Revista Bioética

ISSN: 1943-8042
bioetica@portalmedico.org.br
Conselho Federal de Medicina
Brasil

Garrafa, Volnei
Ampliação e politização do conceito internacional de bioética
Revista Bioética, vol. 20, núm. 1, 2012, pp. 9-20
Conselho Federal de Medicina
Brasília, Brasil

Disponível em: http://www.redalyc.org/articulo.oa?id=361533258002

Como citar este artigo

Número completo
Sistema de Informação Científica
Mais artigos Rede de Revistas Científicas da América Latina, Caribe , Espanha e Portugal
Home da revista no Redalyc Projeto acadêmico sem fins lucrativos desenvolvido no âmbito da iniciativa Acesso Aberto
 29,-)/0$&(&9$,-".)/0$&'$&6$86(-*$&
-8*(!8)6-$8),&'(&<-$="6)
Volnei Garrafa 1

1(%+2$&

!"#$%&'(&)*+),-.)/0$
! "#$%&'!(')*'!+!,!-$'.%/0!1'$)&2/'$"+*3+0!)4+$'"!%"1,$3'*3+!1'1+/!*'!$+&+*3+!'"1/%'56,!+!1,/%)7'56,!8'!
'9+*8'!:%,#)&'!%*3+$*'&%,*'/0!;2*8'"+*3'8'!*'! !"#$%$&'()*+,-!%.$#).(/%!)0,(12"$)!) ,%!,3(.)456$+(.)8'!
<*+.&,=!>!1$+.+*3+!+.328,!;'7!2"!:$+4+!?%.3@$%&,!8+.3+!1$,&+..,0!$+/'&%,*'*8,!,.!1$,:/+"'.!#)&,.!&,*3+"1,-
$A*+,.!&,"!'!'32'/!&$%.+!+&,*B"%&'!+!.,&%,1,/C)&'!"2*8%'/0!D2+!E2.)F&'"!'!*+&+..%8'8+!8+!"28'*5'.!&,*&$+-
3'.!*,!&'"1,!8'!#)&'!'1/%&'8'=! *'/%.'*8,!&+$3'.!.%32'5G+.!*'.!D2'%.!'!:%,#)&'!4+"!;'/?'*8,!,2!*6,!.+!"'*%-
;+.3'*8,!&,",!8+4+$%'0!",.3$'!'!2$9H*&%'!8+!.+!1'..'$!'!3$'3'$!8+!",8,!8%.)*3,!,.!&,*I%3,.!",$'%.!&,*.3'3'8,.!
?,8%+$*'"+*3+=!>!,:E+)4,!8'!8%.&2..6,!#!$+4%.'$!'/92"'.!&,*&+15G+.!&,*.+$4'8,$'.!8'!:%,#)&'!D2+!+4%3'"!
8+.*28'$!,.!$+'%.!1$,:/+"'.!$+/'&%,*'8,.!&,"!'.!8+.%92'/8'8+.!.,&%'%.0!1$,1,*8,!*,4,.!$+;+$+*&%'%.!3+@$%&,.!+!
"+3,8,/@9%&,.!8+!'32'56,!;232$'!1'$'!'!"+."'=!J,*&/2%!.29+$%*8,!'/92"'.!"+8%8'.!+!"28'*5'.!K!+1%.3+",/@-
9%&'.!+!1$L)&'.!K!*+&+..L$%'.!',!+*;$+*3'"+*3,!8'.!D2+.3G+.!:%,#)&'.!8'D2%!1'$'!'!;$+*3+=!
3),)4!)%567)4(M!-%,#)&'=!N+",&$'&%'=!O,/C)&'=!P'Q8+!1Q:/%&'=!!-$'.%/=! "#$%&'!(')*'=!

1(%+2(8&
29,-)6-:8&;&9$,-".)6-:8&'(,&6$86(9*$&-8*(!8)6-$8),&'(&<-$="6)
(')*,'"#$%&'!R!-$'.%/0!1'$)&2/'$"+*3+0!?'*!3+*%8,!%"1,$3'*3+!;2*&%@*!+*!/'!$+&%+*3+!'"1/%'&%@*!R!1,/%)7'-
&%@*!8+!/'!'9+*8'!:%,#)&'!%*3+$*'&%,*'/0!;2*8'"+*3'8'!+*!/'! !"#$%$",7+)*+,-!%.$#).(/%!)0,(12"$)8) !%!"9(.)
456$+(.!8+!/'!<STPJ>=!T/!1$+.+*3+!+.328%,!$+'/%7'!2*!:$+4+!?%.3@$%&,!8+!+.3+!1$,&+.,0!$+/'&%,*'*8,!/,.!1$,-
:/+"'.!#)&,.!&,*3+"1,$L*+,.!&,*!/'!'&32'/!&$%.%.!+&,*@"%&'!R!.,&%,1,/C)&'!"2*8%'/0!D2+!E2.)F&'*!/'!*+&+.%-
8'8!8+!&'":%,.!&,*&$+3,.!+*!+/!&'"1,!8+!/'!#)&'!'1/%&'8'=! *'/%7'*8,!&%+$3'.!.%32'&%,*+.!+*!/'.!&2'/+.!/'!:%,-
#)&'!?'!;'//'8,!,!*,!"'*%;+.3L*8,.+!&,",!8+:+$C'0!.+!*,3'!/'!2$9+*&%'!8+!1'.'$.+!'!'*'/%7'$!8+!",8,!8%.)*3,!
/,.!&,*I%&3,.!",$'/+.!&,*.3'3'8,.!'&32'/"+*3+=!T/!,:E+)4,!8+!+.3'!8%.&2.%@*!+.!$+4%.'$!'/92*'.!&,*&+1&%,*+.!
&,*.+$4'8,$'.!8+!/'!:%,#)&'!D2+!+4%3'*!8+.*28'$!/,.!$+'/+.!1$,:/+"'.!$+/'&%,*'8,.!&,*!/'.!8+.%92'/8'8+.!
.,&%'/+.0!1$,1,*%+*8,!*2+4,.!$+;+$+*&%'/+.!3+@$%&,.!R!"+3,8,/@9%&,.!8+!'&32'&%@*!;232$'!/'!:%,#)&'=!J,*&/2-
R+!.29%$%+*8,!'/92*'.!"+8%8'.!R!&'":%,.!K!+1%.3+",/@9%&,.!R!1$L&)&,.!K!*+&+.'$%,.!'/!+*;$+*3'"%+*3,!8+!/'.!
&2+.),*+.!:%,#)&'.!8+!'?,$'!+*!'8+/'*3+=
3),)<!)%56,)4(M!-%,#)&'=!N+",&$'&%'=!O,/C)&'=!P'/28!1Q:/%&'=!-$'.%/=! "#$%&'!(')*'=

<%*!)6*
>?9)8%-$8&)8'&9$,-"6-.)"$8&$@&*7(&-8*(!8)"$8),&6$86(9*&$@&<-$(*7-6%
(')*! "+$%&'!'*8!-$'7%/!?'4+!1'$)&2/'$/R!1/'R+8!'*!%"1,$3'*3!$,/+!%*!3?+!$+&+*3!+U1'*.%,*!'*8!1,/%)&%7'),*!
,;!3?+!%*3+$*'),*'/!:%,+3?%&.!'9+*8'0!:'.+8!,*!3?+!*+,-!%.$#) !"#$%$2(+)(+)0,(!39,".)$+:)456$+);,<93.!,;!
<STPJ>=!V?+!1$+.+*3!.328R!%.!'!:$%+;!?%.3,$R!':,23!3?%.!1$,&+..0!:R!$+/')*9!&,*3+"1,$'$R!+3?%&'/!%..2+.!3,!
3?+!W,$/8!&2$$+*3!+&,*,"%&!'*8!.,&%,1,/%)&'/!&$%.%.0!3?'3!E2.);R!3?+!*++8!;,$!&,*&$+3+!&?'*9+.!%*!3?+!F+/8!
,;!'11/%+8!+3?%&.=! *'/R7%*9!&+$3'%*!.%32'),*.!%*!W?%&?!:%,+3?%&.!%.!;'%/%*9!,$!*,3!:+%*9!'11/%+8!'.!%3!.?,2/80!
3?%.!1'1+$!.?,W.!3?+!2$9+*&R!,;!.3'$)*9!3,!'*'/R7+!3?+!",$'/!&,*I%&3.!;,2*8!%*!,2$!)"+.!%*!'!8%X+$+*3!W'R=!
V?+!12$1,.+!,;!3?+!8%.&2..%,*!%.!3,!$+4%+W!.,"+!&,*.+$4')4+!4%+W.!,;!:%,+3?%&.!3?'3!'4,%8!3,!2*&,4+$!$+'/!
1$,:/+".!$+/'3+8!3,!.,&%'/!%*+D2'/%)+.0!:R!1$,1,.%*9!*+W!3?+,$+)&'/!'*8!"+3?,8,/,9%&'/!W,$Y!$+;+$+*&+.!;,$!
3?+!;232$+=!Z3.!&,*&/2.%,*!.299+.3.!.,"+!"+'.2$+.!'*8!&?'*9+.0!;$,"!+1%.3+",/,9%&'/!'*8!1$'&)&'/!*'32$+.0!
*+&+..'$R!W?+*!;'&%*9!:%,+3?%&'/!%..2+.!;$,"!*,W!,*=
A(;&B$!'%M!-%,+3?%&.=!N+",&$'&R=!O,/%&R=!O2:/%&!?+'/3?=!-$'7%/=!(')*! "+$%&'=!!!!!!!!!!!

CD& O@.[8,23,$! 9'$$';'4,/*+%\9"'%/=&,"! K! J,"%3H! Z*3+$*'&%,*'/! 8+! -%,#)&'! 8'! <*+.&,]Z-J^! _+8+! (')*,[ "+$%&'*'! +! 8,! J'$%:+! 8+!
-%,#)&']_+8:%,#)&'^!<*%4+$.%8'8+!8+!-$'.C/%'!`<*-a0!-$'.C/%']Nb0!-$'.%/=

E$!!(%9$8'F86-)
J'%U'!O,.3'/!cdefg^!JTO!gchcd[hgc0!-$'.C/%']Nb0!-$'.%/=

N+&/'$'!*6,!?'4+$!&,*I%3,!8+!%*3+$+..+=

Rev bioét (Impr.) 2012; 20 (1): 9-20

9
 45,-)/0$&(&5$,-".)/0$&'$&2$12(-*$&-1*(!1)2-$1),&'(&9-$:"2)
! "#$%&'! (')%*'! )+,+! -'-+.! $+/+$+*&%'.! *'!
$+&+*)+! '"-.%'012! +! -2.%)%3'012! 4'! '5+*4'! 6%2-
#)%&'! %*)+$*'&%2*'.! 78+! 9+! /8*4'"+*)28! :! 4+&%-
9%,'"+*)+! :! &2"! '! Declaração Universal sobre
!"#$!%&'(')!*(!$"+',-.&/"+!4'!;*+9&2!<=;>=?@A!
em 2005 1B! )#!2!/%*'.!429!'*29!CD!'!)+"E)%&'!6%2-
!"#$%&'(&)*+),-.)/0$
#)%&'!%*)+$*'&%2*'.!'-2*)','!"'99%,'"+*)+!-'$'!
78+9)F+9! 6%2"#4%&'9! +! 6%2)+&*2.G5%&'9B! H2*)8-
42A! *'! "#$%&'! (')%*'! :! +! *2! >$'9%.! -'$)%&8.'$-
"+*)+!:A!*+9)'!#-2&'!IE!9+!&2"+0','!'!)$'6'.J'$!
/2$)+"+*)+! *29! "+%29! '&'4K"%&29! '! '"-.%'012!
42! 9+8! )+$$%)G$%2! 4+! +9)842A! $+/.+L12! +! '012B! !
M2&%+4'4+! >$'9%.+%$'! 4+! >%2#)%&'! <M>>A! /8*4'4'!
+"!NCCO@!+!'!P+4+!(')%*2Q "+$%&'*'!+!42!H'$%6+!
4+! >%2#)%&'! 4'! ;*+9&2! <P+46%2#)%&'A! %4+'.%3'4'!
+"!RDDR!+!&$%'4'!/2$"'."+*)+!+"!"'%2!4+!RDDS@!
/2$'"!4+&%9%,'9!*+9)+!9+*)%42B
T9!"'$&29!4+!$+/+$K*&%'!78+!+9)%"8.'$'"!
'! M>>! +! '! P+46%2#)%&'! '! %*&8$9%2*'$! -2$! +9)+!
*2,2! &'"%*J2! &$U)%&2! )K"! $+.'012! 4%$+)'! &2"!
'9!-'8)'9!2/%&%'%9!429!&2*5$+9929!"8*4%'%9!-$2-
"2,%429! -+.'! 0/$(*/&$!"/&1' 2++"%!&$!"/' "3' !"-
($4!%+!<V >@!+"!WG78%2XY'-12!<NCCZ@!+!>$'9U.%'X
>$'9%.!<RDDR@!:!+9)+![.)%"2!%*)+5$'."+*)+!2$5'-
*%3'42! -+.'! M>>B! T9! )+"'9! 2/%&%'%9! +9&2.J%429!
-'$'! 29! 42%9! +,+*)29! :! !"#$!%&' 51"6&1 e Bio-
#$!%&7' 8"9(*' (' 0/:-+$!;&' :! +9)%"8.'$'"! 2! %*U&%2!
4+!4%9&899F+9!&2"!$+.'012!'2!'-$2/8*4'"+*)2!
4'! &2*)$'4%012! ,+$%/%&'4'! +*)$+! '! -$+98"U,+.!
8*%,+$9'.%4'4+! 429! 78')$2! -$%*&U-%29! 4+! \+2$-
5+)2]*! -$2-29)29! -'$'! '! 6%2#)%&'! '! -'$)%$! 429!
^9)'429!;*%429!4'! "#$%&'!<^; @!+!)'"6#"!4'!
^8$2-'A!+!'!*+&+99%4'4+!4+!78+!/299+!$+9-+%)'-
4'!'!-.8$'.%4'4+!&8.)8$'.!-$G-$%'!4+!&'4'!.85'$A!
&2"! )24'9! '9! 98'9! 4%/+$+*)+9! *8'*0'9! "2$'%9A!
/%&'*42! +,%4+*)+A! )'"6#"A! '! *+&+99%4'4+! 4+!
'"-.%'012! 4'! '5+*4'! 6%2#)%&'! -'$'! '.#"! 4'9!
78+9)F+9!6%2"#4%&'9!+!6%2)+&*2.G5%&'9! 2.
T!-$%"+%$2!+*&2*)$2!$+&8-+$28!'9!%4+%'9!-%2-
*+%$'9!4+!_2`+$! S!$+.'&%2*'4'9!&2"!'!5.26'.%3'012!
4'! 6%2#a&'A! '! 9+*9')+3! *'! '-.%&'012! 42! 9'6+$! +! 2!
$+9-+%)2!b9!78+9)F+9!'"6%+*)'%9c!2!9+58*42A!&2*)$%-
68%8! -'$'! '! '6+$)8$'! 4+! 4%9&899F+9! &2"! $+.'012! b!
*+&+99%4'4+!4+!$+9-+%)2!b!-.8$'.%4'4+!"2$'.A!'.#"!
4+!-$2-2$!'!'"-.%'012!+!-2.%a3'012!4'!'5+*4'!6%2-
#a&'!%*)+$*'&%2*'.! dA!4'*42!"'%9!,%9%6%.%4'4+!b9!)+-
"Ea&'9!9'*%)E$%'9A!92&%'%9!+!'"6%+*)'%9!OAe.
Rev bioét (Impr.) 2012; 20 (1): 9-20
10
1*(2('(1*(%&&3&+4&5$+2$&'(&6-%*7!-)888
.'9)'%$!H'"-6+..A!+*)12!-$+9%4+*)+!4'!V >A!
+9)+,+! +"! >$'9U.%'! +"! "'$02! 4+! NCCZ! -2$! 2&'9%12!
42! VV! H2*5$+992! >$'9%.+%$2! 4+! >%2#a&'A! $+'.%3'42!
"+9+9!'*)+9!42!+,+*)2!4+!WG78%2A!&8I2!)+"'!&+*)$'.!
/2%!+9)'6+.+&%42!-2$!98'!%*9-%$'012B!V"-$+99%2*'42!
&2"!2!-'$'42L2!+!'9!&2*)$'4%0F+9!78+!,%8!+*)$+!'!
&'-%)'.!42!-'U9!+!'!,%9%)'!78+!-29)+$%2$"+*)+!/+3!'2!
J29-%)'.!-[6.%&2!4'!-2-8.29'!+!-$26.+"Ea&'!/',+.'!
4+! ?+.%G-2.%9A! +"! M12! _'8.2A! 2*4+! /2%! 2$5'*%3'42!
8"! 9+"%*E$%2! 4+! 42%9! 4%'9! '-G9! 2! &2*5$+992! *2!
J29-%)'.!-[6.%&2!42!.2&'.A!+L-$+9928!*'!8*(+!9(/$<+'
="1-./' -86.%&'4'! *'! +4%012! 42! 02 ' >(?+! 4'!
-$%"',+$'!+8$2-+%'!4'78+.+!'*2!78+A!'-G9!'!,%9%)'A!
-'9928!'!-+$&+6+$!'!*')8$+3'!4'!6%2#a&'!4+!"242!
&2"-.+)'"+*)+!4%/+$+*)+f
@!A('-.&'A!+B"'9"'C-B"'9!D%!1'9(A('+(*'+-+$(/$&*'-.'
+(*A!;"'9('+&E9('FE61!%&'%".'"'.G/!."'9('*(%-*+"+'('
F*"61(.&+'.&%!;"+'9('F"6*(H&I'J!'"'9(+&K"'&.6!(/-
$&1' F*"A"%&9"' F(1&' -*6&/!H&;B"' .&++!A&7' +(.' -.&'
&9(C-&9&' !/3*&L(+$*-$-*&' F&*&' +-+$(/$ML1"I' >(++('
.(!"7' %"/4(%!' F(++"&+' 9($(*.!/&9&+' &' (/%"/$*&*'
-.&' !"#N%&'C-('3&;&'-.&'O(/-G/&'9!3(*(/;&'F&*&'
&' +&E9(' 9(' +(-+' F&G+(+' (' F&*&' &' C-&1!9&9(' 9(' +(-'
9(+(/A"1A!.(/$"' (...)' 2' P !"#N%&' 51"6&1Q' /B"' 9(A('
+(*'-.&'&.6!;B"'/("%"1"/!&1'C-('+!*A&'F&*&'.&/$(*'
&+'F(++"&+'%"/3"*.&9&+'%".'/"++"+'F&*&9!O.&+'9('
%".F"*$&.(/$"'."*&1'"-'.(+."'F&*&'F(*+-&9!L1&+'
&'&*O-.(/$&*'/"'/"++"'(+N1"'9('*&%!"%G/!"'gI
T!)+"'!4'!9'[4+!-[6.%&'!+!&2.+a,'A!+9-+&%h&'-
"+*)+A!+$'!)$'6'.J'42!*2!&2*)+L)2!4'!6%2#a&'!-2$!
-+978%9'42$+9! 6$'9%.+%$29! 4+94+! 2! %*U&%2! 429! '*29!
CDB! 2! -$+/'&%'$! .%,$2! -86.%&'42! *2! -'U9A! +"! NCCOA!
>+$.%*58+$A!"+*)2$!%*)+.+&)8'.!4'!P+/2$"'!M'*%)E$%'!
6$'9%.+%$'! +! +LQ"+"6$2! 42! 0/$(*/&N"/&1' !"($4!%+'
="..!R((!4'!;*+9&2!<V>H@A!'99%"!9+!"'*%/+9)28f
(...)' 2F*(%!(!' .-!$"' &' !/$(*F*($&;B"' 9&' F"1GN%&' +&-
/!$M*!&'%"."'.(!"'F&*&'$"*/&*'.(/"+'9(+!O-&!+'&+'
F(++"&+'('.&!+'(C-S/!.('&'+"%!(9&9('(...)'T+$('1!A*"'
*(F*(+(/$&' +-6+$&/%!&1.(/$(' &' F*!.(!*&' $(/$&NA&7'
6(.L+-%(9!9&7'9('&6"*9&*'"'&++-/$"'%".'-.&'UN-
%&'C-('F&*$('9&'(VF(*!W/%!&'9('-.'O*&/9('F&G+'9"'
 !"#$%&'()*)"(#$+,%&'()-().(/.*$0()$/0*1/%.$(/%#)-*)2$(3+.%
!"#$%&'#()*+,)-()"+.-(/)'#0()!")"(1#"!.2($)3(-
!"#$%&'%'%( %$)*+,)#&',!"-!$#)&.'%'#-/$0%+-#1/' %"#'
/2$%3#' %' %"#' )+4!&56#.' &%0' 7,#$' # $)&)/+#1/' 8&'
9$/+-%)$#&'/!'")0)-%&.'0#&.'#/',/+-$:$)/.'");#+1/<&%'
8&'-$#1)6=%&'7"/&>7,#&'%!$/ %)#&'%'#/'1%2#-%'2)/?-
5,/')+-%$+#,)/+#"' .
!"#$%&' ()*(%&' +)' ,)&-.$&/+%#)&' 0/1$%0/$&' +/'
2,%1/'3)0(#)')4)&5')&,)1$/46)0()'718#/66' 9')'9%#-
()&'10:';"'</=$/6'/'0/(.#/4'/,#%*$6/>?%')0(#)'/'@$%2-
A1/5'%'+$#)$(%'.0$B)#&/4'/%'/1)&&%'C'&/D+)')'/&'#/=E)&'
,%4FA1/&' -.)' 6.$(/&' B)=)&' $6,4$1/6' 0/' 6)48%#' %.'
,$%#'-./4$+/+)'+)'B$+/',/#/'/&',)&&%/&')'1%6.0$+/-
+)&G'H',/#A#'+/')*,/0&?%'I4%@/4'+%'6%+)4%'0)%4$@)-
#/4'+)'6)#1/+%'0%&'/0%&'JK5'/&'6D4A,4/&'1#$&)&'-.)'
,/&&/#/6'/'/&&%4/#'%'6.0+%'0%'$0F1$%'+%'&21.4%'LLM'
N' )&,)1$/46)0()' %&' /()0(/+%&' ()##%#$&(/&' +)' OKKP'
)6' Q%B/' M%#-.)' )' /' /I.+/' 1#$&)' )1%0R6$1/' 6.0-
+$/4'+)'OKK 5'-.)'1%0A0./'/(2'8%;)5'$0F1$%'+)'OKPO'
N'+)&0.+/#/6'.6'-./+#%'&%1$%,%4FA1%',)#B)#&%S'/&'
#$-.)=/&'&%1$/$&')'%',%+)#',)#6/0)1)6'0/&'6?%&'+)'
,%.1%&5' 1%0A0./' 1#)&1)0()' /' +),#)+/>?%' +%' 6)$%'
/6@$)0()' )' /&' 6/$%#$/&' ,%,.4/1$%0/$&' &)I.)6' +$&-
(/0()&'+%&'@)0)T1$%&'+%'+)&)0B%4B$6)0(%G
H'@.&1/',%#'0%B%&',/#/+$I6/&'+)',#%+.>?%'
)'1%0&.6%')',%#'%.(#%&'A,%&'+)'B$+/')6'&%1$)+/+)'
#)-.)#' /' #)/,#%,#$/>?%' +/' ,%4FA1/' ,)4/' 1$+/+/0$/5'
@)6'1%6%'/'1%0&(#.>?%'+)'0%B%&')&,/>%&',D@4$1%&'
,/#/'+)@/()#'/4()#0/AB/&',/#/'%'+)&)0B%4B$6)0(%5'
+)@/()' /(2' /I%#/' @4%-.)/+%' ,)4/' B$&?%' )1%0%6$-
1$&(/'B$I)0()5'-.)')*/4(/'%'1#)&1$6)0(%'/'-./4-.)#'
1.&(%')'$I0%#/'&).&')<)$(%&'0)</&(%&'0/'&%1$)+/+)'11.
U'1%01)$(%'+)'@%"),)1#1%'A#,)/+#"'B$!-#'/+%-
(/+%'+)&+)'%&'/0%&'VK'0%'W.(?%5',)-.)0%'#)$0%')0-
1#/B/+%'0/'1%#+$48)$#/'+%'X$6/4/$/5')0(#)'/'Y8$0/')'
Z0+$/5'+)[0)'-.)'%',#$01F,$%'@"&$1%',/#/'I/#/0A#'/'
<)4$1$+/+)'2'-.)'/')1%0%6$/')&();/'/'&)#B$>%'+%'@)6\
)&(/#'+/',%,.4/>?%G'M&&%'2'@)6'+$<)#)0()'+%'-.)'&)'
B$.' 0/' #)1)0()' 1#$&)' )1%0R6$1/' 6.0+$/4' /1$6/' #)-
<)#$+/5' -./0+%' $0$6/I$0"B)$&' -./0A/&' +)' +$08)$#%'
,D@4$1%'N'&.[1$)0()&',/#/'/1/@/#'1%6'/',%@#)=/')'
/')*14.&?%'&%1$/4'0%'6.0+%',)#$<2#$1%'N'<%#/6'/,4$-
1/+/&' ,)4%&' ,/F&)&' 1/,$(/4$&(/&' 1)0(#/$&' ,/#/' )B$(/#'
/'-.)@#/'+)'I#/0+)&')6,#)&/&',#$B/+/&5')6'0%6)'
+/'6/0.()0>?%'+/',#%+.>?%5'+/'B$#(./4'I/#/0A/'+)'
)6,#)I%&')'+/'&%@#)B$B]01$/'+%'&$&()6/'11.
^.#/0()'+21/+/&5'0/'&)I.0+/'6)(/+)'+%'&2-
1.4%' LL5' %' 9.0+%' _%0)("#$%' M0()#0/1$%0/4' 39_M:'
$0()#B$.'+.#/6)0()'0/')1%0%6$/'+%&',/F&)&'4/A0%\
/6)#$1/0%&5' )*$I$0+%' -.)' %&' I%B)#0%&' +/' #)I$?%'
0?%' $0()#<)#$&&)6' 0%&' +)&A0%&' +/' $0$1$/AB/' ,#$B/-
+/5' ,)#6$A0+%' /' -.)@#/' +)' )6,#)&/&' (#/+$1$%0/$&'
1%6%'/'!/#$I5',%#')*)6,4%5',/#/'1$(/#'.6'+%&'$0D-
!"#$%&'(&)*+),-.)/0$
6)#%&'1/&%&'@#/&$4)$#%&G'`./0+%'/'1#$&)'18)I%.'/%'
Q%#()5' /' #)1)$(/' 1/,$(/4$&(/' $0B)#().\&)S' I%B)#0%&'
1%6%'%'+%&'abH'/;.+/#/6')&1/0+/4%&/6)0()')6-
,#)&/&' 1%6%' Y$(c' W/0d5' e)0)#/4' _%(%#&' %.' 9%#+' /'
0?%'$#)6'C'</4]01$/G'^%$&',)&%&')'+./&'6)+$+/&5'%.'
6)48%#5' f</>/6' %' -.)' +$I%5' 6/&' 0?%' </>/6' %' -.)'
</>%g5'1%6%'&)'4$/')6'-./4-.)#';%#0/4'+)'/6,4/'1$#-
1.4/>?%'C'2,%1/G
Y%6%'%'-.)'/-.$'2'+$&1.A+%'()6'#)4/>?%'+$-
#)(/' 1%6' /' 6)48%#' %.' ,$%#' -./4$+/+)' +)' B$+/' )' /'
&%@#)B$B]01$/'+)',)&&%/&')',%B%&5',/#)1)'&)#'/,#%-
,#$/+%'-.)'/'@$%2A1/5'0%&',#h*$6%&'/0%&5'1%6)1)'/'
$01%#,%#/#'C&'&./&'+$&1.&&E)&'%'1%01)$(%'+)'2)/ /-
"C5,#5' +)&)0B%4B$+%' ,%#' 9%.1/.4(' 125' /&&$6' 1%6%' %'
1%01)$(%'+)'2)/ /1%$.
b6/'1%0(#$@.$>?%'%#$I$0/+/'0/'H62#$1/'i/A0/'
)' -.)' #)1.,)#/' fB)48/&' 0%B$+/+)&g' 0%' +)@/()' &%-
@#)'f+)&)0B%4B$6)0(%g'2'%'1%01)$(%'+)'2%0'D)D%$5'
/0AI/'[4%&%[/'+)'B$+/'+/&'&%1$)+/+)&'$0+FI)0/&'+/'
#)I$?%'/0+$0/5')&,)1$/46)0()'+/'W%4FB$/')'+%'a-./-
+%#5'-.)';"'/'$014.F#/6')6'&./&'1%0&A(.$>E)&G'Q)&&)'
1%01)$(%'0?%'1%0(/6'(/0(%'/&'#$-.)=/&5'%.'&);/5'/&'
1%$&/&'-.)'/&',)&&%/&',#%+.=)65'6/&'%'-.)'/&'1%$-
&/&',#%+.=$+/&',#%,%#1$%0/6'1%01#)(/6)0()',/#/'/'
B$+/'+/&',)&&%/&G'Q/'<%#6.4/>?%'+/'7"/&/7#'1/'2%0'
viver' 0?%' &?%' 1%0&$+)#/+%&' /,)0/&' %&' @)0&' 6/()-
#$/$&5'6/&'%.(#%&'#)<)#)01$/$&'1%6%'%'1%08)1$6)0(%'
+%'$0+$BF+.%5'&).'#)1%08)1$6)0(%'&%1$/4')'1.4(.#/45'
%&'1h+$I%&'2A1%&')')&,$#$(./$&'+)'1%0+.(/'&)I.$+%&'
,)4/'&%1$)+/+)'+/'-./4'</=',/#()5'&./'#)4/>?%'1%6'/'
0/(.#)=/5'%&'B/4%#)&'8.6/0%&5'/'B$&?%'+)'<.(.#%'Pj.
Q)&&)' 1%0()*(%5' /' )1%0%6$/' +)B)' &)' ,/.(/#'
,)4/'1%0B$B]01$/'&%4$+"#$/5'&)6'6$&2#$/5'&)6'+$&1#$6$-
0/>?%5'I/#/0A0+%'%'0)1)&&"#$%',/#/'/'&%@#)B$B]01$/'
+$I0/'+)'(%+%&G'U'2%0'D)D%$')*,#)&&/'/'/[#6/>?%'+)'
+$#)$(%&')'I/#/0A/&'&%1$/$&5')1%0R6$1/&')'/6@$)0(/$&G'
k%+/&'/&',)&&%/&'(]6'$I./46)0()'%'+$#)$(%'C'B$+/'+)-
1)0()5' -.)' 48)&' /&&)I.#)' &/D+)5' /4$6)0(/>?%5' "I./'
4$6,/5'%*$I]0$%',.#%5'6%#/+$/'/+)-./+/5'&/0)/6)0-
(%'/6@$)0(/45')+.1/>?%5'(#/@/48%5')6,#)I%5'+)&1/0-
&%')'h1$%5'1.4(.#/'T&$1/5'B)&(."#$%5'/,%&)0(/+%#$/G
Rev bioét (Impr.) 2012; 20 (1): 9-20
11
 3;,-)/0$&(&;$,-".)/0$&'$&<$2<(-*$&-2*(!2)<-$2),&'(&=-$>"<)
!"#$%& '$%& "'("$%& $)!"& (*+,(%%$%& $& +$,-,& '$&
."/0-1$&'(&2!3'$4(3#$56/&(+"%#(4/789"1$&'(&,$":&
7$-3/;$4(,"1$3$<&1/3%#,!='$&(&'(2(3'"'$&+(7$&>??&
(& @('."/0-1$& $/& 7/39/& '$%& A7-4$%& '!$%& '01$'$%<&
$1$.$,$4&"31/,+/,$'$%&B&Declaração Universal so-
!"#$%&'()*# "#+%!"%,&-# ./0*1&-& '$& C3(%1/& 10<&D/-
!"#$%&'(&)*+),-.)/0$
4/7/9$'$& (4& /!#!.,/& '(& EFFG& $+8%& 4$"%& '(& '/"%&
$3/%&'(&"3#(3%$%&'"%1!%%H(%&(&7!#$%I&
J/'/& /& 7/39/& +,/1(%%/& '(& %!$& $+,/K$56/& "3-
17!"&'(&2/,4$&4$,1$3#(&$&1D$4$'$&2*!,*#3"#$/"1&-#
4%!"-<&'(&3/K(4.,/&'(&EFFL<&)!$3'/& EM&."/(-1"%-
#$%<& ,(+,(%(3#$3'/& /3:(& +$=%(%& 7$-3/;$4(,"1$3/%<&
%(&4$3"2(%#$,$4&"3#(,3$1"/3$74(3#(&'(&4/'/&1/3-
#!3'(3#(& 1/3#,$& /& #(/,& '(& !4$& K(,%6/& '$& NC?NO&
)!(&$#0&(3#6/&$+,(%(3#$K$&1/3#(A'/&4$,1$'$4(3-
#(& ."/#(13/789"1/& (& ,(%#,"-K/& $/%& "3#(,(%%(%& '/%&
+$=%(%&+(,"20,"1/%&PL.
Q& ,(!3"6/& (*#,$/,'"3R,"$& '/& S?TUC3(%1/& +,/-
4/K"'$&3$&T"'$'(&'/& 0*"1/&1"31/&$3/%&'(+/"%<&(4&
3/K(4.,/& '(& EFFV<& 2/"& /+/,#!3$& +$,$& $& Q40,"1$&
W$-3$&,("K"3'"1$,&X&(&#(,&,(1/3D(1"'$&3(%%(&"4+/,-
#$3#(&(K(3#/&"3#(,3$1"/3$7&X&$&+$#(,3"'$'(&'$&"'("$&
'(&"317!%6/&'$%&)!(%#H(%&%$3"#R,"$%&(&%/1"$"%&3/&1/3-
#(*#/& '$& N(17$,$56/& (& '$& +/7"-:$56/<& 3(1(%%R,"$& (&
"3'"%+(3%RK(7<&'(%#$%&)!(%#H(%&15.
Y4./,$&%(#/,(%&4$"%&#,$'"1"/3$"%&(&1/3%(,K$'/-
,(%&'$&."/0-1$&"3#(,3$1"/3$7&#(3D$4&+,/#(%#$'/&,!"-
'/%$4(3#(&1/3#,$&(%#(&Z3/K/&(%#$'/&'(&1/"%$%[& P\;PV<&
'(2(3'(3'/& %(!%& "3#(,(%%(%& +$,-1!7$,(%& +/,& !4$&
%!+/%#$& $4+7"$56/& '(%3(1(%%R,"$& (& '(%/,'(3$'$<&
%(9!3'/&(7(%<&'/%&1/3D(1"4(3#/%&)!(&]R&'(-3D$4&
(4&%(!%&3"1D/%&4/3/+87"1/%&2!3'$'/%&3/%&)!$#,/&
+,"31=+"/%&"3"1"$74(3#(&+,/+/%#/%<&/!#,/%&$+(3$%&^-
1$,$4& (4& $.%/7!#/& %"7_31"/<& '(%'(3D/%/& (& 1,=-1/<&
2,(3#(&B&"'("$;2/,5$&'(&!4$&."/0-1$&$4+7"$'$<&4$"%&
7"K,(&(&7".(,#$'/,$<&)!(&K(31(!&/&(4.$#(&(&1/4(5$&
$&%(&'"2!3'",&4!3'/&$2/,$I&&
1)2$!)3)&(3&4564&7&!).8(%&9+(&(:-#(3&
3+')2/)%
`& %01!7/& aaS& #,/!*(& 3/K"'$'(%<& (3#,(& (7$%& $&
1,"%(& (1/3b4"1$& (& /& 2,$1$%%/& '/& 4/'(7/& 3(/7".(-
,$7&'(&4(,1$'/<&1/4&+"/,$&'$&%"#!$56/&(&$!4(3#/&
'$& K!73(,$56/& +$,$& $%& +/+!7$5H(%& 4$"%& +/.,(%& '/&
4!3'/I&Q&."/0-1$&36/&^1/!&"4!3(&$&#!'/&"%%/I&c(7/&
1/3#,R,"/<& /%& 1/31("#/%& '",(#$4(3#(& ,(7$1"/3$'/%&
Rev bioét (Impr.) 2012; 20 (1): 9-20
12
1/4&$&(*+$3%6/&'(%(32,($'$&'/&4/'(7/&'(&1$+"#$-
7"%4/&97/.$7":$'/&2/,$4&#$4.04&'",(#$4(3#(&$+7"-
1$'/%&$/&1/3#(*#/&1/31("#!$7&(&+,R-1/&'$&."/0-1$&
(4&'"K(,%$%&%"#!$5H(%<&(%+(1"$74(3#(&3/&1$4+/&'$%&
+(%)!"%$%&17=3"1$%&4!7-1_3#,"1$%&3$%&)!$"%&%(&'(%#$-
1$4<&+/,&(*(4+7/<&#(4$%&$+,/K$'/%&+(7$&K(,%6/&'(&
>(!7UEFFd&'$&+")5*!*67&#3"#."5-%18/"&eNOf<&1/4/&$&
g(*"."7":$56/&'/&!%/&'/&+7$1(./&e$56/&+/+!7$,4(3-
#(&1/3D(1"'$&1/4/&Z'!+7/&-,*13*!3[f&(&/&'(%1/4-
+,/4"%%/& '/%&+$#,/1"3$'/,(%&+$,$&1/4&/%&%!]("#/%&
'$%&+(%)!"%$%&$+8%&/&#0,4"3/&'/&(%#!'/<&$%+(1#/%&
$'"$3#(&$3$7"%$'/%I
T/4/&1/3%()!_31"$<&]!3#/&1/4&1(,#/&'(%9$%#(&
'(&%(!&1/31("#/&/,"9"3$7<&%(&+/'(&1/3%#$#$,<&$704&'$&
,("31"'_31"$&'(&$3-9/%&+,/.7(4$%&e1/4/<&+/,&(*(4-
+7/<&/&(%1$3'$7/%/&1$%/&'$%&+(%)!"%$%&'(%(3K/7K"'$%&
+(7/&9*(&1*5#:1-(,/,"#&;#."*5,<&;&hSOUYCQ&3$&i!$#(-
4$7$<&(4&PVLM<&/3'(&4"7D$,(%&'(&+(%%/$%<&"317!%"K(&
1,"$35$%<&2/,$4&+,/+/%"#$74(3#(&"3/1!7$'/%&1/4&4"-
1,/,9$3"%4/%&K(30,(/%f<&/&%!,9"4(3#/&'(&%"#!$5H(%&
,(7$-K$4(3#(&3/K$%&e1/4/&/&'!+7/&+$',6/&+$,$&$%&
+(%)!"%$%& 17=3"1$%f& )!(& 3(1(%%"#$4& %(,& (32,(3#$'$%&
+(7/%&(%+(1"$7"%#$%&+,(/1!+$'/%&(4&+,/4/K(,&!4$&
."/0-1$&K(,'$'(",$4(3#(&1/4+,/4(-'$&1/4&$&]!%-
-5$<& $& 1"'$'$3"$& (& /%& '",("#/%& D!4$3/%<& '(& $1/,'/&
1/4&/%&,(2(,(31"$"%&+,/+/%#/%&+(7$%&h$5H(%&C3"'$%&
(<&+$,-1!7$,4(3#(<&+(7$&C3(%1/I&Q&1/3%#,!56/&(&1/-
7/1$56/&(4&+,R-1$&'(&3/K$%&"3"1"$-K$%&4!3'"$"%&'(&
/,9$3":$56/& '$%& 2/,5$%;#$,(2$& '$& ."/0-1$<& 1/4/& /&
`.%(,K$#8,"/&'(&?"/0-1$&(&/&c,/9,$4$&'(&?$%(&'(&
Y%#!'/%&%/.,(&?"/0-1$&'$&C3(%1/<&$704&'$&,(1(3#(&
1,"$56/&'$&:1,"!1*(&1*5#4--&)%*(&1#&;#=3/)*(&1#%1#
=,<%)-&eSQYYf<&(3-'$'(&"3#(,3$1"/3$7&1/4&3/K$%&.$-
%(%<&2$:(4&+$,#(&'(%#(&1/3#(*#/<&]!3#$4(3#(&1/4&$&
4(31"/3$'$&@('."/0-1$I
S%%/& %"93"^1$& )!(& #(4$%& 1/4& _32$%(& !3"7$#(,$7&
(&(*$9(,$'$&3$&$!#/3/4"$&(&3$%&'(1"%H(%&"3'"K"'!$"%&
"%/7$'$%& (& $3#(1"+$'$4(3#(& "32/,4$'$%& e%1;&!0"3#
3")%-%&1# 0*>%1?f<& +/,& (*(4+7/<& 36/& %6/& 4$"%& %!-
^1"(3#(%& $/& '(.$#(& ."/0-1/& 97/.$7I& (!& /.](-K/&
1(3#,$7&3/&+,(%(3#(&$,-9/<&+/,#$3#/<&0&X&$&+$,-,&'$&
$#!$7& %"#!$56/& %/1"/+/7=-1$& (& (1/3b4"1$& 4!3'"$7&
(&'$&3(1(%%"'$'(&'(&%(&+$%%$,&$&$3$7"%$,&'(&4/'/&
'"2(,(3#(&/%&$3-9/%&1/3g"#/%&4/,$"%&e"3'"K"'!$"%&(&
%/1"(#R,"/%f&(&$%&3/K$%&%"#!$5H(%&)!(&1/4(5$4&$&%(&
$+,(%(3#$,& X& '(4/3%#,$,& $& 3(1(%%"'$'(& '(j& $f& ,(-
K"%$,&1(,#$%&1/31(+5H(%&1/3%(,K$'/,$%&'$&."/0-1$&
 !"#$%&'() * #)$%+,&'() -) .)/.*%0) %/0*1/&.%)/&$ -* 2%)3+.&
!"# "$%&'(# )"*+!)',# -*# ,"'%*# .,-/0"('*# )"# )"*%-
1!'0)')"# *-2%'0# '%+)'# $",%32')-*# +-# (!+)-# 2-+-
&"(.-,4+"-5#/6#.,-.-,#+-$-*#,"7","+2%'%*#&"8,%2-*#
"# ("&-)-081%2-*# "*."2%'0("+&"# ,"0'2%-+')-*# 2-(#
)%7","+&"*#7-,('*#7!&!,'*#)"#'&!'9:-#.,;<2'#.','#-#
&",,%&8,%-#)'#/%-=<2'>######
,#+1%&2!$3,(4)%&)1"#$%&(&$+*!$%&1$5$%&
1$%&6+)-%&)&3-$7"8)&5(4&9),:)1'$&;$+&10$&%(&
4)1-9(%*)1'$&8$4$&'(5(!-)<&
?-# 2-+&,;,%-# )"# .,"$",# !"# '# '.0%2'9:-# )-#
(-)"0-#2'.%&'0%*&'#+"-0%/",'0#.!)"**"#1",',#&'+&-*#
.-)","*#2-+2"+&,')-*#+'*#(:-*#)"#&:-#.-!2-*#"#)"#
('+&",#'#2-+<+!%)')"#)"#&'+&'*#%+@!*<9'*#"#.,-/0"-
('*# *-2%'%*A# *%1+%32'<$'# .',2"0'# )-*# ("(/,-*# )'#
2-(!+%)')"# /%-=<2'# %+&",+'2%-+'0# B# "*."2%'0("+-
&"#)-*#.'C*"*#)%&-*#)"*"+$-0$%)-*#B#'.0%2-!#,"2"%&'*#
=<2'*#2-(.0"&'("+&"#" !%$-2')'*#D*# !"*&E"*# !"#
"*&'$'(#*-/#*"!#)-(C+%-#"#,"*.-+*'/%0%)')">#?#*"-
1!%,A#*:-#/,"$"("+&"#'.,"*"+&')'*#2%+2-#)%7","+&"*#
*%&!'9E"*A#"+&,"#(!%&'*#-!&,'*A#+'*# !'%*#&'%*#7'&-*#
'2-+&"2",'(#F"#2-+<+!'(#'2-+&"2"+)-6>#
&&&& Comercialização dos estudos clínicos e das
!"#$%!$&'()*$&+*$&,!$-.#$*$&)/0&$! !$&1.0*2/$
#G:-#2,"*2"+&"*A#+-*#H0<(-*#'+-*A#-*#%+$"*-
!"#$%&'("')*+%,*$-,.%&'$,*#&#*/.%#*.&'("'0*1&"&'
,./%&' "!' $"&$"&' /%!' #%2*&' (,%3*&' (.,"/.%#*(*&' *'
(%"#4*&' 56"' *7"$*!' %&' 0*/."#$"&' ("&$"&' 0*1&"&8'
!*&'"9"/6$*(%&'#%&'0*1&"&'0%+,"&'"'("'+*.9%'#12")'
"/%#:!./%;'<&$6(%',")* 2*!"#$"',"/"#$"'!%&$,%6'
56"'(*&'=;>>?'#%2*&'(,%3*&'("&"#2%)2.(*&'#%'@!-
+.$%'!6#(.*)'"#$,"'=ABC'"'DEEC'&%!"#$"'=E'",*!'
("& #*(*&'*'(%"#4*&'/%!6#&'(%&'0*1&"&'0%+,"&'20
F' .#/)6.#(%' #"&$*' ).&$*' *' !*)G,.*' "' *' $6+",/6)%&"8'
%' #H!",%' ("' #%2%&' !"(./*!"#$%&' &%+"' 0*,*' D=;'
<&$"' 7*$%' .#(./*' 56"' (6,*#$"' %&' H) !%&' IE' *#%&'
F' %6' &"J*8' #%' 0",1%(%' "!' 56"' *' 0*, /.0*4K%' "!'
"&$6(%&' /)1#./%&' !6) /L#$,./%&' (%&' 0*1&"&' 0%+,"&'
*6!"#$%6'&.3#.M/* 2*!"#$"'F'0%6/%'!*.&'("'=N'
(*&' .#%2*4O"&' 7*,!*/%)-3./*&' 7%,*!' (.,.3.(*&' *'
(%"#4*&' 56"' *7"$*!' 0,"(%!.#*#$"!"#$"' *&' 0%-
06)*4O"&'("&$"&'0*1&"&'21.
P&',"/"#$"&'!6(*#4*&'#*' !"#$%$&'()*!)+!#-
,-./0!' /%!' ,")*4K%' *%' 6&%' Q!*.&' R"912")S' (%' 0)*-
/"+%'"'(*'*6&L#/.*'("'/%!0,%!.&&%'(%&'0*$,%/.#*-
(%,"&'/%!',")*4K%'*%&'&6J".$%&'(%&'"&$6(%&'("0%.&'
("'&"6'$T,!.#%8'2",.M/*(%&'#*'P&&"!+)".*'UT(./*'
U6#(.*)'VPUUW',"*).X*(*'"!'%6$6+,%'("'DEEY'"!'
Z"6)[\%,".*8' ("!%#&$,*!' 56"' *&' 0,"&&O"&' /*0.$*-
).&$*&' .#$",#*/.%#*.&' #K%' &%!"#$"' 2"#/",*!' /%!%'
$*!+T!' ("&#6(*,*!' *' .#&"#&.+.).(*("' (%' /*0.$*)'
!"#$%&'(&)*+),-.)/0$
7,"#$"' *%' &%7,.!"#$%' ("' !.)]O"&' ("' 0"&&%*&' "!'
$%(%'%'!6#(%;'Z6+!"$",'*'&*H("'(*&'0"&&%*&'*'%+-
J" 2%&'"/%#:!./%&'T'.#*/".$G2")8'&"36#(%'*'^"(+.%-
T /*'#*' !"#$%$"-1.)*!)21%*(3$),(3%!)45"$)!.)#$,)
6.7!,58$"-(.!,)"(.),!%!,)90:$.(,)22'"!'#%2"!+,%'
("'DEEY'V!"#%&'("'6!'!L&'*0-&'*',"6#.K%'("'Z"6)W;'
^".$","_&"'56"'"&$*'H) !*'("/)*,*4K%'7%.'*0,%2*(*'
0%,'6#*#.!.(*("'"!'*&&"!+)".*'/%!'*'0*, /.0*4K%'
("'IEE'+.%" /.&$*&'("'("X'0*1&"&')* #%_*!",./*#%&;'
A !"#$%$"-1.) *!) 21%*(3$) "90,"&&%6' 56"' *'
#%2*' 2",&K%' (*' `a' ;(*!) $<!=$%) 8%$7!:!.=!) $) ,!-
80%$.&$>)()3!:?!,=$%)!)(,)*-%!-=(,)*$,);!,,($,)/0!)
;$%5"-;$:)"(:()7(#0.=@%-(,)!:);%(=("(#(,)*!);!,-
/0-,$,):A*-"$,);!#():0.*() 22;''b&'/%!.$L&'("'T /*'
"!'0"&56.&*'(*'!*.%,.*'(%&'0*1&"&'(*'c7,./*8'%#("'
T' &.3#.M/* 2%' %' #H!",%' ("' "&$6(%&' /)1#./%&' ("-
&"#2%)2.(%&' /%!' /%%0",*4K%' .#$",#*/.%#*)8' "&$K%'
/%!0%&$%&' #*' 3,*#("' !*.%,.*' 0%,' !"!+,%&' ("2.-
(*!"#$"' Q$,".#*(%&S' 0")%&' 0*1&"&' 0*$,%/.#*(%,"&'
("' */%,(%' /%!' *&' )"3.&)*4O"&8' ,"3,*&' "' .#$","&&"&'
("&&"&' 0,-0,.%&' 0*1&"&;' d%,' !".%' ("' %7",$*&' Q3,*-
$6.$*&S' ("' /6,&%&' .#$"#&.2%&' ("' Q$,".#*!"#$%' ("'
J%2"#&' 0"&56.&*(%,"&' )* #%_*!",./*#%&S' V%6' Q/6,-
&%&'("'*!"&$,*!"#$%S8'&"'%&')".$%,"&'0,"7",.,"!W'%'
efa'"'%6$,%&'%,3*#.&!%&'(%&'<gP'2L!'0,%/6,*#(%8'
#%&'H) !%&'*#%&8'$*!+T!'*$,*.,'.#2"& 3*(%,"&'(*'
,"3.K%' 0*,*' &6*&' ,"3,*&' "' 7%,!*&' ("' *$6*,8' .#7").X-
!"#$"'/%!'0*, /.0*4K%'"'*$T'*0%.%'("'$T/#./%&'"'
%,3*#.&!%&')%/*.&8'/%!%'JG'*/%#$"/"6'#*'P,3"# #*8'
h,*&.)8'\].)"8'd",6'"'i"#"X6")*;''''''
!"#$%#&'%#(" )#*"+',-" %
vulnerabilidade social
b&'$",!%&'("'/%#&"# !"#$%'.#7%,!*(%'Vj\fW8'
/%#]"/.(%&' #%' h,*&.)' /%!%' $",!%&' ("' /%#&"# -
!"#$%' ).2,"' "' "&/)*,"/.(%' Vj\k<W8' 7%,*!' .#/%,0%,*-
(%&'/%!%'%+,.3*$-,.%&'#*'*#G).&"'("'0,%$%/%)%&'("'
0"&56.&*' /)1#./*' .#$",#*/.%#*.&8' /%!%' &"' $%(*&' *&'
0"&&%*&' 56"' %&' *&&.#*!' 7%&&"!' *6$:#%!*&8' /%!'
*&'"9/"4O"&'/%#]"/.(*&;'U*&'&K%',*,%&'%&'"&$6(%&'
56"' *0,%76#(*!' %' *&&6#$%' "!' &.$6*4O"&' /%!6#&'
Rev bioét (Impr.) 2012; 20 (1): 9-20
13
 12,-)/0$&(&2$,-".)/0$&'$&3$43(-*$&-4*(!4)3-$4),&'(&5-$6"3)
!"#$%&"'"#$'()*+(),!"#,!-!.#$!(#'/'-$0!.#1'#% %0-
*%2'3"-!# *4 ,)! %0# 5# $'""!%"# 64'# 7!# "%2'-# ) -
8'($('8%(# !# 64'# 0''-# 5.# 8'-%# 64'# 1)('8%-' 8'# "'#
('0%,)! %#,!-#%#940 '(%2)0)1%1'#"!,)%0:
;# 940 '(%2)0)1%1'# "!,)%0# 8'-# ('0%<7!# ,!-# %#
'"8(484(%# 1'# 9)1%# ,!31)% %# 1%"# $'""!%":# = 8('# %"#
!"#$%&'(&)*+),-.)/0$
")84%<>'"# ?'(%1!(%"# 1'# 940 '(%2)0)1%1'# "!,)%0# '-#
$'"64)"%"# !"#$%&"'"#$'()*+(),!".#$!1'-#"'(#,)8%1%"@#
%#2%)/%#,%$%,)1%1'#1'#$'"64)"%# !#$%&"A#1)"$%()1%-
1'"#"!,)!',! B-),%"# %#$!$40%<7!A#2%)/!# &9'0#1'#
) "8(4<7!# 1%"# $'""!%"A# ) %,'"")2)0)1%1'# %# "'(9)<!"#
1'# "%C1'# '# 940 '(%2)0)1%1'"# '"$',&D,%"# ('0%,)! %-
1%"#,!-#!#?E '(!#*'-) ) !#'#,!-#64'"8>'"#(%,)%)"#'#
+8 ),%".#' 8('#!48(%"#FG.
H#")? )D,%1!#1'#940 '(%2)0)1%1'#"!,)%0#0'9%#%!#
,! 8'/8!# 1'# *(%?)0)1%1'.# 1'"$(!8'<7!.# 1'2)0)1%1'.#
I1'"J*%9!(',)-' 8!# 5# $!$40%<>'"# 1'"*%9!(',)1%"# 5#
'.# ) ,04")9'.# 1'# %2% 1! !.# ' ?0!2% 1!# 1)*'(' 8'"#
*!(-%"#1'#'/,04"7!#"!,)%0.#1'#1)"8% ,)%-' 8!#!4#)"!-
0%-' 8!# 1'# ?(4$!"# $!$40%,)! %)"# ,!-# ('0%<7!# %!"#
2' 'K,)!"#$(!$!(,)! %1!"#$'0!#1'"' 9!09)-' 8!#FL.
;#430)M%<7!#1!"#NOP#1'9'#"'(#('9)"8%#,!-#('0%<7!#%#"4%#
('%0#'D,Q,)%.#$!)"# !"#$%&"'"#$'()*+(),!"#$'""!%"#"!,)%0-
-' 8'#940 '(Q9')"#%"") %-#1!,4-' 8!"#"'-#,! R'-
,)-' 8!# $0' !# 1%"# ,)(,4 "8S ,)%"# '# ,! "'64E ,)%"#
1'#"'4#%8!:#
;0+-#1)""!.#'"841!"#-403,E 8(),!"#) 8'( %,)!-
%)"# '#,!-$0'/!"# ,!-# !9!"# -'1),%-' 8!"# ?'(%0-
-' 8'#%$('"' 8%-#NOP#0! ?!"#I%0?4 "#,R'?%-#%#8'(#
-%)"# 1'# FT# $Q?) %"J.# *%8!# !2"'(9%1!# $'0!# %48!(# '#
,!((!2!(%1!# ) *!(-%0-' 8'# $!(# 1)9'("!"# ) 8'?(% -
8'"# 1'# O=U# '-# 8!1!# !# $%&":# ="8'"# NOP# ('9'0%-V"'#
%2"!048%-' 8'# ) ,!-$('' "&9')"# %!# ,)1%17!# ,!-
-4-.# !2"8%,40)M% 1!# %# ,!-$('' "7!# '/%8%-' 8'#
1!"#-%)!('"#) 8'('""%1!"@#!"#"4W')8!"#1%#$'"64)"%:#
U(!$!")<>'"# *484(%"# 1%# 2)!+3,%# 1'9'-# ,%-) R%(#
!#"' 31!#1'#64'#'"8'"#NOP#"'W%-#"42"384&1!"#$!(#
*!(-%"#-%)"#")-$0'".#1)('8%"#'#'*'39%"#1'#,! 8(!0'#
$!(#-')!#1'#,!-)8E"#1'#+3,%#1'9)1%-' 8'#8(') %-
1!".# ('%0-' 8'# ) 1'$' 1' 8'".# %39!"# '# $('"' 8'"#
%!# 0! ?!# 1'# 8!1!# !# $(!,'""!# 1%"# $'"64)"%"# '# 7!#
"!-' 8'# !#W40?%-' 8!#) ),)%0#1!#$(!8!,!0!#5#,!-!#
,!"84-%#%,! 8','(#'-#?(% 1'#$%(8'#1!"#,%"!".#$!(#
'/'-$0!.# !"#,!-)8E"#,('1' ,)%1!"# !#X(%")0:
!"!#$%&'()!*+,!"-!($&,.*)/+0*1&'
H#%(3?!#YZ#1%#[\X[]#1'D '#64'#!#,!-$%(3-
Rev bioét (Impr.) 2012; 20 (1): 9-20
14
0R%-' 8!#1!"#2' 'K,)!"#1%"#$'"64)"%"#2)!-+1),%"#
+#1'9'(#64'#8!1!#="8%1!V-'-2(!#1%"#^%<>'"#\ )-
1%"#1'9'#"'#,!-$(!-'8'(#%#,4-$()(:#O%"!#!"#$%&"'"#
(),!"#'"39'""'-#('%0-' 8'#1)"$!"8!"#%#8!-%(#1',)-
">'"#$!0&3,%"#,!-#8%0#,!-$(!-)""!.#!#8'-%#$!1'()%#
8'(# )-$0),%<>'"# $(!*4 1%"# !# -!1!# ,!-!# *484(%"#
$!0&3,%"# ,)' _D,%"# '# '"8(%8+?)%"# "% )8Q()%"# $%""%-
()%-#%#"'(#*!(-40%1%"#-4 1)%0-' 8':#P"8!#")? )D,%#
64'@#%J#-'"-!#64% 1!#!"#'"841!"#*!""'-#,! 14M)-
1!"#'-#$%&"'"#1'"' 9!09)1!".#'"8'"#'"8%()%-#,!--
$(!-'31!"#%#,!-$%(30R%(#2' 'K,)!"#1'""'#'"841!.#
!" #$%&'()$%" '*!" *+" #$,+ +" !" - + ./*)/0! .1*
I%(8:#YZ#1%#[\X[]JA#2J#$%(%#4-%#'"8(%8+?)%#"% )8Q()%#
?0!2%0# "'# 8!( %(# ('%0)1%1'.# +# ','""Q()!# 64'# !# 1'-
"' 9!09)-' 8!# 1'# $!0&3,%"# 1'# $'"64)"%"# %,)! %)"#
%#$%(8'#(),%#1!#-4 1!#) ,04%#$(!W'8!"#"4"8' 8Q9')"#
$%(%#64'#!"#2' 'K,)!"#('"408% 8'"#1'#"'4"#$(!?(%-
-%"# $!""%-# 9)(# %# "'(# ,!-$%(30R%1!"# ,!-# %<>'"#
'-# 1'"' 9!09)-' 8!# '.# $() ,)$%0-' 8'.# %64'0'"#
$%&"'"#$!2('"#'#1'#2%)/!#) ?('""!#',! B-),!#25.
H#%(3?!#YG#1%#[',0%(%<7!.#64'#8(%8%#1%#`+*)0-$-
%0 -$- " "'**# %$23*a.#%$('?!%#64'#$"+*)0-$%0 -$- "
.1% "*+"+ % +"4(!$.*+" "$"'**# %$23*"0.1 %.$'0*.$)"
#$%$" +1 "5!"- / !"+ %" +&!()$-$+ 1:#;#,!!$'(%<7!#
) 8'( %,)! %0#'-#2)!+3,%.#$!(#"4%#9'M.#+#W4"3D,%1%#
!# %(3?!# YZ.# 64'# 8(%8%# '"$',)D,%-' 8'# 1%"# $'"-
64)"%"# ,!-# "'('"# R4-% !".# $'0!# ,!-$(!-)""!# '-#
,! ")1'(%(# %"# . ' ++0-$- +" +# ',5'$+" -*+" #$,+ +"
!" - + ./*)/0! .1*6" -$+" '*!(.0-$- +" 0.-,7 .$+" "
-$+" #*#()$28 +" /(). %9/ 0+:# = 64% 8!# !# %(3?!# YG#
%#"!0)1%()'1%1'#D?4(%#,!-!#!#9%0!(#-!(%0#1'#0'?)3-
-%<7!#$%(%#%"#$(Q3,%"#1'#,!!$'(%<7!#) 8'( %,)! %0.#
!#%(3?!#YZ#'"8%2'0','#'/'-$0!"#$%(%#%#'*'39%<7!#1!#
,!-$%(30R%-' 8!#1'#2' 'K,)!"#%#$%(3(#1%"#) 9'"3-
?%<>'"#1'"' 9!09)1%"# !#,%-$!#1%#,)E ,)%:
;# "!0)1%()'1%1'# '/$('""%# %# [\X[].# $!(8% -
8!.#('64'(#4-#!0R%(#1)*'(' 8'#5#2)0%8'(%0#'#%!#-'"-
-!# 8'-$!# R!()M! 8%0# 5# ' 8('# $'""!%".# ?(4$!"# !4#
"'8!('"#64'#'"87!#'-#")84%<>'"#R)"8b(),!V"!,)%)"#1)"-
3 8%".#*(' 8'#c"#64%)"#4 "#"'#,%$%,)8%-#%#%$!)%(#!"#
!48(!"#1'#-!1!#1'") 8'('""%1!.#"'-#$('!,4$%<7!#
,!-#('8!( !#-%8'()%0#!4#1'#64%064'(#!48(%# %84('-
M%:# =# 64% 1!# '"8%# "!0)1%()'1%1'# !,!(('# ' 8('# 1)*'-
(' 8'"#$%&"'"#5#!#-%)"#*!(8'#'#!(?% )M%1!#%$!)%#!4-
8(!"#) 8'('""'"#%0+-#1'#('%0-' 8'#%W41%(#1)% 8'#1'#
4-%#")84%<7!#1'#*(%?)0)1%1'#8'-$!(Q()%#!4#$'(-%-
' 8'#5#'"8QV"'#% 8'#4-#('%0#64%1(!#1'#,!!$'(%<7!:#
 !"#$%&'()*+*#)$%,-&'()*.)*/)0/+%1)*%01+20&/%)0&$*.+*3%)4,/&
!"#$%!&' (")*+(,-*"#*' *.(/#*-' 0*+1#!/' 2!"/#1"#*/'
"1'3(/#40(1'1"561'*'0*2*"#*'"!/'7$1(/'1/'189*/'3$-
-1"(#:0(1/' %*' /!+(%10(*%1%*&' !)*0*2(%1/' ;!0' %*#*0-
-("1%1/'"189*/&'1;*"1/'/*';0*/#101-'1'%()*0*"#*/'
)!0-1/'%*'*.;+!018<!'*'%*'5010'=1"#16*-'1!'+!"6!'
%!'#*-;!'%17$*+*/'7$*&';0*#*"/1-*"#*&'/*'%(/;$-
/*01-'1'>1$.(+(10?&')016(+(,1"%!'1("%1'-1(/'!/';!=!/'
"*2*//(#1%!/'%*'1-;10!@'
!"#$%"&'()(*&*!+"$,(&)+!+"&-*!
A/#*' B' $-' #*-1' 7$*' #1"#!' 1' C(!B521' */#1%$-
!"# $#%&'('%)%#*+',#!)%-!$.'+!&)(# .#%"#!/'*%"#%
0)"'1%#/&#.'%,'+%)02* $%,'*&'$%)*.'+#$%()!$%&'(,+'-
(#3"'$%$'&!)0(# .#1%&'('%4#+0! 2*#+%561%7)00)-) %58
#% 9) !#0$% 5:1% ).;% <*#% )% Declaração Universal sobre
!"#$%&'(')!*(!+",'-./&0",%")%= #$&'%0-#%"#*%>)-
2+) .#% ?!$!@!0!")"#% ! .#+ )&!' )01% ! &'+,'+) "'% )'%
&' .#/.'% ")% +#$,' $)@!0!")"#% )% .#(A3&)% "'% "!+#!.'%
)'%)&#$$'%B%$)C"#%,)+)%.'")$%)$%,#$$')$%D)+.E%FGHE%%
I% +#J#+!"'% )+32'1% )0;(% "#% "#K !+% <*#% )% ,+'-
('LM'%")%$)C"#%#%"'%"#$# ?'0?!(# .'%$'&!)0%"#?#%
$#+%'@N#3?'%&# .+)0%"#%<*)0<*#+%2'?#+ '%"#('&+A-
3&'1%&' $!"#+)%<*#%*$*J+*!+%'%()!$%)0.'%,)"+M'%"#%
$)C"#%)3 2O?#0%;%*(%"'$%"!+#!.'$%J* ")(# .)!$%"#%
.'"'%$#+%-*() '1%+#<*#+# "'%<*#%'%,+'2+#$$'%")%
&!P &!)%#%")%.#& '0'2!)%"#?#%)(,0!)+Q%)H%'%)&#$$'%)%
&*!")"'$%"#%$)C"#%"#%<*)0!")"#%#%)%(#"!&)(# .'$%
#$$# &!)!$1%! &0*! "'%#$,#&!)0(# .#%)<*#0#$%,)+)%)%
$)C"#%"#%(*0-#+#$%#%&+!) L)$1%*()%?#R%<*#%)%$)C-
"#%;%#$$# &!)0%B%?!")%#(%$!%#%"#?#%$#+%&' $!"#+)")%
&'('%@#(%$'&!)0%#%-*() 'S%@H%'%)&#$$'%)% *.+!LM'%
)"#<*)")% #% A2*)% "#% @')% <*)0!")"#S% &H% )% (#0-'+!)%
")$%&' "!LT#$%"#%?!")%#%"'%(#!'%)(@!# .#S%"H%)%#0!-
(! )LM'%")%()+2! )0!R)LM'%#%")%#/&0*$M'%"#%! "!?O-
"*'$%,'+%<*)0<*#+%<*#%$#N)%'%('3?'S%#H%)%+#"*LM'%
")%,'@+#R)%#%"'%) )0J)@#3$('%1.
U$.*"'% +#&# .#(# .#% "#$# ?'0?!"'% '% 4+)$!0%
"#(' $.+)% '% &)(! -'% '+!2! )0% ,#+&'++!"'% #$,#&!-
K&)(# .#% ,#0)% @!';3&)% "'% ,)O$% )% J'+(*0)LM'% "#%
0! -)$% )*.V&.' #$% "#% #$.*"'% #% ,#$<*!$)1% )% ,)+3+%
")% +#0)LM'% # .+#% #$$)$% 0! -)$% #% '% ,+'&#$$'% -!$.V+!-
&'% <*#% &' $'0!"'*% )% W#J'+()% X) !.A+!)% )&!' )0% #%
<*#%&' .#(,0)%'%.#()%")%$)C"#%&'('%J).'+%"#%! -
&0*$M'%$'&!)0%29E%9#$.#%#$.*"'%#(#+2!+)(%&).#2'+!)$%
.#V+!&)$%<*#%#$.M'%#(%,#+J#!.)%&' $' Y &!)%&'(%)$%
+#&'(# ")LT#$% ")% = #$&'% +#0)&!' )")$% &'(% )% "!-
(# $M'% $'&!)0% ")% <*#$.M'% #% <*#% .P(% +#0)LM'% &'(%
2+*,'$%'*%$#2(# .'$%,)+3&*0)+(# .#%?*0 #+A?#!$S%
&'(%)$%+#0)LT#$%"#%,'"#+%)%,)+3+%")%!"# 3K&)LM'%
")$%"#$!2*)0")"#$%$'&!)!$S%&'(%)%<*)0!")"#%"#%?!")%
")$%,#$$')$%#%&'(%'$%,+V,+!'$%"!+#!.'$%-*() '$%Z[.
I% )&#$$'% * !?#+$)0!R)"'% B% $)C"#1% ,'+.) .'1%
,)$$)% )% ! .#2+)+% )% '?)% )2# ")% @!';3&)% "'% $;&*0'%
!"#$%&'(&)*+),-.)/0$
\\]1%?!$.'%&'('%"!+#!.'%"#%&!")") !)1%$# "'%+#$,' -
$)@!0!")"#%"'$%U$.)"'$%,+'?#+%'%(O !('% #&#$$A+!'%
,)+)% <*#% )$% ,#$$')$% ?!?)(% &'(% "!2 !")"#E% ^#$.)%
)0.*+)%"'%"#$# ?'0?!(# .'%$'&!#.A+!'%(* "!)01%&'(%
.) .)%&!P &!)%#%.#& '0'2!)%"!$,' O?#!$1%)%$)C"#% %)$-
$!(%&'('%)%#"*&)LM'% % M'%,'"#%$#2*!+%$# "'%?!$.)%
&'('%'@N#.'%?*02)+%"#%&' $*('%)&#$$O?#0%$'(# .#%
B<*#0)$% ,#$$')$% ,+!?!0#2!)")$% <*#% "!$,T#(% "#% +#-
&*+$'$%().#+!)!$%,)+)%)"<*!+!_0)1%&'('%$#%J'$$#%*()%
(#+&)"'+!)%<*)0<*#+1%"!$,' O?#0% '%(#+&)"'E
!"#$%!&'()'$"%)*)&&)
I%,'"#+%"'%(#+&)"'%J)+()&P*3&'%;%+#)0!")"#%
! "!$&*`?#0E%a%! "C$.+!)%J)+()&P*3&)%'$&!0)%"'%,+!-
(#!+'%)'%<*)+.'%0*2)+%# .+#%)$%,+! &!,)!$%)3?!")"#$%
0*&+)3?)$% '% (* "'% &' .#(,'+Y #'1% &'(,#3 "'%
$'(# .#%&'(%'$%2+) "#$%@) &'$%! .#+ )&!' )!$%ZF e
&'(%'$%(#+&)"'$%"#%)+()$%@;0!&)$%#%"#%"+'2)$E%U(%
5[[b1%'%(#+&)"'%")%A+#)%('?!(# .'*%&#+&)%"#%bc[%
@!0-T#$%"#%"V0)+#$%#%),# )$%'!.'%#(,+#$)$%"'%+)('%
J'+)(%+#$,' $A?#!$%,'+%G[d%"#%.'"'%'%('?!(# .'%
K ) &#!+'%(* "!)0% )<*#0#%) '%Z5.
% U(% ,)+)0#0'1% #/!$.#(% ),+'/!()")(# .#% :[%
(!0% +#,+#$# .) .#$% ")$% ! "C$.+!)$% J)+()&P*3&)$%
'$% U=a1% '% <*#% ,+','+&!' )% )% +#0)LM'% "#% *(% +#-
,+#$# .) .#% ,)+)% &)")% 81:% (;"!&'$% ZZ% e% ,+','+LM'%
$!(!0)+%J'!%# &' .+)")% )%a0#() -)1%W#! '%= !"'%#%
f+) L)% ZG1%'%<*#%"#(' $.+)%'%2+)*%"#%! ?#$3(# .'%
<*#%)$%#(,+#$)$%J)R#(%#(%,*@0!&!")"#%#%,+'('LM'%
"#% ?# ")$E% g'"'$% #$$#$% ")"'$% ,#+(!.#(% )?)0!)+% )%
2+)?!")"#% "'$% &' >!.'$% "#% ! .#+#$$#% # ?'0?# "'% )%
! "C$.+!)% J)+()&P*3&)1% ,#$<*!$)"'+#$% #% (;"!&'$1%
-)N)% ?!$.)% <*#% $M'% )$% ! "C$.+!)$% <*#% ,).+'&! )(%
'$% #$.*"'$1% '$% ,#$<*!$)"'+#$% $M'% $#*$% #/#&*.'+#$%
#%'$%(;"!&'$1%)<*#0#$%<*#%),0!&)(%B%,',*0)LM'%'$%
+#$*0.)"'$%'@3"'$%ZbE%] J#0!R(# .#1%$M'%+#0)3?)(# -
.#% #$&)$$'$% '$% .+)@)0-'$% &!# `K&'$% ,+'"*R!"'$% '%
&)(,'% ")% @!';3&)% <*#% $#% ,+#'&*,)(% #(% ) )0!$)+%
.)!$%&' .+)"!LT#$E
^#$.#%.V,!&'%#$,#&OK&'% M'%$#%,'"#%"#!/)+%"#%
+#2!$.+)+% )% "#$#<*!0!@+)")% &'(,'$!LM'% ")% 7'(!$-
Rev bioét (Impr.) 2012; 20 (1): 9-20
15
 26,-)/0$&(&6$,-".)/0$&'$&4$34(-*$&-3*(!3)4-$3),&'(&9-$="4)
!"#$%&'(&)#*)&("')+#,-#.("/-&'"+"0()#12$*.("3#,"#
4('( /%5("# ,)# 2(6'&()# -# $-&'"+"0()7# ('&89:(,)# ,-#
)')+( )5#)# -085)';)#-#+(:-5);!"#'"#9-5&),"#,-#"5-
0)'( 9" # 0-'-<&)9-'/-# 9",(=&)," # 1>?43@# A /)#
&"9( !"#%#&"9B" /)#B"5#9)( #,-#CD#9-9:5" 7#')#
9)("5()#B- E8( ),"5- #-#/%&'(&" #5-+)&("')," #&"9#
!"#$%&'(&)*+),-.)/0$
- /-#&)9B"#,"#&"'F-&(9-'/"@#GB- )5#,-#H('&8+)," #
)#8'(H-5 (,),- #BI:+(&) 7#98(/" #,-+- #9)'/69#&"-
'F-&(," # &"9B5"9( " # BI:+(&" # ,-# /5):)+F"# &"9#
-9B5- ) #98+<')&("')( 7#,(5-/)9-'/-#('/-5- ),) #
'"# /-9)7# &"9"# )# 4"' )'/"7# J=K-5# -# "8/5) @# 2"'-
(,-5"#('-E8LH"&"#"#M)05)'/-#&"'M(/"#,-#('/-5- - #
,-#/)+# (/8);!"7#B"( #)#B- ")#E8-#N8+0)#%#)#9- 9)#
-'H"+H(,)# '"# B5"&- "# ,-# B5",8;!"# ,)E8-+- # B5"-
,8/" #E8-#- /!"# -',"#":N-/"#,-#,( &8 !"#B)5)#+(-
:-5);!"#'"#9-5&),"@
G(',)# &"9# 5-+);!"# O# 2$*.("7# P)KQ -# '-&- -
R5("# 5-0( /5)5# E8-# " # B"8&" # 5-B5- -'/)'/- # ,"#
&F)9),"# -/"5#,"#&"'/5"+-# "&()+7#E8-#('/-05)H)9#
8)# &"9B" (;!"# ('(&()+7# # )# ):)',"')5)9# NR# '" #
B5(9S5,(" #,-# -8#P8'&("')9-'/"#B"5#/-5-9# 8) #
B" (;T- #9('"5(/R5() #5-B-<,)9-'/-#H-'&(,) #') #
,- -E8(+(:5),) #,( &8 T- #-#H"/);T- #H-5(=&),) #
'"#&(/),"#"50)'( 9"@#U)+-#5-0( /5)57#)(',)7#E8-#5--
B5- -'/)'/- # ,)# :("%<&)# N)9)( # =K-5)9# B)5/-# "8#
P"5)9# -E8-5# &"'H(,)," # )# B)5<&(B)5# ,)# 5-P-5(,)#
&"9( !"#V#P)/"#H( /"#&"9"#')/85)+7#5"<'-(5"#-#)/%#
- -'&()+# ') # &"9( T- # (9(+)5- # -W( /-'/- # ') #
');T- #,- -'H"+H(,) @##
1('-')%&(&2+')3/)%&3(4(%%5!-)%&6)!)&
(37!(3*)!&$%&)3"#$%&(&3$8$%&6!$9,(2)%
#*"H) #9-,(,) #/-S5(&) #-#"8/5) #,-#"5,-9#B5R-
<&)#B) )5)9#)# -5#'-&- R5() #-#)/%#(',( B-' RH-( #
B)5)#E8-#)#:("%<&)#&"'<'8-#9)'/-',"7#'- /-#('L&("#
,"# %&8+"#XXY7# 8)#)&-(/);!"# "&(-/R5()#-#)&),69(&)#
('/-5')&("')+#B)5)#E8-# -#P"5/)+-;)#-#B" )#-'P5-'/)5#
" #'"H" #-#)'<0" #B5":+-9) 7#:-9#&"9"#" #,- )=" #
E8-# -# )B5- -'/)9# '- /-# 9"9-'/"# F( /S5(&"# B-+"#
E8)+# B) )# "# 98',"# 0+":)+(K),"@# A'/5-# "8/5) 7# !"#
)')+( ),) #)# -08(5#E8)/5"#,(P-5-'/- # (/8);T- @####
!"#$%&'()*+",-,$.("/+0"12&3451&+0","
2,-,2,34&(&0"/(&:(4,)!)/0$&;3-8(!%),&%$9!(&
<-$="4)&(&:-!(-*$%&>+2)3$%
> # B5('&LB(" # -# 5-P-5-'&()( # &"' /)'/- # ,)#
Rev bioét (Impr.) 2012; 20 (1): 9-20
16
Z[.Z\# ,-H-9# -5# +-H)," # O# B5R<&)# B-+" # B)L - 7#
(' </8(;T- 7# -'<,),- # -# B- ") # E8-# - /-N)9# ,-#
)&"5,"#&"9#-+- @#A9:"5)# -N)#&"55-/"#)=59)5#E8-#
) #,-&+)5);T- #('/-5')&("')( #'!"#/69# !"#"$%&'()*-
+$"%&$,- ),%#): "+8/)#-#8'(P"59-#-9#/",) #) #+-0( -
+);T- # ,"9% <&) 7# %# ('E8- <"'RH-+# E8-# B" 8-9#
.%/0)&'()*+$"07#E8-#)P-/)#)#/"," #" #A /)," @#J"5#( "7#
/69#&)5R/-5#"5(-'/),"5#-#B-,)0S0(&"#,-#)+/"#H)+"5#C].
J)5)#G',58-/7#%#B" LH-+#)=59)5#E8-#- /-#H)+"5#N85L-
,(&"#NR# -#/5)' P"59"8#-9#-=&R&()#N85L,(&)#C^.
GB- )5#,)#P"5;)#F( /S5(&)#,)#-WB5- !"#nor-
1%& ,20& .$,"(/%,- # B)5)# ,-P('(5# "# &"'/-I,"# ,) #
,-&+)5);T- 7#%#,- -NRH-+#E8-#- /-#&"'/-I,"#B) -#
)# -5# ('/-5B5-/),"# &"9"# (',(5-/)9-'/-# &"' /)'-
/-# ,) # B5SB5() # +-0( +);T- # ')&("')( 7# -08',"#
?5" QA B(-++#C_@#[9)#('(&()/(H)#B" (/(H)#'"# -'/(,"#
,-#,)5#9)( #P"5;)#)" #B5('&LB(" #&"'/(," #')#Z--
&+)5);!"# %# )E8-+)# 5-+)&("'),)# &"9# "# - /L98+"# O#
"50)'(K);!"#,-#PS58' #"P(&()( #,-#058B" #,-#B)L - #
B5SW(9" 7# '"# -'/(,"# ,)# &"' /58;!"# ,-# &"'H-'-
;T- # 5-0("')( # 1,"# 4-5&" 8+7# B"5# -W-9B+"3@# $)+#
9-,(,)#B5"B"5&("')#)"#&"'/-I,"#,"#(' /589-'/"#
89)#+-0(/(9(,),-#E8-7#-9:"5)#'!"#)+&)'&-#)(',)#
)#P"5;)#,-#+-(7#)H)';)#)+%9#,"# -'/(,"#,-#'"59)#
'!"# H('&8+)'/-7# )B5"W(9)',"# ) # 5-&"9-',);T- #
,-# B" LH-( # )B+(&);T- # B5R<&) # '" # B5SB5(" # B)L-
- # (0')/R5(" # C`@# 2"9# "# B) )5# ,"# /-9B"7# -5()#
,- -NRH-+# E8-# ?# ,-# 9","# &5- &-'/-# ?# " # B)L - #
('&"5B"5) -9# O # 8) # +-0( +);T- # " # B5('&LB(" #
&"'/(," #'" #)5/(0" #B"5#-+- #9- 9" #)B5"H)," #
')#Z-&+)5);!"@###
2. Construção de novos marcos
&36,23(4&+3(&0"/,"12+6,)*+"789(3(
a# &"'H-'(-'/-# E8-# /"," # " # B5":+-9) # )E8(#
9-'&("')," #-#E8-# -#5-P-5-9#O #,( B)5(,),- #&"' -
/)/),) #') #&"',(;T- #,-#H(,)#,-#B- ") #,-#,(P-5-'-
/- # +80)5- # ,"# B+)'-/)# '!"# (0)9# )&"'/-&-',"# '" #
B5SW(9" #/-9B" 7#('&+8 (H-#B)5)#)#B5SB5()# -085)';)#
," #F):(/)'/- #," #B)L - #5(&" @#>#&5- &-'/-#P-'b9--
'"#,)#9(05);!"#,-#9(+FT- #,-#B- ") #,"# 8+#B)5)#"#
'"5/-#%#B5"H)#,- /)#'"H)#9",)+(,),-#,-#c(' -085)'-
;)d@#>#98',"#NR#'!"#B",-#V#9"5)+9-'/-#V#&"'H(H-5#
&"9#)#&"'/5),(;!"#,-#/-5#+80)5- #"',-#) #B- ") #H(-
H-9#-9#9%,()#9)( #,-#_D#)'" #1e)B!"7#A[G7#A85"B)#
>&(,-'/)+3#-'E8)'/"#-9#"8/5" #'!"#)+&)';)9# -E8-5#
" #fD#1.85g(')#h) "7#i-55)#j-")#-/&3@#
 (+5%#/01&!,!5&%#67/01&!4&!3&-3,#.&!#-.,)-/3#&-/%!4,!8#&963/
!"#$"%&'#%()'*+!&,-./#.,+!01'!%'!2-"'!#,),!%"%-
.'3/!$'!41%56/!7*,8/*!01'!,84'5)'!$"3"#1"-!'!%1&-"-
3"-!/!'9&*,-/6:,!'!/!"#'01"$/$'+!'3!$"-'6:,!/!13!
3'*;,-! 2,3&/-5*;/3'#.,! $,%! 8'#'<2",%=! >'%%'!
%'#5$,+! #,),%! 3/-2,%! "#.'-#/2",#/"%! $'! &-,.'6:,!
;13/#/+!8'3!2,3,!),*./$,%!?!3'*;,-!,-7/#"@/6:,!
%,2"'.(-"/+! $')'3! 2,3'6/-! /! %'-! 2,#%.-1A$,%! &'*/!
2,31#"$/$'! $'! #/6B'%! 2,3! ,! /&,",! $/! 8",C52/! '!
%'1%!'%&'2"/*"%./%!'!-'&-'%'#./#.'%=
!"#$%&'()*+$,"(-./&+$"-0$)"(-1$(*$"2-"
normas nacionais de controle e dos comitês de
!"#$%&'(')(''#$%&'(*'+(,-.!,&
!"#$%&'()*"($+'!($'%&%,!&'(-'%.*(%/0*'%&.$"$&
'(-'+$"& !& "1#!& $& %*"& %*21'-!& (!& -*%*(0!30'#*()!&
-$%& .*%41'%$%& +'*(56+$%& *#& +$-$& .$7%8& 9!":#;& $%&
.$"<+13$"'-$-*%&*&(*+*%%'-$-*%&-*&+$-$&.$7%&-*0*#&
&-*6('<0$#*()*& &%*"&+!(%'-*"$-$%&.$"$&41*;&.!"&
*=*#.3!;&!%&*(%$'!%&+37('+!%&-*&#:)!-!%&-'$2(>%<-
+!%;& ."*0*(<0!%& !1& )*"$.?1<+!%;& +!#!& $<0'-$-*%&
%!+'$'%& 23!@$3'A$-$%;& %*B$#& "*$3'A$-!%& "*%.*')$(-!&
!%&-'"*')!%&C1#$(!%&D1(-$#*()$'%&EF;GH.
I3:#&-*&@!$%&(!"#$%&-*&"*213$J,!&*&+!()"!3*;&
:&'(-'%.*(%/0*3&41*&!%&#*+$('%#!%&-*&+!()"!3*&:<-
+!&D1(+'!(*#&$-*41$-$#*()*&*&41*&!%&-'D*"*()*%&
+!#')?%&-*&:<+$&.$%%*#&$&$)1$"&-*&#!-!&+$-$&0*A&
#$'%& $<0!;& .$"<+'.$<0!& *;& +$%!& (*+*%%/"'!;& '()*"-
0*(<0!8&I&."*%*(J$&-!&+!()"!3*&%!+'$3&-$&.!.13$J,!&
K-*0'-$#*()*&."*.$"$-$&):+('+$&*&*<+$#*()*L&:&'(-
-'%.*(%/0*3&(*%)*&+!()*=)!8&
M#&*=*#.3!&"*+*()*&%*&-*1&(!&9*"1;&!(-*&
$):& .!1+!& )*#.!& '(*='%)'$#& (!"#$%& ($+'!($'%&
-*& "*213$J,!& :)'+$& .$"$& $%& .*%41'%$%& +!#& %*"*%&
C1#$(!%;& $):& 41*& -!'%& D1(+'!(/"'!%& -!& N'('%-
):"'!& -$& O$P-*& %*& #$)"'+13$"$#& *#& 1#& +1"%!& $&
-'%)Q(+'$& 41*& $& R*-@'!:)'+$& M(*%+!& ."!#!0*&
$(1$3#*()*&%!@"*&!&$%%1()!8&S!#!&)"$@$3C!&D'($3&
!@"'2$)>"'!& -!& +1"%!;& ."!.1%*"$#& 1#& 9"!2"$#$&
$+'!($3&-*&R*213$J,!&T)'+$&($%&9*%41'%$%&.$"$&!&
.$7%8&U%)*%&$31(!%&"*3$)$#&41*&$.*%$"&-$&*(!"#*&
"*$J,!&+!()"/"'$&-*&*#."*%$%&-*&#*-'+$#*()!%&*&
-*&."!D'%%'!($'%&#:-'+!%&$&*3$%&"*3$+'!($-$%;&41*&
*%)$0$#& K#$3L& $+!%)1#$-!%& $& )"$@$3C$"& +!#& !&
"*%.$3-!&-*&$321(%&+C$#$-!%&V+!#')?%&'(-*.*(-
-*()*%&-*&:)'+$&*#&.*%41'%$W;&!&#'('%)"!&-$&O$P-
-*;&+!#&!&$.!'!&-!&."*%'-*()*&-$&R*.P@3'+$;&'#-
.3$()!1& ($+'!($3#*()*& $& ."!.!%)$;& 41*& *%)/& *#&
.3*(!& D1(+'!($#*()!;& '#.*-'(-!& !%& $@1%!%& $):&
*(),!&."$)'+$-!%&($41*3*&.$7%&+!()"$&!%&%1B*')!%&
#$'%& 013(*"/0*'%;& ."'(+'.$3#*()*& !%& 41*& .$")'+'-
.$0$#&-*&*(%$'!%&+37('+!%8
!"#$%&'(&)*+),-.)/0$
'/0'1,2& (3(%!*(42"')('5(6(5(4%!&!,'
%"4789(!,'('(-.!3! 5&)",'4&'%"4,25.:;"')('4"9"'
)!,%.5,"'('+58$%&' !"#$%&
I321#$%& #*-'-$%& %,!& (*+*%%/"'$%& .$"$& .!%-
%'@'3')$"&!&*(D"*()$#*()!&D1)1"!&$!%&(!0!%&."!@3*-
#$%& *& .$"$& $)1$3'A$"& *& "*D!"J$"& $& +$.$+'-$-*& -*&
+!(%)"1JX*%& +!(B1()$%& K !"! #$%& '(#)*#+,L8& *%%*&
%*(<-!;& -*)*"#'($-$%& +$)*2!"'$%& !1& "*D*"*(+'$'%&
%,!&'(-'%.*(%/0*'%&.$"$&!&$3+$(+*&-*&!@B*<0!%&+!(-
+"*)!%& *& P)*'%8& U()"*& !1)"$%;& %*& .!-*#& #*(+'!($"&
$%&%*21'()*%;&.!"&(>%&."!.!%)$%&C/&$321#&)*#.!&$&
.$"<"&-$%&+!(+31%X*%&-*&%*#'(/"'!%&-*%*(0!30'-!%&
.*3$& & R*-@'!:<+$& M(*%+!Y& -'/3!2!;& $"21#*()$J,!;&
"$+'!($3'-$-*;& +!*"?(+'$;& +!(%*(%!& *& -*+'%,!& GZ;GE;&
*=.3'+$-$%&$&%*21'"8
t!"#$%&'&
T& $& )"!+$& !1& -'%+1%%,!& -*& '-*'$%;& !.'('X*%& *&
+!(+*')!%& +!#& 0'%)$%& [& %!31J,!& -*& ."!@3*#$%;& $!&
*()*(-'#*()!&!1&C$"#!('$8&\&-'/3!2!&:&-'"'2'-!&[&
+!#."**(%,!&"*+7."!+$&*()"*&!%&'()*"3!+1)!"*%8&T&!&
'()*"+Q#@'!& -*& '-*'$%;& !.'('X*%& *& '(D!"#$JX*%& *(-
)"*&!%&%1B*')!%&GF8&9$"$&C$0*"&-'/3!2!&:&'(-'%.*(%/0*3&
*='%<"&!&#7('#!&+!(%*(%!&GG.
t!()'*+,-./01&
I"21#*()!&:&!&#*'!&.*3!&41$3&%*&)*()$&+!#-
."!0$"& !1& "*D1)$"& 1#$& )*%*;& +!(0*(+*(-!& !& '()*"-
3!+1)!"&%!@"*&$&0*"-$-*&!1&D$3%'-$-*&-$&#*%#$8&T&
41$341*"& "$A,!;& ."!0$;& -*#!(%)"$J,!;& '(-7+'!& !1&
#!<0!&+$.$A&-*&+$.)$"&!&+!(%*(<#*()!&*&'(-1A'"&[&
.*"%1$%,!&!1&+!(0'+J,!]&:&$&"$A,!&"*%.!(%/0*3&.!"&
-$"&+"*-'@'3'-$-*&$&1#&$%%1()!&-10'-!%!8
t!2/3#&-/%#4/4,
\&"$+'!($3'%#!&:&!&"*+!(C*+'#*()!&-$&$1)!-
"'-$-*&-$&"$A,!8&I&"$A,!;&.!"&%1$&0*A;&:&$&D$+13-$-*&
-$&#*()*&41*&+!(%'%)*&*#&.*(%$"&-*&#!-!&+!(%'%-
)*()*& G^8& !&"$+'!($3'%#!&%*&$-#')*&1#$&+3$%%*&-*&
0*"-$-*%& !"'1(-$%& -$& '()1'J,!& -'"*)$& -!& '()*3*+)!;&
Rev bioét (Impr.) 2012; 20 (1): 9-20
17
 :;,-)/0$&(&;$,-".)/0$&'$&4$34(-*$&-3*(!3)4-$3),&'(&<-$="4)
!"#"$%&'#()*+#,'#()-(.-"#,(#/"0-"/1&'#$".$23")#"#
$"#'/4"+#('#"+/505$+'6#7#0(-5'.()5,(,"#%"+#/(/")#
,"-5$53'# .($# ,5$-!$$4"$8# "35%(.,'# !"# $"9(+# "$%*-
0"5$8#"#.(#/0'-!0(#,"#-'.$".$'$#*:-'$6
t&1$(!234-)
!"#$%&'(&)*+),-.)/0$
;5<.5=5-(#'0,"+8#-'.">&'#'!#?(0+'.5(#,".-
%0'# ,"# !+# $5$%"+(# '!# -'.9!.%'# ,"# -'.?"-5+".-
%'$8#">/0"$$(.,'#-'.='0+5,(,"#,"#/0'/'$514"$#(#
!+(#0"<0(#,"#-05%*05'$6#7#(0<!+".%(1&'#*#-'.$5-
,"0(,(# -'"0".%"# !(.,'# $!($# /(0%"$# "$%&'# 0")(-
-5'.(,($# ".%0"# $58# "$/"-5()+".%"# !(.,'# %()# 0"-
)(1&'#"$%@#,"#(-'0,'#-'+#!+#/(,0&'#'!#+',")'6#
A#=0" !".%"#-'.$5,"0(0# !"#-'5$($#-'"0".%"$#$&'#
-'+/(%23"5$# BC6#D#,5$-!0$'#"#($#/0@%5-($#E5'*%5-($#
,"3"+#$"0#-'"0".%"$6
t&1$3%(3%$
F"="0"G$"# H# ">5$%I.-5(# ,"# (-'0,'# ".%0"# '$#
+"+E0'$# ,"# ,"%"0+5.(,(# !.5,(,"# $'-5()# .'# !"#
,5J# 0"$/"5%'# (# /05.-2/5'$8# 3()'0"$8# .'0+($# '!# 'E9"-
:3'$# ,"$"9(,'$# /'0# !+(# -'+!.5,(,"8# E"+# -'+'#
('$#+"5'$#/(0(#()-(.1@G)'$#BK6#L>5$%"+#<0(!$#,"#-'.-
$".$'8#/'5$#'#-'.$".$'#-'+/)"%'#.&'#*#-'+!+".%"#
()-(.1(,'6# D# -'.$".$'# %"+# /(/")# 5+/'0%(.%"# .'#
,"$".3')35+".%'# ,"# /')2:-($# /ME)5-($8# /'0# ">"+-
/)'8#.(#,"N.51&'#,"#/05'05,(,"$#$(.5%@05($#=0".%"#(#
!+# '01(+".%'# 5.$!N-5".%"6# 7$# ,5="0".%"$# +',()5-
,(,"$#,"#-'+5%I$#'!#-'.$")?'$#,"#*:-(#"#E5'*:-(#
=0" !".%"+".%"#%I+#."-"$$5,(,"#,"#-'.$%0!50#-'.-
$".$'$#(#/(0:0#,"#,5="0".1($6#O(.%'#(#(0<!+".%(1&'#
-'+'#(#0(-5'.()5,(,"8#'#,5@)'<'#"#(#-'"0I.-5(#$&'#
5+/'0%(.%"$# 5.$%0!+".%'$# %"P05-'$# "# /0@:-'$# .(#
E!$-(#,'#-'.$".$'6
t&5(4-%0$
A# '# (%'# ,"# ,"=5.50# (# /'$51&'# %'+(,(# -')"%5-
3(+".%"# /'0# !+(# -'+5$$&'# '!# -'+5%I8# (# /(0%50#
,'# ,5@)'<'# "# ,'# ()-(.-"# ,'# -'.$".$'8# "# )"3@G)(#
"="%53(+".%"#H#(/)5-(1&'#/0@%5-(#.(#0"()5,(,"8#,"#
!"#$%&'(')*$+*,&$%-%.-!"!%&'%/$)0'!1)/,-%.!$0'!,&-%)-%2'(-3!'&$)&-%&'%-4'!56!-%&$%78%9$)#!'(($%:!-(,+',!$%
&'%:,$;"/-<%!'-+,=-&$%'2%:!-(>+,-<%?,(5!,5$%@'&'!-+<%'2%ABCBDEFF.
Rev bioét (Impr.) 2012; 20 (1): 9-20
18
+','# !"#'$#/0'E)"+($#"+#(.@)5$"#$"9(+#"="%5-
3(+".%"#0"$')35,'$6##
1$3%-'(!)/6(%&73)-%
Q'+#'#$!0<5+".%'#,(#E5'*:-(#"+#+"(,'$#,'$#
(.'$#KR8#*#5."<@3")#0"<5$%0(0# !"#$5<.5N-(:3'$#(3(.-
1'$#(-'.%"-"0(+#-'+#0")(1&'#H#-'.$%0!1&'#"#(/)5-(-
1&'#,"#/0'/'$%($#%"P05-($#"#+"%',')P<5-($#.'#-(+/'#
,($# *:-($# (/)5-(,($8# -'+# '# 5.%!5%'# ,"# +")?'0(0# ($#
-'.,514"$# ,"# 35,(# "# (# $'E0"353I.-5(# ,($# /"$$'($# "#
-'+!.5,(,"$#.'#/)(."%(8#,"#(-'0,'#-'+#'$#'E9":3'$#
'05<5.(5$#,"$%"#.'3'#%"005%P05'#,'#-'.?"-5+".%'#-5".-
SN-'6#7#0"-".%"#-05$"#"-'.T+5-(#"#$'-5'/')2:-(#+!.-
,5()#%0'!>"#H#$!/"0U-5"#".'0+"$#-'.%0(,514"$#+'0(5$#
.'# !"#$"#0"="0"#(#-'+/'0%(+".%'$#5.,535,!(5$#"#/M-
E)5-'$#"+#%','#'#+!.,'8#=(J".,'#."-"$$@05'# !"#(#
E5'*:-(#(%!()5J"#$!(#(<".,(#"#$"#5.-'0/'0"#('#)(,'#
,'$#$"%'0"$#,"+'-0@:-'$# !"#)!%(+#/")(#,5+5.!51&'#
,($#5.9!$:1($#"#/")'#,50"5%'#,"#(-"$$'#/(0(#'#+(5'0#
.M+"0'#/'$$23")#,"#/"$$'($#"#-'+!.5,(,"$#('$#E"-
."U-5'$#,'#,"$".3')35+".%'#-5".SN-'#"#%"-.')P<5-'6
V'#$".:,'#+(-0'#,($#(.@)5$"$#$'-5')P<5-(#"#
*:-(8#5$$'#$5<.5N-(# !"#('#5.3*$#,"#$"<!50#/0'/'.-
,'#!+#!.53"0$()5$+'#*:-'#/0'3".5".%"#,'$#/(2$"$#
-".%0(5$#"# !"#.(#+(5'0#/(0%"#,($#3"J"$#-?"<(#('$#
/(2$"$# /"05=*05-'$# -'+# (0"$# "# ='01(# ,"# 3"0,(,"5-
0'# 5+/"05()5$+'# +'0()# BW# X& -'+# 5,"5($# (0:-!)(,($#
"#">/'0%(,($#$"+#'#."-"$$@05'#N)%0'#"#(,(/%(1&'#
-'.%">%!()# H$# ."-"$$5,(,"$# ,($# .(14"$# +".'$#
,"$".3')35,($# 89# *# 5.,5$/".$@3")# !"# !+(# .'3(#
E5'*:-(8# +(5$# ,5.Y+5-(# "# /')5:J(,(8# -'.$%0!(# "#
-')' !"#('#,5$/'0#,($#.(14"$#"#-'+!.5,(,"$#+(5$#
."-"$$5%(,($#,"#E".$#,"#-'.$!+'#+2.5+'$#/(0(#(#
$'E0"353I.-5(#?!+(.(#!+#-'.9!.%'#,"#="00(+".-
%($#-'.-0"%($#,(#%"'05(#"#,'#+*%','#-5".SN-'# !"8#
0"$/"5%(.,'#(#/)!0()5,(,"#?5$%P05-(#,"#-(,(#)!<(08#
/'$$5E5)5%"# (# E!$-(# ,"# ,"$:.'$# /0P/05'$# ,"# +','#
-''/"0(:3'8# $"+# 5.%"0="0I.-5($# "$/M05($# "# -'+# (#
,"35,(#,5<.5,(,"6############
 !"#$%&'()*)"(#$+,%&'()-().(/.*$0()$/0*1/%.$(/%#)-*)2$(3+.%

1(2(!345-)%

1. !"#$%&#'()*+#,*-#'./,*0$%+#,*1#!#*#*2+34#'()5*#*6%7$4%#*/*#*63893!#:*;/48#!#'()*0$%</!,#8*
,)=!/*>%)?@4#*/*;%!/%9),*A3B#$),*C%$9/!$/9D:*E/$/=!#F*0$/,4)G*HIIJ*C#4/,,)*KI*#")*HIILD:*
;%,1)$M</8F*NO1FPP3$/,+)4:3$/,4):)!"P%B#"/,PIIQRPIIQRSQPQRSQTI1)!:1+U*
2. E#!!#U#*V5*W/,,%$%*X:*>%)?@4#F*1)+/!*/*%$Y3,@'#:*Z()*W#38)F*X)[)8#G*HIIK:
K:* W)O/!*V\:*>%)/9N%4,F*#*=!%+"/*9)*9N/*U393!/:*-/]*^/!,/[F*W!/$@4/_A#88G*QL`Q:

!"#$%&'(&)*+),-.)/0$
R:* a%4b8/!*;:*6)B=%$#'()*=%)?@4#*/*1)8M@4#:*c$F*E#!!#U#*V5*W/,,%$%*X:* 1:*4%9:*1:*QJ_S:
5. >/$#9#!*Z:*;%,43!,)*+)*1!/,%+/$9/:*c$F*E#!!#U#*V5*W/,,%$%*X:* 1:*4%9:*1:*HJ_KK:
S:* E#!!#U#*V5*W)!9)*;:*c$9/!</$@)$*=%)/9N%4,F*#*1!)1),#8*U)!*1/!%1N/!#8*4)3$9!%/,*%$*#*4)$9/d9*)U*
1)]/!*#$+*%$Y3,@4/:*>%)/9N%4,:*HIIKGQ`eJ_SfFKLL_RQS:*
`:* 6#B1=/88*g:*W!/,%+/$9h,*6)83B$:*cg>*-/],:*QLLTG*`*eZ1!%$"fFQ_H:***
T:* >/!8%$"3/!*E:*g1!/,/$9#'():*c$F*E#!!#U#*V:*;%B/$,()*+#*?@4#*/B*,#i+/*1i=8%4#:*Z()*W#38)F*
j#438+#+/*+/*Z#i+/*Wi=8%4#*0ZWPk/88)""*j)3$+#@)$G*QLLJ:*1:*%_%%%:*
9. Z4N!#BB*j\:*>%)?@4#F*#*9/!4/%!#*B#!"/B*+#*,#i+/:*>!#,M8%#F*2+%9)!#*0$>G*QLLS:
10. j)!9/,*Wg6:*l@4#*/*,#i+/F*m3/,9./,*?@4#,5*+/)$9)8n"%4#,*/*8/"#%,5*9)B#+#,*+/*+/4%,./,5*#39)-
$)B%#*/*+%!/%9),*+)*1#4%/$9/F*/,93+)*+/*4#,),:*Z()*W#38)F*2W0G*QLLT:**
11. 6#44%#_>#<#*Z:*>/B_<%$+#,*#,*$)<#,*%+/%#,:*X/*o)$+/*;%18)B#@m3/_>!#,%8:*HIILGH`FK:
12. j)34#389*o:*-#,4%B/$9)*+#*=%)1)8M@4#:*Z()*W#38)F*o#!@$,*j)$9/,G*HIIL:
QK:* E#!!#U#*V:*\/+=%)?@4#F*3$#*%$%4%#@<#*+/*0$/,4)*1#!#*gB?!%4#*X#@$#*[*/8*6#!%=/:*\/<*\/+=%)-
?@4#:*HIQIGQeQfFR_QS:
QR:* 6#!9#*+/*>3/$),*g%!/,*,)=!/*>%)?@4#*[*;/!/4N),*A3B#$),:*Z/4!/9#!%#*+/*;/!/4N),*A3B#$),*
+/*g!"/$@$#P\/+=%)?@4#*0$/,4):*\/<%,9#*>!#,%8/%!#*+/*>%)?@4#:*HIIJGQeKfFKQ`_HH:*
15. E#!!#U#*V:*\/+=%)?@4#F*#*0$/,4)*%$%@#@</*U)!*X#@$_gB/!%4#*#$+*6#!%==/#$:*QS9N*Z/,,%)$*)U*9N/*
c$9/!$#@)$#8*>%)/9N%4,*6)BB%O//*)U*9N/*0$/,4)G*HK_HJ*$)<*HIILG*o?d%4)*6%9[:***
QS:* X#$+B#$$*-5*Z4Np4b8/$b*0:*j!)B*9N/*2+%9)!,*_*0$/,4)*q+/48#!/,h*3$%</!,#8,*)$*=%)/9N%4,*#$+*
N3B#$*!%"N9,*_*B#$[*3$/d1/49/+*3$%</!,#8*9!39N,*3$/#!9N/+*=[*0-*=)+[:*;/<*a)!8+*>%)/9N:*
HIIJGJeKfF*%%%_<%:
Q`:* a%88%#B,* ^\:* 0$%</!,#8* +!#r* +/48#!#@)$* )$* =%)/9N%4,* #$+* N3B#$* !%"N9,:* ;/<* a)!8+* >%)/9N:*
HIIJGJeKfFHQI_J:**
QT:* >/$#9#!*;:*sN/*9!)3=8/*]%9N*3$%</!,#8*+/48#!#@)$,:*;/<*a)!8+*>%)/9N:*HIIJGJeKfFHHI_R:
19. E!#4%#* ;:* X#* +/48#!#4%n$* 3$%</!,#8* ,)=!/* =%)?@4#* [* +/!/4N),* N3B#$),F* #8"3$#,* 48#</,* 1#!#*
,3*8/493!#:*c$F*E!),,_2,1%/88*A5*EnB/&_Zt$4N/&*u5*)!"#$%&#+)!/,:*;/48#!#4%n$*0$%</!,#8*,)=!/*
>%)?@4#*[*;/!/4N),*A3B#$),*+/*8#*0$/,4):*E!#$#+#F*2+%9)!%#8*6)B#!/,G*HIIS:*1:*L_H`:**
20. 6N%!#4* W5* s)!!//8/* 2:* E8)=#8* U!#B/])!b* )$* /,,/$@#8* N/#89N* \v;:* X#$4/9:* HIISGKS`eLJHHfF*
Q:JSI_Q:
21. E#!!#U#*V5*Z)8=#bb*^A5*V%+#8*Z5*X)!/$&)*6:*>/9]//$*9N/*$//+[*#$+*9N/*"!//+[F*9N/*m3/,9*U)!*#*
Y3,9*#$+*U#%!*/9N%4,*)U*48%$%4#8*!/,/#!4N:*^*o/+*29N%4,:*HIQIGKSeTfFJII_R:*
22. g,,)4%#'()* o?+%4#* o3$+%#8:* 6#!9#* +/* 6n!+)=#* ,)=!/* l@4#* /$* c$</,@"#4%n$* 4)$* Z/!/,*
A3B#$),:*\/<%,9#*>!#,%8/%!#*+/*>%)?@4#:*HIITGReK_RfFTQ:*
HK:* X)!/$&)* 6:* X),* %$,9!3B/$9),* $)!B#@<),* /$* ?@4#* +/* 8#* %$</,@"#4%n$* /$* ,/!/,* N3B#$),* /$*
gB?!%4#*X#@$#F*#$t8%,%,*+/*,3*1)9/$4%#8*/w4t4%#:*c$F*k/[/3d*E5*W/$4N#,&#+/N*V5*Z##+#*g5*4)-
)!+/$#+)!/,:*l@4#*+/*8#*%$</,@"#4M)$*/$*,/!/,*N3B#$),*[*1)8M@4#,*+/*,#83+*1i=8%4#:*>)")9tF*
0$%</!,%+#+*-#4%)$#8*+/*6)8)B=%#P\/+=%)?@4#*0$/,4)G*HIIS:*1:*QS`_LI:**
HR:* E#!!#U#*V5*W!#+)*oo:*s/$9#@<#,*+/*B3+#$'#,*$#*;/48#!#'()*+/*A/8,%$b%F*U3$+#B/$9#8%,B)*
/4)$xB%4)5*%B1/!%#8%,B)*?@4)*/*4)$9!)8/*,)4%#8:*6#+*Z#i+/*Wi=8%4#:*HIIQGQ`eSfFQRTL_LS:
25. X)!/$&)* 65* E#!!#U#* V5* Z)8=#bb* ^A5* V%+#8* Z:* A%++/$* !%,b,* #,,)4%#9/+* ]%9N* 48%$%4#8* 9!%#8,* %$* +/-
</8)1%$"*4)3$9!%/,:*^*o/+*29N%4,:*HIQIG*KSeHfFQQQ_J:
HS:* >/!8%$"3/!*E:*y3/,@)$%*+%*<%9#F*/@4#5*,4%/$&#5*,#839/:*s)!%$)F*2%$#%+%G*QLLQ:**
H`:* 6N#$,)$*o^5*6#88#N#$*;5*/+%9)!,:*sN/*")#8,*)U*B/+%4%$/F*9N/*U)!")O/$*%,,3/,*%$*N/#89N*4#!/*
!/U)!B:*a#,N%$"9)$F*E/)!"/9)]$*0$%</!,%9[*W!/,,G*QLLL:
HT:* ;#$%/8,*-:*^3,9*N/#89N*4#!/:*-/]*u)!bF*6#B=!%+"/*0$%</!9,%9[*W!/,,G*QLTJ:
29. W)!9)*;:*>%)?@4#*/*m3#8%+#+/*+/*<%+#F*#,*=#,/,*+#*1%!zB%+/*,)4%#8*$)*4)!#'()*+)*>!#,%8*C9/,/D:*
>!#,M8%#F*0$%</!,%+#+/*+/*>!#,M8%#G*HIIS:*
KI:* W)!9)*;5*E#!!#U#*V:*g*%${37$4%#*+#*!/U)!B#*,#$%9t!%#*$#*4)$,9!3'()*+#,*=%)?@4#,*=!#,%8/%!#,:*
6%7$4*Z#i+/*6)8/@<#:*HIQQGQS*eZ318*QfF`QL_HL:*
KQ:* Z9_ $"/*^6:*Xh/$</!,*+/*8#*1%838/F*8/*+/,,)3,*+/*8h%$+3,9!%/*1N#!B#4/3@m3/:*He*/+:*o)$9!/#8F*
X/,*2+%@)$,*24),)4%?9?G*HIIT:
KH:* o/88)*;\5*6)3@$N)*g5*Z#$9),*E25*g!#iY)*s:*g$t8%,/*=%)?@4#*+)*1#1/8*+)*/,9#+)*$#*"#!#$@#*#)*
#4/,,)*#*B/+%4#B/$9), ! !"#$%&&%'%#()#*+,,-#./)#0-&1-#.)#-&2%!34%5-&+67#83-9:;%#+#<323,=!;3%#
6%!31>&3%7#8&%6?,3%"#@!<36%AB>1+5&%#C!+6;-#5+#83-9:;%#5%#C!8D#EFFG7#H7IJKLM7
LL7# *-N!3O%!#/7#PO-#H%N6#'-&#1O+#H344%Q#/+5+R!3!2#1O+#&+,%:-!6O3H#S+1T++!#5-;1-&6#%!5#5&U2#
;-VH%!3+67#I"#+!1%!2,+V+!17#8&31#*+5#W7#EFFLDLEXYGMFFZ"II[\K\E7
LM7# P3,,+&&-35+&#*7#*%]3!2#1O+#V-<+#3!1-#5&U2#6%,+67#^%1U&+7#EFFMDMLFY\X\[Z"M[XKG7

Rev bioét (Impr.) 2012; 20 (1): 9-20

19
 12,-)/0$&(&2$,-".)/0$&'$&3$43(-*$&-4*(!4)3-$4),&'(&5-$6"3)

04+( 5&3!67&(89(:.33.;.(<+(=6-.>&-("?@6$"&-9(!-A.%&(>(-&"$!%.%'(%&6%!(A!3B$6.(?.("$!6"$.(>(!B2$!7.(
!?(6!C&"$&D(E.?F%(8&?!"G,.+(/H))IJK/L')**MJH+
0*+( :NB!7MEO6"P!7(Q+(5.(R!"?.3."$N6(S6$,!3-.?(-&#3!(T$&UG".(>(R!3!"P&-(VFB.6&-'(F6(#.?.6"!(
%!( -F( ,$C!6"$.+( W6'( 8.-.%&( X9( "&&3%!6.%&3.+( E&#3!( ?.( %$C6$%.%( >( ?&-( 23$6"$2$&-'( .6O?$-$-( %!(
?.(R!"?.3."$N6(S6$,!3-.?(-&#3!(T$&UG".(>(R!3!"P&-(VFB.6&-(%!(?.(S6!-"&+(X.%3$%'(8$,$A.-I(
/HHY+(2+(4*4+(
0J+( 16%3F!A(1E+(8&BF6$".#$?$%.%(%!(?.(R!"?.3."$N6(S6$,!3-.?(-&#3!(T$&UG".(>(R!3!"P&-(VFB.6&-(
!6(?.(?!C$-?."$N6(?.G6&.B!3$".6.(>(%!?(8.3$#!+()*AP(E!--$&6(&;(AP!(W6A!36.G&6.?(T$&!AP$"-(8&B-
!"#$%&'(&)*+),-.)/0$

B$Z!!(&;(AP!(S6!-"&I(/0M/4(6&,(/HH[I(XU\$"&(8$A>+(((
0Y+( :3&--M=-2$!??( V+( 5.( R!"?.3."$N6( S6$,!3-.?( %!( T$&UG".( >( R!3!"P&-( VFB.6&-( %!( ?.( S6!-"&( >(
?.(R!"?.3."$N6(%!(E.6A&(R&B$6C&(-&#3!(T$&UG".(>(R!3!"P&-(VFB.6&-+( !,$-A.(T3.-$?!$3.(%!(
T$&UG".+(/HHJI0K)L'JM)0+
0[+( :.33.;.(<+(8&6,!6]^&( !C$&6.?(%&(X!3"&-F?(-&#3!(T$&UG".'(FB.(23&2&-A.(%.(8OA!%3.(S6!-"&(
%!(T$&UG".(%.(S6T+(W6'(T.3#&-.(E_9(&3C.6$7.%&3+(T$&UG".(!B(%!#.A!'(.`F$(!(?O(;&3.+(T3.-@?$.'(
W2!.I(/H))+(2+()aJM44+
aH+( :.33.;.(<9(5&3!67&(8+(V!?-$6`F!(/HHY'(3!%F]^&(%!(23&A!]^&(!(B.\$B$7.]^&(%!($6A!3!--!-(23$-
,.%&-+(1XT( !,(1--&"(XU%(T3.-+(/HH[I44KaL'4)aMY+
a)+( :.33.;.(<9(17.B#Fb.(5=c+(=2$-A!B&?&C@.(%!(?.(#$&UG".'(!6;&`F!(?.G6&M.B!3$".6&+( !,$-A.(T3.-
-$?!$3.(%!(T$&UG".+(/HHJI0K0L'0aaM4[+
a/+( :.33.;.(<9(d&Z&e(X9(E..%.(19("&&3%!6.%&3!-+(=-A.AFA&(!2$-A!B&?NC$"&(%!(?.(#$&UG".+(XU\$"&'(
S6.BfS6!-"&I(/HH4+ !"!#$%&'()*+))+))
a0+( V.#!3B.-(g+(5.($6"?F-$N6(%!?(&A3&+(T.3"!?&6.'(h.$%N-I(/HH4+ !,$-.%&'/0+0+)/
aa+( _!3$(R+(i$?&-&j.(B&3.?+(E^&(h.F?&'(5&>&?.I(/HHa+ 123&,.%&'(/*+0+)/
a4+( TF6C!(X+(R$"$&6O3$&(%!(j?&-&j.+(E^&(h.F?&'(h!3-2!"G,.I(/HH/+
a*+( 1##.C6.6&(_+(R$"$&6O3$&(%!(j?&-&j.+(E^&(h.F?&'(X.3G6-(i&6A!-I()[[[+
aJ+( h&-A(E:9(!%$A&3+((=6">"?&2!%$.(&;(#$&!AP$"-+(_!e(Q&3k'(lP&B2-&6(:.?!I(/HH0+(,&?+(/+
aY+( :.33.;.(<9(5&3!67&(8+(X&3.?($B2!3$.?$-B(.6%(BF?GM"!6A3$"("?$6$".?(A3$.?-($6(2!3$2P!3.?("&F6A3$!-+(
8.%(E.m%!(hm#?$".+(/HHYI/aK)HL'//)[M/*+

Rev bioét (Impr.) 2012; 20 (1): 9-20

20