Questões éticas em pacientes terminais segundo o personalismo ontológico de Elio Sgreccia

Abstract

Among the many ethical issues experienced by terminal patients, both euthanasia and dysthanasia stand out as being considered immoral by the ontological personalism proposed by Elio Sgreccia. The aim of this paper is to verify if Sgreccia’s theory can be rationally justified in an objective way and if it has necessity and universality criteria. The method used was the analysis of the author's own texts and sources, taking the historical review of medical ethics since Hippocrates as an approach technique, as well as comparing the ontological personalism with the main ethical theories, emphasizing the concepts of life, person, health, disease and the human body. The study presents the ontologically based personalism with the principles of protection of life, freedom-responsibility, totality and subsidiarity, in a comparison with the principlism and its principles of autonomy, beneficence, nonmaleficence and justice. Sgreccia’s theory is reported as a solution to dilemmas when using its secondary principles of less harm and double effect, and also presents the need to create a hierarchy system for its primary principles. The hierarchy of benefit stands out from autonomy, thus demonstrating the intrinsic and inalienable value of life, as well as the subordination of freedom to that value. Therefore, it is possible to conclude that, according to the author, the main ethical dilemmas concerning the end of life in terminal patients are due to the lack of standard expressions, especially between passive euthanasia and dysthanasia. The elucidation is given when applying the initial concepts which the author collects in the Aristotelian-Thomistic source, as well as in an understanding of autonomy similar to that proposed by Kant, and of death not as an event but as a process which starts with terminal illness.