Pressupostos epistemológicos dos modelos de clínica psquiátrica da atualidade: uma abordagem pragmática
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Data
2010-02-10
Autores
Oliveira, Alex Fabrício de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A presente dissertação discute questões no âmbito da filosofia da ciência, mais especificamente tópicos da filosofia da psiquiatria. Examinamos a concorrência entre dois modelos de clínica psiquiátrica na atualidade, o “tradicional” e o modelo da reforma psiquiátrica, que poderia ser entendida como disputa entre paradigmas no campo da saúde mental. Sugerimos que a adesão ao modelo da reforma psiquiátrica tem ocorrido essencialmente por razões político-ideológicas, mas pouco se têm discutido os pressupostos epistemológicos que fundamentariam esse modelo. Argumentamos a favor da hipótese de que os modelos médicos comporiam um todo auto-sustentado, que abarcaria desde uma concepção de mundo e de como poderíamos conhecê-lo, à concepção do objeto de estudo e daí às estratégias diagnósticas e terapêuticas. Assumindo tal hipótese, o presente trabalho visa identificar alguns fundamentos ontológicos e epistemológicos de ambos os modelos de clínica psiquiátrica. Nosso objetivo central é discutir fundamentos epistemológicos para uma clínica da reforma que fossem capazes de ampliar o foco da atenção em saúde, preservando valores como a liberdade, singularidade e indeterminação do sujeito e, ao mesmo tempo, manter a possibilidade de um empreendimento com rigor científico. No âmbito da psiquiatria tradicional, debitária do modelo biomédico da medicina geral, indicamos a provável relação entre fundamentos onto-epistemológicos mecanicistas e objetivistas e a instituição de um reducionismo ontológico e metodológico, com conseqüências indesejáveis para a prática clínica. Por outro lado, apoiados na teoria sistêmica, na teoria de níveis, na teoria da autoorganização e no pluralismo epistemológico, argumentamos que uma forma de pluralismo perspectivista e uma cosmologia não-mecanicista de inspiração peirceana contribuiriam para...
The present dissertation discusses questions in the realm of philosophy of science, more specifically issues concerning the philosophy of psychiatry. We examine the opposition between two active models of clinical psychiatry, the “traditional” and the psychiatric reform models, which could be understood as a dispute between different paradigms in the field of mental health. We suggest that adherence to the psychiatric reform model has occurred essentially for political-ideological reasons, but that there has been little discussion of the epistemological presuppositions on which the model is based. We argue in favor of the hypothesis that medical models comprise a self-sustaining whole, which proceeds from a conception of the world and how we might understand it, to the conception of the object under study, and from there to diagnostic and therapeutic strategies. Given such a hypothesis, this work aims to identify some of the ontological and epistemological foundations of both models of clinical psychiatry. Our central objective is to discuss epistemological fundamentals for clinical reform, capable of broadening the focus of study in the field of health while preserving values such as liberty, singularity and indeterminateness of the subject, with due consideration given to the maintenance of scientific rigor throughout the process. From the perspective of traditional psychiatry, founded on the biomedical model of medicine in general, we indicate the likely relationship between mechanicist and objectivist ontoepistemological fundamentals and the establishment of an ontological and methodological reductionism, having undesirable consequences for clinical practice. From the other perspective, based on the theories of systems, levels and self-organization, and on epistemological pluralism, we argue that a type of perspectivist pluralism and a Peircean nonmechanicist cosmology could... (Complete abstract click electronic access below)
The present dissertation discusses questions in the realm of philosophy of science, more specifically issues concerning the philosophy of psychiatry. We examine the opposition between two active models of clinical psychiatry, the “traditional” and the psychiatric reform models, which could be understood as a dispute between different paradigms in the field of mental health. We suggest that adherence to the psychiatric reform model has occurred essentially for political-ideological reasons, but that there has been little discussion of the epistemological presuppositions on which the model is based. We argue in favor of the hypothesis that medical models comprise a self-sustaining whole, which proceeds from a conception of the world and how we might understand it, to the conception of the object under study, and from there to diagnostic and therapeutic strategies. Given such a hypothesis, this work aims to identify some of the ontological and epistemological foundations of both models of clinical psychiatry. Our central objective is to discuss epistemological fundamentals for clinical reform, capable of broadening the focus of study in the field of health while preserving values such as liberty, singularity and indeterminateness of the subject, with due consideration given to the maintenance of scientific rigor throughout the process. From the perspective of traditional psychiatry, founded on the biomedical model of medicine in general, we indicate the likely relationship between mechanicist and objectivist ontoepistemological fundamentals and the establishment of an ontological and methodological reductionism, having undesirable consequences for clinical practice. From the other perspective, based on the theories of systems, levels and self-organization, and on epistemological pluralism, we argue that a type of perspectivist pluralism and a Peircean nonmechanicist cosmology could... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Epistemologia, Psiquiatria - Filosofia, Reforma dos serviços de saúde, Pragmatismo, Doenças mentais, Paradigmas (Ciencias sociais), Pluralismo epistemológico, Pragmatism, Epistemological pluralism, Psychiatric reform, Extended medical practice
Como citar
OLIVEIRA, Alex Fabrício de. Pressupostos epistemológicos dos modelos de clínica psquiátrica da atualidade: uma abordagem pragmática. 2010. 126 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Filosofia e Ciências de Marília, 2010.