Por meio de uma intensa exploração doutrinária, vem se discutindo as mutações do direito frente à explosão tecnológica no mundo e, em especial, à tecnificação das atividades de atuação do Estado. Diante dessa situação, exploramos na doutrina internacional e nacional o conceito de um instituto intimamente ligado à tecnificação da atividade Estatal chamado de discricionariedade técnica. Com esta exploração, temos o intuito de demonstrar que, além de esta doutrina ser plenamente aplicável no direito pátrio, a situação de fato correspondente à tecnificação pela aplicação ao direito dos conhecimentos científicos de engenharia, biologia, medicina, saúde pública, entre outros, impulsionado pelas agências reguladoras, demanda o seu reconhecimento como forma de controle e proteção dos direitos contra eventuais abusos e ilegalidades da Administração Pública e, especialmente, da Administração Pública Sanitária. Por isso, iniciamos com os conceitos da discricionariedade técnica em suas duas modalidades e, após isto, buscamos, nas mais recentes doutrinas, os conceitos e limites identificados para a atividade discricionária técnico-administrativa, além de exemplificar ao leitor, circunstâncias em que tal discricionariedade se impõe. Paralelamente à conceituação, demonstramos a correlação e a relevância do reconhecimento deste instituto para o direito sanitário, buscando exemplos existentes neste ramo jurídico para melhor ilustrar a pesquisa. Após conceituar e exemplificar, passamos, finalmente, a justificar a real relevância deste estudo levantando na doutrina os limites formais e materiais deste instituto, como maneira de fornecer ferramentas para a proteção dos direitos coletivos e individuais contra atos ilegais. / By means of an intense doctrinaire exploration, people have discussed the mutations of law before the technological explosion in the world and, especially, to the technological development of the activities which the State acts. Because of that situation, we have explored in the international and national doctrine the concept of an institute connected to the technological development of the State activity which is called technical discretionarity. With this exploration, we wish to demonstrate that, not only is this doctrine fully applicable in Paternal Law, actually the situation corresponding to the technical development by means of the application to the right of the scientific knowledge of engineering, biology, medicine, public health, among others, impelled by Regulatory Authorities, demands its recognition as a way to control and protect the rights against eventual abuses and illegalities of Public Administration and, especially, of Health Administration. Therefore, we began with the concepts of the technical discritionarity in its two modalities and, after that, we searched, in more recent doctrines, the concepts and identified limits for the technical-administrative discretionary activity, besides exemplifying the reader, circumstances in which such discritionarity is imposed. Parallel to the conception, we demonstrated the correlation and the relevance of the recognition of this institute for Health Law, looking for existing examples in this juridical branch in order to better illustrate the research. After classifying and exemplifying it, we finally started to justify the real relevance of this study raising in the doctrine the formal and material limits of this institute, as a way to supply tools for the protection of collective and individual rights against illegal actions.

Introdução - No Brasil mais da metade dos nascimentos ocorrem por meio de cesariana. As pacientes atendidas pelos planos e seguros saúde têm maior chance de passar por uma cirurgia. Embora seja um recurso que salva vidas, a cesárea sem indicação clínica acarreta riscos de saúde imediatos e de longo prazo. Objetivo - Analisar a regulação orientada à redução das cesarianas sem indicação clínica expedida pela Agência Nacional de Saúde Suplementar (ANS) através das Resoluções Normativas RN 368/2015, RN 387/2015 e RN 398/2016 da ANS. Esta tese é uma pesquisa qualitativa com base documental e entrevistas com representantes de entidades relevantes para a formulação de políticas de saúde materna e para a regulamentação dos planos e seguros de saúde. Resultados - Questões relacionadas à regulação das profissões, do modelo assistencial e da relação entre os agentes estão presentes nas causas do problema e não são suficientemente atendidas pelas resoluções normativas. Conclusão - A regulação da assistência obstétrica na saúde suplementar exige ação coordenada de agentes, instituições e entidades que atuam no mercado e na regulação dos planos de saúde, estabelecimentos hospitalares e profissões de saúde, de modo a promover o desenvolvimento de um plano de ação integrado / In Brazil, more then a half of childbirths are delivered by cesarean section. Healthcare insurance system\'s patients have a higher chance to experience surgery. Although an important resource to save lives, cesareans without clinical justifications may cause immediate and in long-term health risks. Objective - Analyse ANS obstetric regulation focused on reducing no clinical indicated cesareans as issued in RN 368/2015, RN 387/2015 and RN 398/2016. The present thesis is qualitative research based on documents and maternal health policies stakeholders interviews. Results - Professional rules and standards, the maternal health assistance model and the relationship between obstetric actors and entities are issues related to the problem causes and not efficiently developed and solved by ANS normative resolutions. Conclusion - Obstetric assistance regulation in Brazilian private health insurance and plans demands action by the Health Ministry coordinating all authorities responsible for healthcare plans, hospitals, and professionals in obstetric assistance as a means of developing an integrated solution plan

Si le principe de précaution a pour berceau la sphère environnementale, il s'est détaché de cette dernière pour assez vite investir le domaine de la santé humaine et acquérir une certaine autonomie. Son histoire reste très liée à la jurisprudence communautaire quant à sa définition et à son régime juridique. Si de nombreux pays l'ont plus ou moins bien inséré au sein de leurs droits nationaux, il occupe une place de choix en France depuis 2005 où, inscrit dans la Constitution grâce à la Charte de l'environnement, il est devenu une norme ayant le rang le plus élevé. Permettant de prendre des mesures de précaution quand une activité est susceptible de causer un dommage grave pour l'environnement et la santé humaine, il semble être la réponse la plus adaptée à l'impossibilité de consentir à l'incertitude de la science. C'est au niveau de la conception du médicament que la philosophie du principe de précaution se trouve le plus en harmonie. Afin de mieux le caractériser, le principe de précaution peut être rapproché de la notion de précaution qui est présente depuis la nuit des temps en santé. "Primum non nocere" est la règle de conduite des professionnels de santé. Le principe de précaution, qui est une sorte d'outils dans la gestion des risques hypothétiques, renferme deux obligations: une obligation d'évaluation du risque et une obligation de prévention. S'il est doté d'une fonction préventive face au risque incertain, il n'est pas dépourvu d'une mission réparatrice.Son régime juridique concerne tant le droit public que le droit privé, et les juges ne peuvent plus ignorer ce principe perçu comme une clé pour l'avenir. / If the principle of precaution has its roots in the sphere of the environment, it has more recently found relevance, indeed a certain independence, within the domain of human health. With regards to its definition and to its legal regime, its history remains closely linked to community jurisprudence. Many countries have, to a greater or lesser extent, included it within their national rights, and since the environmental Charter of 2005 it enjoys à "special place" in France, where it is now written into the Constitution and has become one of the mostly highly valued norms. When an activity could cause serious harm to the environment or to human health it would appear that the most suitable response, while not directly admitting to the uncertainty of science, would be to ensure that precautionary measures are taken. Philosophically, the principle of precaution finds itself most in harmony when applied to the development of new medicines. To characterise best the principle of precaution, it can be likened to the notion of precaution present in health care since time immemorial. "primum non nocere" is the first rule of health care professionals. The principle of precaution, a useful tool for the management of hypothetical risk, encompasses two imperatives: that of evaluating risk and that of prevention. If on the one hand it is charged with a preventive function in the face of uncertain risk, that is not to say that it is deprived on the other of a reparatory mission. Its legal regime concerns as well public law as private law, and judges can no longer ignore this principle, now seen as "a key for the future".

Le médicament est un bien de santé ; il est un élément incontournable d’un droit à la santé efficace. Il doit être de bonne qualité et son accès doit se faire selon les besoins. S’interroger sur la sécurité sanitaire et l’accès aux médicaments c’est tenter de concilier, droit, économie, éthique et politique. Dans les PED, les faiblesses des revenus et de la capacité de production de médicaments sont des facteurs qui perturbent la mise sur le marché et la surveillance du médicament. Une fois sur le marché, sa distribution est également perturbée par des circuits parallèles illicites difficilement maîtrisables. Malgré les efforts des autorités politiques pour rendre le médicament accessible, des difficultés subsistent. Ces difficultés sont liées pour partie au droit des brevets. En effet, la protection du médicament confère un monopole d’exploitation à son titulaire qui fixe les prix en dehors de toute concurrence. Ces difficultés ont conduit à l’assouplissement du droit des brevets, mais l’usage de ces flexibilités n’est pas aisé pour les PED. La recherche de la santé pour tous et l’économie procèdent de logiques distinctes et le concept du médicament comme bien public demeure un idéal à réaliser, ce qui appelle sans doute à une relecture du droit des brevets. / Drug is a public good of health and an essential element of the right to effective health. It has to be of good quality and its access should be made according to the needs. By questioning the safety and the access to medicines, we attempt to reconcile, law, economics, ethics and politics. In developing countries, the weaknesses of income and the limited production capacity of drugs are factors that alter the placing on the market and the supervision of medication. Once on the market, illegal parallel circuits that are difficult to control also disturb its distribution. Despite the efforts of the political authorities to make drugs available, many challenges remain. These difficulties are partly related to patent law. Indeed, the protection of the drugs confers a monopoly on its holder, which sets prices without any competition. These difficulties have led to the relaxation of patent law, but the use of these flexibilities is not easy for developing countries. The pursuit of health for all and the economic system respond to different logics and the concept of drug as a public good remains an ideal to be achieved, which probably calls for a rereading of the patent law.

Por meio de uma intensa exploração doutrinária, vem se discutindo as mutações do direito frente à explosão tecnológica no mundo e, em especial, à tecnificação das atividades de atuação do Estado. Diante dessa situação, exploramos na doutrina internacional e nacional o conceito de um instituto intimamente ligado à tecnificação da atividade Estatal chamado de discricionariedade técnica. Com esta exploração, temos o intuito de demonstrar que, além de esta doutrina ser plenamente aplicável no direito pátrio, a situação de fato correspondente à tecnificação pela aplicação ao direito dos conhecimentos científicos de engenharia, biologia, medicina, saúde pública, entre outros, impulsionado pelas agências reguladoras, demanda o seu reconhecimento como forma de controle e proteção dos direitos contra eventuais abusos e ilegalidades da Administração Pública e, especialmente, da Administração Pública Sanitária. Por isso, iniciamos com os conceitos da discricionariedade técnica em suas duas modalidades e, após isto, buscamos, nas mais recentes doutrinas, os conceitos e limites identificados para a atividade discricionária técnico-administrativa, além de exemplificar ao leitor, circunstâncias em que tal discricionariedade se impõe. Paralelamente à conceituação, demonstramos a correlação e a relevância do reconhecimento deste instituto para o direito sanitário, buscando exemplos existentes neste ramo jurídico para melhor ilustrar a pesquisa. Após conceituar e exemplificar, passamos, finalmente, a justificar a real relevância deste estudo levantando na doutrina os limites formais e materiais deste instituto, como maneira de fornecer ferramentas para a proteção dos direitos coletivos e individuais contra atos ilegais. / By means of an intense doctrinaire exploration, people have discussed the mutations of law before the technological explosion in the world and, especially, to the technological development of the activities which the State acts. Because of that situation, we have explored in the international and national doctrine the concept of an institute connected to the technological development of the State activity which is called technical discretionarity. With this exploration, we wish to demonstrate that, not only is this doctrine fully applicable in Paternal Law, actually the situation corresponding to the technical development by means of the application to the right of the scientific knowledge of engineering, biology, medicine, public health, among others, impelled by Regulatory Authorities, demands its recognition as a way to control and protect the rights against eventual abuses and illegalities of Public Administration and, especially, of Health Administration. Therefore, we began with the concepts of the technical discritionarity in its two modalities and, after that, we searched, in more recent doctrines, the concepts and identified limits for the technical-administrative discretionary activity, besides exemplifying the reader, circumstances in which such discritionarity is imposed. Parallel to the conception, we demonstrated the correlation and the relevance of the recognition of this institute for Health Law, looking for existing examples in this juridical branch in order to better illustrate the research. After classifying and exemplifying it, we finally started to justify the real relevance of this study raising in the doctrine the formal and material limits of this institute, as a way to supply tools for the protection of collective and individual rights against illegal actions.

Made available in DSpace on 2010-04-20T20:51:43Z (GMT). No. of bitstreams: 3 78157.pdf.jpg: 30491 bytes, checksum: 2ce4d991a0a1c52f388fd76e6f9fc00c (MD5) 78157.pdf: 1779874 bytes, checksum: 304164897240614f31e2a09433fcbb53 (MD5) 78157.pdf.txt: 259128 bytes, checksum: c1820fbb6dfc113ae040d668629692ca (MD5) Previous issue date: 2006-01-18T00:00:00Z / Neste trabalho, foi analisada a evolução das práticas de proteção à saúde no Estado de São Paulo, desenvolvidas pelos órgãos estaduais de Saúde Pública, bem como estudada a evolução desses serviços denominados Vigilância Sanitária. Analisou-se também de que modo se desenvolveram, desde sua origem no século XIX até o final do século XX, as principais tarefas dos órgãos do Serviço Sanitário do Estado, quais sejam: controle das localidades, habitações, ocupação e parcelamento do solo; controle do meio ambiente, da poluição do ar e das águas; fiscalização da alimentação pública, do fabrico e consumo de alimentos e bebidas; controle do exercício de profissões ligadas à saúde; normalização do funcionamento de serviços de assistência à saúde e conexos; controle de drogas e medicamentos; controle de produtos ligados à saúde e conexos; saneamento das fábricas, oficinas e saúde do trabalhador; notificação e supervisão de doenças infecto-contagiosas e, finalmente, ações de educação em saúde, que constituem atribuições e funções dessa atividade. Muitas das funções e tarefas desenvolvidas atualmente pelos serviços de Vigilância Sanitária vêm sendo realizadas desde a criação do Serviço Sanitário do Estado, em 1892, ou mesmo anteriormente, apesar da Vigilância Sanitária, enquanto atividade sistematizada e organizada, ser algo recente no Estado de São Paulo, pois o CVS- Centro de Vigilância Sanitária foi criado em 1986. Sendo assim, apresenta-se aqui a evolução histórica dessa atividade sob a responsabilidade do Governo do Estado de São Paulo, apontando fatos relevantes no seu desenvolvimento, bem como os organogramas correspondentes a várias estruturas organizacionais. São analisadas também, segundo as atribuições mencionadas anteriormente, as evoluções da legislação básica presente nos sete Códigos Sanitários Estaduais vigentes nesse período. / This paper analyze the evolution of the practice on health protection in São Paulo State , developed by State Service of Public Health, also studies the evolution of these services known as health surveillance. It also analyzes how the main duties from States Services of Surveillance, such as : home place control, habitation, occupation and parcel ground; environmental control, including air and water pollution; control of food and drink production; control of professional practice related to health; health care services standardization; drugs and medicines control; health products correlated control ; working and occupational health; infectious diseases notification; and finally health education. These are functions and attributions of this activities, that developed from the beginning of the XIX Century until the end of the XX Century. Many of the functions and practices developed nowadays by the health surveillance services have been done since the origin of the State Sanitary Service in 1892, or even before, even though the health surveillance, while organized and systematized activity, is new in São Paulo State, because 'CVS – Centro de Vigilancia Sanitaria' was created in 1986. On this sense, it´s presented here, the historical evolution of this activity under de responsibility of the São Paulo State Government pointing relevant facts in its development, as well as the correspondent organization chart of the many organizational structure. Its also analyses, according to attributions in the seventy State Code Health Law valid in this period.

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No. of bitstreams: 1 Dissertacao Carolina.pdf: 1432080 bytes, checksum: a5e0e845f04d358b368bb6802020460f (MD5) Previous issue date: 2013-08-28 / A pesquisa discute o processo de formulação da política pública em reprodução humana assistida, de modo especial o Projeto de Lei nº 517/2011 e sua entrada na agenda governamental do Estado de São Paulo, no intuito de investigar o porquê, como e para que se dá o processo de formulação do “Programa de Assistência Básica em Reprodução Humana” (Projeto de Lei n º 517/2011) na agenda governamental do Estado de São Paulo. Especificamente, buscou-se ainda: identificar o problema que justifica a formulação da política de assistência em reprodução humana assistida no sistema público de saúde do Estado de São Paulo à luz do modelo teórico de política pública de Kingdon; levantar e sistematizar os documentos existentes sobre as propostas/alternativas para a assistência em reprodução humana assistida no sistema público de saúde do Estado de São Paulo; mapear os atores/participantes do processo de formulação da política pública em reprodução humana assistida na agenda governamental do Estado de São Paulo. Assim, este estudo pretende ampliar a compreensão dos direitos sociais, quais sejam: o direito à saúde e o direito sexual e reprodutivo a luz da Lei do Planejamento Familiar, a fim de que as camadas menos favorecidas economicamente possam desfrutar desses direitos, por vezes tolhidos pelo sistema econômico neoliberal e capitalista. Tais direitos auxiliam na construção de um Estado do Bem Estar Social, no qual a cidadania pode ser exercida de maneira salutar à dignidade da pessoa humana. Nesse sentido, a metodologia adotada foi de uma pesquisa qualitativa com revisão bibliográfica, análise documental e o delineamento do estudo de caso, o qual utilizou como instrumento de coleta de dados a entrevista, para buscar a percepção dos atores envolvidos no processo de formulação da política supramencionada, tendo como referencial teórico o modelo de políticas públicas de Kingdon. O caso estudado foi o Projeto de Lei nº 517/2011, que institui o “Programa de Assistência Básica em Reprodução Humana”, da Assembleia Legislativa do Estado de São Paulo. Os dados obtidos evidenciaram que, no Brasil, a política pública ora abordada é escassa, refletindo, pois, no acesso a uma classe menos favorecida. Desse modo, fica evidenciada a necessidade da participação do Estado, através das ações formuladas pelo Sistema Único de Saúde (SUS) ou pelas Parcerias Público-Privadas (PPP). Ressalta-se, entretanto, que as questões orçamentárias para a consecução das políticas de reprodução humana assistida representam empecilhos para sua implementação, devido à limitação dos recursos governamentais, haja vista que a previsão orçamentária ainda é insuficiente. Outrossim, deve-se atentar para o discurso do benefício das privatizações nas prestações dos serviços garantidos constitucionalmente à população como um todo, uma vez que a ausência de regras bem definidas pode favorecer ao desvio dos objetivos reais da referida política, não atendendo, pois, ao público ao qual se destina. / The research discusses the process of public policy-making in assisted human reproduction, particularly the Bill of Law nº 517/2011 and its entry into the government agenda of the State of São Paulo, in order to investigate why, how and who gives the process of formulating the "Basic Assistance Program in Human Reproduction" (Bill nº 517/2011) on the government agenda of the State of São Paulo. Specifically, we sought also to identify the problem that justifies the policy formulation assistance in assisted human reproduction in the public health system of the State of São Paulo the light of the theoretical model of public policy Kingdon; lift and systematize existing documents on proposals / alternatives for assistance in assisted human reproduction in the public health system of the State of São Paulo; map the actors / participants in the formulation of public policy on assisted human reproduction in the government agenda of the State of São Paulo. Thus, this study aims to broaden the understanding of social rights, namely: the right to health and the right to sexual and reproductive Light Family Planning Law, in order that the economically less privileged can enjoy these rights sometimes hampered by neoliberal and capitalist economic system. Rights which help in building a State of Social Welfare, in which citizenship can be exercised so salutary to human dignity. In this sense, the methodology adopted was a qualitative study with literature review, documentary analysis and design of the case study, which used as a tool for data collection interview to seek the perception of the actors involved in the process of policy formulation above, with the theoretical model of public policies Kingdon. The case studied was the Draft Law nº 517/2011, establishing the "Basic Assistance Program in Human Reproduction," the Legislature of the State of São Paulo. The data showed that, in Brazil, the public policy discussed herein is scarce reflecting, as the access to a class less favored. Thus, it is clear the need for the participation of the state through the actions made by the Unified Health System (SUS) or the Public-Private Partnerships (PPP). It is noteworthy, however, that the budget issues for achieving policy assisted reproduction represent impediments to its implementation due to limited government resources, given that even the budget forecast is still insufficient. Furthermore, attention should be paid to the speech of the benefit of privatization in those services constitutionally guaranteed to the population as a whole, since the absence of well-defined rules may favor the deviation of the real objectives of the policy not serving as the public for which it is intended.

Le droit de la santé réglemente les actions de santé lato sensu. En encadrant juridiquement une pluralité d'actes médicaux, comme l'AMP, l'interruption de grossesse, l'examen des empreintes génétiques ou encore les dons d'éléments et produits du corps humain, il influence le droit extra-patrimonial de la famille. Cette influence est protéiforme et se manifeste à la fois sur la détermination des liens familiaux et sur les droits et devoirs en découlant. Le droit comparé franco-suisse, dans sa fonction de connaissance du droit, permet de révéler les manifestations de cette influence. Le droit de la santé français exerce fréquemment un rôle moteur, subversif des concepts civilistes traditionnels. Le droit de la santé et le droit de la famille sont le plus souvent pensés séparément, le premier tendant parfois à s'autonomiser. À l'inverse, le droit de la santé suisse s'inspire régulièrement des constructions civilistes préexistantes, même si la finalité sanitaire justifie parfois un renouvellement des concepts. Ainsi, les deux champs du droit sont le plus souvent pensés globalement, approche dont le droit français gagnerait à s'inspirer. L'influence du droit de la santé sur le droit extra-patrimonial de la famille doit être repensée en tenant compte des objectifs poursuivis par les différentes règles de droit. La spécificité des actes médicaux à finalité familiale justifie que le droit de la santé soit cantonné à un rôle technique, suiveur de l'évolution du droit de la famille. En revanche, lorsqu'il réglemente les actes médicaux susceptibles d'influencer les droits et devoirs familiaux, le droit de la santé peut exercer un rôle complémentaire à celui du droit de la famille. / Health law regulates medical activity. By giving a legal framework to several medical acts, such as ART, abortion, DNA identification or donations of components and products of the human body, it influences extrapatrimonial family law. This influence is undeniably protean as it is exerted on both the definition and the legal regime of family ties. In its quest for improving knowledge of legal systems, French-Swiss comparative law can reveal and explain the manner in which this influence is expressed. In France, health law often plays a leading role, thus subverting traditional family law concepts and sometimes leading to inconsistencies. Health law and family law are usually viewed separately, with health law often taking an autonomous stance. In Switzerland, on the other hand, health law frequently draws on preexisting civil and family law concepts. Most of the time, these two fields of law are thought of together. This analysis incites us to rebuild French law in the light of Swiss law. The influence of health law on extrapatrimonial family law must be rethought, by taking into account the goal of each legal rule. The specificity of medical acts pursuing family interests justifies confining health law to a technical role, following the evolution of family law. Health law must be a tool for family law. However, health law can complement family law when it comes to the determination of family rights and duties. This complementarity is expressed either through the articulation of both branches of law when common goals are visible, or through the search for criteria capable of reconciling the conflicting goals pursued by these two subjects.

Cette thèse s’intéresse à la protection de la vie privée informationnelle dans le contexte de la biosécurité. La biosécurité se définit comme le processus qui vise à prendre en charge, dans une optique de sécurité nationale, les menaces et dangers que représentent les épidémies de maladies infectieuses pour la santé des populations humaines et la sécurité de l’État. Notre projet remet en question l’idée selon laquelle la conduite des activités de surveillance de la santé publique implique nécessairement une diminution de la protection offerte aux renseignements personnels sur la santé. Nos recherches tendent à démontrer que la conciliation de la surveillance de la santé et la protection de la vie privée est non seulement possible, mais qu’elle est surtout nécessaire. Nous portons plus précisément notre attention sur le cas de la collecte et de l’utilisation de renseignements dépersonnalisés sur la santé par les systèmes de surveillance syndromique. Bien calibrée et soigneusement réglementée, cette forme novatrice et particulière de surveillance offrirait le double avantage de réduire les risques d’atteintes à la vie privée des individus et d’augmenter de manière considérable l’efficacité des capacités étatiques en matière de détection des épidémies. / This thesis focuses on the protection of privacy in the context of biosecurity. Biosecurity is concerned with the threats that epidemics of infectious diseases present to public health and national security. The main goal of my thesis is to challenge the idea that conducting meaningful public health surveillance necessarily implies that the scope of the legal protection given to personal health information has to be reduced. My research demonstrates that, given certain conditions, a public health surveillance conducted with carefully configured syndromic surveillance systems operating with de-identified health data would increase both the efficiency of surveillance in terms of its capacity to detect emerging epidemics and the level of informational privacy of the patients.

Early diagnosis is a promising strategy to reduce premature mortalities and for optimal use of resources. But the absence of mathematical models specific to the data settings in LMIC’s impedes the construction of economic analysis necessary for decision-makers in the development of cancer control programs. This thesis presents a new methodology for parameterizing the natural history model of breast cancer based on data availabilities in low and middle income countries, and formulation of a control optimization problem to find the optimal screening schedule for mammography screening, solved using dynamic programming. As harms and benefits are known to increase with the increase in the number of lifetime screens, the trade-off was modeled by formulating the immediate reward as a function of false positives and life-years saved. The method presented in thesis will provide optimal screening schedules for multiple scenarios of Willingness to Pay (numeric value assigned for each life-year lived), including the resulting total number of lifetime screens per person, which can help decision-makers evaluate current resource availabilities or plan future resource needs for implementation.