Judicialização da saúde: dilema moral e consequências econômicas para o sistema único de saúde
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Tipo
TCC
Data de publicação
2022-12
Periódico
Citações (Scopus)
Autores
Almeida, Jéssica Cavalcante
Orientador
Lima, Fernando Rister de Sousa
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Resumo
O presente trabalho tem como intuito discutir a judicialização da saúde no Brasil. Para isso foi lançado mão da literatura pertinente ao tema e, também, foram utilizados dados disponibizados pelo CNJ sobre essa questão.
Na sequência, três teóricos da filosofia política foram abordados, sendo eles: Jeremy Bentham, John Rawls e Immanuel Kant. Suas teorias foram abordadas porque se entende que, além de tudo, a judicialização da saúde é um dilema moral. Isso posto, por meio de suas teorias, houve a tentativa de compreender o que cada um pensaria sobre o tema proposto.
Destaca-se que o tema do presente trabalho é bastante complexo, sendo que há argumentos pertinentes tanto em relação à contribuição e importância da judicialização da saúde no Brasil, quanto para os desdobramentos negativos que ela pode causar.
Devido a isso, decidiu-se usar três teóricos para pensar o tema. O intuito foi trazer uma pluralidade de ideias e de formas de pensar sobre o que é certo a se fazer. Assim, não se tem como objetivo trazer apenas uma resposta sobre o que é certo no caso concreto – até porque como será visto ao longo do trabalho não há apenas uma resposta correta – mas contribuir para a reflexão sobre o tema proposto.
Assim sendo, há duas hipóteses principais para o fenômeno da judicialização da saúde no Brasil. A primeira dela aduz que a judicialização da sáude no Brasil é algo negativo, dado que há um desvio de recursos públicos que são utilizados para atender tais demandas. Esses recursos poderiam estar sendo utilizados para melhorar a saúde e o bem-estar da coletividades, por meio do SUS, por exemplo. Contudo, são usados para atenderem demandas individuais.
Ao encontro desse pensamento se encontra a teoria utilitarista de Jeremy Bentham. Para o utilitarismo é necessário maximizar a felicidade para o maior número de pessoas possível. Neste caso, usar dos recusos públicos para atender demandas coletivas ao invés de individuais é uma forma de maximizar a felicidade da população.
Por outro lado, há quem argumente que a judicialização da saúde é positivo. Isso
porque a CRFB/88 em seu art. 196 garante que a saúde é um direito de todos e um dever do Estado. Além disso, argumentam que reinvidicar tais direitos é uma questão de cidadania e que isso fortacele a democracia.
Assim, Kant sustenta que o ser humano é um fim em si mesmo e que não deve ser usado como instrumento para o benefício alheio. Desta forma, com isso esse pensamento em vista, é possível usar dessa afirmação para ser favorável e defender a importância da judicialização da saúde.
Ainda sobre isso, John Rawls possui um exercício mental que denomina como “véu da ignorância”. Rawls defende que devemos imaginar que estamos cobertos por um “véu da ignorância”, o qual impede de saber quem somos e em qual parte da sociedade estamos inseridos. Assim, nossas afirmações sobre o que é justo não levaria em conta nossa posição social. Portanto, não saberíamos a qual classe social pertencemos, qual a nossa orientação sexual, etnia, etc.
Desta forma, considerando esse exercício mental proposto por Rawls, se entende que no geral as pessoas seriam favoráveis à judicialização da saúde, dado que grande parte das pessoas não gostariam de correr o risco de serem enfermos e, assim, precisarem de uma prestação positiva do Estado e não poderem obtê-la.
The present work aims to discuss the judicialization of health in Brazil. For this, the literature relevant to the topic was used and data made available by the CNJ on this issue were also used. Subsequently, three theorists of political philosophy were approached, namely: Jeremy Bentham, John Rawls and Immanuel Kant. His theories were addressed because it is understood that, above all, the judicialization of health is a moral dilemma. That said, through their theories, there was an attempt to understand what each one would think about the proposed theme. It is noteworthy that the subject of the present work is quite complex, and there are pertinent arguments both in relation to the contribution and importance of the judicialization of health in Brazil, as well as the negative consequences that it can cause. Because of this, it was decided to use three theorists to think about the topic. The aim was to bring a plurality of ideas and ways of thinking about what is right to do. Thus, the objective is not to provide just one answer about what is right in the specific case - even because as will be seen throughout the work there is not just one right answer - but to contribute to the reflection on the proposed theme. Therefore, there are two main hypotheses for the phenomenon of the judicialization of health in Brazil. The first one argues that the judicialization of health in Brazil is something negative, given that there is a diversion of public resources that are used to meet such demands. These resources could be used to improve the health and well-being of communities, through the SUS, for example. However, they are used to meet individual demands. In line with this thought is the utilitarian theory of Jeremy Bentham. For utilitarianism it is necessary to maximize happiness for as many people as possible. In this case, using public resources to meet collective rather than individual demands is a way of maximizing the happiness of the population. On the other hand, there are those who argue that the judicialization of health is positive. This is because the CRFB/88 in its art. 196 guarantees that health is a right for all and a duty of the State. Furthermore, they argue that claiming such rights is a matter of citizenship and that this strengthens democracy. Thus, Kant maintains that the human being is an end in itself and that it should not be used as an instrument for the benefit of others. In this way, with this thought in view, it is possible to use this statement to be favorable and defend the importance of the judicialization of health. Still on this, John Rawls has a mental exercise that he calls the “veil of ignorance”. Rawls argues that we should imagine that we are covered by a “veil of ignorance”, which prevents us from knowing who we are and in which part of society we are inserted. Thus, our claims about what is fair would not take into account our social position. Therefore, we would not know what social class we belong to, what our sexual orientation, ethnicity, etc. In this way, considering this mental exercise proposed by Rawls, it is understood that, in general, people would be in favor of the judicialization of health, since most people would not like to run the risk of being sick and, thus, need a positive provision of health care State and cannot obtain it.
The present work aims to discuss the judicialization of health in Brazil. For this, the literature relevant to the topic was used and data made available by the CNJ on this issue were also used. Subsequently, three theorists of political philosophy were approached, namely: Jeremy Bentham, John Rawls and Immanuel Kant. His theories were addressed because it is understood that, above all, the judicialization of health is a moral dilemma. That said, through their theories, there was an attempt to understand what each one would think about the proposed theme. It is noteworthy that the subject of the present work is quite complex, and there are pertinent arguments both in relation to the contribution and importance of the judicialization of health in Brazil, as well as the negative consequences that it can cause. Because of this, it was decided to use three theorists to think about the topic. The aim was to bring a plurality of ideas and ways of thinking about what is right to do. Thus, the objective is not to provide just one answer about what is right in the specific case - even because as will be seen throughout the work there is not just one right answer - but to contribute to the reflection on the proposed theme. Therefore, there are two main hypotheses for the phenomenon of the judicialization of health in Brazil. The first one argues that the judicialization of health in Brazil is something negative, given that there is a diversion of public resources that are used to meet such demands. These resources could be used to improve the health and well-being of communities, through the SUS, for example. However, they are used to meet individual demands. In line with this thought is the utilitarian theory of Jeremy Bentham. For utilitarianism it is necessary to maximize happiness for as many people as possible. In this case, using public resources to meet collective rather than individual demands is a way of maximizing the happiness of the population. On the other hand, there are those who argue that the judicialization of health is positive. This is because the CRFB/88 in its art. 196 guarantees that health is a right for all and a duty of the State. Furthermore, they argue that claiming such rights is a matter of citizenship and that this strengthens democracy. Thus, Kant maintains that the human being is an end in itself and that it should not be used as an instrument for the benefit of others. In this way, with this thought in view, it is possible to use this statement to be favorable and defend the importance of the judicialization of health. Still on this, John Rawls has a mental exercise that he calls the “veil of ignorance”. Rawls argues that we should imagine that we are covered by a “veil of ignorance”, which prevents us from knowing who we are and in which part of society we are inserted. Thus, our claims about what is fair would not take into account our social position. Therefore, we would not know what social class we belong to, what our sexual orientation, ethnicity, etc. In this way, considering this mental exercise proposed by Rawls, it is understood that, in general, people would be in favor of the judicialization of health, since most people would not like to run the risk of being sick and, thus, need a positive provision of health care State and cannot obtain it.
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Palavras-chave
judicialização , saúde , moral , judicialization , health , morals