physician, patient and health institutions which are outside the technical-scientific framework of routine medical practice. Physicians tend to adopt the norms and rules provided for in the Medical Ethics Code to guide the exercising of their professional practice. However, it has recently become challenging to apply these norms to all conduct since some issues faced in the professional practice are simply not provided for by such norms. Ethical consideration in practice drawing solely on the medical ethics code in Brazil has proved insufficient, both in the context of universal issues such as organ transplants, start and end-of-life, as well as in addressing specific issues such as allocation of funds for health. Clinical bioethics employs clinical cases and situations as an instrument for discussion. These discussions entail analysis of not only the facts and circumstances surrounding each case, but also the values which lead to patients, health teams and institutions opting to recommend, accept or refuse a given conduct.
临床生物伦理学源于在医生、患者和医疗机构之间的关系中引入不同伦理价值观的需求，这些关系超出了常规医疗实践的技术科学框架。医生倾向于采用医学伦理准则中规定的规范和规则来指导他们的专业实践。然而，最近将这些规范应用于所有行为变得具有挑战性，因为专业实践中面临的一些问题根本没有被此类规范所涵盖。仅依据巴西医学伦理准则进行实践中的伦理考量已被证明是不够的，无论是在器官移植、生命起始与终结等普遍问题的背景下，还是在解决诸如卫生资金分配等具体问题时。临床生物伦理学将临床病例和情况用作讨论的工具。这些讨论不仅需要分析每个病例周围的事实和情况，还需要分析导致患者、医疗团队和机构选择推荐、接受或拒绝特定行为的价值观。
