Biomedical Innovations in Cancer Care and the Increasing of Health Inequalities in Brazil

• In Event: Emergent Technologies in Biomedicine and Healthcare: Boundaries, Tensions, and Possibilities - II

Abstract

The objective of this study is to understand how biomedical innovations in cancer care are being incorporated into oncology across different institutions of the Brazilian health system and how they affect health inequalities. We also seek to understand how oncologists deal with the ethical dilemmas that emerge from the unequal access to the benefits of such new therapeutic interventions. Ethnographic work was carried out in the cities of Salvador and Rio de Janeiro, Brazil, with oncologists and patients in oncology departments in public and private health institutions. The Unified Health System (SUS) is a universal system whose principle is to provide integral and equal assistance to the entire Brazilian population. In practice, however, the system is fragmented among patients who have private health insurances, with different levels of coverage, and patients who depend only on the public subsystem. The results point to the existence of great inequality in the protocols for cancer treatment depending on the institution where the patient is being treated and the type of health insurance. For oncologists, inequalities in access to new technologies pose ethical dilemmas concerning the existence of different treatment protocols for patients with the same needs. The phenomena of judicialization, is one of the strategies used by physicians to deal with the unequal access to high cost medicines, but this also generates other forms of stratification. We conclude that the way in which new biomedical technologies are being incorporated into the oncological practice in Brazil is contributing to the increase of health inequalities.

Author

• Jorge Alberto Bernstein Iriart, Instittuto de Saúde Coletiva da Universidade Federal da Bahia