The Spirit Level. Why Equality is Better for Everyone

The title of this excellent book uses ‘Medical’ in the broadest possible sense, as the information contained within the book is generic to all healthcare teachers. It is a multi-author book, with t...

A Practical Guide for Medical Teachers.

this article presents a student’s perspective on Jewish studies in Sweden over the past ten years. By identifying the milestones of her own educational and professional path, the author discusses three questions of particular interest for a student wanting to pursue any kind of Jewish studies in a Nordic country, using Sweden as an example, namely: 1) How to compose a curriculum that leads to doctoral studies? 2) What can be said about the ‘identity’ of Jewish studies in Sweden? 3) Can a degree in the subject field of choice also lead to a career outside the academic framework?

A guide for the perplexed.

Brazil's unified health system: the first 30 years and prospects for the future.

A textbook of family medicine

This article discusses the relation between sheltering practice and social medicalization in the primary care. It begins with a revision about social medicalization and mentions some influences concerning the organization of the Brazilian primary care. It also indicates that the ground of receptivity proposal was provided by those influences. It argues the potentiality to accomplish the sheltering with a demedicalization and interdisciplinary action and its reverse effect, when restricted simply to emergency medic care. There are hereby suggested changes in the management and organization of routines, agendas as well as collective and individuals activities of the professionals with the intention to reduce medicalization. The conclusion favors the expansion of experimentation on sheltering as a strategy in dealing with unexpected events and with primary care spontaneous demand, always watching out for its medicalization potential.

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Acolhimento e (des)medicalização social: um desafio para as equipes de saúde da família

O objetivo deste artigo e discutir aspectos da "integralidade", principio normativo do SUS, a partir de pesquisas organizadas ao redor da categoria "racionalidade medica" e da epistemologia de Ludwik Fleck. O artigo discute a categoria integralidade, defendendo que a mesma tem distintos significados para doentes e curadores especializados; tem maior relevância e significa uma missao permanente para estes ultimos; vincula-se ao relacionamento curador-doente e a eficacia da acao terapeutica. A integralidade constitui um grave problema para a biomedicina, cujo saber esquartejou o doente e centrou sua acao nas "doencas biomedicas". Ai, a integralidade esta tanto mais bloqueada quanto mais especializado o ambiente. A atenuacao desses bloqueios passa pela periferia dos circulos especializados e pelo trabalho em equipes multidisciplinares, traduzidos no SUS, acertadamente, como prioridade para a atencao primaria ou basica. Inversamente, outras racionalidades, como a homeopatia e a medicina tradicional chinesa, comportam um saber/pratica facilitador da integralidade nos seus circulos esotericos e seu desafio, alem de sua presenca incipiente no SUS, e levar ao mundo de suas praticas, a integralidade de seus circulos esotericos originais.

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Racionalidades médicas e integralidade

This article aims to justify the necessity of quaternary prevention in face of ‘obstetric violence’ (OV), expression that comprises all forms of harms and violence originated by professional obstetric care, as well as to discuss actions and strategies of quaternary prevention to be taken by family physicians,primary care providers and their professional associations. The prevalence of obstetric violence in Brazil is high: ¼ of women report that they have suffered abusive treatment during birth delivery, besides the excess of unnecessary interventions (i.e. venoclisis, routine oxitocin, and episiotomy),consequently denying them a best practice care such as vertical position, allowing the pregnant woman to freely move, eat, and have a companion during labour process. There is an excess of caesareans (55.6% of the total births) in Brazil, most prevalent on the private sector (85%) than in the public health system (40%). We propose and discuss actions of quaternary prevention against obstetric violence: (1) the elaboration (individual and collective) of birth plans oriented by primary care teams during antenatal care (for which we suggest a guideline); (2) the introduction of other qualified professionals on the caring for low risk birth (including qualified family physicians); and (3) the participation of family physicians and other primary care providers and their associations on the social and political movement for “humanization of birth”, supporting the changes on currently functioning maternity wards and new initiatives on birth delivery care.

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Violência obstétrica e prevenção quaternária: o que é e o que fazer

/pdf/medicalizacion-social-i-el-exito-excesivo-del-epistemicidio-3peovhnsiw.pdf

Medicalización social (I): el éxito excesivo del epistemicidio moderno en la salud

O processo de medicalizacao social no Brasil e intenso e importante para o SUS (especialmente o PSF) e a Saude Coletiva. O objetivo deste artigo e refletir sobre tal processo, numa perspectiva critica e "diagnostica". Para isso, e apresentada uma sintese livre de ideias de Illich (1975) sobre o tema, seguida de uma interpretacao do mesmo a partir da concepcao epistemologica de Fleck (1986). A medicalizacao transforma culturalmente as populacoes, com um declinio da capacidade de enfrentamento autonomo da maior parte dos adoecimentos e das dores cotidianas. Isso desemboca num consumo abusivo e contraprodutivo dos servicos biomedicos, gerando dependencia excessiva e alienacao. Vista pelas ideias de Fleck, ela e a previsivel consequencia da socializacao forcada e acelerada do estilo de pensamento biomedico (centrado no controle, nas acoes e interpretacoes heteronomas) para contingentes populacionais pouco modernizados, plurietnicos e multiculturais, como a maioria da populacao brasileira.

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Charles Dalcanale Tesser

Papers

Acolhimento e (des)medicalização social: um desafio para as equipes de saúde da família

Racionalidades médicas e integralidade

Violência obstétrica e prevenção quaternária: o que é e o que fazer

Medicalización social (I): el éxito excesivo del epistemicidio moderno en la salud

Medicalização social (I): o excessivo sucesso do epistemicídio moderno na saúde