The Brazilian Collective Health movement has, over the last 25 years, yielded countless and fruitful upshots, such as the flourishing of high quality periodicals such as Interface.
Since it first appeared, Interface has stood out as an arena for reflections on education, communication and health. It stands out for its editorial quality and for the beauty of each one of its editions. The current issue (number 14, volume eight) is no different.
In the course of our Collective Health evolution, an extraordinary diversity of themes developed, as the annals of our national congresses clearly reveal. However, paradoxically, the theme of Health as such is one of those that, perhaps due to its being assumed to be understood and a starting point, was developed the least. Several of our best thinkers have pointed out this gap. Until when will the theme of health be seen from the standpoint of its counterpart, disease?
The "On Health" dossier presented here shows us that new voices and reflections are joining the effort to develop the theme of Health within the scope of our movement.
Beginning, although not in the order in which the papers are presented, with Ricardo Teixeira's extremely interesting contribution: "Grand Health: an introduction to the medicine of the Body With No Organs". Ricardo finds in Spinoza the inspiration to think about Grand Health. A gradual and spiral construction, in which each turn adds elements of emancipation: the power of action and thought, the perseverance of desire, the strengthening of conatus and good cheer. The capacity to affect and to be affected, imagination and willpower. Freedom that will be essential for constructing Reason, the coexistence of bodies, choices committed to the realization of happiness. Truth, freedom, and happiness as Grand Health synthesis. The capacity for self-determination, with the institution of rules that are convenient to one. Thus, the results of the life that was lived and the path that was trodden. Life in its fullest sense, therein included and comprised the risks of the path undertaken. As in Lúcio Fontana's painting, which Ricardo used to introduce his doctoral thesis, of which this article is but a small sample, that which we are privileged to glimpse through the foliage is sufficient to impel one to turn inward and assess the dimension of the space revealed for the formulation of a theory of Health.
José Ricardo Ayres take part in the debate with his elegant, consistent and didactic thoughts on the many senses of this care process. In this delicate work of theoretical and conceptual "goldsmithery", he shows us the many facets of a core concept for healthcare practices comprised within the human dimension into which Grand Health has introduced us. Relying once again on mythology, which, as defended by Vico, is part of human proto-history, and on Heidegger's philosophy, José Ricardo explores care as an ontological category, detailing each one of its constituent characteristics. The following step, underpinned by Michel Foucault's genealogy, is the analysis of care for oneself as a universal need and attribute of human beings. Finally, care as a critical and reconstructive category emerges from the elaborate construction, potentially capable of reinventing Health praxis.
André Martins adds yet one more turn to this screw, discussing one of the biopolitical powers: medical power. The author characterizes the current state of the relation between the power of Medicine and the autonomy of patients, highlighting the relative aspects of the supposedly scientific, true and objective character of medical knowledge and know-how. Once again, in this dossier, we are led to reflect on health, as seen by several thinkers, amongst which the author stresses the contributions of Canguilhem, Spinoza, Winnicott and Nietzche, temporarily closing the cycle that articulates this contribution with the Grand Health and Care themes, which we discussed previously.
Completing the dossier, we have a contribution from Francisco Ortega on the biopolitics of health, now in its properly political dimension. Ortega's text is stimulating and provocative. With the help of the theoretical contributions of Agnes Heller, Hanna Arendt and Michel Foucault, the author analyzes the paradoxical political emptying that the particularizing policies defended by organized interest groups in modern society represent. To what extent does the widespread participation and the predominance of "political correctness" constitute a negation of politics?
This set of original contributions certainly adds new prospects and planes of discussion and in-depth discussion to the theme of Health, expanding the range of possible dialogues, calling for new theoretical contributions, formulating queries and pointing out paths.
Besides the "On Health" dossier, this issue offers has free-standing articles, brief notes and reports. Among the several articles presented I would like to highlight three. Lilian Koifman's article deals with the comparative analysis between the process of curricular reform at the Federal Fluminense University and the Buenos Aires University medical schools, stressing the role of more or less organic articulation between the educational apparatus and healthcare policy. Gimol Benzaquem Perosa and Letícia Macedo Gabarra present very well conducted empirical research on the explanations given by children about the cause of disease. Inesita Soares de Araujo submits a new approach for charting the area of Social Communication around public policies.
Undoubtedly, as was the case of previous issues, different audiences may benefit from Interface's permanent invitation to dialogue. A dialogue that will become even more productive if the transgression of boundaries, as insinuated by the periodical's very name, is taken seriously!
Rita Barradas Barata,
Assistant professor of the Social Medicine Department,
Scholl of Medical Sciences, Santa Casa de São Paulo