Análise bioética da relação médico-paciente na perícia médica da Previdência Social

Abstract

This dissertation presents and discusses research results developed as prerequisite for obtaining the master s degree in Bioethics, applied Ethics and Public Health by the graduate program in Bioethics, applied Ethics and Public Health at the University of the State of Rio de Janeiro, in association with Federal University of Rio de Janeiro, Oswaldo Cruz Foundation and the Fluminense Federal University. The qualitative methodology research analyzed empirical material composed sample records of the Ombudsman of Brazilian`s Social Security System containing complaints about the medical examinations. The Social Security System has life and its complications in the population of insured persons as object of care and controls. The sick leave benefits is the most often granted between all social security benefits being due only to its policyholders in double condition of vulnerability, disease and work disability. The verification of incapacity to work is carried out by medical experts of Social Security as prerequisite for access to benefit and serves as a cost-control mechanism. The results of the study show that the task of access control, held at the interface with insured, requires an offset of medical care function as a result of the nature of medical-legal examinations, where place of the control is the beneficent exception. Such attributions determine a specific risk to the medical-legal examinations that we understand to be of moral order. The complaints about the medical work in Social Security were understood as dysfunctions index on this interface, as well as the records of violence around this activity. As results of the limits to access the benefits, in the form in which of these limits are placed. The analysis of this interface puts into sharp relief the paradox of social security protection that works by removing parts of its population under protection and characterizes the medical patient relationship in Medical Social Security expertise as morally conflictive. The research, in accordance with a critical bioethics approach, that emphasizes the public policies that affect the life, understands Social Security as Biopolitics and medical expertise as an expression of Biopower according political philosophy of Michel Foucault. It s up to society reflect seriously on these control practice and define the scope and form of social security protection considering that this protection produces tension between individual and collective needs. It s up to each and every one to keep in mind the ethical dimension of the social security policy