CHRONIC PATIENTS IN AN EMERGENCY HOSPITAL: A LOOK FROM THE INTERVENTIONIST BIOETHICS

Objective: To know the bioethical dilemmas that emerge in the chronification of patients hospitalized in the Emergency Hospital of the Municipality of Córdoba, Argentina. Methodology:  Through the ethnographic method, a qualitative study was carried out, where a fieldwork was carried out applying document analysis technique (clinical histories, intervention protocols), participant observation of hospital dynamics and open interviews to the 12 members of the interdisciplinary commission, created in 2012 to elaborate the Guide on adequacy of the therapeutic effort - dignified death -. An ethnographic analysis was made to the data collected. Through a "dense description" (Geertz 1973) the different layers of meanings present in the situation investigated were understood, understanding it as a method of gathering information as well as an instrument for the production of interpretations. Results: From the investigation of the ethnographic analysis, the following possible situations emerged from the perspective of an interventionist bioethics: the dehumanization of the patient, the impact of the trauma on the family group, therapeutic harrassment, the distortion of the institutional profile, the absence of specialized personnel for the integral therapeutic approach, the lack of institutional containment and the patient "social case". Conclusion: We understand that interventionist bioethics could play a modulatory role in the allocation of limited health resources, so it is developed as a discipline that has increasing relevance in the development of ethical tools, social justice and collaboration with and in the empowerment of various subaltern and / or violated sectors. It is important to highlight the importance of both the role of the State, and that of collective and individual subjects, when it comes to protecting this type of patients with the creation of neurorehabilitation centers, palliative care centers, intermediate and middle-class homes. The final bet is towards a Bioethics of Intervention: collective, practical, applied and committed to the "public" and to the social in its broadest sense to deconstruct the presented dilemmas.