"É para o seu próprio bem": a dimensão ética das ferramentas de detecção de risco de suicídio e da intervenção paternalista

Auteurs

DOI :

https://doi.org/10.31977/grirfi.v22i1.2774

Mots-clés :

Suicídio; Autonomia; Intervenção paternalista; Inteligência artificial; Redes sociais.

Résumé

O impedimento de indivíduos acometidos por enfermidade psíquica em risco de suicídio é bem justificado. Mas o impedimento do suicida racional é complicado pelo conflito entre defendermos a vida e defendermos a autonomia, como ilustrado pelas diversas abordagens filosóficas quanto à dimensão ética do suicídio. Argumentaremos que a intervenção paternalista sobre o indivíduo autônomo, desde que de natureza pontual e escopo limitado, é também justificada. Para tanto iremos nos valer da distinção entre autonomia superficial (shallow) e profunda (deep), bem como de fatores complicadores oriundos de literatura médica recente: a questão da ambivalência e o cry for help model. Dedicaremos especial atenção também às implicações éticas de novas estratégias de detecção de risco que utilizam inteligência artificial aplicada a bases de dados de redes sociais como o Facebook. Embora os dados preliminares sugiram ser ferramentas eficazes, a falta de transparência, regulamentação e consentimento coloca em risco liberdades e direitos civis. 

Téléchargements

Les données relatives au téléchargement ne sont pas encore disponibles.

Biographie de l'auteur

Alexander Maar, Centro Federal de Educação Tecnológica de Minas Gerais (CEFET – MG)

Doutor(a) em Filosofia pela  University of Auckland (U.AUCKLAND), Nova Zelândia. Professor(a) do Centro Federal de Educação Tecnológica de Minas Gerais (CEFET – MG), Belo Horizonte – MG, Brasil.

Références

ABP. Suicídio – informando para prevenir. Brasília: Conselho Federal de Medicina, 2014.

ALLEN, T.; SELGELID, M. Necessity and least infringement conditions in public health ethics. Medicine, Health Care and Philosophy 20, p. 525-535, 2017.

ARONSON, R. “Albert Camus”. In: ZALTA, E. (Org.) Stanford Encyclopedia of Philosophy, 2017. Disponível em: https://plato.stanford.edu/archives/sum2017/entries/camus/. Acesso em: 30 nov. 2020.

BARNETT I; TOROUS J. Ethics, transparency, and public health at the intersection of innovation and Facebook’s suicide prevention efforts. Ann Intern Med. 170, p. 565-566, 2019.

BARRACLOUGH, B. et. alii. A Hundred Cases of Suicide. British Journal of Psychiatry, v. 125, p. 355-373, 1974.

BATTIN, M. P. The Death Debate. Upper Saddle River: Prentice Hall, 1996.

BEAUCHAMP, T. “Suicide”. In: REGAN, T. (Org.) Matters of Life and Death: New Introductory Essays in Moral Philosophy. New York: McGraw Hill, p. 83-104, 1993.

BERTOLOTE, J. M.; FLEISCHMANN, A. Suicide and psychiatric diagnosis. World Psychiatry I 3, p. 181-185, 2002.

BIGGAR, N. Aiming to Kill. London: Darton, Longman and Todd, 2004.

BRANDT, R. “The Morality and Rationality of Suicide” In: PERLIN, S. (Org.) A Handbook for the Study of Suicide. Oxford: Oxford University Press, 1975.

BRASIL. Ministério da Saúde. Trabalhando Juntos para Prevenir o Suicídio: 10/9 - Dia Mundial de Prevenção do Suicídio. 9 de setembro de 2020. Disponível em: http://bvsms.saude.gov.br/ultimas-noticias/3286-trabalhando-juntos-para-prevenir-o-suicidio-10-9-dia-mundial-de-prevencao-do-suicidio. Acesso em: 2 dez. 2020.

CAMPBELL, R.; COLLINSON, D. Ending Lives. Oxford: Basil Blackwell, 1988.

CAMUS, A. The Myth of Sisyphus. Harmondsworth: Penguin Books, 1975 [1942].

CARRIEW, J. Will Facebook’s new oversight board be a radical shift or a reputational shield? The Guardian, 7 de maio de 2020. Disponível em: https://www.theguardian.com/technology/2020/may/07/will-facebooks-new-oversight-board-be-a-radical-shift-or-a-reputational-shield. Acesso em: 10 dez. 2020.

CARTER, G.et alii. Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales. Br. J. Psychiatry 210, p. 387-395, 2017.

CAVANAGH, J. T. et alii. Psychological autopsy studies of suicide: a systematic review. Psychological Medicine 33, p. 395-405, 2003.

CHALIHA, J.; LE JOLY, E. The Joy in Loving: A Guide to Daily Living with Mother Theresa. London: Penguin Books, 1996.

CHAR, D; SHAH, N.; MAGNUS, D. Implementing Machine Learning in Health Care – Addressing Ethical Challenges. N. Engl. J. Med. 378, p. 981-983, 2018.

CHILDRESS, J. F. et alii. Public health ethics: Mapping the terrain. The Journal of Law, Medicine & Ethics, v. 30, p. 170-178, 2002.

CHOLBI, Michael. Suicide Intervention and Non-ideal Kantian Theory. Journal Of Applied Philosophy 19, p. 245-259, dez. 2002.

CHOLBI, M. Suicide. Peterborough (CAN): Broadview, 2011.

CONFESSORE, N. Cambridge Analytica and Facebook: The Scandal and the Fallout So Far. The New York Times, 4 de abril de 2018. Disponível em: https://www.nytimes.com/2018/04/04/us/politics/cambridge-analytica-scandal-fallout.html. Acesso em: 4 dez. 2020.

COPPERSMITH, G. et alii. Natural language processing of social media as screening for suicide risk. Biomed. Inform. Insights, v. 10, 117822261879286, 2018.

COSCULLUELA, V. The Ethics of Suicide Prevention. International Journal of Applied Philosophy 9, p. 35-41, 1994.

COSCULLUELA, V. The Ethics of Suicide. New York: Garland Publishing, 1995.

CURTICE, M. Article 3 of the Human Rights Act 1998: implications for clinical practice. Advances in Psychiatric Treatment, v. 14, p. 389-97, 2008.

D’HOTMAN, D. et alii. AI-enabled suicide prediction tools: ethical considerations for medical leaders. BMJ Leader. 23 de setembro de 2020.

DWORKIN, G. “Paternalism”. In: BECKER, L. (Org.) Encyclopedia of Ethics. Nova York: Garland Publishing, p. 939-942, 1992.

HILL, T. Kantian perspectives on the rational basis of human dignity. In: DÜWELL. J. (Org.) The Cambridge Handbook of Human Dignity: Interdisciplinary Perspectives. Cambridge: Cambridge University Press, p. 215-221, 2014.

HUME, D. “On Suicide”. 1777. Disponível em: https://www.open.edu/openlearn/ocw/pluginfile.php/623438/mod_resource/content/1/ofsuicide.pdf Acesso em: 14 nov. 2020.

HUTCHINSON, A. Facebook Outlines Ongoing Efforts to Prevent Self-Harm to Mark World Suicide Prevention Day. Social Media Today, 11 de setembro de 2019. Disponível em: https://www.socialmediatoday.com/news/facebook-outlines-ongoing-efforts-to-prevent-self-harm-to-mark-world-suicid/562644/. Acesso em: 23 nov. 2020.

KANT, I. “A Doutrina na Virtude - Parte I”. In: A Metafísica dos Costumes – contendo a Doutrina do Direito e a Doutrina da Virtude. São Paulo: Edipro, 2003, p. 263-289.

KANT, I. Crítica da Razão Prática. São Paulo: Brasil Editora, 2004.

KANT, I. Fundamentação da Metafísica dos Costumes. Lisboa: Edições 70, 2007.

KELLY, C.; DALE, E. Ethical perspectives on suicide and suicide prevention. Advances in Psychiatric Treatment 17, p. 214-219, 2011.

MA-KELLAMS, C. Searching for Suicide. Behavioral Scientist, 1o de setembro de 2015. Disponível em: https://behavioralscientist.org/google-search-suicide/. Acesso em: 4 dez. 2020.

MA-KELLAMS C.et alii. Rethinking Suicide Surveillance: Google Search Data and Self-Reported Suicidality Differentially Estimate Completed Suicide Risk. Clin. Psychol. Sci. 4, p. 480-484, 2016.

MATSAKIS, L.; LAPOWSKI, I. Everything We Know About Facebook’s Massive Security Breach. Wired, 28 de setembro de 2018. Disponível em: https://www.wired.com/story/facebook-security-breach-50-million-accounts/. Acesso em: 6 dez. 2020.

MCKERNAN, L. et. alii. Protecting Life while Preserving Liberty: Ethical Recommendations for Suicide Prevention with Artificial Intelligence. Front Psychiatry 9, p. 1-5, 2018.

MILL, J. S. “Penal Code for India”. In: ROBSON, J. M.; MOIR, M. (Orgs.) The Collected Works of John Stuart Mill. Toronto and Buffalo: Univ. of Toronto Press, 1986 [1838], p. 17-30.

MILL, J. S. On Liberty. Kitchener: Batoche Books, 2001 [1859].

MOWER, A. John Stuart Mill (1806-1873). 2015. Disponível em: https://ethicsofsuicide.lib.utah.edu/selections/john-stuart-mill/. Acesso em: 16 nov. 2020.

MURRAY, A. Suicide in the Middle Ages. Volume I: The Violent against Themselves. Oxford: Oxford University Press, 1998.

NYS, T. R. V. Paternalism in public health care. Public Health Ethics, v. 1, p. 64-72, 2008.

OMS. Prevenção do Suicídio: Manual para Professores e Educadores, 2000.

POMPILI, M. et alii. Insomnia as a predictor of high-lethality suicide attempts. Int. J. Clin. Pract. 67, p. 1311-1316, 2013.

RADDEN, J. Diseases as Excuses. Philosophical Studies 42, p. 349-362, 1982.

SNEDDON, A. Equality, justice and paternalism: re-centering debate about physician assisted suicide. Journal of Applied Philosophy 23, p. 387-404, 2006.

SZASZ, T. Fatal Freedom. Syracuse: Syracuse University Press, 2002.

UNITED KINGDOM. The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. University of Manchester, 2017

UNITED STATES. Department of Health and Human Services. A Supplement to Mental Health: A Report of the Surgeon General, 2001.

UNITED STATES. Office of the Surgeon General. A Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention. Appendix D, Groups with Increased Suicide Risk. Washington: US Department of Health & Human Services, 2012.

VATICAN. Sacred Congregation for the Doctrine of Faith. Declaration on Euthanasia, 1980.

WALSH, C. G.; RIBEIRO, J. D.; FRANKLIN, J. C. Predicting risk of suicide attempts over time through machine learning. Clin. Psychol. Sci. 5, p. 457-469, 2017.

WHO. Suicide. 2021. Disponível em: https://www.who.int/news-room/fact-sheets/detail/suicide Acesso em: 19 fev. 2022.

Téléchargements

Publiée

2022-02-27

Comment citer

MAAR, Alexander. "É para o seu próprio bem": a dimensão ética das ferramentas de detecção de risco de suicídio e da intervenção paternalista. Griot : Revista de Filosofia, [S. l.], v. 22, n. 1, p. 95–116, 2022. DOI: 10.31977/grirfi.v22i1.2774. Disponível em: https://periodicos.ufrb.edu.br/index.php/griot/article/view/2774. Acesso em: 21 nov. 2024.

Numéro

Rubrique

Artigos