Dentistry, Education, Public Health, Environmental and Occupational Health, Public Health, Environmental and Occupational Health
43
Scopus Publications
Scopus Publications
End-of-life practices and advance directives: a bioethical analysis based on discussions in the Brazilian Federal Legislative Branch Melisse Eich, Marta Verdi, Pedro Paulo Scremin Martins, Mirelle Finkler Salud Colectiva, 2026 El debate legislativo brasileño sobre prácticas de fin de vida involucra tensiones ético-axiológicas relacionadas con la eutanasia, el suicidio asistido, los cuidados paliativos y las directivas anticipadas de voluntad, en el que se confrontan concepciones divergentes de estas prácticas y el valor de la vida, influyendo en la formulación normativa del proceso de morir. Este estudio analiza cómo tales tensiones son construidas y justificadas en los discursos del Poder Legislativo Federal, comprendiendo los sentidos normativos y la jerarquía de valores atribuidos a los cuidados paliativos y a las directivas anticipadas de voluntad, así como sus implicaciones ético-morales. Se realizó una investigación documental cualitativa, orientada por la hermenéutica-dialéctica y fundamentada en referentes contemporáneos de la bioética de la responsabilidad y de la bioética cotidiana. Se examinaron 193 documentos legislativos federales (1981–2020). Del análisis emergieron dos categorías temáticas: 1) conjunto paliativo: sentidos y atribuciones, que evidencia la tendencia legislativa a limitar el derecho a la negativa terapéutica; y 2) instrumentos y mecanismos de acción para la inversión de las directivas anticipadas de voluntad, que revela la restricción de instrumentos destinados a la protección de la autonomía. Los resultados señalan la prevalencia de argumentos basados en valores vitales, tratados como absolutos, en detrimento de valores personales como la dignidad humana, la autonomía y la autodeterminación, lo que puede restringir el derecho a morir con dignidad en Brasil.
Tooling Up Nursing Research: Ethical Tensions Within Psychometric Scale Development Ricardo Ayala, Mirelle Finkler, Pierre Pariseau‐Legault Nursing Inquiry, 2026 The past two decades have witnessed a great interest in psychometric research in nursing, characterised by a marked increase in measurement tools. This approach has been lauded for its methodological sophistication—yet beneath this polish lies an unexamined ethical cost. This paper interrogates the proliferation of psychometric instruments as an indicator of deeper disciplinary tensions: the quest for legitimacy, the valorisation of quantifiable research output and the bureaucratic allure of metrics. We examine three core risks—namely ethical redundancy, resource misallocation and evidence fragmentation—and argue for a recalibration of instrument development grounded in collective accountability, theoretical coherence and editorial restraint.
Artificial Intelligence, Human Rights and Social Justice: A Bioethical Analysis of International Recommendations Suliane Motta do Nascimento, Márcia De Oliveira, Dalila Cassunde Oliveira, Mirelle Finkler, Fernando Hellmann, et al. Revista De Bioetica Y Derecho, 2025 A Inteligência Artificial (IA) vem transformando rapidamente diversos setores sociais, desde a saúde até a gestão pública, mas também levanta questões éticas complexas, especialmente em contextos de desigualdade estrutural. Este artigo tem como objetivo analisar quatro diretrizes internacionais sobre ética da IA, publicadas por organismos multilaterais: Organização para a Cooperação e Desenvolvimento Econômico - OCDE (2024), Organização das Nações Unidas para a Educação, Ciência e Cultura - UNESCO (2021), Organização Mundial da Saúde – OMS (2021) e Grupo de Especialistas de Alto Nível em Inteligência Artificial da Comissão Europeia (2019). A partir de uma abordagem qualitativa e da técnica de Análise de Conteúdo Temática, identificaram-se 27 questões éticas que foram organizadas em três grandes categorias: “Promoção dos Direitos Humanos”, “Riscos e Prevenção de Danos” e “Justiça Social”. Os resultados mostram que, embora compartilhem princípios como transparência, responsabilidade e equidade, os documentos variam em suas recomendações e se destinam a contextos institucionais distintos, muitas vezes descolados das realidades vividas por países do Sul global. Argumenta-se que a incorporação da Bioética Cotidiana — com seu foco em justiça social, engajamento democrático e enfrentamento das desigualdades — é fundamental para contextualizar e operacionalizar essas recomendações de forma justa e eficaz. Conclui-se que os esforços globais de regulamentação da AI devem ser acompanhados por mecanismos de governança éticos que não reproduzam lógicas de colonialidade tecnológica, mas que assegurem a participação social, a proteção de direitos e o reconhecimento das vulnerabilidades.
Ethical conflict resolution in the domain of interprofessional education and collaborative practice: initial results of a scoping review Lilian Suelen de Oliveira Cunha, Mirelle Finkler, Ana Caroline Machado Journal of Interprofessional Care, 2025 Despite the growing global emphasis on interprofessional education and collaborative practice (IPECP) in healthcare, ethical competence development remains underexplored. This article presents initial findings from an ongoing scoping review aimed at addressing two key questions: How does the existing literature describe the precursors of ethical conflict resolution in IPECP? What gaps in knowledge persist in this area? A search across eight electronic databases selected 27 eligible articles, which underwent thematic content analysis. The analysis identified eleven primary themes concerning the factors influencing interprofessional ethical conflict resolution and revealed a notable gap: insufficient strategies for integrating ethical competence and conflict resolution into the daily practices of healthcare professionals. While the literature stresses the importance of ethics education and training for students and professionals alike, there is a clear need for further exploration of effective frameworks tailored to IPECP contexts.
Collaborative competence, values, and ethics in interprofessional education and collaborative practice: findings from a scoping review Lilian Suelen de Oliveira Cunha, Juliana Praxedes Campagnoni, Mirelle Finkler, Maria Fernanda Vásquez Valência Journal of Interprofessional Care, 2025 Despite the abundance of studies on Interprofessional Education and Collaborative Practice (IPECP) and the integration of competencies into health curricula, there appears to be a lack of understanding of the development of ethical competencies for interprofessional teamwork.The objective of this scoping review was to examine how collaborative competence in values/ethics is characterized and developed within IPECP, along with an understanding of researchers' recommendations. A comprehensive search of nine databases was conducted for the period between 2011 and 2025, encompassing a total of 52 studies. The review identified several key findings, including: focus on IPEC Core Competences; an emphasis on certain values/ethics sub-competencies; the identification of conflicts related to professional hierarchy; and a range of approaches to developing ethical competence through educational strategies. The review highlights challenges in fostering ethical competence in IPECP, noting progress and limitations.
End-of-life practices: a bioethical analysis of Brazilian Legislative projects, 1981-2020 Melisse Eich, Marta Verdi, Mirelle Finkler, Pedro Paulo Scremin Martins Saude E Sociedade, 2024 Voluntary active euthanasia (VAE) and assisted suicide (AS) constitute end-of-life practices that aim to minimize the suffering of people with incurable diseases, preserving their human dignity in the face of death. However, taboos and controversies still surround them. This study aims to investigate the legal-normative status of these practices in Brazil via a qualitative documentary research with data from the Federal Legislative Power websites from 1981 and 2020. The dialectical hermeneutic proposal of this study discusses the path of political decisions on VAE, AS (and their relations with orthothanasia and palliative care), and the practical effects of their values and moral constructions on people’s self-determination in the dying process and in society.
From ethical confrontation to suffering: what did the Covid-19 pandemic teach us about the work process in oral health Cristine Maria Warmling, Mirelle Finkler, Luciana Zambillo Palma, Fabiana Schneider Pires, Renata Cristina Soares Fornazari, et al. Interface Communication Health Education, 2024 Este estudo qualitativo multicêntrico objetivou compreender como as dificuldades no processo de trabalho foram percebidas e sentidas por trabalhadores de saúde bucal (cirurgiões-dentistas, técnicos e auxiliares) em termos éticos e de saúde mental no enfrentamento da pandemia de Covid-19. Realizou-se a análise textual discursiva das respostas de 2560 trabalhadores a três questões abertas de um websurvey, entre agosto e outubro de 2020, na região sul do Brasil. As principais dificuldades do processo de trabalho foram: compreensão sobre suspensão dos atendimentos eletivos e priorização de urgências; acesso aos serviços; e implementação de protocolos de biossegurança. As dificuldades tornaram-se base para alguns problemas éticos: incertezas na priorização de casos, riscos aumentados e condutas profissionais heterogêneas. O sofrimento dos trabalhadores foi explícito: angústia por cobranças da população, medo pela situação da pandemia, situação de exaustão no trabalho e descaso da gestão.
Interprofessional education in traditional and complementary medicine: a scoping review Janaina Carneiro de Camargo, Mirelle Finkler, Juliana Praxedes Campagnoni, Mariana Cabral Schveitzer, Marta Verdi, et al. Journal of Interprofessional Care, 2024 Interprofessional education (IPE) is a teaching method that improves collaboration and communication across health professions. There are consistent reports of poor interprofessional collaboration and communication between conventional health professionals and traditional and complementary medicine (TCM) professions. The application of IPE within courses that provide training in TCM requires close examination. This research aimed to identify the state of the art in IPE in TCM teaching. A scoping review was conducted. Thirteen databases were searched to identify citations up to March 2021. Thirty articles were selected after filtering for relevance against the inclusion criteria. The included articles were categorized into four a priori categories: Knowledge and Attitudes of students and professionals about TCM and IPE; Competencies of IPE in TCM; Teaching about TCM using IPE and Challenges and Opportunities for IPE in TCM. Nineteen of the included articles reported empirical research and primarily presented the evaluation of IPE activities within TCM courses or workshops; six studies consisted of texts with propositions and theoretical analyses; and five were case/experiential reports of IPE and TCM interventions, with or without evaluation of results. The studies report all health science students (undergraduate and graduate) exposed to IPE demonstrate a decrease in prejudice and an increase in knowledge about TCM. A sense of partnership developed through the collaborative competencies common to IPE and TCM and integrated care of patients. IPE in the context of TCM has been used for fostering integrative health care through the collaborative work of professional teams. Implementing IPE in TCM teaching requires inclusion in the curriculum, primarily undergraduate and research training.
Interprofessional Health Education in the neoliberal context: inconsistencies and challenges María Fernanda Vásquez, Mirelle Finkler, Ricardo Ayala, Marta Verdi Interface Communication Health Education, 2023 Resumen Se trata de un artículo crítico y reflexivo que pretende discutir algunas de las incoherencias e incompatibilidades estructurales del modelo propuesto para la formación y atención en salud denominado Educación Interprofesional y Práctica Colaborativa (EIPC), en el contexto de racionalidad neoliberal de los países latinoamericanos. Se destaca cómo este modelo puede contestar dicha racionalidad, siendo relevante para la instauración de subjetividades profesionales críticas y éticas con su contexto. De esta manera se pretende contribuir a la creciente literatura sobre perspectivas críticas de la formación y el trabajo en salud.
