The subject, its praxis and consequences

I recently received a summons made to me by Maria Helena Machado, coordinator of the research team “Working Conditions of Health Professionals in the Context of Covid-19 in Brazil” (original study)¹ and “Invisible healthcare workers: work conditions and mental health in the context of Covid-19 in Brazil” (subproject)² to comment on the text “The perspective of Ethics and Bioethics on the worker and work in healthcare, in the context of the COVID-19 pandemic in Brazil”, from Professor Swedenberger Barbosa, aware that the article will be included in a thematic edition of Revista Ciência & Saúde Coletiva.

From the outset, I recognize in the article the same availability that the author had already projected in previous works that I know and about which I already had the opportunity to offer my opinion. Notably, the book Bioethics in the Brazilian State. Current Situation and Future Perspectives³, which is part of a political-epistemological field, also present in the text I comment on, in which the author establishes a cogent relationship between bioethics and human rights. Indeed, after UNESCO, in 2005, approved the content of the Universal Declaration of Bioethics and Human Rights, this relationship inevitably operated, and the field began to incorporate, traditional biomedical and biotechnological aspects in studies in the area, as well as the themes of social bioethics with a focus on the universalization of rights and access to public health services and others that give concreteness to the rights of citizenship.

In the book, the author deepens the interdisciplinary approach he had already been taking by claiming a closer approximation between these fields. There, he began to problematize the issues that are present in the article, focused on the work conditions of health professionals:

How, for example, can we advance so that personal, moral and social rights are guaranteed in the light of new biomedical technologies? How to generate the interface between the constitutional principles of citizenship and human dignity and the urgent decisions that involve conduct and moral regulations in their bioethical dimension and that interfere in human life? How can the current legal order and judicial decisions be considered and updated as ‘fair’ in terms of the principles and foundations of law and bioethics? How to deal with scarce health resources and life decisions? We understand that these and other issues should be part of an agenda for multidisciplinary discussions, not restricted to Academia, in which human dignity and fundamental freedoms are safeguarded, among other elements. An important instrument for carrying out this study and debate is the Universal Declaration on Bioethics and Human Rights, evaluating its application to the Brazilian reality, its relationship with the country’s legislation and eventual existing contradictions, which necessarily implies a deep analysis of our legal order and our ethical and moral conduct³.

Thus, with Marilena Chauí, the author assumes that ethical action is that which makes the subject inseparable from its praxis and consequences. This refers to the notion of moral conscience, that is, the ethical subject is the one who knows what he does, what motivated him and is responsible for his desire and action. And this brings him to the thinker who is his reference in Bioethics, Hans Jonas, with whom he considers it necessary and urgent to assume a conception of responsibility that operates as an ethical principle to conduct actions, especially political ones, to preserve the integrity of the human being will form the generations to come.

For this reason, another important contribution by the author, always present in his works, pays close attention to the demands for realizing rights and citizenship, in a complex and unequal society it is not possible without inventing, building, and experimenting with new paradigms for action transforming policy, a task that, in the democratic state of law, involves organized society, but which cannot do without the action of agents and state public policies. This dimension, strong in Swedenberger’s approach, will appear, for example, in a book he organized for Ipea, based on the Seminar from which the work derives: Bioethics in debate - here and outside⁴.

In the article I am examining, these assumptions are present, especially when the research completely reveals, in relation to health professionals in the context of the pandemic, what happened in Brazil in the last four years. Contrary to all the moral and sanitary principles that recommend responsible efforts, what was seen, amid the functional and erratic disorientation of authorities from which a minimum of coordination should be expected, granting that they do not stick to malicious intentions, a posture that exceeds “all limits” to the impulse of “murderous stupidity” that implied the “president in the face of the coronavirus pandemic” to the point of a “delinquent irresponsibility”, which does not even pretend “capacity and maturity to lead the nation of 212 million inhabitants at a dramatic moment in their collective trajectory”. This is what the Folha de São Paulo newspaper said in an editorial (“O que Pensa a Folha”, 12/12/2020), when apostrophizing: “No more bullying with the vaccine!”.

Swedenberger Barbosa’s article opens up current and future perspectives to guide public policies for the realization of rights. And it serves as a reference for later notes in the sense of not losing sight of the necessary relationship between bioethics and the right to health, including the rights of health workers and, based on this relationship, identifying and confronting the dilemmas that open up for discussion and application of the ethical foundations of public health actions and policies.

Referências

• ¹
  Machado MH, coordenadora. Pesquisa: Condições de trabalho dos profissionais de saúde no contexto da Covid-19 no Brasil. Rio de Janeiro: ENSP/CEE-Fiocruz; 2020/2021.
• ²
  Machado MH, coordenadora. Pesquisa: Os trabalhadores invisíveis da saúde: condições de trabalho e saúde mental no contexto da Covid-19 no Brasil. Rio de Janeiro: ENSP/CEE-Fiocruz; 2021/2022.
• ³
  Barbosa SN. A Bioética no Estado Brasileiro. Situação Atual e Perspectivas Futuras. Brasília: Editora UnB; 2010.
• ⁴
  Barbosa SN, organizador. Bioética em debate - aqui e lá fora. Brasília: Ipea; 2011.

Publication Dates

• Publication in this collection
  23 Oct 2023
• Date of issue
  Oct 2023