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The de-judicialization of health: mediation and interinstitutional dialogues

Abstract

Based on an examination of legislation, jurisprudence and doctrine, the usual path of requests for medicines in the Sistema Único de Saúde (Unified Health System) is analyzed, with a focus on requests falling outside the Relação Nacional de Medicamentos Essenciais (National List of Essential Medicines). The usual approach, where the only solution to a negative response is the filing of lawsuits, overloads the system, increasing complexity and causing iniquities. In this context, the present article aims to rethink this approach through non-judicial mechanisms of conflict resolution. Based on the premise that judicialization is neither born nor ends in the judiciary, measures to “de-judicialize” health are considered: the adoption of mediation chambers outside the protocols of the Unified Health System and prior to judicial demands; the reinforcement of interinstitutional dialogue between entities such as the Defensoria Pública (Public Defender’s Office), the Ministério Público (Public Prosecutor’s Office), the Secretaria de Saúde e Núcleos de Apoio Técnico dos tribunais (Health Department) and the Núcleos de Apoio Técnico (Technical Support Centers) of the Courts; and the expansion of non-judicial channels, facilitating access, reducing non-treatment expenditure, and improving public health.

Judiciary; Public health; Judiacialization of health; Health care evaluation mechanisms

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