Agenda única de saúde: a busca do acesso universal e a garantia do direito à saúde

Este trabalho visa identificar os determinantes da ampliação de demandas judiciais contra os gestores do SUS. Em sua maioria (85%) relacionam-se ao fornecimento de medicamentos e são geradas, no âmbito do Judiciário, pelo entendimento daquele órgão que o Poder Público está descumprindo o direito à saúde constitucionalmente adquirido. Foi realizada uma revisão bibliográfica acerca de sistemas nacionais de saúde com princípios constitutivos básicos semelhantes aos do SUS, tendo sido selecionados o Canadá, Colômbia e Espanha. O objetivo foi observar se àqueles sistemas apresentam as dificuldades experimentadas pelo SUS, ou se existe, no sistema nacional, alguma peculiaridade. Foram analisados os artigos da Constituição de 1988 relativos à saúde, observando-se em vários deles pouca clareza na descrição de conceitos que parecem dar margem a múltiplos entendimentos dos atores envolvidos com a implementação do SUS. Desenvolveuse uma pesquisa quali-quantitativa: o 1 componente foi realizado por meio de entrevistas com atores chave, representantes do Executivo, Legislativo, Judiciário, Órgãos de Classe, Conselhos de Saúde e Gestores. A etapa quantitativa foi realizada a partir da coleta, sistematização e análise de dados acerca das demandas judiciais chegadas aos gestores do SUS localizados no Rio de Janeiro (SMS, SESDEC e NERJ). Os entendimentos dos entrevistados mostraram-se muito distintos e bastante relacionados com seus locais de atuação. Foi observado que o Judiciário, grosso modo, ratifica as prescrições médicas, determinando aos gestores, tornados réus, o fornecimento de produtos de saúde que vão desde os medicamentos essenciais até os de dispensação excepcional e mesmo, algumas substâncias importadas. As liminares não atendem as padronizações definidas pelas Políticas Nacionais de Assistência Farmacêutica, nem as que dizem respeito às relações pactuadas entre os gestores nem a responsabilização existente por nível de gestão. Tais questões têm gerado um tensionamento permanente entre o Executivo da saúde, Judiciário e população, uma vez que o cumprimento das determinações judiciais representa, para o gestor, uma necessidade de realocação orçamentária para a aquisição de medicamentos não planejados, que pode determinar a não realização de ações programáticas prioritárias. Parece que estas ações do Judiciário, ainda que legítimas, não necessariamente favorecem a equidade de acesso ao SUS. Por último, foram definidos 3 núcleos causais para a ampliação das demandas judiciais de saúde: o 1, derivado da pouca clareza de alguns conceitos constitucionais determinada pela falta de consenso político quando dos trabalhos da ANC, que deixaram estas definições para regulamentações posteriores, que não ocorreram; o 2, representado pela não contestação da maior parcela das prescrições médicas, pelo Judiciário, o que parece demonstrar o poder das profissões, medicina e direito, e, a inexistência de regulação do exercício profissional pelo Estado e o 3, determinado pela pouca articulação no SUS entre a gestão financeira e da atenção à saúde, o que parece impedir que os gestores atuem como protagonistas destas situações, deixando de promover articulações entre os Poderes do Estado, Instituições, Órgãos de Classe e a sociedade para definição de estratégias comuns voltadas à resolução dos problemas apontados neste estudo.

Las empresas sociales del estado y el derecho fundamental a la salud. Estudio de caso hospital simón bolívar E.S.E (2002-2014)

El presente trabajo busca hacer un análisis sobre los arreglos institucionales introducidos con la ley 100 de 1993 a las Empresas Sociales del Estado (ESE), y cómo estos han afectado la prestación del servicio de salud y la garantía del derecho; para lo cual se escoge como ejemplo el Hospital Simón Bolívar E.S.E de Bogotá durante los años 2002 a 2014. Se explica como con la implementación de la descentralización, el modelo de aseguramiento y la autonomía financiera se afectó la prestación del servicio de salud, teniendo en cuenta la introducción de un eslabón dentro del sistema de salud: las Empresas Promotoras de Salud (EPS).

Fundamental Right to Freedom of Conscience without Objection? Some Notes for its Recognition as a Fundamental Guarantee

Conscientious objection is defined as the ability to depart from statutory mandates because of intimate convictions based on ethical or religious convictions. A discussion of this issue presents the conflict between the idea of a State concerned with the promotion of individual rights or the protection of general interests and an idea of law based on the maintenance of order and against a view of the law as a means to claim the protection of minimum conditions of the person. From this conflict is drawn the possibility to argue whether conscientious objection should be guaranteed as a fundamental right of freedom of conscience or as a statutory authority legislatively conferred upon persons. This paper sets out a discussion around the two views so as to develop a position that is more consistent with the context of social and constitutional law.

"Right to Personal Liberty Under the Indian Constitution - With Special Reference to Judicial Process"

The nature and extent of protection secured to personal liberty has been a subject matter of great controversy and debate. The expression "procedure established by law" as a standard of protection for personal liberty has been looked upon as highly unsatisfactory and inadequate. For, unlike the specific attributes of liberty that are separately guaranteed under Art.19, ‘personal liberty‘ as guaranteed by Art.21 does not obligate the .Legislature to comply with the requirements of justice and reasonableness as and when it enchroaches upon that right. Though the concept of ‘personal liberty‘ has received an evolutive and expansive meaning through judicial process, the standard of protection which the judicial process could secure to personal liberty through the interpretation of Art.21 has been far from satisfactory Even after four decades of judicial process in the interpretation of Art.21 the problem of evolving a just and adequate standard of protection for personal liberty in that Article continues to be 21 crucial constitutional issue, craving for a. satisfactory solution. And the present study is a humble attempt to unravel this problem and to Search for a reasonable solution.

The Right to Water in the Case-Law of the Inter-American Court of Human Rights

The human right to water is nowadays more broadly recognised, mainly due to the essential societal function that this resource plays; likewise, because of the present water scarcity is generating conflicts between its different uses. Thus, this right aims at protecting human beings by guaranteeing access to clean water that is essential to satisfy vital human needs. Similarly, access to clean water is an important element to guarantee other rights including the right to life and health. The recognition of the right to water is mainly achieved in two ways: as a new and independent right and as a subordinate or derivative right. Concerning the latter, the right to water can emanate from civil and political rights, such as the right to life; or can be derived from economic, social and cultural rights, including the right to health, the right to an adequate standard of living, and the right to housing. This contribution explores the position of the Inter-American Court of Human Rights regarding the right to water, and analyses whether the Court has recognised the right to water and, if so, in which manner.

Delimitation of the Right to Life by Healthcare Professionals: Up to what point should the right to life be protected?

This article explores the medical care standard required by law for terminally illpatients and the possibility of limiting therapeutic efforts while respecting the duediligence expected from doctors. To this end, circumstances are identified in whichthe doctor is forced to choose between two possible actions: to guarantee the right tolife by continuing treatment, or to limit the right to healthcare by limiting therapeuticefforts. Two cases taken from English Common Law were reviewed that decided onthe factual problem at hand. In our country, the Constitutional Court established aline of jurisprudence on the role of the doctor in deciding whether or not to continuetreatment for a terminally ill person. Lastly, jurisprudence precedents are presentedalong with a comparative analysis of the solutions given in Great Britain andin Colombia.

Millennium development goals: progress towards the right to health in Latin america and the Caribbean

Includes bibliography

Media diversity as a guarantee to cultural diversity: the promotion of identities from an international law approach

This article deals with several international instruments which provide legal guarantees for media diversity, which is essential for the promotion of cultural diversity. Based on several articles of the Convention of cultural diversity, the General Comment of the Committee on Economic, Social and Cultural Rights No. 21 on the right to take part in cultural life, as well as the work of the UN Independent Expert on Cultural Rights, this article aims to identify legal tools for the establishing of measures promoting cultural diversity in the media. This article looks at the case study of Honduran Garifuna community radios. It emphasizes the importance of taking into account the economic aspects of cultural and communicational rights.

Tthe right to effective judicial protection and disability: the convention on the rights of persons with disabilities

On 13 December 2006, the General Assembly of the United Nations adopted the Convention on the Rights of Persons with Disabilities (CRPD). It is the first comprehensive human rights treaty of the 21st century. The Convention is intended as a human rights instrument with an explicit, social development dimension. It adopts a broad categorization of persons with disabilities and reaffirms that all persons with all types of disabilities must enjoy all human rights and fundamental freedoms. Precisely, the Convention marks a 'paradigm shift' in attitudes and approaches to persons with disabilities The Convention contains two articles directly connected with judicial effective protection, one more than the other, but on the other hand, one cannot be understood without the other. Both articles are Article 12 –Equal recognition before the law- and Article 13 –access to justice- As a scholar in Procedural Law, my contribution to the International Scientific Congress on Private Law of the Philippines and Spain aims to enshrine the relevant importance of the both provisions that guarantee effective judicial protection for persons with disabilities in order to analyze, subsequently, the implementation of them in Spanish legislation

Applying integrated resource and environmental management to transmission right-of-way maintenance

The concept of a substantive integrator is introduced as a method for integrated resource and environmental management as a means to assimilate different resource values at the operational or field level. A substantive integrator is a strategic management tool for integrating multiple uses into coprorate management regimes that traditionally manage for single values. Wildlife habitat management is presented as a substantive integrator for managing vegetation on electric utility power line corridors. A case study from northern British Columbia provides an example of wildlife habitat management as a means to integrate other resource values such as aesthetics, access and subsistence along British Columbia Hydro and Power Authority's transmission rights-of-way.

HVAC system size – getting it right

There is evidence that many heating, ventilating & air conditioning (HVAC) systems, installed in larger buildings, have more capacity than is ever required to keep the occupants comfortable. This paper explores the reasons why this can occur, by examining a typical brief/design/documentation process. Over-sized HVAC systems cost more to install and operate and may not be able to control thermal comfort as well as a “right-sized” system. These impacts are evaluated, where data exists. Finally, some suggestions are developed to minimise both the extent of, and the negative impacts of, HVAC system over-sizing, for example: • Challenge “rules of thumb” and/or brief requirements which may be out of date. • Conduct an accurate load estimate, using AIRAH design data, specific to project location, and then resist the temptation to apply “safety factors • Use a load estimation program that accounts for thermal storage and diversification of peak loads for each zone and air handling system. • Select chiller sizes and staged or variable speed pumps and fans to ensure good part load performance. • Allow for unknown future tenancies by designing flexibility into the system, not by over-sizing. For example, generous sizing of distribution pipework and ductwork will allow available capacity to be redistributed. • Provide an auxiliary tenant condenser water loop to handle high load areas. • Consider using an Integrated Design Process, build an integrated load and energy use simulation model and test different operational scenarios • Use comprehensive Life Cycle Cost analysis for selection of the most optimal design solutions. This paper is an interim report on the findings of CRC-CI project 2002-051-B, Right-Sizing HVAC Systems, which is due for completion in January 2006.