Extensão do Tratamento Involuntário às Patologias Infecciosas, pertinente ou abusiva? - A opinião médica no Centro Hospitalar Universitário de São João

Abstract

Diagnosing the legal gap in the framework of infectious diseases, particularly concerning the lack of expedient, effective mechanisms capable of timely action to establish the mode of operation of public health authorities for the application of laws defending the health of individuals or others, the aim is to gather the opinions of medical specialists directly involved in this context, specifically within the Centro Hospitalar Universitário de São João, in order to contribute to the improvement of the current modus operandi. To achieve this objective, a review of the existing literature on the topic was conducted, followed by the development of a cross-sectional study involving the distribution of a questionnaire via email to medical specialists working in the fields of Infectious Diseases, Internal Medicine, and Pulmonology at the aforementioned hospital unit. Out of the 37 physicians who responded to the questionnaire, 73.0% reported encountering at least one instance of treatment refusal in the face of an infectious disease that could pose a danger to the life or physical integrity of the individual or others. From the same set of responses, it was also found that 83.8% of respondents believe that the absence of a legal instrument, similar to that provided for in the Mental Health Portuguese Law allowing for involuntary treatment, constitutes a danger to public health. They also argue that physicians dealing with infectious diseases should have a legal instrument enabling them to facilitate involuntary treatment. While not unanimously agreed upon, there appears to be a common understanding that there should be a change in the current legislative framework so that involuntary treatment, as an extension of what is already established in the case of mental illness, can be established with a balance between the individual rights of the citizen and the interests of public health, even outside the scope of a state of emergency declaration.