CONFLITOS E ABORDAGEM BIOÉTICA DE CRIANÇAS COM DISTÚRBIOS DO DESENVOLVIMENTO SEXUAL

Autores

  • Ida Cristina Gubert Universidade Federal de Minas Gerais (UFMG)

DOI:

https://doi.org/10.7213/revistapistispraxis.6038

Palavras-chave:

Bioética, Intersexo, Ambiguidade genital, Distúrbios do desenvolvimento sexual

Resumo

Hermafroditismo, genitália ambígua, intersexo são termos hoje sob a designação de distúrbios do desenvolvimento sexual e que traduzem, em última análise, uma discordância entre o sexo cariotípico, fenotípico e gonadal, resultando em uma indefinição ou ambiguidade da sexualidade da criança afetada. Essas condições, ainda que raras,e até pouco tempo não muito divulgadas em função do estigma e da vergonha, hoje estão mais abertas e difundidas, mas sua abordagem ainda é controversa. Aspectos desafiantes da abordagem e conduta para com os sujeitos afetados pelos distúrbios do desenvolvimento sexual são a pressão da sociedade pelo conhecimento e consequentemente definição do sexo da criança, a autonomia desse sujeito, os princípios de beneficência,a tomada de decisões “no melhor interesse da criança” e o consentimento/ assentimento para a abordagem terapêutica mais adequada. As controvérsias expostas no texto convidam a uma reflexão multidisciplinar no enfoque desses casos.

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Referências

ALLEN, L. Disorders of sexual development. Obstetrics & Gynecology Clinics of North America, v. 36, n. 1, p. 25-45, 2009.

BARBARO, M.; WEDELL, A.; NORDENSTRÖM, A. Disorders of sex development. Seminars in Fetal and Neonatal Medicine, v. 16, n. 2, p. 119-127, 2011.

BARTHOLD, J. S. Disorders of sex differentiation: a pediatric urologist’s perspective of new terminology and recommendations. The Journal of Urology, v. 185, n. 2, p. 393-400, 2011.

BRADLEY, S. J. et al. Experiment of nurture: ablatio penis at 2 months, sex reassignment at 7 months, and a psychosexual follow-up in young adulthood. Pediatrics, v. 102, n. 1, p. e9, 1998.

COLEMAN, D. L. The legal ethics of pediatric research. Duke Law Journal, v. 57, n. 3, p. 517-524, 2007.

DAABOUL, J.; FRADER, J. Ethics and the management of the patient with intersex: a middle way. Journal of Pediatric Endocrinology & Metabolism, v. 14, n. 9, p. 1575-1583, 2001.

DIAMOND, M. A critical evaluation of the ontogeny of human sexual behavior. 1965. Disponível em: <http://www.hawaii.edu/PCSS/biblio/articles/ 1961to1999/ 1965-critical-evaluation.html>. Acesso em: 12 jun. 2011.

DIAMOND, M. Sex, gender, and identity over the years: a changing perspective. Child & Adolescent Psychiatric Clinics of North America, v. 13, p. 591-607, 2004.

DIAMOND, D. A. et al. Sex assignment for newborns with ambiguous genitalia and exposure to fetal testosterone: attitudes and practices of pediatric urologists. Journal of Pediatrics, v. 148, n. 4, p. 445-449, 2006.

DREGER, A. M. (Ed.). Intersex in the age of ethics. Hagerstown: University Publishing Group, 1999.

FRADER, J. et al. Health care professionals and intersex conditions. Archives of Pediatric & Adolescent Medicine, v. 158, n. 5, p. 426-428, 2004.

GILLAM, L. H.; HEWITT, J. K.; WARNE, G. L. Ethical principles for the management of infants with disorders of sexual development. Hormone Residence in Paediatrics, v. 74, n. 6, p. 412-418, 2010.

HUGHES, I. A. et al. Consensus statement on management of intersex disorders. Pediatrics, v. 118, n. 2, p. 448-500, 2006.

HUGHES, I. A. et al. Consequences of the ESPE/LWPES guidelines for diagnosis and treatment of disorders of sex development. Best Practice & Research Clinical Endocrinology & Metabolism, v. 21, n. 3, p. 351-365, 2007.

KIPNIS, K. Seven vulnerabilities in pediatric research. Theoretical Medicine, v. 24, n. 2, p. 1076-1120, 2003.

KIPNIS, K. Gender, sex, and professional ethics in child and adolescent psychiatry. Child & Adolescent Psychiatric Clinics of North America, v. 13, n. 3, p. 695-708, 2004.

LEVY, M. L.; LARCHER, V.; KURZ, R. Informed consent/assent in children. Statement of the ethics working group of the Confederation of European Specialists in Pediatrics. European Journal of Pediatrics, v. 162, n. 9, p. 629-633, 2003.

LUX, A. et al. Clinical evaluation study of the german network of disorders of sex development (DSD)/intersexuality: study design, description of the study population, and data quality. BMC Public Health, v. 9, p. 110, 2009.

MAHARAJ, N. R. et al. Intersex conditions in children and adolescents: surgical, ethical and legal considerations. Journal of Pediatric and Adolescent Gynecology, v. 18, n. 6, p. 399-402, 2005.

MARTIN, P. Moving toward an international standard in informed consent: the impact of intersexuality and the internet on the standard of care. Duke Journal of Gender Law & Policy, v. 9, n. 135, p. 135-169, 2002.

MIESZCZAK, J.; HOUK, C. P.; LEE, P. A. Assignment of the sex of rearing in the neonate with a disorder of sex development. Current Opinion in Pediatrics, v. 21, n. 4, p. 541-547, 2009.

PASTERNAK, J. Genética molecular humana: mecanismos das doenças hereditárias. São Paulo: Manole, 2002.

RANGECROFT, L. Surgical management of ambiguous genitalia. Archives of Disease in Childhood, v. 88, n. 9, p. 799-801, 2003.

REY, R. A.; GRINSPON, R. P. Normal male sexual differentiation and aetiology of disorders of sex development. Best Practice & Research Clinical Endocrinology & Metabolism, v. 25, n. 2, p. 221-238, 2011.

SPRIGGS, M.; SAVULESCU, J. The ethics of surgically assigning sex to intersex infants. In: BENATAR, D. (Ed.). Cutting to the core: exploring the ethics of contested surgeries. Lanham: Rowman & Littlefield Publishers, 1998. p. 638-658.

WALKER, J. The death of David Reimer: a tale of sex, science and abuse. 2004. Disponível em: <http://reason.com/archives/2004/05/24/the-death-of-david-reimer>. Acesso em: 9 June 2011.

WIESEMANN, C. et al. Ethical principles and recommendations for the medical management of differences of sex development (DSD)/intersex in children and adolescents. European Journal of Pediatrics, v. 169, n. 6, p. 671-679, 2010.

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Publicado

2012-10-06

Como Citar

Gubert, I. C. (2012). CONFLITOS E ABORDAGEM BIOÉTICA DE CRIANÇAS COM DISTÚRBIOS DO DESENVOLVIMENTO SEXUAL. Revista Pistis Praxis, 4(1), 33–49. https://doi.org/10.7213/revistapistispraxis.6038

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