Cuidados paliativos e práticas de saúde: um estudo sobre a gestão da morte na sociedade contemporânea

Abstract

This work aims to investigate the processes of normalization and management sociomedical of death in contemporary society, from the analysis of patterns of care in medicine from the Anglo-Saxon called palliative care, a process of institutionalization in Brazil is in full course. Part, initially, the analysis of transformations in social seizures of death that occurred in the course of the twentieth century, especially the period 1960-1970, in whole, created the conditions of possibility of the emergence of palliative care as a model end of life management. Then, from the notion of normalization of ducts of Michel Foucault, there will be a critical analysis of the conception of "good death" as one of the main devices at regulating this new medical practice. Seeks to problematize the formation of this new knowledge and new discipline through questions about the medical control of important sectors of biological life, like currently on the process of dying, anchored largely in the normalization process in today's society, which in health assumes a form medicalizing and, more recently, biomedicalizing.The research is guided by the theoretical reference of Collective Health, with emphasis on the articulation of a critical reading of Western medicine, its rationale and its devices, whose monopoly concerns the individual bodies and populations through the normatization process, as theorized by Michel Foucault and Giorgio Agamben. Besides the theoretical research aimed at understanding the position taken by life and death in the biopolitical context and in the medical device, was effected one field research on "Clínica da Dor e Cuidados Paliativos"(Pain Clinic and Palliative Care), in the University Hospital Clementino Fraga Filho - HUCFF- UFRJ. From the ethnographic observation seeks to investigate the implementation of a palliative care service in the Brazilian public health system and how it materializes in everyday care for normative management of death. The study showed that in addition to a more normative management, expressed in the conception of "good death", cohabiting arrangements for care in these health practices, whose emphasis is on the ethical aspects of recognizing the other as a legitimate other, and in consideration of his ability to self-determination and asceticism. It was possible observed in daily clinical work the effort of professionals to build a relationship of care open to the uniqueness, which points to the paradoxes of care. From these data outline some concepts of care they have in "modes of subjectivity" singular, rooted in alterity relations, that´s permite the creation of a potential space for living and dying.