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Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2022.tde-14042023-145049
Document
Author
Full name
Yuri Nishijima Azeredo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2022
Supervisor
Committee
Schraiber, Lilia Blima (President)
Almeida Filho, Naomar Monteiro de
Ayres, Jose Ricardo de Carvalho Mesquita
Camargo Junior, Kenneth Rochel de
Title in Portuguese
Dos tratados clínicos à medicina baseada em evidências: ciência, tecnologia e trabalho
Keywords in Portuguese
Ciência e saúde
Filosofia
Medicina clínica
Sociologia médica
Tecnologia
Trabalho
Abstract in Portuguese
Este estudo trata da conformação da medicina contemporânea como prática histórica e social, cuja prática vem sendo penetrada de forma crescente pela ciência e tecnologia. Busca-se, então, analisar as peculiaridades da relação entre ciência, tecnologia e o trabalho em saúde nas últimas décadas do século XX e o começo do século XXI. Tomou-se como material empírico o Tratado de Clínica Cecil Textbook of Medicine no qual foram analisados capítulos acerca de duas doenças específicas - hipertensão arterial e úlcera péptica -, além de textos acerca da educação médica e organização da assistência. Além disso, realizou-se entrevistas com docentes e preceptores de escolas médicas. O material obtido permitiu identificar elementos nucleares da prática da prática médica, como a experiência clínica e a relação médico-paciente, tensionados pelo rápido desenvolvimento e incorporação das novidades tecnológicas no campo da saúde. A desvalorização social da experiência clínica pessoal em detrimento da sobrevalorização do respaldo científico dos procedimentos, submetidos a testes de eficácia de resultados, encerra uma prática cada vez mais prescrita e que obstaculiza as relações de confiança entre médicos e pacientes, elemento fundamental ao cuidado
Title in English
From clinical treatises to evidence-based medicine: science, technology and work
Keywords in English
Clinical medicine
Philosophy
Science and health
Sociology of health
Technology
Work
Abstract in English
This study deals with the conformation of contemporary medicine as a historical and social practice, whose practice has been increasingly penetrated by science and technology. It seeks, then, to analyze the peculiarities of the relationship between science, technology and health work in the last decades of the 20th century and the beginning of the 21st century. The Cecil Textbook of Medicine was used as empirical material, in which chapters on two specific diseases - arterial hypertension and peptic ulcer - were analyzed, as well as texts on medical education and organization of care. In addition, interviews were carried out with professors and preceptors of medical schools. The material obtained allowed us to identify core elements of the practice of medical practice, such as clinical experience and the doctor-patient relationship, strained by the rapid development and incorporation of technological innovations in the health field. The social devaluation of personal clinical experience to the detriment of the overvaluation of the scientific support of the procedures, submitted to tests of effectiveness of results, ends a practice that is increasingly prescribed and that hinders the relationships of trust between doctors and patients, a fundamental element in care
 
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Publishing Date
2023-04-17
 
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