O fomento à participação social no SUS e a observância da alteridade para o acesso humanizado aos procedimentos de alta complexidade

Abstract

This dissertation aims to analyze the relevance of community participation as a guideline of the Unified Health System, given the inequities of access to highly complex procedures. Addressing the theme contextualized in public health finds social and practical justification, as there are several dilemmas present in the sector, which exceed economic aspects and lead to non-observance of fundamental rights, notably the right to life and health. The persistent problem of the allocation of scarce resources is the background of the reflection made according to the theoretical framework of Bioethics of Protection, and requires the adoption of criteria that allow fair and equitable allocation decisions, given the existence of vulnerable users. The state of vulnerability of public health users will be commented from the bioethical meanings attributed to vulnerability, analyzing the functioning of the reference and counter-reference system, popularly known as regulation. Sometimes the patients or their families, in search of health care, assume the role of intercommunicating the levels of care or the sectors with each other, despite the information deficit, because they do not know their own terms and procedures, and end up being harmed by the operational failures of the public health system. Other challenges are faced for access to high complexity, such as the high cost, both from the point of view of technological investment, and the need for professional training to handle the new technologies incorporated. Countering these challenges with a view to improving the quality of life and overcoming or mitigating existing vulnerabilities requires that the people be led to actively participate in the formulation and control of public health policies, including those aimed at high complexity. Finally, alterity will be verified as a tool for the construction of an effective social participation, protecting the vulnerable individual whose empowerment is crucial not only for the proper development of the participatory management model, but, above all, for the humanization of care, mitigating the negative effects of the system's bureaucracy.