Bioethical aspects of health judicialization for drugs in 13 municipalities in the midwest of Santa Catarina, Brazil/Aspectos bioeticos de la judicializacion de la salud por farmacos en 13 ayuntamientos en el medio oeste de Santa Catarina, Brasil/Aspectos bioeticos de la judicializacion de la salud por farmacos en 13 ayuntamientos en el medio oeste de Santa Catarina, Brasil

Health's judicialization is a recent phenomenon in Brazil, with serious repercussions for the Brazilian public health system. The aim of this work was to study its occurrence in thirteen small towns in the Midwest of Santa Catarina, southern Brazil, in the period of 2007-2012, analyze bioethical issues related and propose solutions. The results showed that, in this period, the total value/year of lawsuits by drugs increased almost 10 times, benefiting only 175 patients, or 0.134% of 129,497 inhabitants, at a cost of R$ 1.484.389,92 (US$ 740,000). Therefore, it can be inferred that the principle of autonomy of these patients and physician, committed, intensely, the equity and fair distribution of the scarce resources. It was concluded that this phenomenon, in the study area, has many features similar with those of large urban centers, has been unfair from the point of view of bioethical principles and also that the implementation of an Intermunicipal Committee of Bioethics could act as a mentor and educator in the careful definition of autonomy, fairness and justice in the allocation of scarce resources of health. Further studies are needed to assess the consequences of health's judicialization nationally and find solutions more ethically appropriate. Key words: judicialization, bioethics, health resources, equity in the resource allocation, pharmaceutical preparations /supply & distribution A judicializacao na saude e um fenomeno recente no Brasil, com serias repercussoes no sistema de saude publico brasileiro. O objetivo deste trabalho foi estudar sua ocorrencia em treze municipios de pequeno porte no Meio-Oeste de Santa Catarina, sul do Brasil, no periodo de 2007 a 2012, analisar os aspectos bioeticos relacionados e propor solucoes. Os resultados evidenciaram que, neste periodo, o valor total/ano das demandas judiciais por medicamentos aumentou quase 10 vezes, beneficiando apenas 175 pacientes, ou 0,134% dos 129.497 habitantes, ao custo de R$ 1.484.389,92 (US$ 740.000). Portanto, pode-se inferir que o atendimento ao principio da autonomia destes pacientes e do medico, comprometeu, de forma intensa, a equidade e a justa distribuicao dos recursos. Conclui-se que este fenomeno, na regiao estudada, apresenta muitos aspectos semelhantes aos dos grandes centros urbanos, tem sido injusto do ponto de vista dos principios bioeticos e que a implantacao de um Comite Intermunicipal de Bioetica poderia agir como orientador e educador na definicao criteriosa da autono