Brazil: Transparência nas relações entre médicos e indústria e disponibilização de prontuário a juízes estão entre as principais mudanças no novo Código de Ética Médica

São louváveis os avanços e atualizações do novo Código de Ética Médica, mas é preciso assegurar que instrumentos processuais sejam efetivamente aplicados, para que se garanta que o exame do prontuário pelo Juiz da causa não ocorra em prejuízo do sigilo garantido constitucionalmente a tal documento, não podendo ser permitido o acesso indevido a informações de saúde por seguradoras, potenciais empregadores e terceiros.

O novo Código de Ética Médica, instituído pela resolução 2.217/18 do Conselho Federal de Medicina (CFM), entra em vigor e substitui a versão anterior de 2009. O novo Código mantém a estrutura principal do Código anterior e faz modificações que evidenciam a preocupação em trazer maior clareza e assertividade a certos aspectos. Uma das mudanças que merece atenção foi a inclusão de que a medicina "será exercida com a utilização dos meios técnicos e científicos disponíveis que visem os melhores resultados", sempre observando as normas elaboradas pelo CFM quando utilizar mídias sociais e instrumentos correlatos.

Essa alteração pode ser interpretada como um reconhecimento do CFM de que meios tecnológicos avançados podem ser utilizados pelo médico na busca dos melhores resultados para os seus pacientes, novidade essa bastante oportuna em tempos de tanta discussão sobre inovação em saúde, saúde digital e telemedicina. Por outro lado, no que se refere à comunicação e assistência remota de serviços médicos, o novo Código manteve a vedação da prescrição de tratamentos e outros procedimentos sem o exame direto do paciente, salvo em casos de comprovada urgência ou emergência. Tal previsão deve ser melhor regulada na nova resolução sobre Telemedicina.

Além disso, há inédita preocupação com o médico com deficiência, com a previsão expressa de que o médico com deficiência ou doença tem o direito de exercer a profissão sem ser discriminado, sempre dentro do limite de suas capacidades e da segurança dos pacientes, o que representa um reconhecimento institucional da importância da diversidade e inclusão.

Ademais, a norma esclareceu que a vedação de vantagens decorrentes da atuação de médicos com a indústria não abrange apenas a comercialização de produtos, mas também a prescrição de medicamentos, órteses, próteses ou implantes de qualquer natureza, cuja compra decorra de influência direta em virtude da atividade profissional da medicina, aspecto bastante relevante em tempos em que cada vez mais se exige transparência nas relações entre médicos e indústria.

No mesmo sentido, foi vedada aos médicos a utilização de formulários de outras instituições para atestar, prescrever e solicitar exames em instituições diferentes. A redação anterior proibia apenas a utilização de formulários de instituições públicas em clínicas privadas. Essa ampliação também alinha o novo Código com regras de transparência e independência nas relações entre médicos e indústria e o aproxima de regras já impostas às indústrias farmacêuticas pela ANVISA, que veda a propaganda ou publicidade de empresas à indústria em blocos de receituários.

Outra alteração bastante relevante é a autorização de liberação de cópias do prontuário médico para atendimento de ordem judicial, mesmo sem o consentimento do paciente. Até agora, o encaminhamento do prontuário pelo médico somente era feito a perito médico nomeado pelo Juízo – e não ao Juiz diretamente – com o objetivo de resguardar a privacidade do paciente. Assim, tanto o médico responsável pelo paciente quanto o perito médico estariam obrigados pelo sigilo profissional a resguardar a privacidade do paciente. A nova regra equiparou o prontuário a outros documentos também considerados confidenciais, mas que já tinham exibição autorizada e usualmente realizada em Juízo, como declarações de imposto de renda, segredos de negócio e relatórios de dados sigilosos sobre usuários de internet, os quais são cotidianamente apresentados para apreciação por Juízes, apesar do seu caráter sigiloso.

Contudo, é pertinente ponderação sobre em que medida a autorização de exibição do prontuário médico ao Juiz, mediante sua apresentação nos autos de demanda judicial, expõe esse documento de maneira desmedida e com potencial de causar danos ao paciente.

Existe aparato processual para resguardar a confidencialidade do prontuário médico, de modo a prevenir danos ao paciente decorrentes do aproveitamento indevido, por terceiros, das informações sensíveis ali contidas. A lei prevê a possibilidade da tramitação de ação judicial na qual se apresente prontuário médico, em segredo de justiça. Dessa forma, somente o Juiz, as partes e os seus procuradores teriam acesso ao prontuário. Além disso, outras medidas simples poderiam impor restrição de acesso ao prontuário, como uso de pastas em apartado aos autos e o cadastro do prontuário como sigiloso, de modo que fique disponível para consulta somente pelo Juiz.

São louváveis os avanços e atualizações do novo Código de Ética Médica, mas é preciso assegurar que instrumentos processuais sejam efetivamente aplicados, para que se garanta que o exame do prontuário pelo Juiz da causa não ocorra em prejuízo do sigilo garantido constitucionalmente a tal documento, não podendo ser permitido o acesso indevido a informações de saúde por seguradoras, potenciais empregadores e terceiros.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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