El presente trabajo abordó el daño a la autonomía decisoria de las y los pacientes provocado por el incumplimiento del deber de informar del médico en la relación clínica, planteando la hipótesis de que esta categoría tiene un carácter extrapatrimonial y es independiente de los daños corporales que se produzcan en el paciente. En el presente trabajo se ha utilizado el método dogmático y analítico. Reconocer este daño permite distanciarse de la opinión generalizada de la doctrina en Chile que identifica el daño por incumplimiento de deber de informar del médico, exclusivamente, con la pérdida de la oportunidad. Con el fin de corroborar la hipótesis descrita se plantean como objetivos, en primer lugar, indagar sobre los argumentos que han colocado a la pérdida de la oportunidad como daño indemnizable frente al incumplimiento de deber de información de médico; en segundo lugar, analizar el contenido y naturaleza de daño a la autonomía decisoria de las y los pacientes y su aplicabilidad al caso de incumplimiento de deber de informar del médico.
The right to health in Brazil, defined in the 1988 Constitution, is guaranteed and strengthened through a broad structure of participation and social oversight. Transformative structural changes, such as the digital transformation of many aspects of the Brazilian National Public Health System, can be powerful tools for expanding access and equity in services. At the same time, however, they can create new forms of exclusion due to geographical, technological and digital literacy barriers. This research sought to explore, through interviews, the perspectives of representatives of social oversight within the Brazilian National Public Health System regarding the process of digital transformation of health. The results show that the SUS Digital Program has been positively transforming access to services. However, social participation has not yet been fully incorporated, and digital transformation is perceived as a management process lacking social oversight.
Public consultations are a mechanism of social participation in the regulatory process characterized by the discourse of ensuring the effectiveness of the results to promote the democratization of the process and to serve capitalist interests. The Brazilian Health Regulatory Agency is responsible for regulating the health risks related to products and services, constituting both a health action and an instrumentofeconomicorganization within society amid competing interests. This article is a documentary analysis aimed at investigating the attributes and development processes of the Brazilian Health Regulatory Agency's public consultations from January 1999 to April 2023. The documents were categorized into four groups: specific legislation, reports and publications of the Agency, reports and publications of the federal government, and scientific evidence. A total of 654 documents were collected; 350 were selected for full-text review; data were extracted from 50 sources. The institutionalization of procedures to improve regulatory quality in internal norms, driven or not by force of law and decrees, was fundamental to establish standards for publicity, transparency, deadlines, and forms of contribution to public consultations, corroborating evidence of normative advances and institutional performance to promote social participation in technical decision-making spaces. It was also observed that a favorable context in the federal government resulted from the publication of standards related to good regulatory practices in the Brazilian Health Regulatory Agency in 2008, 2018 and 2021, institutionally consolidating public consultations as a practice of social participation in health standardization. However, social participation in public consultations is unequal and the diversity of mechanisms for engagement in regulation may favor better-organized groups. We conclude that investments in education initiatives are necessary, as education is a mediator of qualified participation, a driver of citizen political awareness, and a powerful tool to democratize the regulation of health risk.
Significant scientific progress has been made in understanding the judicialization of health, particularly its normative and institutional causes. However, there are still gaps in describing the profile of litigants in such cases and in understanding how different types of profiles influence the claims made and judicial decision-making. Few studies adjust their findings for socio-economic, age, or gender differences, and even fewer provide information about the race of plaintiffs, with such information remaining largely incomplete. This study contributes to the literature on the subject by examining health judicialization initiated by a specific group-patients under 18. By controlling for age, inequalities by gender and race become more evident. All cases regarding health litigation decided by the Sao Paulo State Court of Justice between 2011 and July 2022, with children or adolescents aged zero to 18 as plaintiffs, were analyzed. The data show a predominance of cases filed on behalf of younger, white children, especially male boys, involving claims related to Autism Spectrum Disorder or Attention Deficit Hyperactivity Disorder. This trend is even stronger within the private health sector. The study suggests that inequalities in access to healthcare services are reflected in different profiles of healthcare litigation
This paper examines the harm to the patient's decision-making autonomy caused by the physician's breach of his duty to inform, proposing the hypothesis that such harm is non-pecuniary in nature and is different from any bodily harm caused to the patient. The study adopts a dogmatic and analytical method. Recognizing this form of damage offers an alternative to the prevailing doctrinal opinion in Chile, which equates the harm resulting from the breach of the physician's duty to inform, exclusively with loss of opportunity. To substantiate the described hypothesis, the objectives are, first, to investigate the arguments that have recognized loss of opportunity as a compensable form of damage in the case under study; and second, to analyze the nature and scope of damage to the patients' decision-making autonomy and its applicability to cases involving breach of the physician's duty to inform.
