Résumé
Resumo Trata-se de ensaio conceitual sobre a ideia de ruptura paradigmática e sua implicação na leitura histórica da saúde pública/coletiva, campo em que se confundem as dimensões política e científica. Um argumento inicial serve para esclarecer o caráter polissêmico e pré-conceitual de “paradigma”, atento às implicações conceituais, mas reafirmando sua utilidade semântica. Segue com a discussão de rupturas essenciais e cumulativas, aplicada ao confronto da ruptura epistêmica promovida pelos centros de saúde distritais e idealização do movimento de reforma sanitária. Conclui pela dificuldade do paradigma “saúde coletiva” em sustentar sua independência discursiva, de modo que a difusão planetária da matriz discursiva dos centros de saúde pela Fundação Rockefeller ainda se configura como a última ruptura paradigmática holística da saúde pública brasileira.
Abstract This conceptual essay investigates the idea of paradigmatic rupture and its implications in historical interpretations of public/collective health, where the dimensions of politics and science intermingle. The polysemic and pre-conceptual nature of “paradigm” is clarified, taking account of the conceptual implications, while reaffirming their semantic usefulness. Essential and cumulative ruptures are discussed and applied to the confrontation of the epistemic rupture brought about by district health centers and the goals of the public health reform movement. The difficulty of the collective health paradigm in maintaining its discursive independence is presented, such that the global spread of the discursive matrix of health centers by the Rockefeller Foundation still constitutes the most recent holistic paradigmatic rupture in Brazilian public health.
Sujets)
Humains , Santé publique/histoire , Réforme des soins de santé , Politique , Médecine préventiveRésumé
Medical science is both scientific and humanistic,and medical humanities education is an ever-lasting theme.To enhance residents'health,a new health service reform is being carried out by the government to promote the transformation towards the bio-psycho-social medical model.Social reality,mental environment and social factors have significant effects upon health.To impart medical humanities knowledge and cultivate quality of humanities are the missions of higher education.Based upon the practice of medical humanities education in Sun Yat-sen University and the experience of developed countries and regions,and by elaborating the theory to deepen understanding of medical humanities the author is to deal with the real needs and to enhance educational effectiveness of countermeasures.