Uncertainty in Health: Theoretical and Empirical Debates

Beck introduced the concept of organized irresponsibility, which expresses the definitions, calculations and decisions of risk based on modern traditional rationality and its impact on institutions, which become, to some extent, ghost institutions due to the confusion of large-scale risks. In health, it can be suitable to several areas: epidemiological surveillance, surveillance of food, chemical and pharmaceutical products, the market and transplantation of human and non-human organs, tissues and fluids, iatrogenesis in healthcare services and health systems, etc. In all of them, the issue of uncertainty and large-scale risks is so difficult to address, since the entire healthcare apparatus presupposes linear responses to risk and effective actions regarding the alleged safety and protection of life. The empirical-theoretical challenge is how to introduce uncertainty into the definitions, calculations and decisions of risk, considering the context of the risk society and the protection of life?

The institutional dimension of healthcare services and health systems is another challenging topic, since in the current scenario they reproduce and multiply organized irresponsibility they are co-producers of risks and uncertainties. This creates a paradox and an ambiguity. Health - a field of knowledge, practices and public policies –is perceived as legitimate and safe. However, anchored in the logic of first modernity, it is faced with a reality of reflexivity and risk in a second modernity way. The ambiguity is therefore evident: health produces and is a result of organized irresponsibility. Such paradoxes and ambiguities call into question the ideals of social protection, not only in relation to access to health, health insurance, retirement and pensions, but also in relation to the preservation and protection of life. What is the preservation of health and life, what is social protection in the context of large-scale uncertainties and risks? This work problematizes these questions on Brazil’s perspective.