Priorização de pacientes no âmbito microalocativo: reflexões sobre a formação acadêmica e a ética

Abstract

Introduction: The microallocation of resources is a constant practice in the Emergency Care Units, so professionals constantly need to prioritize patients. This choice involves bioethical, moral dilemmas and the need for academic preparation. Objective: To analyze the narratives of health professionals working in a Emergency Care Unit regarding academic and bioethical training for decision making in situations of scarce resources. Methodology: Qualitative study carried out through the narrative interview at a Care Unit in Belo Horizonte MG. Twenty-five health professionals participated. The study was approved by the Ethics and Research Committee of the Federal University of Minas Gerais under the number 54212116.0.0000.5149 and by the Risoleta Tolentino Neves Teaching, Research and Extension Center. Result and discussion: In the analysis of the discursive practices of the professionals it was possible to perceive anxiety for the decision making, moral conflicts in relation to the microallocation of the resources and lack of definition of what is bioethics. The knowledge acquired in the undergraduate course did not contemplate care alternatives in the midst of the scarcity of resources, directly reflecting the way in which prioritization of patients in the microallocation field occurs in the emergency. They use the Manchester Protocol to support patient prioritization in risk classification, but feel unprepared for reality when need to microlocate resources to patients in the same emergency room. Conclusion: The narratives show fragility in the academic and bioethical formation, for the prioritization of patients in the microalocative scope, being this process learned in the care practice.