Medical autonomy above all? Medical councils on drug interventions against COVID-19

Abstract

The policy for dealing with the health emergency caused by COVID-19 was marked by disputes on several fronts, including regarding the pharmacological approach to the disease. In this study, we sought to analyze the normative position of the Brazilian medical council system regarding the prescription of medications against COVID-19. This system is a permanent institution of undeniable relevance during health crises. We conducted a document analysis of the regulations published on the subject during the pandemic. Through content analysis techniques, we sought to identify and describe the position contained in these regulations regarding the prescription of medications. We characterized this position regarding the medications prescribed and the objective of the prescription. Thus, we identified a stance favorable to the possibility of varied pharmacological interventions for cases of varying severity, despite the recognized lack of scientific evidence substantiating these prescriptions. We identified off-label use and medical autonomy as key concepts for understanding this set of regulations. Off-label use appears as a framework that allows the prescription of these medications, given the recognized lack of evidence; The principle of autonomy is invoked as a guiding principle for this position when the council refers primarily to medical autonomy.