Moral conflicts and techno-scientific judgments: aspects involving the care of people living with HIV/AIDS
Oliveira, Luzia Aparecida
Abstract
INTRODUCTION: The health work, understood as social work, expresses two distinctive dimensions of action: productive action, within a rationality aimed at specific purposes, and communicative action, based on subjects interaction. The objective of the present study was to describe the moral aspects involved in the judgment of health professionals in the design of therapeutic projects to assist people living with HIV/AIDS, as well as their main conflicts. METHODS: In a qualitative study, in-depth interviews were conducted between 2007-2008 with health workers and participant observation was carried out during case discussion meetings in STD/AIDS specialized clinics in the city of São Paulo. Discourse Ethics, Bioethics and Comprehensive Care were the theoretical framework of the analysis. RESULTS: Values such as social justice and solidarity constitute important references of commitment for the participants health actions. This commitment was expressed through discourses in favor of inclusive practices (non-discriminatory), based on the Brazilian Unified Health System and Human Rights principles. The need for singular therapeutic projects for users brought the concepts of treatment and care together. The construction of singular therapeutic projects, as well as the values and interests of the actions proposed, were challenged in the face of conflictive situations in which users demands were either far beyond the possibilities of health services or violated institutional/social norms. The main strategy adopted in order to manage these situations was team discussion. Overall, the most frequent arguments expressed the defense of public interests and life protection to the detriment of apparently private interests. CONCLUSIONS: It is necessary to acknowledge users potential to conflict solving and to share the normative criteria more actively with them, including those more familiar with the debate on ethics. The dialectic connection between linguistic mediation (communicative action), work (its social function) and subjects interaction in the search for shareable interests enables the ethical reflection that may indicate possible ways. The Comprehensive Care as a normative horizon to therapeutic projects indicates the enactment of the humanization of health practices. Therefore, these practices become committed with the fulfillment of values related to mankind happiness, democratically validated as the common well-being.
Keywords
Bioethics, Health assistance, HIV, Humanization of assistance, Retrospective moral judgmen
Avaiable at:
http://www.teses.usp.br/teses/disponiveis/5/5137/tde-08092009-133421/publico/luziaaoliveira.pdf
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