Dalmaso AW. Análise de transformações da técnica em medicina: reflexões sobre uma proposta metodológica . [Analysis of changes in medical techniques: reflections on a methodological proposal.] Interface - Comunicação, Saúde, Educação [Interface -Communication, Health, Education] (Batucatu, Brazil) 2000 February; 6:49 -60.

Objectives: To analyze the formation of contemporary medicine as social-historical practice, which involves techniques that are increasingly penetrated by scientific rationality.

Methodology: Bibliographic review of the best known medical treatises and medical publications from the second half of the twentieth century.

Results: The author adopted the viewpoint of good practice to trace the articulation between medical practice and advances in technique. Comparison among historical periods (the years 1950, 1970, and 1990) clarified an evolutionary process, with many tensions at play in the understanding of what constitutes good practice by physicians.

The author confirmed a technical variation, characterized by the separation of personal clinical experience from the results of research on medical practice. The objective of the latter research was to give scientific backing to procedures tested for efficiency and outcomes. The author likewise observed a great expansion of centers specializing in research. The clinic - a technical approach, developed in proximity to the ill person and involving operational work that applied science to individual care and action - was gradually set aside for more theoretical and research-based knowledge.

Conclusions: Recognizing all elements that comprise the care offered to the sick person can contribute to understanding such care as a technology of work. This understanding identifies contradictions and relativizes the myth that services can be offered according to the “way of science,” whose effects tend to obscure the social, psychological, biological, and ethical dimensions of medicine.

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