Soluções para a prática do living will no Brasil
Neste artigo, apresento uma proposta de solução jurídica para que uma pessoa, em um período futuro de incapacidade superveniente, possa se beneficiar de um contrato, denominado Acordo Vital, em que tenha planejado a administração de seus bens e os cuidados com a sua pessoa. Sugiro que o contrato de Acordo Vital seja celebrado com a família para garantir que os cuidados a serem recebidos durante o período de incapacidade superveniente sejam executados em conformidade com a vontade manifestada pelo paciente enquanto ele ainda tem discernimento e capacidade civil plena. As situações não previstas no contrato seriam decididas por uma pessoa de confiança do incapaz, designada no contrato antes do início da incapacidade. O curador, signatário do contrato, deverá seguir, para o bom exercício da curatela, as decisões dessa pessoa designada no contrato.
Há pouco mais de um ano, fui procurado por um médico psiquiatra interessado em uma solução jurídica para um paciente inconformado. O paciente tinha surtos psicóticos eventuais e não respondia a remédios. Quando aconteciam os surtos, a família cuidava desse paciente, causando a sua indignação, por motivos que não são relevantes para este artigo. O paciente preferia ser tratado por um determinado amigo. Tal manifestação de vontade, quando feita pela pessoa ainda mentalmente sadia ou civilmente capaz de fato, é válida nos EUA e tem o nome de living will. No Brasil, no entanto, não há previsão legal específica para o caso.
Neste artigo, farei uma análise da legislação aplicável ao caso, com o propósito de construir argumentos juridicamente válidos que sustentem a eficácia da declaração antecipada de vontade (DAV) do paciente que tem o direito de escolher como será tratado durante um período de incapacidade superveniente.
Acredito ser necessário reconstruir todo um raciocínio fundamentando-se no Direito pátrio, sendo inútil simplesmente traduzir termos e processos do Direito americano na esperança vã de que o Direito comparado faça jurisprudência favorável.
O que é incapacidade superveniente
Incapacidade superveniente é um estado de saúde futuro, permanente ou transitório, em que uma pessoa perde o discernimento e a capacidade jurídica de fato, necessários para administrar os próprios bens e reger a sua vida, o que a torna dependente da participação de uma outra pessoa em seus atos da vida civil, ou até mesmo acarreta a substituição de sua vontade pela vontade de outra pessoa, que passa a ser denominada responsável legal ou curador.
Capacidade de fato e capacidade de direito
Capacidade de direito é uma aptidão para aquisição de direitos e obrigações na vida civil, inerente a todas as pessoas nascidas e vivas. Essa capacidade todos nós temos: crianças, jovens, adultos, idosos, doentes e retardados mentais, índios, presidiários, escravos…
Além da capacidade de direito existe a capacidade de fato, que é a aptidão da pessoa para utilizar os seus direitos e exercê-los por si mesma. Quando a pessoa não precisa de um responsável legal, ou seja, quando ela é independente dos pais, tutores ou curadores, ela tem capacidade de fato. E nunca perde a capacidade de direito, a não ser com a morte, quando a pessoa deixa de existir, não fazendo mais sentido falar em capacidade de alguém que não existe mais.
Observe-se ainda que ninguém perde a capacidade de fato simplesmente por ser idoso, conforme podemos concluir da leitura das listas dos absolutamente ou relativamente incapazes encontradas nos artigos 3º e 4º do Código Civil (Lei 10406/02). O idoso pode se tornar absoluta ou relativamente incapaz se perder discernimento, se não puder exprimir mais sua vontade ou se for pródigo, ébrio ou viciado em tóxicos.
Adequação, à lei, do planejamento da incapacidade superveniente
O planejamento da incapacidade superveniente pode ser feito por contrato, que deve envolver as partes que estarão comprometidas necessariamente com os cuidados ao paciente, o autor do planejamento. Tal contrato, que passaremos a chamar de Acordo Vital, deve considerar o que dispõe o Código Civil (Lei 10406/02) em especial os seus artigos 1767 a 1783, acerca da Curatela; o Código de Processo Civil (Lei 5869/73), em especial os artigos 1177 a 1186; e a legislação especial sobre internações psiquiátricas (Lei 10.216/01).
O Acordo Vital deve reunir as pessoas que, por lei, são indicadas para cuidar de quem perde a capacidade. Quem tem a iniciativa do Acordo Vital não pode decidir quem será seu curador, pois essa decisão cabe ao juiz com base na lei.
Tendo o propósito de formalizar um consenso entre as partes, seria inútil se o Acordo Vital formalizasse regras a serem seguidas mas que fossem contrárias ao que diz a lei sobre o processo de interdição. É essencial que o Acordo Vital esteja de acordo com a lei. Confira-se adiante como a lei determina a forma de escolha do curador, aquele que cuida de alguém que perdeu a capacidade de fato por ter perdido o discernimento.
Curatela
Curatela, no Código Civil brasileiro, é o encargo atribuído a alguém, chamado curador, para cuidar de uma pessoa que perdeu a capacidade civil de fato, ou seja, que não pode mais reger a sua própria vida ou administrar seus bens.
O artigo 1775 do Código Civil determina a ordem em que deve ser escolhido o curador. O curador é ou será, de direito, a primeira pessoa entre os familiares na ordem abaixo:
- cônjuge ou companheiro;
- pai ou mãe;
- descendente que se demonstrar mais apto, respeitando-se a ordem de proximidade de parentesco;
O Art. 1.778 do Código Civil diz que a autoridade do curador estende-se à pessoa e aos bens dos filhos do curatelado, observado o art. 5o. Ou seja, o curador passa a cuidar do curatelado e dos filhos que estejam sob a sua guarda.
Por força do artigo 1.774 do Código Civil, aplicam-se à curatela as disposições concernentes à tutela, onde encontramos, por exemplo, as incumbências do tutor ou curador quanto à pessoa tutelada ou curatelada:
Art. 1.740. (…):
I – dirigir-lhe a educação, defendê-lo e prestar-lhe alimentos, conforme os seus haveres e condição;
II – reclamar do juiz que providencie, como houver por bem, quando o menor haja mister correção;
III – adimplir os demais deveres que normalmente cabem aos pais, ouvida a opinião do menor, se este já contar doze anos de idade.
Art. 1.741. Incumbe ao tutor, sob a inspeção do juiz, administrar os bens do tutelado, em proveito deste, cumprindo seus deveres com zelo e boa-fé. (Grifei)
Resta claro que o curador tem poderes de administração dos bens e de cuidados com o curatelado, devendo porém ser ouvida a opinião do curatelado, se tiver capacidade suficiente de entendimento das situações em que deverá opinar. Sim, pois se o tutor tem o dever de ouvir o menor, e as disposições da tutela aplicam-se à curatela, tanto maior será o dever do curador de ouvir a vontade do curatelado, especialmente se a vontade do curatelado tiver sido manifestada ainda durante o seu estado de capacidade.
Não basta, no entanto, que a pessoa manifeste a sua vontade ainda durante a sua capacidade, pois ninguém pode prever todas as situações por que passará no futuro, sendo muito difícil pensar e manifestar a sua vontade de forma a cobrir todas as hipóteses que sejam do seu interesse.
Como poderia a pessoa manifestar a sua vontade de forma a evitar uma situação futura em que um curador poderia administrar seus bens e cuidar de sua pessoa de forma contrária à sua vontade? Acredito que o Acordo Vital aqui proposto seja uma solução viável para esse caso, pois é compatível com a lei brasileira.
Processo de interdição e nomeação de curador
A nomeação do curador é feita na sentença do processo de interdição, conforme o artigo 1183 do Código de Processo Civil (CPC). Interdição é o reconhecimento da “incapacidade civil de fato” de alguém, o que se dá em sentença proferida por juiz. A sentença pode interditar a pessoa em vários níveis, podendo a interdição ser parcial.
Os efeitos da sentença de interdição são imediatos, não sendo suspensos por eventual recurso.
A sentença de interdição é declaratória de um estado anterior de saúde, de perda de discernimento que leva à incapacidade de fato. Caso seja provado que o paciente produziu ato nulo, por falta de capacidade de fato ou por ter violado a lei por outros motivos, a sentença poderá retroagir declarando a nulidade desse ato anterior à sentença.
Se a sentença determinar um momento no passado a partir do qual o paciente deve ser considerado incapaz, os atos e os negócios jurídicos praticados pelo paciente após esse momento serão considerados nulos.
O CPC exige o registro da sentença no Registro Civil de Pessoas Naturais e a sua publicação por três vezes (artigo 1184 do CPC), mas alguns autores entendem que não é necessário esperar essas etapas para que a sentença faça efeito, o que me parece correto, pois o registro e a publicação na imprensa não são requisitos para a perda da capacidade, mas sim para a publicidade do estado de saúde do interdito.
Impossibilidade de tradução literal do living will
O living will costuma ser traduzido por “testamento vital”. Não creio ser essa uma boa tradução, pois testamento, no Direito brasileiro, é definido nos artigos 1857 a 1887 do Código Civil como uma manifestação de vontade para depois da morte. E o artigo 1887 diz que a lei não admite outros testamentos especiais além dos contemplados no Código. Ora, não há nenhum testamento especial no Código que permita a manifestação de vontade a ser cumprida ainda durante a vida do testador.
O “testamento vital”, assim como o “mandato duradouro” com a outorga de poderes por procuração a uma pessoa que ajudaria a fazer cumprir o testamento vital, são expressões usadas no Portal testamentovital.com.br, por exemplo. A organizadora do Portal, a advogada Luciana Dadalto, adota essas expressões. Mas assim como o termo testamento não me parece adequado para os fins do planejamento da incapacidade superveniente, a procuração (contrato típico de mandato) é extinta quando a pessoa mandante perde a capacidade de fato ou de direito (artigo 682, II, do Código Civil).
No presente artigo, proponho solução que possa ser efetiva na atual legislação brasileira, para a prática do living will, sob a forma de contrato que chamo de Acordo Vital.
Condições para validade do Acordo Vital
O Acordo Vital, para ter validade, ou seja, para estar de acordo com a lei, deve atender a determinados requisitos, dos quais são essenciais os seguintes:
Capacidade das partes
As partes devem ser capazes de fato no momento da contratação, ou devem estar representadas ou assistidas por seus responsáveis legais. Como em qualquer contrato, as partes devem ser identificadas inequivocamente.
Objeto lícito
O objeto ou propósito do contrato tem que estar de acordo com a lei.
Objeto possível, determinado ou determinável
O objeto ou propósito tem que ser factível pelas pessoas que se obrigam no contrato, e as obrigações têm que ser determinadas ou determináveis.
Forma adequada
A forma adequada ao contrato de Acordo Vital é a escrita, mas não necessariamente a pública, feita em cartório. A forma escrita é sempre recomendável quando pode existir a necessidade, mais tarde, de provar o que foi pactuado. Porém, a lei não exige nenhuma forma específica para esse tipo de contrato.
Eficácia do contrato de Acordo Vital
Para ter eficácia, o Acordo Vital deve resolver os conflitos de interesses entre os familiares e evitar que as pessoas com poderes legais para atuar como curadoras interfiram de forma danosa nos cuidados desejados pelo paciente. Para isso, é necessário que o Acordo Vital seja assinado pelo interessado no planejamento de sua incapacidade, pelo seu cônjuge, pelos seus pais e pelos seus descendentes, se houver.
O contrato de Acordo Vital deve ser assinado ainda pela pessoa que o paciente indica como aquele que deve ser ouvido quanto às decisões médicas e de administração dos bens, que normalmente caberiam à família do interditado. Essa pessoa deve figurar como anuente, ao menos.
Os familiares devem figurar como contratados. No Acordo Vital, os familiares recebem a obrigação de não fazer, de não interferir nos desígnios do escolhido pelo paciente para reger sua vida no período de incapacidade. Porém, os familiares têm esse direito de cuidar do interditado, por lei.
Com isso, o que se espera do contrato de Acordo Vital, é que as partes encontrem uma forma de acordo em que o paciente terá, provavelmente, que oferecer alguma compensação aos familiares para que eles aceitem o compromisso de respeitar os desígnios do escolhido pelo paciente.
A vantagem do Acordo Vital é a possibilidade de discussão de assuntos relevantes para o período de incapacidade do paciente, durante um período de sanidade e capacidade civil do mesmo. O paciente, ainda são, pode negociar com os seus familiares a melhor forma de ser tratado futuramente, quando sua manifestação de vontade terá eficácia reduzida.
Recomenda-se que as obrigações do paciente assumidas no contrato de Acordo Vital (compensações aos familiares, se for o caso) sejam cumpridas no período em que o paciente ainda está são. O cumprimento após a interdição dependeria de intervenção judicial.
Conclusão
O planejamento da incapacidade de um paciente por contrato, para o qual sugerimos o nome de Acordo Vital, é uma solução viável para evitar que um curador passe a administrar seus bens e cuidar de sua pessoa de forma contrária à sua vontade. Trata-se de um acordo em família para que o paciente, que se preocupa com uma eventual perda de capacidade civil de fato futura, manifeste determinadas vontades para o futuro e possa combinar com seus familiares o respeito a desígnios de outra pessoa, escolhida pelo paciente enquanto ele ainda tem capacidade de fato para tanto.
Essa pessoa escolhida pelo paciente não será necessariamente o curador nomeado na sentença de interdição, mas será ouvida pelo curador que tiver o direito legal de ser nomeado por ser o familiar mais próximo do paciente.
Apesar da falta de previsão legal de um contrato típico com a finalidade de produzir uma declaração antecipada de vontade desse tipo, nada impede que o processo de interdição seja acompanhado por um contrato de Acordo Vital, respeitadas as normas materiais e processuais sobre interdição e curatela, e os requisitos de validade do negócio jurídico.
Além desses conceitos básicos do Direito brasileiro, devem-se observar as circunstâncias específicas de cada caso, para a redação, pelos advogados contratados, de Acordos Vitais válidos e eficazes.
Seria dispensável dizer que o advogado deve ter competência para facilitar o acordo entre as partes, mas tenho a impressão de que a nossa civilização ainda não tenha essa cultura, que talvez dependa de um maior domínio da dialética.
Referências não mencionadas no corpo do artigo
PEREIRA, Caio Mario da Silva. Instituições de Direito Civil, vol I, 21ª edição. Editora Forense – Rio de Janeiro, 2005.
1. http://bernardomonteiro.wordpress.com/2012/02/08/menor-e-pessoa-incapaz-mas-como-assim/
2. Andrade, Odilon de. Comentários ao Código de Processo Civil, vol. VII, pp. 259-260, apud. Sarmento, Eduardo Sócrates Castanheira. A Interdição no Direito Brasileiro, 2ª Edição, Editora Lumen Juris – Rio de Janeiro, 2008.
Palavras-chave
Living will, incapacidade, idoso, Alzheimer, Parkinson, demência, coma, esquizofrenia, psicose, surto, surto psicótico, contrato, testamento vital, acordo vital, interdição, curatela, DAV.
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