Braz. j. . vol.83 número6

BrazJOtorhinolaryngol.2017;83(6):609---610

www.bjorl.org

Brazilian

Journal

of

OTORHINOLARYNGOLOGY

EDITORIAL

Ethical

and

legal

aspects

in

the

care

of

singers

and

actors

夽

Aspectos

éticos

e

legais

no

atendimento

de

cantores

e

atores

When treating singers and actors,especially in the acute phase,many clinical questionsarise,such as: Can he/she sing or act?Should he/shesing or act? Is alesion already present? Is there risk of injury? Additionally, ethical and legalaspectsalsodeserveconsiderationwhentreatingthese professionals.

Failure to appropriately respond to these issues may resultinviolationsoftheMedicalEthicsCodeandFederal MedicalCouncilResolutions.Therefore,itisappropriateto presentsomecareguidanceandrecommendationsfor situa-tionswhentheseindividualsseektreatment;thisbeginsat thereception.The attitudeoftheestablishment’sstaffis crucial.Theyshouldbeinstructed totreatfamous people likeallotherpatientsandnottorequestautographsortake selfieswiththem.Thesingeroractor,whenseeking medi-calassistance,isinapossiblesituationofvulnerabilityand needstobeprotected.Thepostingofsuchselfieonsocial mediaor sendingit byWhatsAppviolatesthe principleof medical confidentiality; it is forbidden for a physician to refer to identifiable clinical cases, to display patients or their portraitsin thegeneral communication media,even withthepatient’sconsent.

At the reception, in addition to the patient, family members,bodyguards,manager,producer,pressofficerand others maybe present. Itis important toask the patient whoshouldbeallowedtoentertheconsultationroom,who should accompany him/her during the anamnesis, physi-cal examination, and discussion of diagnostic hypotheses and conduct, which can rarely result in suspension of performance.1_{Whenspeakingwiththepatient,itis}

essen-tialtobecarefulwiththewords chosenandalwaystobe supportive.Regardingtheproduction,alwaysrememberthe

夽 _{Pleasecitethisarticleas:KornGP,MichaelisJr.C,MoraesVR.}

Ethicaland legalaspectsinthecare ofsingersand actors.Braz JOtorhinolaryngol.2017;83:609---10

importanceof confidentiality. Dependingonthesituation, itisadvisabletoasknon-familymemberstogivetheclient privacywhenpresentinganunfavorablediagnosis.

Inthecaseofaperformancecancelation,itisessential toinformthepatientabouttherisk offibrosisor injuryif he/shechoosestogothroughwiththeperformance.Such information should be included in the patient’s medical records.As recommendedby the Federal Medical Council (CFM), the medical record must contain the clinical data necessary for adequate case managementand it must be filledout,inchronologicalorder,containingthedate,time, doctor’ssignatureandRegionalMedicalCouncil(CRM) reg-istrationnumber.2

Any information on the client must remain within the healthfacility.Itshouldbenotedthatotherpeoplemight attempttoobtaininformationabouttheclient’shealthand career.3 _{Whenitisthepatientwhodecidestopublish}

pic-tureswiththephysician,thelattercandecidewhetherto agreewithitornot.TheadviceoftheFederalMedical Coun-cilisthattheydonotallowit,asifitisfoundoutthatthe doctoris being‘‘highlypraised’’bypatients,theCFMwill investigate.UseofWhatsAppshouldalsobelimmited, pri-vate andconfidential and cannotgo beyond the limitsof theclosedgroup of experts,theclinical staffor between doctorsandtheirpatients.Toprovidingconsultations, mak-ingdiagnoses or prescribingmedicationsby any means of communicationisstillprohibited,underthepenaltiesofthe law,accordingtotheLegalDepartmentofABORL-CCFwhich participatesinthiseditorial.

Finally,clinicalcasesofprofessionaluseofthevoiceare ofgreatinteresttocolleagueswhoworkmoreinthelarynx andvoicearea.Incongresses,symposiaandcourses,many ofthedetailsofsuchcasesareofgreatdidacticrelevance. The identity of the patients deserves complete confiden-tiality,andtheirdisclosureshouldonlyoccuruponwritten authorizationby thepatientor hisor herlegal guardian.4

Similarly,the lecturer shouldconsidernotauthorizingthe

http://dx.doi.org/10.1016/j.bjorl.2017.08.005

610 EDITORIAL

recording,filmingorphotographingthematerialbecauseit canbemisused bytheeventparticipants,forexample,in socialmedia.

Conflicts

of

interest

Theauthorsdeclarenoconflictsofinterest.

References

1.MishraS,RosenCA,MurryT.24hourspriortocurtain.JVoice. 2000;14:92---8.

2.Brasil,Resoluc¸ãoCFMn◦_{1931,de24desetembrode2009,aprova}

oCódigodeÉticaMédica,DiárioOficialdaUniãode13deoutubro de2009,Sec¸ãoI,p.90.Retificac¸ãopublicadanoDiárioOficialda Uniãode13deoutubrode2009,Sec¸ãoI,p.173.

3.Sataloff RT, Benninger MS. Medical-legal implications of pro-fessional voice care. In: Benninger MS, Murry T, editors.The performer’svoice.SanDiego:PluralPublishing;2006.p.289---94.

4.Brasil, Resoluc¸ão CFM n◦ _{1974, de 19 de agosto de 2011,}

Estabelece os critérios norteadores da propaganda médica, Diário Oficial da União de 19 de agosto de 2011, Sec¸ão I, p.241---244.

GustavoPolacowKorna,∗_{,CarlosMichaelisJr.}b,c,d,

VaniaRosaMoraesd

a_{UniversidadeFederaldeSãoPaulo(Unifesp/EPM),Escola}

PaulistadeMedicina,SãoPaulo,SP,Brazil

b_{UniversidadedeCoimbra,DireitoemMedicina,}

Coimbra,Portugal

c_{EscolaPaulistadeDireito(EPD),DireitoMédico,}

SãoPaulo,SP,Brazil

d_{Associac¸ãoBrasileiradeOtorrinolaringologiaeCirurgia}

Cérvico-Facial(ABORL-CCF),DepartamentoJurídico, SãoPaulo,SP,Brazil

∗_{Correspondingauthor.}