Moraes Ilara Hämmerli Sozzi de, Prado Lívia Antunes
Escola Nacional de Saúde Pública Sérgio Arouca, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2018 Oct;23(10):3267-3276. doi: 10.1590/1413-812320182310.15942018.
The world is currently experiencing complex threats to privacy in health (PH) in the context of the growing virtualization of bodies and biographies exposed in social networks. This paper aims to identify the approaches to PH in Brazilian scientific production in the light of Collective Health (CH). This is an exploratory, analytical-descriptive study reviewingpapers from Brazilian Collective Health journals of excellence from 2000 to 2017. Papers employing PH as their object were selected for further analysis. We found that papers are commonly anchored in the perspective that the "professional's fear of punishment" is the borderline inhibiting PH violation actions. However, neither the legal-normative framework nor the technological security apparatus sufficed. In the Unified Health System (SUS), threats escalate in initiatives of the SUS Card, PEP, Regulatory Centers and Telehealth. The results corroborate a hypothetic gap in the production of the subject in Collective Health journals of excellence. The discussion is about institutional omission; adoption of the ICF for the use of individual data; opacity on the revenue of public expenditure in the technological security apparatus. Respect for PH must bethe result of a political-ethical agreement, in which all start to act ethically in defense of privacy by choice and not coercion and fear of penalties.
在社交网络中，随着身体和个人经历的虚拟化程度不断提高，当今世界正面临着对健康隐私（PH）的复杂威胁。本文旨在从集体健康（CH）的角度，确定巴西科学生产中有关健康隐私的方法。这是一项探索性的分析描述性研究，回顾了2000年至2017年巴西优秀集体健康期刊上的论文。选择以健康隐私为研究对象的论文进行进一步分析。我们发现，这些论文通常基于这样一种观点，即“专业人员对惩罚的恐惧”是抑制侵犯健康隐私行为的界限。然而，法律规范框架和技术安全手段都不够充分。在统一卫生系统（SUS）中，SUS卡、预防母婴传播（PEP）、监管中心和远程医疗等举措中的威胁不断升级。研究结果证实了优秀集体健康期刊在该主题研究方面存在假设性差距。讨论内容包括机构疏忽；采用国际功能、残疾和健康分类（ICF）来使用个人数据；技术安全手段公共支出收入的不透明性。对健康隐私的尊重必须是政治伦理协议的结果，在该协议中，所有人都开始通过选择而非强制和对惩罚的恐惧来道德行事，以捍卫隐私。
