BETWEEN THE ABSENCE OF ILLNESS AND POSSIBLE CARE: HEALTH ACCORDING TO FEMALE USERS OF THE FAMILY HEALTH STRATEGY PROGRAM

Abstract This article presents meanings that women users of the Family Health Strategy program attribute to health and its relation to care. The qualitative method was applied, using as a theoretical reference the discussions of Canguilhem and Winnicott on the notion of health, as well as notes on the medicalization of life. The fieldwork was developed through in-depth interviews between May and July 2015, with users of the Family Health Strategy program, and was treated with a hermeneutical analysis. Health, related both to the absence of illness and to complete well-being, as well as to the disposition to face the sufferings inherent to life. There is a coexistence between the unconditional trust in medical technology and a wager on intuitive care modes or those originated from social relationships. The health service contributes to the access to the treatment and, at the same time, reinforces the commitment to the prevention of all the misfortunes of the body, as well as the idea that the right to health care is related to the individual responsibility to keep it perfect. In a culture marked by individualism and competitiveness, individuals living in contexts of deep social injustice submit to rules to prevent the risk of becoming ill, but their possibilities of creating unique ways of enjoying life are restricted.

摘要 本文探讨了家庭健康策略（Family Health Strategy）项目女性使用者所赋予健康的意义，及其与照护的关联。本研究采用质性研究方法，以康吉莱姆（Canguilhem）与温尼科特（Winnicott）关于健康概念的讨论，以及生命医疗化的相关论述作为理论参照。实地研究于2015年5月至7月间开展，通过对该项目使用者的深度访谈完成，并采用诠释学分析方法进行解读。研究表明，健康既指无疾病状态，亦指向完整的福祉，同时涵盖直面生命固有苦难的精神状态。研究同时揭示了女性使用者并存的两种健康认知：一方面是对医疗技术的无条件信任，另一方面则是倚赖直觉式照护或源自社会关系的照护模式。医疗服务既为使用者提供了治疗途径，同时也强化了预防身体所有病痛的责任，以及“医疗照护的权利与个体保持健康完美的个人责任息息相关”这一观念。在以个人主义与竞争性为特征的文化语境中，身处深度社会不公背景下的个体虽会遵循规则以规避患病风险，但其创造独特生活享受方式的可能性却受到限制。