ASSISTENTIAL AND BIOETHICAL CHALLENGES OF THE JUDICIALIZATION OF HEALTHCARE DURING THE COVID-19 PANDEMIC: JURISPRUDENTIAL ANALYSIS, EQUITY AND ACCESS TO TREATMENTS
Judicialization of Health; Bioethics; COVID-19; Right to Health; Health Policy
“_The judicialization of health care constitutes a structural phenomenon in Brazil, intensified during the COVID-19 pandemic, a period in which judicial decisions began to directly interfere in the organization of the health system, in access to treatments, and in the formulation of public policies. The general objective of this study is to conduct a critical investigation of the bioethical challenges inherent to the judicialization of health care in the context of the COVID-19 pandemic, seeking to understand this phenomenon in its legal, ethical, and health-related dimensions. The investigation adopts a qualitative, exploratory, and analytical approach, with thematic content analysis of judicial decisions, selected through systematic sampling (k=18) from a universe of 17,537 judicial cases identified on the AASP®/JUIT® platform, of which 585 comprise the final sample after the application of eligibility criteria, deduplication, and exclusion. The systematic analysis of the rulings allowed for the construction of four analytical categories: access to ICU beds and scarcity of health resources; federative conflicts and management of the Unified Health System; provision of medications in the context of the pandemic; and compulsory vaccination and individual autonomy. The results show that judicialization, although it functions as a mechanism to correct state omissions, produces significant tensions regarding equity, the allocation of scarce resources, and the sustainability of the health system. It is concluded that judicialization operated simultaneously as an instrument for guaranteeing individual rights and as a factor of systemic tension, revealing distinct decision-making patterns across the four analyzed axes and a gradual process of institutional maturation of the Judiciary, reinforcing the need for bioethical parameters to guide judicial decisions in future public health emergency contexts._”