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Publication
A Gestão de Unidades de Saúde como Fonte de Dilemas Éticos
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Abstract(s)
O progresso tecnológico da medicina e os constrangimentos trazidos por novos modelos de administração pública, tornam a Gestão de Unidades de Saúde (GUS) uma fonte de dilemas éticos (Faria et al., 2010). É urgente que este ramo da gestão se individualize das esferas empresarial e médica, e assuma a sua posição única e particular no campo da gestão. À semelhança de outras classes profissionais, é fundamental que os gestores possam auxiliar-se de ferramentas próprias para um exercício ético das suas funções, pois é a ele que cabe a hercúlea tarefa de casar a ética médica com a ética empresarial. O código de ética poderá constituir-se como garantia de uma base ética bem definida, ditando quais os princípios e valores éticos que orientam a acção do gestor, para garantir o aceso equitativo aos cuidados de saúde (Faria et al., 2010), sem colocar em causa a estabilidade e sustentabilidade da organização que dirige (Perene et al., 2020; Cinaroglu, 2016). Numa era onde as necessidades em saúde aumentam, e os recursos se tornam cada vez mais escassos, é imperativa uma gestão organizacional eticamente fundamentada e estruturada, para diminuir o risco de viés ao assumir as suas responsabilidades sociais e empresariais (Begun et al., 2018). Procedendo a uma Revisão Sistemática de Literatura (RSL), identificamos apenas nove artigos (num universo superior a 4000) que abordam a necessidade de uma Código de Ética para Gestores de Saúde, facto demostrativo da necessidade de um aprofundamento científico do tema. Impere remover o rótulo de monstro de duas cabeças que Drucker (1993) lhe colocou, e assumir a natureza distinta da GUS. Os resultados obtidos confirmam que a implementação deste código permite não só sustentar o corpo administrativo no seu processo de tomada de decisão, mas também na gestão dos recursos, ora escassos, ora dispendiosos, perante um público progressivamente mais exigente em cuidados de saúde. Adicionalmente, foi possível apurar que este documento é pilar na construção de uma identidade própria da GUS, e, por conseguinte, impulsor da credibilidade social e prestígio sociais dos seus profissionais. No entanto, também ficou claro que existem ainda algumas lacunas na literatura. Por isso, e como linha de investigação futura, sugere-se o aprofundamento científico dos processos de tomada de decisão per se, isto é, averiguando a forma como eles efectivamente se desenrolam no seio do corpo administrativo, sob a forma de estudo-inquérito. Posteriormente, estes dados poderiam ser cruzados com uma RSL mais ampla e actualizada ao tema, a fim de preencher essa lacunas, ou identificar novos caminhos de investigação.
The technological progress in medicine and the constraints brought by new models of public administration, make the Management of Health Organisations (MHO) a source of ethical dilemmas (Faria et al., 2010). It urges that this area of management can be individualised from the business and medical spheres, and assume its unique and specific position in the field of management. Like other professional classes, it is essential for managers to be able to use their own tools for an ethical exercise of their functions, as it is a Herculean task to marry medical ethics with business ethics. The code of ethics may be a guarantee of a well-defined ethical basis, dictating which principles and ethical values guide the manager’s action to ensure equitable access to health care (Faria et al., 2010), without jeopardizing the stability and sustainability of the organization that he runs (Perene et al., 2020; Cinaroglu, 2016). In an era where health needs are increasing, and resources become increasingly scarce, it is imperative to have an organizational management ethically based and structured, to reduce the risk of bias when assuming social and business responsibilities (Begun et al., 2018). By conducting a Systematic Literature Review (SLR), we identified only nine articles (in a universe of more than 4000) that address the need for a Code of Ethics for Health Managers, which demonstrates the need for scientific deepening of the topic. It is imperative to remove the two-headed monster label that Drucker (1993) has put on it, and assume the distinct nature of Management of Health Organisations. The results obtained confirm that the implementation of this code allows not only to support the administrative body in its decisionmaking process, but also in the management of resources, sometimes scarce, sometimes expensive, to a progressively more demanding public in health care. Additionally, it was possible to find that this document is a pillar in the construction of an identity of Management of Health Organisations, and therefore, drive social credibility and prestige of its professionals. However, it was also clear that there are still some gaps in the literature. Therefore, and as guiding line for future research, it is suggested the scientific deepening of decision-making processes per se, that is, by investigating how they realistically unfold within the administrative body, in the form of study-inquiry. Subsequently, these data could be cross-checked with a broader and updated SLR on the subject, aiming to fill those gaps and identify new research paths.
The technological progress in medicine and the constraints brought by new models of public administration, make the Management of Health Organisations (MHO) a source of ethical dilemmas (Faria et al., 2010). It urges that this area of management can be individualised from the business and medical spheres, and assume its unique and specific position in the field of management. Like other professional classes, it is essential for managers to be able to use their own tools for an ethical exercise of their functions, as it is a Herculean task to marry medical ethics with business ethics. The code of ethics may be a guarantee of a well-defined ethical basis, dictating which principles and ethical values guide the manager’s action to ensure equitable access to health care (Faria et al., 2010), without jeopardizing the stability and sustainability of the organization that he runs (Perene et al., 2020; Cinaroglu, 2016). In an era where health needs are increasing, and resources become increasingly scarce, it is imperative to have an organizational management ethically based and structured, to reduce the risk of bias when assuming social and business responsibilities (Begun et al., 2018). By conducting a Systematic Literature Review (SLR), we identified only nine articles (in a universe of more than 4000) that address the need for a Code of Ethics for Health Managers, which demonstrates the need for scientific deepening of the topic. It is imperative to remove the two-headed monster label that Drucker (1993) has put on it, and assume the distinct nature of Management of Health Organisations. The results obtained confirm that the implementation of this code allows not only to support the administrative body in its decisionmaking process, but also in the management of resources, sometimes scarce, sometimes expensive, to a progressively more demanding public in health care. Additionally, it was possible to find that this document is a pillar in the construction of an identity of Management of Health Organisations, and therefore, drive social credibility and prestige of its professionals. However, it was also clear that there are still some gaps in the literature. Therefore, and as guiding line for future research, it is suggested the scientific deepening of decision-making processes per se, that is, by investigating how they realistically unfold within the administrative body, in the form of study-inquiry. Subsequently, these data could be cross-checked with a broader and updated SLR on the subject, aiming to fill those gaps and identify new research paths.
Description
Keywords
Processo de Tomada de Decisão Alocação de Recursos. Códigos de Ética Dilemas Éticos Gestão de Unidades de Saúde