Inter-institutional dialogues in the judicialization of health as a sustainability strategy for the SUS

ABSTRACT This study aims to explore the dialogic strategies adopted in the conduct of health processes filed by the Public Defender’s Office in Barreiras-BA, in order to demonstrate that the complex and polycentric character of judicialization requires an articulated action between the actors involved, aimed at guaranteeing the sustainability of the Unified Health System. A descriptive and retrospective methodology was adopted, focusing on a documental basis. The data were obtained from a list of cases prepared by the Public Defender’s Office operating in the municipality, followed by consultation of the entirety of the records on the website of the Court of Justice of Bahia. 94 cases were analyzed, filed between January 2019 and December 2021. The analysis of dialogic practices was based on Habermas’ Theory of Communicative Action. It was concluded that the Defender’s Office has a leading role in the pre-procedural stage, seeking, in a communicative action, the extrajudicial resolution of conflicts. On the other hand, the attitude of Organs recipient bodies showed a failure in public health management, which acts strategically and does not have extrajudicial resolution as a priority. Furthermore, the need to strengthen the NAT-Jus remained evident, which is still poorly consolidated in the Bahian Judiciary.

摘要 本研究旨在探究巴伊亚州巴雷拉斯市公共辩护办公室提交的健康类司法程序中所采用的对话策略，以期阐明司法化进程所具备的复杂性与多中心性特征，要求各参与主体开展协同联动行动，以保障统一健康体系（Unified Health System）的可持续性。本研究采用描述性回溯性研究方法，以文献资料为核心分析基础。研究数据首先取自该市政辖区内公共辩护办公室编制的案件清单，随后通过巴伊亚州法院官网调取全部相关案卷进行核查。本次研究共分析了2019年1月至2021年12月期间提交的94起案件。对话实践分析基于哈贝马斯交往行为理论（Habermas’ Theory of Communicative Action）。研究结论表明，公共辩护办公室在程序前置阶段发挥主导作用，通过交往行为寻求冲突的非司法解决路径。反观相关接收主体的态度则暴露出公共卫生管理存在短板：此类机构采取策略性行动，并未将非司法解决方式作为优先事项。此外，强化NAT-Jus的必要性依然凸显，而该机制在巴伊亚州司法体系中仍未得到充分巩固。