Navegando por Palavras-chave "Direito à Saúde"
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- ItemSomente MetadadadosAnálise das decisões judiciais do Supremo Tribunal Federal sobre medicamentos conforme os conceitos da medicina baseada em evidências(Universidade Federal de São Paulo (UNIFESP), 2012) Barroso, Luciana Rosa Batista [UNIFESP]; Silva, Edina Mariko Koga da [UNIFESP]Introdução: Este trabalho propos-se a identificaras decisoes judiciais do Supremo Tribunal Federal sobre medicamentos, julgadas entre 01 de julho de 2007 a 01 de julho de 2011,e classifica-los conforme as evidencias cientificas da Medicina Baseada em Evidencias, conhecendo e analisando a conduta normativa daquele Tribunal quanto a efetividade do direito a Saúde. METODO: O presente estudo qualifica-se como estudo descritivo, retrospectivo de pesquisa em bases secundarias, que resultou numa populacao de 347 (trezentos e quarenta e sete) decisoes judiciais. Aplicados as decisoes judiciais os criterios de inclusao e exclusao, a amostra selecionada composse de 24 (vinte e quatro) decisoes judiciais, nas quais identificou-se 34 (trinta e quatro) medicamentos, que foram analisados e classificados conforme as evidencias cientificas na Medicina Baseada em videncias. Resultados: Do total dos medicamentos solicitados ao Poder Judiciario, 11,8% ja haviam sido incorporados nos Protocolos Clinicos e Diretrizes Terapeuticas do SUS. O percentual dos medicamentos sem evidencias de efetividade (14,7%), somado ao percentual dos medicamentos equivalentes e ja incorporados pelo SUS na data do julgamento (35,3%), chega a 50% dos medicamentos solicitados e concedidos. 11,8% dos medicamentos solicitados e concedidos sao de evidencia limitada, e necessitam de avaliacao especial pelas suas peculiaridades: tratamento em criancas cuja efetividade aguarda maiores estudos cientificos.26,4% dos medicamentos solicitados e concedidos sao medicamentos com evidencia cientifica, porem incorporados tardiamente pelo SUS, apos a data de julgamento da acao pelo Supremo Tribunal Federal. Dentre as regioes do pais, a Regiao Nordeste (39,48%), seguida pela Regiao Sul (34,21%), representam as mais ativas no processo de judicializacao da Saúde, contra 15,78% dos medicamentos oriundos de solicitacao da Regiao Sudeste. CONCLUSOES: baseando-se neste estudo, concluimos que as decisoes judiciais demonstram-se equivocadas, e expressam a assimetria do sistema de Saúde, e a nao observancia dos criterios de uso racional de medicamentos pelos membros do Poder Judiciario. Diante dos resultados, e muito embora a legislacao sobre Assistencia Farmaceutica e novas Tecnologias em Saúde tenha um carater inovador, somente atingira seus efeitos, se forem suas previsoes integradas pelas evidencias cientificas, na conducao das politicas publicas, e nas decisoes oriundas do Poder Judiciario
- ItemAcesso aberto (Open Access)HIV/AIDS como determinantes sociais no processo de marginalização do público LGBTQIA + no Brasil(Universidade Federal de São Paulo, 2021-08-17) Tavares, Danilo Antônio [UNIFESP]; Thomaz, Silvia Maria Tagé [UNIFESP]; http://lattes.cnpq.br/2147936574575153; http://lattes.cnpq.br/5718211607593933; Universidade Federal de São Paulo (UNIFESP)O presente trabalho estudou a trajetória sócio-histórica das pessoas LGBT’s no Brasil. Como base orientadora do processo de pesquisa temos a concepção crítica marxista, considerando o objeto de pesquisa em suas dimensões filosóficas, materiais, concretas e políticas, tendo em perspectiva suas contradições e conflitos, entendendo a questão do direito à saúde de forma ampliada e não isolada das práticas políticas, guiadas por uma “finalidade intimamente relacionada com a transformação das condições [da sociedade]”, (SEVERINO, 2007, p. 116). Foram analisados os determinantes econômicos, históricos, políticos e legais que influenciaram o reconhecimento dos direitos LGBT’s, ao destacar eventos e documentos que colaboraram para sua construção, problematizando a questão da saúde, e da marginalização, assim como analisar os desafios para a efetivação e manutenção do direito à cidadania sob a lógica do sistema capitalista. A criminalização da homofobia, e a regulamentação de políticas direcionadas às pessoas LGBT’s nos formatos das leis, permitem vislumbrar no horizonte essas conquistas como um avanço, mas sobretudo tornam tais conquistas como objeto de luta para que o seu exercício de direito seja cumprido ainda que sob a égide do capitalismo, e que possibilita também questionar a violência, marca da sociedade de classes, e quaisquer outros tipos de violação de direitos nesse sentido respectivamente.
- ItemAcesso aberto (Open Access)Humanos ou cobaias? Trajetórias de cuidado e o desafio do direito à saúde de pessoas travestis e transexuais.(Universidade Federal de São Paulo (UNIFESP), 2019-09-09) Antognetti, Marcia Regiane Borges [UNIFESP]; Surjus, Luciana Togni de Lima e Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This research aimed to understand the main difficulties and advances to ensure access to health in the context of Public Health Policy, from the perspective of transvestites and transsexuals that use the Health Clinic for transvestites and transsexuals of the Guilherme Álvaro Hospital, in the city of Santos - SP. We mapped the demand for the transsexualization process, as well as the socioeconomic and cultural conditions of this population. The issue of prejudgment, discrimination and violence suffered by transsexuals in their daily lives was addressed, especially with regard to assistance and shelter in the health service. These are people who express themselves in the world according to the gender which they identify themselves, regardless of the biological sex they were born with, making them targets of violence of all kinds and vexatious situations, because they are in disagreement with the cisheteronormative standards that govern our society. Initially, a systematic literature review was conducted as a methodological effort in order to identify the themes that have been explored in the tradition of health itself. We determined for a qualitative research, under the reference of critical and narrative hermeneutics, through the reconstruction of care trajectories. In this study, we detected that from the point of view of transsexuals’ people, the existence of the specific outpatient clinic sounds like an important social gain, coming from the movements between the interested population and the Sexual Diversity Commission of Santos. For being exclusively linked to SUS, even not have their own funds to pay for doctor’s visits, exams and treatments, it is possible to remain in the service, making it an important protagonist in terms of guaranteeing health as a right for all. We identified as the main advances in access to health, the assistance provided by professionals who work directly in the specific outpatient clinic, providing the acquisition of reports for the rectification of the first name and sex judicial process, acquisition of hormones and performance of surgeries, except for sexual reassignment. We attested that transsexuals’ people see transphobia, prejudgment, discrimination, violence and the nonuse of the social name as important factors that prevent them from accessing health, or even associating to it. They are treated with indifference and are often not even listened. They feel as if they were guinea pigs, due to lack of technical ignorance and practical knowledge of the professionals when they are approach with this theme. Interviewees emphasize that, the biggest barrier is the (de)user embracement and (de)assistance. We verified that the guarantee of the right to health depends on the relationships between health professionals and transsexuals’ people, through the recognition of this population and its singularities, as well as the implementation and strengthening of the LGBT public health policy. We have the challenge to ensure the rights to health of this population, injecting ways to raise awareness and qualify professionals, overcoming the barriers mentioned in this study, investing in a humanized user embracement, free of discrimination, prejudgment and violence, in order to flow the happiness projects of each person assisted.
- ItemAcesso aberto (Open Access)Judicialização da saúde na voz do usuário: a procura do cuidado através da justiça(Universidade Federal de São Paulo (UNIFESP), 2019-02-05) Capiberibe, Cláudia Camargo [UNIFESP]; Rios, Ademar Arthur Chioro dos [UNIFESP]; http://lattes.cnpq.br/9454572596499303; http://lattes.cnpq.br/2555792761200636; Universidade Federal de São Paulo (UNIFESP)Introduction: In Brazil, health has been a constitutional right since 1988, but the lack of full service to the population by SUS [Sistema Única de Saúde – Brazil’s public healthcare system] or the private sector has led to the judicialization of health, a legal recourse that allows for the enforceability of rights when these are denied by the parties responsible, and which has transformed into an alternative means for accessing medicines, services and products not covered by the policies and protocols of SUS or on the lists of the ANS [Brazil’s National Health Agency]. It is a phenomenon that involves multiple parties, with distinct and often conflicting objectives and interests. Studies have shown that the judicialization of health is a legitimate form of pressuring the State, but one which has relevant secondary effects, such as significant impact on costs and increasing inequalities in access to and use of healthcare services. Its complexity and effects have been well studied, but the point of view of the user has been mostly ignored. Objective: To analyze the experiences of people who have sought redress in the courts to have access to services and to guarantee their health. Methodology: The investigation, based on a micropolitical approach, was conducted through qualitative research. Seven interviews were carried out with people who reside in Sao Paulo and have initiated court actions, selected at random from the search tool of the Sao Paulo Court of Justice and through indications from de first selected interviewed. Resorting to personal documents and using oral history techniques, the research seeks to identify the users' care maps, the obstacles they face, as well as the strategies and mechanisms used to attain their health objectives. Results and Discussion: The data from the research was organized along cutting-planes: the experience with the infirmity and the experience with the judicialization process. The first permitted the construction of care maps and the second allowed for the description and analysis of the trajectory relative to the legal requests. These experiences played out in different planes of visibility, with relevant meanings, made visible/utterable by repeated examination of the narratives. The users initiate actions in the Court against SUS and/or the private healthcare provider motivated fundamentally by their suffering and the desire to recover autonomy, reduce the financial impact of the infirmity and by the belief that therapies and innovative technologies not yet contemplated by the System might provide better quality of life. They see themselves as guaranteeing unseen and unconsidered health needs, exercising a kind of "social control" and demanding fair return for taxes paid. The Court becomes an important and decisive point on the care maps of these users and their families. Judicialization, however, ends up becoming yet another form of regulating access to use of the healthcare system and a form of privileged access to public funds, creating a “marketplace” for health services and products, a shortcut for technological incorporation and greater iniquity. To the users, however, the parties that act in this complex arena are not motivated by personal interests or economic gain. Instead, they are imagined to be links in the system willing to produce alternatives so that the care map may be complemented or improved, without any moral or ethical judgement, as well as providing an individualized solution. Conclusion: The empirical results of the research demonstrate that there is great diversity in the narrated experiences, which allowed for the identification of various facets to the judicialization of healthcare. The most common and relevant to the users who go through the experience is the desire to survive the infirmity, recover their health and improve their quality of life, whatever the cost and through whatever means at their disposal, including judicialization, and despite regulations or other rules of the system or societal interests, which appear to be insufficient to limit their actions.