Franco de Sá Ronice, Nogueira Julia, De Almeida Guerra Vanessa
Programa de Pós Graduação em Saúde Coletiva, Universidade Federal de Pernambuco, Rua Professor Moraes Rego sn, Cidade Universitária, Recife, Pernambuco, Brazil.
Faculdade de Educação Física da Universidade de Brasília UNB - Asa Norte, Brasília - DF, Brazil.
Health Promot Int. 2019 Mar 1;34(Supplement_1):i74-i81. doi: 10.1093/heapro/day087.
Conventional medicine-understood as a medicalized and commodified model based on biomedical and natural hard sciences that provide legitimization and institutionalism to its practices-is hegemonic in health systems. This article examines interfaces between health promotion (HP) and traditional and complementary medicine (T&CM), especially as found in the Brazilian Health System (SUS). In order to analyze the tensions between paradigms that strive for scientific authority in public policies and practices, especially those related to SUS, we rely on Bourdieu's concept of scientific field. Our guidelines to identify the principles and values that mark the HP and T&CM movements were official documents (policies) and scientific publications on the subject. Analysis showed that the underlying values and principles of HP and T&CM converge and add complexity to the health model and its praxis-HP with its theoretical advances and T&CM with its conceptually coherent practices. Both movements recognize the multidimensional and indivisible nature of 'being' and its social and environmental determination. Together, they strengthen the possibilities of offering practices based on HP principles, such as holism, integrality, sustainability, empowerment, autonomy, social participation and others. This encounter offers a promising path for strengthening resistance against the individualized and monetized 'out-of-pocket' medicine model, and favors the reorientation of primary health care toward a more democratic and health-promoting model for SUS.
传统医学——被理解为一种基于生物医学和自然硬科学的医学化和商品化模式，为其实践提供合法性和制度性——在卫生系统中占据主导地位。本文探讨了健康促进（HP）与传统和补充医学（T&CM）之间的界面，特别是在巴西卫生系统（SUS）中发现的情况。为了分析在公共政策和实践中，尤其是与SUS相关的政策和实践中，追求科学权威的范式之间的紧张关系，我们依赖布迪厄的科学场域概念。我们用以确定标志着HP和T&CM运动的原则和价值观的指导方针是关于该主题的官方文件（政策）和科学出版物。分析表明，HP和T&CM的潜在价值观和原则相互融合，为健康模式及其实践增添了复杂性——HP有其理论进步，T&CM有其概念上连贯的实践。这两个运动都认识到“存在”的多维和不可分割的本质及其社会和环境决定性。它们共同增强了提供基于HP原则的实践的可能性，如整体主义、整体性、可持续性、赋权、自主性、社会参与等。这种相遇为加强对个体化和货币化的“自掏腰包”医学模式的抵制提供了一条充满希望的道路，并有利于将初级卫生保健重新定位为一种更民主和促进健康的SUS模式。
