THERAPEUTIC FRAGMENTATION IN AUTISM SPECTRUM DISORDER: BIOETHICAL IMPLICATIONS OF THE JUDICIALIZATION OF HEALTH AND PROPOSAL OF AN EVIDENCE-BASED CLINICAL-NORMATIVE PROTOCOL
DOI:
https://doi.org/10.56238/revgeov17n5-111Keywords:
Autism Spectrum Disorder, Judicialization of Healthcare, Bioethics, Evidence-Based Practice, Clinical ProtocolsAbstract
Autism spectrum disorder (ASD) requires intensive, continuous, and multidisciplinary care, with therapeutic strategies that vary according to the level of support needed. In Brazil, however, the organization of care for individuals with ASD is marked by significant therapeutic fragmentation, characterized by the absence of standardized clinical protocols, variability in professional practices, and limited integration between public and private healthcare systems. This scenario has contributed to the increasing judicialization of healthcare, often resulting in the granting of treatments without consistent technical-scientific parameters. The present study aims to analyze therapeutic fragmentation in ASD care in Brazil through an integrative literature review and jurisprudential analysis, as well as to propose an evidence-based clinical-normative protocol aimed at improving the quality of clinical and judicial decisions. The research was conducted through the analysis of scientific literature in relevant databases, combined with a qualitative analysis of judicial decisions. The results show high variability in therapeutic prescriptions, a predominance of judicial reasoning based on principles, and the absence of structured parameters to guide care decisions. Based on the synthesis of scientific evidence, international guidelines, and patterns observed in judicialization, a structured clinical-normative protocol is proposed, with the aim of stratifying therapeutic intensity and promoting greater consistency in care. It is concluded that the adoption of evidence-based protocols can contribute to reducing unjustified variability, optimizing resource allocation, and enhancing coherence in judicial decisions, fostering a more equitable and efficient care model for individuals with ASD.
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