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O direito ? sa?de e a pol?tica nacional de aten??o oncol?gica: uma an?lise a partir da crescente judicializa??o dos medicamentos antineopl?sicos

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Previous issue date: 2012-04-16 / The 1988 Federal Constitution of Brazil by presenting the catalog of fundamental rights and
guarantees (Title II) provides expressly that such rights reach the social, economic and
cultural rights (art. 6 of CF/88) as a means not only to ratify the civil and political rights, but
also to make them effective and practical in the life of the Brazilian people, particularly in the
prediction of immediate application of those rights and guarantees. In this sense, health goes
through condition of universal right and duty of the State, which should be guaranteed by
social and economic policies aimed at reducing the risk of disease and other hazards, in
addition to ensuring universal and equal access to actions and services for its promotion,
protection and recovery (Article 196 by CF/88). Achieving the purposes aimed by the
constituent to the area of health is the great challenge that requires the Health System and its
managers. To this end, several policies have been structured in an attempt to establish actions
and services for the promotion, protection and rehabilitation of diseases and disorders to
health. In the mid-90s, in order to meet the guidelines and principles established by the SUS,
it was established the Pol?tica Nacional de Aten??o Oncol?gica PNAO, in an attempt to
sketch out a public policy that sought to achieve maximum efficiency and to be able to give
answers integral to effective care for patients with cancer, with emphasis on prevention, early
detection, diagnosis, treatment, rehabilitation and palliative care. However, many lawsuits
have been proposed with applications for anticancer drugs. These actions have become very
complex, both in the procedural aspects and in all material ones, especially due to the highcost
drugs more requested these demands, as well as need to be buoyed by the scientific
evidence of these drugs in relation to proposed treatments. The jurisprudence in this area,
although the orientations as outlined by the Parliament of Supreme Court is still in the
process of construction, this study is thus placed in the perspective of contributing to the
effective and efficient adjudication in these actions, with focus on achieving the fundamental
social rights. Given this scenario and using research explanatory literature and documents
were examined 108 lawsuits pending in the Federal Court in Rio Grande do Norte, trying to
identify the organs of the Judiciary behave in the face of lawsuits that seeking oncology drugs
(or antineoplastic), seeking to reconcile the principles and constitutional laws and infra
constitutional involving the theme in an attempt to contribute to a rationalization of this
judicial practice. Finally, considering the Rational Use of health demands and the idea of
belonging to the Brazilian people SUS, it is concluded that the judicial power requires ballast
parameters of their decisions on evidence-based medicine, aligning these decisions housing
constitutional principles that the right to health and the scientific conclusions of efficacy,
effectiveness and efficiency in oncology drugs, when compared to the treatments offered by
SUS / A Constitui??o Federal brasileira de 1988 ao apresentar o cat?logo dos direitos e garantias
fundamentais (T?tulo II), traz, expressamente, que tais direitos alcan?am os direitos sociais,
econ?micos e culturais (art. 6? da CF/88), como forma n?o s? de ratificar os direitos civis e
pol?ticos, mas, tamb?m, de faz?-los efetivos e concretos na vida do povo brasileiro,
especialmente diante da previs?o de aplica??o imediata dos referidos direitos e garantias.
Nesse sentir, a sa?de passa ? condi??o de direito de todos e dever do Estado, o qual dever? ser
garantido mediante pol?ticas sociais e econ?micas que visem ? redu??o do risco de doen?a e
de outros agravos, al?m de garantir acesso universal e igualit?rio ?s a??es e servi?os para sua
promo??o, prote??o e recupera??o (art. 196 da CF/88). Alcan?ar os fins almejados pelo
constituinte para a ?rea da sa?de ? o grande desafio que se imp?e ao Sistema ?nico de Sa?de
e aos seus gestores. Para tanto, diversas pol?ticas p?blicas t?m sido estruturadas na tentativa
de estabelecer a??es e servi?os para a promo??o, prote??o e recupera??o de doen?as e agravos
de sa?de. Em meados da d?cada de 90, e procurando atender as diretrizes e princ?pios
estabelecidos pelo SUS, foi institu?da a Pol?tica Nacional de Aten??o Oncol?gica PNAO, na
tentativa de esbo?ar uma pol?tica p?blica que buscasse atingir o m?ximo de efici?ncia e que
fosse capaz de dar respostas efetivas ao integral atendimento aos pacientes com c?ncer, com
?nfase na preven??o, detec??o precoce, diagn?stico, tratamento, reabilita??o e cuidados
paliativos. No entanto, muitas a??es judiciais t?m sido propostas com pedidos de
medicamentos antineopl?sicos. Essas a??es v?m cercadas de muita complexidade, tanto nos
aspectos processuais quanto nos aspectos materiais, especialmente em raz?o dos altos custos
dos f?rmacos mais solicitados nessas demandas, bem como pela necessidade de serem
balizadas as evid?ncias cient?ficas desses medicamentos em rela??o aos tratamentos
propostos. A jurisprud?ncia nessa ?rea, apesar dos contornos j? delineados pelo Plen?rio do
Supremo Tribunal Federal, ainda est? em pleno processo de constru??o, raz?o pela qual o
presente estudo se coloca na perspectiva de contribuir para a efetiva, eficaz e eficiente
presta??o jurisdicional nessas a??es, com foco na concretiza??o dos direitos fundamentais
sociais. Diante desse cen?rio e utilizando-se da pesquisa explicativa, bibliogr?fica e
documental, foram analisadas 108 a??es judiciais em tr?mite perante a Justi?a Federal, Se??o
Judici?ria do Estado do Rio Grande do Norte, buscando identificar como os ?rg?os do Poder
Judici?rio se portam diante das a??es judiciais que pleiteiam medicamentos oncol?gicos (ou
antineopl?sicos), procurando compatibilizar os princ?pios e normas constitucionais e
infraconstitucionais que envolvem a tem?tica, na tentativa de contribuir para uma
racionaliza??o dessa pr?tica judici?ria. Ao final, considerando o Uso Racional de
Medicamentos e a ideia de pertencimento do SUS ao povo brasileiro, conclui-se que, nas
demandas de sa?de, o Judici?rio p?trio necessita lastrear suas decis?es em par?metros de
medicina baseada em evid?ncias, compatibilizando nessas decis?es os princ?pios
constitucionais que albergam o direito ? sa?de e as conclus?es cient?ficas de efic?cia,
efetividade e efici?ncia dos medicamentos oncol?gicos, quando em compara??o aos
tratamentos oferecidos pelo SUS

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13941
Date16 April 2012
CreatorsSilva, Francisco Livanildo da
ContributorsCPF:37925423404, http://lattes.cnpq.br/6950519368299462, Nobre J?nior, Edilson Pereira, CPF:43045928404, http://lattes.cnpq.br/6219856215182127, Mendon?a, Fabiano Andr? de Souza, CPF:94196834434, http://lattes.cnpq.br/3456431841933671, Bonif?cio, Artur Cortez
PublisherUniversidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Direito, UFRN, BR, Constitui??o e Garantias de Direitos
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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