A antinomia da proposta de humanização do cuidado em saúde

Abstract

Resumo Este ensaio busca contribuir para a (re)formulação de uma linha teórica de análise da humanização do cuidado em saúde, a partir de uma abordagem marxiana. Para tanto, dialogamos com parte da produção científica brasileira, quando constatamos a predominância de uma tendência que centra a estratégia de humanização sobre uma perspectiva subjetiva-relacional, especialmente explícita na Política Nacional de Humanização da Atenção e Gestão no Sistema Único de Saúde. Embora reconheçamos a importância dessa estratégia, apontamos seus limites, ao problematizar o que seja humanização em Marx e, por consequência, demonstrando a estrutura originária do processo de desumanização. Feito isso, esclarecemos que, considerando quais sejam as bases da desumanização, seu enfrentamento deve ir além da esfera subjetiva-relacional, no sentido de atingir a dimensão coletiva da luta de classes, contra o capital. Trata-se de articular a luta particular contra os efeitos desumanizadores do capital na saúde com a luta mais geral, contra o capital nas suas linhas mais fundamentais.

Cuidado em saúde e alienação: relação mediada pela tecnologia

“…Fruitful possibilities for connection between humankind and individuals are created, thus enriching human potentialities. However, this inherent and irrepressible facet of work may, in antagonized societies, be subordinated to particular interests, to the detriment of humankind 2,[8][9][10][11] . This is exactly what happens in capitalism, under the aegis of abstract work.…”

“…In the midst of organization of life through widespread exchange of goods, those who have nothing to sell, except themselves, enter this dynamic in a position of inequality, even if they legally seem equal 1 . This constitutes subsuming of the value of use to the exchange value, in which placing value on the product is of interest, and not necessarily the development of humankind 1,2,6,8,10,11 .…”

“…This process of subsuming from qualitative to quantitative also subsumes the category difference to abstract homogenization. This is an amorphous mass of equal human work (abstract work) that is directed to the needs of the market 1,2,6,8,11 . Under these conditions, the retroactive process of objectification over the subjective sphere begins to act as an obstacle to human potentialities, thereby distancing individuals from the totality of humankind.…”

“…Thinking in line with Lukács 2 , we should place healthcare at the center of social praxis, funded by work. Ultimately, at the ontological level, care is not confused with work itself (as an exchange between humans and nature), because it takes place in the context of exchange between people, with the existence of consciousness at the two poles of the relationship 7,8,11 . However, inside this, it reproduces the procedural nature of work as a synthesis of teleology and causality.…”

“…Concretely, in each historical phase, it is worth observing the particular "clothing" that both have assumed. In the case of capitalism, there is a tendency to homogenize human praxis, such that all human activity at work is reduced so as to equate its different products or services in the market (according to their exchange value) 7,8,11 . Therefore, it is not erroneous to consider healthcare to be work, in the context of a historical period, thereby determining the emergence of abstract work, according to capitalism.…”