Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Sin resumen

Sin resumen

Sin resumen

Sin resumen

This study had the following objectives: to understand the interaction processes among health professionals and foreign users in the Unidades Básicas de Saúde (UBS) and the Program for Family Health (PSF); to get to know the significance of the health professional’s experience as they interact with foreign users; to put in evidence bioetiques issues in the experience of professionals and foreign users interaction. It was used as a theorical referential the Symbolic Interacionism and as methodological reference a Grounded Theory up to an axial coding. Data analysis presented as conceptual ordering, lead to the definition of four great issues: (1) "trying to communicate"; (2) "detecting limits"; (3) "recognizing interaction as a process"; (4) "recognizing different perspectives". The route of professional – foreign users interaction was developed from one choice: attend everyone (indiscriminately) making approximation possible. To recognize or fail to recognize in the foreign user the dignity of human person seems to be the determining factor for the openness of the professional to the interaction, in his disposition to seek strategies.

Ethics has always being present in a more or less explicit way in health care quality; nevertheless, there has not been paid attention enough to the power of quality found in the ethical drive and attitudes of professionals who are leaders in improvement processes. The continuous professional development is a process which must accompany successive stages of professional life with different motivational moments and periods of crisis, for which understanding its ethical basis is convenient by reflecting about health care quality. Professionals who care patients also need attention to diagnose and overcome inertia, lack of initiative, skepticism and lack of self criticism situations. Health care quality can only be guarantee if professionals develop a satisfactory progress in their career, for which it is necessary that personal services and human resources of health care institutions devote their best energies in the promotion of their professionals.

In Chile there are diverse governmental and social instances to work with the health of indigenous populations and there has been fruitful outcome; nevertheless, some health care access and coverage inequities persist in these populations. Biomedical research effort carried out with aboriginal populations in our country is hidden, what threatens many times the genetic patrimony of these communities. This text would like to build a bridge between medical anthropology, public health and bioethics. Considering the state of the art in the issue, we propose some elemental work axis on the issue, which serves as basis to get a place within bioethics endeavors at Chile, with the goal of contributing to a process both necessary and urgent: the formulation of a public health culturally aware.

There is an evident contradiction between what has been stated in Guidelines, Declarations and other international documents and actual facts. Already in WHO statutes, valid since 1948, "enjoying the maximum degree of health possible" is recognized as "one of the fundamental human rights". In present world there are countries in which life expectancy is near 80 years while in others 8 of 10 persons die before 60: the difference of what is "possible" is too big to be accepted. In order to reduce this distance an articulate strategy is necessary in three dimensions: to rethink the relation between legal and moral rights, which avoids to confine social rights simply to the good will or beneficence field; to raise health care golden standard, even in countries with minor available resources, rejecting the idea that the difference lies in an insuperable principle; and a global approach to diverse factors that, determining quality of life and personal and social relations, they also contribute to establish health levels, as well as ways and goals of the therapeutic relation itself.

An interdisciplinary study on bioethics is carried out, regarding health care field and its total quality attributes, with focus in decision making, integrating the main bioethical issues –dignity, autonomy and responsibility- as unavoidable components in decisions geared to continuous total quality improvement in the vast field of medical care. This is an analytic study which puts forward the enormous need to relate in a interdisciplinary way health care services management and some bioethical issues hidden or with little visibility, with the intention of improving awareness of them objectively and to be included in design and consequences estimated though specific indicators.

Argentina had been a fertile ground for reform attempts, focusing in the quality of its health services and subsequently, improving the accessibility and equity to the system. Even though bioethics, as a tool for interdisciplinary reflection, should had been a participant for the foundations of health policies and the impact on its users, it seems that local bioethics had omitted the deleterious consequences created by the lack of governance and corruption on the Argentinean public and social security healthcare systems, choosing instead for focusing in blurry discussions about universal issues related to solidarity and justice, blaming for the failures to the imposition of foreign economical models.