Judicialisation, right to health and justice at Rio de Janeiro’s ‘Health Dispute Resolution Chamber’: Users’ conceptions

ABSTRACT

The responses to the judicialisation are based on legal discourses and local practices that impact on access to health and justice. How citizens understand rights is key to holding government accountable. On a human right in health approach and emphasising the right to health and access to justice, this article explores these links through in-depth interviews of claimants at the Rio de Janeiro State Department, whose assist vulnerable groups. To the interviewees, the right to health was a remote, legal fiction, and entitlement and application were liable be treated ‘flexibly’; judicialisation was a last resort to meet urgent demands and the impossibility of ‘consuming’ by their own means; the lawsuits as ‘slow’, ‘painful’ and unreliable in ensuring rights; access to health involved sacrifices and the need to fight for their rights. They understood was intimately bound up with the vulnerabilities, obstacles and service denial they had encountered previously. The bureaucratic, technological and technocratic dimensions of health care were incomprehensible and created barriers to access and conflicts. The findings suggested ineffective government responses to the main health problems of vulnerable populations and call for urgent efforts to address equitable and emancipatory implementation of health and justice policies.

KEYWORDS:

• Judicialisation
• right to health
• access to justice
• human rights
• healthcare dispute resolution

Acknowledgements

To the research team, for administrative support and fieldwork, Elaneide A. Antunes, Érika Fernandes Tritany, Denise Campos Verginio, Iaralyz Fernandes Farias, Neide Emy Kurokawa e Silva, Priscilla de Oliveira Tavares, Renato Maciel Dantas; to the Rio de Janeiro State Public Defenders, Thaisa Guerreiro de Souza (Coordinator for Health and Collective Care), and Samantha Monteiro de Oliveira (Public Finance Center / CRLS), for supporting the study; to Peter Lenny (MCIL) for the translating our manuscript, and to the CNPq for funding the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 The Regulation System (SISREG) is a web system set up by the Ministry of Health to schedule appointments, tests and medium- and high-complexity procedures, in order to regulate health care supply and demand. Available at: http://www.subpav.org/download/sisreg/_SISREG_regulador_protocolo.pdf

Additional information

Funding

This work was funded by the Brazilian National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq) [402079/2016-7].