ABSTRACT
O presente artigo tem como objetivo refletir, por meio de um estudo teórico, acerca do existencial cuidado (Sorge) no pensamento de Martin Heidegger e amor (Liebe) em Ludwig Binswanger. O texto retoma os principais aspectos da forma como ambos compreendem a noção de cuidado e amor, desdobrando criticamente o impasse gerado a partir daí. Demonstra-se que o cerne da querela se dá no modo como Binswanger compreende e interpreta o ser-no-mundo (In-der-Welt-sein) heideggeriano, ligando-o à noção de ser-para-além-do-mundo (Über-die-Welt-hinaus-sein). O psiquiatra suíço procede desse modo na medida em que julga ter identificado um limite e uma carência do elemento eternidade no modo como Heidegger desenvolve sua ontologia fundamental. Com tal apontamento, Binswanger elege a tonalidade do amor como fundamento de toda relação, que faz dessa experiência de infinito sua forma de ser. No bojo de tal apontamento se encontra o desenvolvimento da Daseinsanálise como o desdobramento a princípio psiquiátrico de uma relação clínica pautada pelo amor como meio do acesso fundamental ao outro e como elemento que promove a cura. O artigo conclui que tal indicação binswangeriana recai sutilmente em elementos instrumentais e produtivistas, uma vez que Binswanger reproduz elementos da técnica justamente lá onde tais elementos deveriam permanecer inoperantes. (AU)
This article is a theoretical study to reflect on the existential care (Sorge) in Martin Heidegger and the love (Liebe) in Ludwig Binswanger. The text retakes the main aspects the way both understand care and love, unfolding in a critical way the impasse caused from there. It is demonstrated that the center of the discussion is the way Binswanger understands and interprets the Heideggerian being-in-the-world (In-der-Welt-sein), linking it to the notion of being beyond the world (Über-die-Welt-hinaus-sein). Binswanger identifies a limit and a flaw in the element of eternity in the way Heidegger develops his fundamental ontology. By this he points out to the experience of love as the basis of each relationship, making this experience of the infinite as the way of being of love and the basis of all relationships. In the center of such consideration is the development of Daseinsanalysis as the unfolding - at first psychiatric - of a clinical relationship guided by love as a means of fundamental access to the other and as an element that promotes healing. It is concluded that the Binswangerian indication subtly falls on the productivism and instrumental elements, since Binswanger reproduces elements of technology exactly where those elements must remain inoperative. (AU)
El objetivo de este artículo es reflejar teóricamente sobre el existencial cuidado (Sorge) en los estudios de Martin Heidegger y amor (Liebe) en Ludwig Binswanger. El texto retoma los principales aspectos de cómo ambos entienden esas nociones, para desplegar críticamente el impasse generado a partir de ahí. El núcleo de la disputa tiene lugar en la forma en que Binswanger entiende e interpreta el ser-en-el mundo (In-der-Welt-sein) heideggeriano, vinculándolo a la noción de estar más-allá-del-mundo (Über-die-Welt-hinaus-sein). El psiquiatra lo hace cuando considera identificar un límite y una falta de eternidad en la forma en que Heidegger desarrolla su pensamiento. Con tal nota, Binswanger elige el tono del amor como la base de cada relación, que hace de esta experiencia del infinito su forma de ser. En el abultamiento de esta nota está el desarrollo de la Daseinsanalysis como un desdoblarse del inicio psiquiátrico de una relación clínica guiada por el amor como el acceso fundamental del otro y aún como aquello que conduce a la cura. El artículo concluye que aquello lo que indica Binswanger se queda sutilmente en elementos instrumentales y productivistas, pues Binswanger reproduce elementos de la técnica donde tales elementos deberían mantenerse inoperantes. (AU)
Subject(s)
Empathy , Love , PsychiatryABSTRACT
"OBJECTIVE: To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA). METHODS: We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional). A strong recommendation indicates that clinicians are certain that the benefits of an intervention far outweigh the harms (or vice versa). A conditional recommendation denotes uncertainty over the balance of benefits and harms and/or more significant variability in patient values and preferences. RESULTS: The guideline covers the use of traditional disease-modifying antirheumatic drugs (DMARDs), biologic agents, tofacitinib, and glucocorticoids in early (<6 months) and established (≥6 months) RA. In addition, it provides recommendations on using a treat-to-target approach, tapering and discontinuing medications, and the use of biologic agents and DMARDs in patients with hepatitis, congestive heart failure, malignancy, and serious infections. The guideline addresses the use of vaccines in patients starting/receiving DMARDs or biologic agents, screening for tuberculosis in patients starting/receiving biologic agents or tofacitinib, and laboratory monitoring for traditional DMARDs. The guideline includes 74 recommendations: 23% are strong and 77% are conditional. CONCLUSION: This RA guideline should serve as a tool for clinicians and patients (our two target audiences) for pharmacologic treatment decisions in commonly encountered clinical situations. These recommendations are not prescriptive, and the treatment decisions should be made by physicians and patients through a shared decision-making process taking into account patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies."
Subject(s)
Arthritis, Rheumatoid , Biological Products , Antirheumatic Agents , GlucocorticoidsABSTRACT
OBJECTIVE: To develop a new evidence-based, pharmacologic treatment guideline for rheumatoid arthritis (RA). METHODS: We conducted systematic reviews to synthesize the evidence for the benefits and harms of various treatment options. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the quality of evidence. We employed a group consensus process to grade the strength of recommendations (either strong or conditional). A strong recommendation indicates that clinicians are certain that the benefits of an intervention far outweigh the harms (or vice versa). A conditional recommendation denotes uncertainty over the balance of benefits and harms and/or more significant variability in patient values and preferences. RESULTS: The guideline covers the use of traditional disease-modifying antirheumatic drugs (DMARDs), biologic agents, tofacitinib, and glucocorticoids in early (<6 months) and established (≥6 months) RA. In addition, it provides recommendations on using a treat-to-target approach, tapering and discontinuing medications, and the use of biologic agents and DMARDs in patients with hepatitis, congestive heart failure, malignancy, and serious infections. The guideline addresses the use of vaccines in patients starting/receiving DMARDs or biologic agents, screening for tuberculosis in patients starting/receiving biologic agents or tofacitinib, and laboratory monitoring for traditional DMARDs. The guideline includes 74 recommendations: 23% are strong and 77% are conditional. CONCLUSION: This RA guideline should serve as a tool for clinicians and patients (our two target audiences) for pharmacologic treatment decisions in commonly encountered clinical situations. These recommendations are not prescriptive, and the treatment decisions should be made by physicians and patients through a shared decision-making process taking into account patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.
