O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil

Detalhes bibliográficos
Autor(a) principal: Rocha, Emerson Ferreira da
Data de Publicação: 2021
Tipo de documento: Tese
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/17469
Resumo: The main objective of this thesis was to identify the processes of rupture and continuity in the policy of coping with AIDS in Brazil, from the legal-institutional point of view and from the organizational and political point of view, in the light of the paradigm of the Ethics of Care. The justification and relevance of the theme are due to criteria: a) epidemiological - the numbers show a worrying increase in the epidemic in an age group that is difficult to manage, such as male adolescents and young adults, and a higher incidence of this problem in historically marginalized groups, such as blacks and brown, being more relevant among black and brown women; b) political – changes that took place in the political scenario, with relevant effects on health policy, challenged the social arrangement that had ensured the policy to fight AIDS a prominent place, both nationally and internationally. The advance of decentralization in the SUS, associated with the taking of neoliberal measures in the scope of public policies, generated positive ruptures, such as the increase in the coverage of assistance to PLWHA. However, it had deleterious effects among them: the loss of prominence of the role of prevention as a right and a care tool, the reduction in the participation of social movements in decision-making, which resulted in the loosening of the collective and emancipatory pact historically associated with achievements of this confrontation; problems related to the limited capacity of some municipalities in the administrative management of public resources; difficulties, given the conservatism that asserted itself at the political level, in the implementation of ethically sensitive policies such as the case of AIDS. As well as the current proposal for fighting AIDS, since 2013 the pharmacological intervention has been adopted. This measure has been intensified to the present day, which occurred uncritically and even in the face of unsatisfactory indicators related to adherence to ARV's, especially when comparing adherence to ART in Brazil (69%) with countries like the United Kingdom (98 %). Which demonstrates some weakness of the policy in this regard. In this sense, assuming the ethics of care as a prevailing moral paradigm in health can contribute to wards escaping from the traps created by the State-control which, through biolaw and biopolitics, tends to homogenize bodies and vulnerabilities.
id UERJ_9e2734c63a6284c6b4a2608cc7943d20
oai_identifier_str oai:www.bdtd.uerj.br:1/17469
network_acronym_str UERJ
network_name_str Biblioteca Digital de Teses e Dissertações da UERJ
repository_id_str 2903
spelling Rios, André RangelOliveira, Fábio Alves Gomes deCosta, Cristiane Maria AmorimSilva, Tatiana Tavares daSilva, Maria Alice daTerto Júnior, Veriano de SouzaRocha, Emerson Ferreira da2022-04-04T17:34:01Z2021-10-14ROCHA, Emerson Ferreira da. O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil. 2021. 207 f. Tese (Doutorado em Bioética, Ética Aplicada e Saúde Coletiva) - Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021.http://www.bdtd.uerj.br/handle/1/17469The main objective of this thesis was to identify the processes of rupture and continuity in the policy of coping with AIDS in Brazil, from the legal-institutional point of view and from the organizational and political point of view, in the light of the paradigm of the Ethics of Care. The justification and relevance of the theme are due to criteria: a) epidemiological - the numbers show a worrying increase in the epidemic in an age group that is difficult to manage, such as male adolescents and young adults, and a higher incidence of this problem in historically marginalized groups, such as blacks and brown, being more relevant among black and brown women; b) political – changes that took place in the political scenario, with relevant effects on health policy, challenged the social arrangement that had ensured the policy to fight AIDS a prominent place, both nationally and internationally. The advance of decentralization in the SUS, associated with the taking of neoliberal measures in the scope of public policies, generated positive ruptures, such as the increase in the coverage of assistance to PLWHA. However, it had deleterious effects among them: the loss of prominence of the role of prevention as a right and a care tool, the reduction in the participation of social movements in decision-making, which resulted in the loosening of the collective and emancipatory pact historically associated with achievements of this confrontation; problems related to the limited capacity of some municipalities in the administrative management of public resources; difficulties, given the conservatism that asserted itself at the political level, in the implementation of ethically sensitive policies such as the case of AIDS. As well as the current proposal for fighting AIDS, since 2013 the pharmacological intervention has been adopted. This measure has been intensified to the present day, which occurred uncritically and even in the face of unsatisfactory indicators related to adherence to ARV's, especially when comparing adherence to ART in Brazil (69%) with countries like the United Kingdom (98 %). Which demonstrates some weakness of the policy in this regard. In this sense, assuming the ethics of care as a prevailing moral paradigm in health can contribute to wards escaping from the traps created by the State-control which, through biolaw and biopolitics, tends to homogenize bodies and vulnerabilities.O objetivo principal desta tese foi identificar os processos de ruptura e continuidade na política de enfrentamento da Aids no Brasil, sob o ponto de vista jurídico-institucional, organizacional e político, à luz do paradigma da Ética do cuidado. A justificativa e relevância do tema se devem a critérios: a) epidemiológicos - os números mostram um preocupante aumento da epidemia numa faixa etária de difícil manejo, como adolescentes e jovens do sexo masculino, e maior incidência deste agravo em grupos historicamente marginalizados, como os pretos e pardos, sendo mais relevante entre as mulheres pretas e pardas; b) políticos – mudanças ocorridas no cenário político, com relevantes reflexos na política sanitária, colocaram em xeque o arranjo social que havia garantido à política de enfrentamento da Aids um lugar de destaque, tanto no âmbito nacional quanto internacional. O avanço da descentralização no SUS, associada com a tomada de medidas neoliberais no âmbito das políticas públicas, gerou rupturas positivas como o aumento da cobertura na assistência às PVHA. Entretanto, teve efeitos deletérios, entre eles: a perda de destaque do papel da prevenção como um direito e uma ferramenta do cuidado, a redução da participação dos movimentos sociais na tomada de decisão – o que resultou no afrouxamento do Pacto coletivo e emancipatório historicamente associado às conquistas deste enfrentamento – ; problemas relacionados à pouca capacidade de alguns municípios na gestão administrativa dos recursos públicos; dificuldades, diante do conservadorismo que se asseverou no plano político, na implementação de políticas eticamente sensíveis como o caso da Aids. A atual proposta de enfrentamento da Aids adotou como primazia, desde 2013, a intervenção farmacológica. Tal medida se intensificou até os dias atuais, o que se deu de forma acrítica e mesmo em face de indicadores insatisfatórios relacionados à adesão aos ARV‘s, especialmente quando comparamos a adesão à TARV no Brasil (69%) com países como o Reino Unido (98%), o que demonstra alguma fragilidade da política neste aspecto. Neste sentido, assumir a ética do cuidado como um paradigma moral vigente na saúde pode contribuir no sentido de escapar das armadilhas criadas pelo Estado – controle que através do biodireito e da biopolítica tende a homogeneizar corpos e vulnerabilidades.Submitted by Marcia CB/C (marciagraziadio@yahoo.com.br) on 2022-04-04T17:34:01Z No. of bitstreams: 1 Tese - Emerson Ferreira da Rocha - 2021 - Completa.pdf: 2259723 bytes, checksum: 2c27fcc29c028066a3a83fdb2f319087 (MD5)Made available in DSpace on 2022-04-04T17:34:01Z (GMT). No. of bitstreams: 1 Tese - Emerson Ferreira da Rocha - 2021 - Completa.pdf: 2259723 bytes, checksum: 2c27fcc29c028066a3a83fdb2f319087 (MD5) Previous issue date: 2021-10-14application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Bioética, Ética aplicada e Saúde ColetivaUERJBrasilCentro Biomédico::Instituto de Medicina SocialPolítica de saúde - BrasilSíndrome de Imunodeficiência Adquirida - prevenção e controleÉticaSaúde públicaAcquired Immunodeficiency Syndrome - prevention and controlEthicsHealth policy - BrazilPublic healthCIENCIAS DA SAUDE::SAUDE COLETIVAO cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no BrasilEthical care and ethics of care: ruptures and continuities in HIV/AIDS policy in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALTese - Emerson Ferreira da Rocha - 2021 - Completa.pdfTese - Emerson Ferreira da Rocha - 2021 - Completa.pdfapplication/pdf2259723http://www.bdtd.uerj.br/bitstream/1/17469/2/Tese+-+Emerson+Ferreira+da+Rocha+-+2021+-+Completa.pdf2c27fcc29c028066a3a83fdb2f319087MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/17469/1/license.txte5502652da718045d7fcd832b79fca29MD511/174692022-09-01 10:29:54.633oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032022-09-01T13:29:54Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
dc.title.alternative.eng.fl_str_mv Ethical care and ethics of care: ruptures and continuities in HIV/AIDS policy in Brazil
title O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
spellingShingle O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
Rocha, Emerson Ferreira da
Política de saúde - Brasil
Síndrome de Imunodeficiência Adquirida - prevenção e controle
Ética
Saúde pública
Acquired Immunodeficiency Syndrome - prevention and control
Ethics
Health policy - Brazil
Public health
CIENCIAS DA SAUDE::SAUDE COLETIVA
title_short O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
title_full O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
title_fullStr O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
title_full_unstemmed O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
title_sort O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil
author Rocha, Emerson Ferreira da
author_facet Rocha, Emerson Ferreira da
author_role author
dc.contributor.advisor1.fl_str_mv Rios, André Rangel
dc.contributor.advisor-co1.fl_str_mv Oliveira, Fábio Alves Gomes de
dc.contributor.referee1.fl_str_mv Costa, Cristiane Maria Amorim
dc.contributor.referee2.fl_str_mv Silva, Tatiana Tavares da
dc.contributor.referee3.fl_str_mv Silva, Maria Alice da
dc.contributor.referee4.fl_str_mv Terto Júnior, Veriano de Souza
dc.contributor.author.fl_str_mv Rocha, Emerson Ferreira da
contributor_str_mv Rios, André Rangel
Oliveira, Fábio Alves Gomes de
Costa, Cristiane Maria Amorim
Silva, Tatiana Tavares da
Silva, Maria Alice da
Terto Júnior, Veriano de Souza
dc.subject.por.fl_str_mv Política de saúde - Brasil
Síndrome de Imunodeficiência Adquirida - prevenção e controle
Ética
Saúde pública
Acquired Immunodeficiency Syndrome - prevention and control
Ethics
topic Política de saúde - Brasil
Síndrome de Imunodeficiência Adquirida - prevenção e controle
Ética
Saúde pública
Acquired Immunodeficiency Syndrome - prevention and control
Ethics
Health policy - Brazil
Public health
CIENCIAS DA SAUDE::SAUDE COLETIVA
dc.subject.eng.fl_str_mv Health policy - Brazil
Public health
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::SAUDE COLETIVA
description The main objective of this thesis was to identify the processes of rupture and continuity in the policy of coping with AIDS in Brazil, from the legal-institutional point of view and from the organizational and political point of view, in the light of the paradigm of the Ethics of Care. The justification and relevance of the theme are due to criteria: a) epidemiological - the numbers show a worrying increase in the epidemic in an age group that is difficult to manage, such as male adolescents and young adults, and a higher incidence of this problem in historically marginalized groups, such as blacks and brown, being more relevant among black and brown women; b) political – changes that took place in the political scenario, with relevant effects on health policy, challenged the social arrangement that had ensured the policy to fight AIDS a prominent place, both nationally and internationally. The advance of decentralization in the SUS, associated with the taking of neoliberal measures in the scope of public policies, generated positive ruptures, such as the increase in the coverage of assistance to PLWHA. However, it had deleterious effects among them: the loss of prominence of the role of prevention as a right and a care tool, the reduction in the participation of social movements in decision-making, which resulted in the loosening of the collective and emancipatory pact historically associated with achievements of this confrontation; problems related to the limited capacity of some municipalities in the administrative management of public resources; difficulties, given the conservatism that asserted itself at the political level, in the implementation of ethically sensitive policies such as the case of AIDS. As well as the current proposal for fighting AIDS, since 2013 the pharmacological intervention has been adopted. This measure has been intensified to the present day, which occurred uncritically and even in the face of unsatisfactory indicators related to adherence to ARV's, especially when comparing adherence to ART in Brazil (69%) with countries like the United Kingdom (98 %). Which demonstrates some weakness of the policy in this regard. In this sense, assuming the ethics of care as a prevailing moral paradigm in health can contribute to wards escaping from the traps created by the State-control which, through biolaw and biopolitics, tends to homogenize bodies and vulnerabilities.
publishDate 2021
dc.date.issued.fl_str_mv 2021-10-14
dc.date.accessioned.fl_str_mv 2022-04-04T17:34:01Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv ROCHA, Emerson Ferreira da. O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil. 2021. 207 f. Tese (Doutorado em Bioética, Ética Aplicada e Saúde Coletiva) - Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/17469
identifier_str_mv ROCHA, Emerson Ferreira da. O cuidado ético e a ética do cuidado: rupturas e a continuidade na política de HIV/AIDS no Brasil. 2021. 207 f. Tese (Doutorado em Bioética, Ética Aplicada e Saúde Coletiva) - Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2021.
url http://www.bdtd.uerj.br/handle/1/17469
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Bioética, Ética aplicada e Saúde Coletiva
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Centro Biomédico::Instituto de Medicina Social
publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da UERJ
instname:Universidade do Estado do Rio de Janeiro (UERJ)
instacron:UERJ
instname_str Universidade do Estado do Rio de Janeiro (UERJ)
instacron_str UERJ
institution UERJ
reponame_str Biblioteca Digital de Teses e Dissertações da UERJ
collection Biblioteca Digital de Teses e Dissertações da UERJ
bitstream.url.fl_str_mv http://www.bdtd.uerj.br/bitstream/1/17469/2/Tese+-+Emerson+Ferreira+da+Rocha+-+2021+-+Completa.pdf
http://www.bdtd.uerj.br/bitstream/1/17469/1/license.txt
bitstream.checksum.fl_str_mv 2c27fcc29c028066a3a83fdb2f319087
e5502652da718045d7fcd832b79fca29
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)
repository.mail.fl_str_mv bdtd.suporte@uerj.br
_version_ 1811728707637739520