Reactions to institutional violence: patient strategies for facing infringements of the right to health in Brazil

Sonia Fleury Psicóloga. Doctora en Ciencias Políticas. Profesora Titular, Escola Brasileira de Administração Pública e de Empresas (EBAPE), Fundação Getulio Vargas (FGV). Brasil , Valéria Bicudo Asistente Social. Magíster en Administración Pública. Profesora Asistente, Universidade Federal Fluminense. Brasil , Gabriela Rangel Psicóloga. Magíster en Políticas Públicas. Secretaria General, Centro Brasileiro de Estudos de Saúde (CEBES). Brasil.
Received: 22 September 2014, Accepted: 22 September 2014, Published: 4 April 2013 Open Access
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Abstract


In this article we identify evidences of inequalities, prejudices and discrimination in the access and utilization of public health services belonging to the Brazilian Unified Health Care System, considering them to be institutional violence and a negation of rights, in order to look at the reactions of the subjects victimized by this process. This research study utilized different methodologies, articulating participant observation, semi-structured interviews, focus groups and dramatization. The results highlight the trajectory in seeking health care as the main expression of inequalities, strengthened by structural factors such as the precarious condition of health care services, which potentiate power asymmetries, and the presence of discrimination derived from stigmas and prejudices. Most patients' reactions to the situation of institutional violence seek an individual solution to the problem, often reaffirming the conditions that generate rights violations. Few patients' reactions question the systemic conditions that determine the continued discrimination.