Racionalidades médicas e integralidade

Abstract

Abstract

Saúde mental infantil na atenção primária à saúde: discursos de profissionais médicos

“…Tesser (2006), ao discutir acerca do sucesso da biomedicina na construção do monopólio do saber legítimo sobre a saúde e a doença, aponta, dentre outros efeitos da racionalidade biomédica, a cres cente tecnificação do ato médico, o uso intensivo de tecnologia e a fragmentação em uma infinidade de saberes específicos, produzindo uma superes pecialização da prática médica. Como reações a estes efeitos emergiram projetos de reforma da assistência médica como a medicina comunitária, a medicina integral e a medicina familiar, incor porando ou não transformações nas estratégias de formação (Paim, 1993) ou outras racionalidades médicas como a homeopatia, a medicina ayurvédica e a medicina tradicional chinesa (Tesser;Luz, 2008). Neste sentido, alguns entrevistados relataram que não concordam com a forma instituída de encami nhamento dos casos e com o desfecho consistindo quase que absolutamente na prescrição de medica mentos, pois consideram ser importante trabalhar com a família e que esta necessita de um suporte psicológico.…”

Contribuições da medicina antroposófica à integralidade na educação médica: uma aproximação hermenêutica

“…According to Fleck, Kuhn and Feyerabend, the place that a certain conception of knowledge occupies among the intellectuals of a society is not determined scientifically 13,45,46 . It results from consensuses that are established fundamentally through power relations that involve values, interests and priorities -winners or losers -of a given time.…”

“…In the debate regarding integrality in the education of healthcare professionals, it is recognized that a model of mechanistic science -a model restricted to measurable and controllable information -is insufficient as the cognitive basis of the education of healthcare professionals 3 . However, as their starting point is the split between natural and human sciences, that is, an understanding of Cartesian traits separating res cogitans from res extensa -a non-holistic comprehension of reality -, the option that is more frequently adopted is that of interdisciplinarity: the perception of a feature of the health-disease process in the perspective of different knowledge methods (of the human or natural sciences) that can be joined a posteriori to construct a picture that is as integral as possible of that situation 13 . Holistic conceptions, like that of anthroposophical medicine and other medical rationalities, enable us to perceive our experience of the world as inseparable from reality itself.…”

“…It is a category that represents a theoretical model that contains the fundamental elements to the recognition of a complex and singular medical system. A medical rationality is an articulated set of knowledge and practices that has six interconnected dimensions: a morphology (equivalent to anatomy in the biomedical rationality); a vital dynamics (physiology); a medical doctrine (which explains what is health, disease and the origin of these conditions); a diagnostic system; a therapeutic system; and a cosmology, a sixth dimension that presents the worldview that provides the basis for the previous dimensions 13 . Luz and collaborators have already identified five medical rationalities: biomedicine or contemporary Western medicine, which nowadays occupies a hegemonic position compared to the others; homeopathy; traditional Chinese medicine; Ayurvedic medicine; and, more recently, anthroposophical medicine 14,15 .…”

“…According to Tesser and Luz 13 , medical rationalities which are considered alternative, complementary and/or integrative, such as homeopathy, Chinese and Ayurvedic medicine, particularly favor integrality in the area of health. In these rationalities, integrality is a presupposition and a principle that articulates their knowledge and practices.…”