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Limits and possibilities for the development of public health research in the legal system

ABSTRACT

OBJECTIVE

To characterize databases of the courts of justice of Brazil as a potential tool for research in Collective Health, in its interface with the legal sciences.

METHODS

Cross-sectional study of quantitative and descriptive nature, focusing on analysis of strategic management and judicial systems.

RESULTS

Databases used by the Common Justice in the Federation Units to systematize judicial processes were identified and analyzed. A total of 123 databases were found in the courts of justice per state, with emphasis on the South and Northeast regions, in contrast to the North region, which has a smaller number of systems. This large number of judicial systems limits access to legal operators, and hinders the collection of evidence by health researchers and, consequently, impacts the strategic management of the Executive Branch. There were limitations from design to transparent and democratic data extraction by the users themselves, as well as restricted integration between bases.

CONCLUSIONS

Although advances have been made in recent years by the courts of justice to unify these databases, the multiplicity of information systems used in the Common State Justice complicates the management of knowledge, limits the development of research, even when carried out by lawyers or researchers in the legal area, as well as generates slow data extraction for public management. It is recognized the need for additional efforts for standardization, as well as for improvement of these databases, expanding access, transparency and integration with a view to a transdisciplinary look between the field of Law and Collective Health.

Judicial Decisions; Jurisprudence; Resources for Research; Health Law; Public Health

RESUMO

OBJETIVO

Caracterizar as bases de dados dos tribunais de justiça do Brasil como potencial ferramenta para a pesquisa em Saúde Coletiva em suas interfaces com as ciências jurídicas.

MÉTODOS

Estudo transversal de natureza quantitativa e descritiva com foco em análise de gestão estratégica e sistemas judiciários.

RESULTADOS

Foram identificadas e analisadas bases de dados utilizadas pela Justiça Comum nas Unidades da Federação para sistematizar processos judiciais. Verificou-se um total de 123 bases de dados nos tribunais de justiça por unidade de federação, com destaque para as regiões Sul e Nordeste, em contraste à região Norte que apresenta menor número de sistemas. Esse grande número de sistemas judiciais limita o acesso a operadores do direito, e dificulta levantamento de evidências por pesquisadores em saúde e, consequentemente, com impactos na gestão estratégica do Poder Executivo. Constatou-se limitações desde o design à extração transparente e democrática de dados pelos próprios usuários, bem como restrita integração entre bases.

CONCLUSÕES

Embora avanços tenham sidos empreendidos nos últimos anos pelos tribunais de justiça para unificação dessas bases, a multiplicidade de sistemas de informação utilizados na Justiça Comum estadual complexifica a gestão do conhecimento, limita o desenvolvimento de pesquisas, mesmo quando realizados por advogados ou pesquisadores da área jurídica, gera lentidão na extração de dados para a gestão pública. Reconhece-se a necessidade de esforços adicionais para a padronização, bem como para aprimoramento dessas bases de dados, ampliando acesso, transparência e integração com vistas a um olhar transdisciplinar entre o campo do Direito e da Saúde Coletiva.

Decisões Judiciais; Jurisprudência; Recursos para a Pesquisa; Direito Sanitário; Saúde Pública

INTRODUCTION

Paths to reflection and research on potential conflicts between the political and legal systems in public health management necessarily include the recognition of aspects involving the distribution and allocation of scarce resources in society11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
. Particularly in a country with the territorial dimension of Brazil, with serious social inequalities that impact on distinct and transitional epidemiological patterns, it becomes even more complex to determine priorities in the health system22. Barreto ML. Desigualdades em Saúde: uma perspectiva global. Cienc Saude Colet. 2017;22(7):2097-108. https://doi.org/10.1590/1413-81232017227.02742017
https://doi.org/10.1590/1413-81232017227...
.

The number of lawsuits in the Judiciary requiring health goods and services has grown significantly in Brazil, especially after 2007, giving rise to the phenomenon of judicialization of the right to public health, which in this work is synonymous with lawsuits against a state entity, demanding health goods and/or services33. Nunes CFO, Ramos Júnior AN. Judicialização do direito à saúde na região Nordeste, Brasil: dimensões e desafios. Cad Saude Colet. 2016;24(2):192-9. https://doi.org/10.1590/1414-462X201600020070
https://doi.org/10.1590/1414-462X2016000...
.

The greater involvement of the Judiciary regarding health policies makes up a greater discussion on the “judicialization of politics”, an expression equivalent to the “politicization of justice”, a reflection of its expansion in the decision-making process of contemporary democracies. In this sense, the judicialization of the right to health emerges as a conflict between the institutionalized system of political action and the legal system44. Tate CN, Vallinder T, editors. The global expansion of Judicial Power. New York: New York University Press; 1995..

The judicialization of the right to health has generated increasingly frequent debates in view of its multiple uses and meanings55. Ramos RS, Gomes GAT, Oliveira DC, Marques SC, Spindola T, Nogueira VPF. O acesso às ações e serviços do Sistema Único de Saúde na perspectiva da judicialização. Rev Lat Am Enfermagem. 2016;24:e2797. https://doi.org/10.1590/1518-8345.1012.2689
https://doi.org/10.1590/1518-8345.1012.2...
, on the one hand, it reinforces the legal dimension of citizenship, materializing a right guaranteed in the Federal Constitution of 1988, which in its Article 196 affirms that health is a right of all and a duty of the State66. Brasil. Constituição da República Federativa do Brasil (1988). Promulgada em 5 de outubro de 1988. Brasília, DF: Senado Federal; 1988. [cited 2021 May 20]. Available from:http://www.planalto.gov.br/ccivil_03/Constituicao/Constituicao.htm
http://www.planalto.gov.br/ccivil_03/Con...
; on the other, it can reinforce conflicts in the federative governance of the Unified Health System (Sistema Único de Saúde - SUS), limiting the ability of the executive power to plan, implement and monitor health policies through rational and equitable criteria77. Menicucci T, Machado JA. Judicialization of health policy in the definition of access to public goods: individual rights versus collective rights. Braz Pol Sci Rev. 2010 [cited 2021 May 20];5 Selec ed. Avialable from: http://socialsciences.scielo.org/scielo.php?script=sci_arttext&pid=S1981-38212010000100002#note
http://socialsciences.scielo.org/scielo....
. The individual character of interventions and the privilege of people with greater knowledge, financial resources or other conditions of differentiated access to justice are also pointed out as critical problems88. Araújo ICS, Machado FRS. A judicialização da saúde em Manaus: análise das demandas judiciais entre 2013 e 2017. Saude Soc. 2020;29(1):e190256. https://doi.org/10.1590/S0104-12902020190256
https://doi.org/10.1590/S0104-1290202019...
.

Certainly, one of the effects of this judicialization phenomenon is the expansion of the interfaces between research in the fields of health and legal sciences. There is an increase in the number of studies and articles published on the subject, with a view to dimensioning and greater understanding of this phenomenon33. Nunes CFO, Ramos Júnior AN. Judicialização do direito à saúde na região Nordeste, Brasil: dimensões e desafios. Cad Saude Colet. 2016;24(2):192-9. https://doi.org/10.1590/1414-462X201600020070
https://doi.org/10.1590/1414-462X2016000...
,99. Oliveira FL Cunha, LG. Os indicadores sobre o Judiciário brasileiro: limitações, desafios e o uso da tecnologia. Rev Direito GV. 2020;16(1):e1948. https://doi.org/10.1590/2317-6172201948
https://doi.org/10.1590/2317-6172201948...
. For example, there are studies with analysis of databases of the Judiciary in the state of Rio de Janeiro on the judicialization of health1010. Pepe VLE, Ventura M, Sant’ana JMB, Figueiredo TA, Souza VR, Simas L, et al. Caracterização de demandas judiciais de fornecimento de medicamentos “essenciais” no Estado do Rio de Janeiro, Brasil. Cad Saude Publica. 2010;26(3):461-71. https://doi.org/10.1590/S0102-311X2010000300004
https://doi.org/10.1590/S0102-311X201000...
,1111. Peçanha LO, Simas L, Luiza VL. Judicialização de medicamentos no Estado do Rio de Janeiro: evolução de 2010 a 2017. Saude Debate. 2019;43 (Nº Espec 4):61-70. https://doi.org/10.1590/0103-11042019S406
https://doi.org/10.1590/0103-11042019S40...
, in the state of Ceará on the phenomenon with recognition of the limits for analysis in the light of epidemiology33. Nunes CFO, Ramos Júnior AN. Judicialização do direito à saúde na região Nordeste, Brasil: dimensões e desafios. Cad Saude Colet. 2016;24(2):192-9. https://doi.org/10.1590/1414-462X201600020070
https://doi.org/10.1590/1414-462X2016000...
, and the Federal District with the analysis of the reality of judicialization in health1212. Diniz D, Machado TRC, Penalva J. A judicialização da saúde no Distrito Federal, Brasil. Cienc Saude Colet. 2014;19(2):591-8. https://doi.org/10.1590/1413-81232014192.23072012
https://doi.org/10.1590/1413-81232014192...
. In a broader approach to the country, the National Council of Justice (Conselho Nacional de Justiça - CNJ) sought to characterize the phenomenon and bring additional reflections on the subject11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
,1313. Conselho Nacional de Justiça; Programa das Nações Unidas para o Desenvolvimento. Judicialização e sociedade: ações para acesso à saúde pública de qualidade. Brasília, DF: CNJ; 2021 [cited 2021 Oct 16]. Available from: https://www.cnj.jus.br/programas-e-acoes/forum-da-saude-3/judicializacao-e-sociedade-acoes-para-acesso-a-saude-publica-de-qualidade/
https://www.cnj.jus.br/programas-e-acoes...
.

As the phenomenon of judicialization grows, there is the weakness of the Judiciary’s information systems in the systematization of data and public access systems to several courts with the potential to access and use information systems. As a result, it may make it impossible or limit fundamental analyses for the implementation of public policies based on scientific evidence, due to limitations and inconsistencies between the databases, in addition to underestimating the processes of judicialization of health11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
,99. Oliveira FL Cunha, LG. Os indicadores sobre o Judiciário brasileiro: limitações, desafios e o uso da tecnologia. Rev Direito GV. 2020;16(1):e1948. https://doi.org/10.1590/2317-6172201948
https://doi.org/10.1590/2317-6172201948...
,1111. Peçanha LO, Simas L, Luiza VL. Judicialização de medicamentos no Estado do Rio de Janeiro: evolução de 2010 a 2017. Saude Debate. 2019;43 (Nº Espec 4):61-70. https://doi.org/10.1590/0103-11042019S406
https://doi.org/10.1590/0103-11042019S40...
,1313. Conselho Nacional de Justiça; Programa das Nações Unidas para o Desenvolvimento. Judicialização e sociedade: ações para acesso à saúde pública de qualidade. Brasília, DF: CNJ; 2021 [cited 2021 Oct 16]. Available from: https://www.cnj.jus.br/programas-e-acoes/forum-da-saude-3/judicializacao-e-sociedade-acoes-para-acesso-a-saude-publica-de-qualidade/
https://www.cnj.jus.br/programas-e-acoes...

14. Vieira FS. Direito à Saúde no Brasil: seus contornos, judicialização e a necessidade da macrojustiça. Brasília, DF: IPEA; 2020 [cited 2021 Oct 16]. (Texto para Discussão; nº 2547). Available from: https://www.ipea.gov.br/portal/index.php?option=com_content&view=article&id=35360
https://www.ipea.gov.br/portal/index.php...
-1515. Conselho Nacional de Justiça. Justiça em números 2021. Brasília, DF: CNJ; 2021 [cited 2021 Oct 16]. Available from: https://www.cnj.jus.br/wp-content/uploads/2021/09/relatorio-justica-em-numeros2021-12.pdf
https://www.cnj.jus.br/wp-content/upload...
.

The criticisms and limitations indicate the need to rethink and better understand the different databases, many of which do not have access to researchers33. Nunes CFO, Ramos Júnior AN. Judicialização do direito à saúde na região Nordeste, Brasil: dimensões e desafios. Cad Saude Colet. 2016;24(2):192-9. https://doi.org/10.1590/1414-462X201600020070
https://doi.org/10.1590/1414-462X2016000...
,1111. Peçanha LO, Simas L, Luiza VL. Judicialização de medicamentos no Estado do Rio de Janeiro: evolução de 2010 a 2017. Saude Debate. 2019;43 (Nº Espec 4):61-70. https://doi.org/10.1590/0103-11042019S406
https://doi.org/10.1590/0103-11042019S40...
. This study aims to characterize the databases of the Courts of Justice (Tribunal de Justiça - TJ) of Brazil as a potential tool for research in Collective Health in its interfaces with the legal sciences. The recognition of the quantity and quality of information available is strategic for more consistent and purposeful analyses, which includes better delimitation of the phenomenon of judicialization of public health policy in Brazil.

METHODS

Study Design

Descriptive cross-sectional study of national scope based on data collected from the State Courts of Justice of the country. The data collection process was carried out between 2019 and 2021 with the identification and characterization of physical and virtual databases used to systematize judicial processes and to recognize the process of filing actions related to public health.

The study was carried out in two stages, both based on formal data and information requirements from the TJ’s ombudsmen via filling out electronic forms available to each one, a process complemented by systematic consultation of official websites. All manifestations followed the rules available in the electronic addresses and internal guidelines directed by each court.

The first stage with the ombudsmen was based on demand composition via e-mail, telephone contact, and specific electronic form available on the websites of the TJ, following specific internal protocols in each Federation Unit (Unidade da Federação - UF). The follow-up of the request was performed with the protocol number generated at the time of the request.

The TJs should respond to three specific items:

  1. What are the names and dates of implementation of the systems used by the operators of law of this UF to register and monitor the physical judicial proceedings filed?

  2. What are the names and dates of implementation of the systems used by the law operators of this UF to register and monitor the filing of virtual lawsuits?

  3. Any observation that the TJ deems pertinent.

After completing the first stage, one decided to complement the data obtained from a second stage, which consisted of sending new requests to the TJ for further detailing of the process of protocol of actions that deal with public health from three questions:

  1. In the available information systems, referred to by the court in the first stage, what is the branch, in the subject tree, to classify and file an action that deals with health? Is there a difference in the protocol when it comes to public health and private health?

  2. Is it possible to carry out the protocol of a process in the competence of the public treasury that is in the health area, without the registration being identified that is in the health area, for example: register as “administrative act/annulment” – but be related to the supply of medicines?

  3. Does the distribution sector make adequacy/compatibility in the registration of actions, correcting any petition errors by the professionals who make the registrations?

Data Analysis

For the first stage, in possession of the collected information, the data were consolidated and organized into tables, with preliminary descriptive analysis. In the few cases in which the same database was informed by the TJ as containing physical and virtual processes, this data was computed only once, to avoid overestimating the local reality.

For the second stage on the process of protocol of actions that deal with public health, the three questions answered by the TJ were consolidated and analyzed descriptively.

Ethical Aspects

The data in this study are secondary and public, according to the principle of advertising of Art. 5th, item LX, of the Federal Constitution of 1988, Art. 189 of the Code of Civil Procedure, and Law No. 12,527/111111. Peçanha LO, Simas L, Luiza VL. Judicialização de medicamentos no Estado do Rio de Janeiro: evolução de 2010 a 2017. Saude Debate. 2019;43 (Nº Espec 4):61-70. https://doi.org/10.1590/0103-11042019S406
https://doi.org/10.1590/0103-11042019S40...
, and other provisions.

In addition, the project was submitted to the Research Ethics Committee of the Universidade Federal do Ceará CEP/UFC/PROPESQ on the Brazil Platform, which had as its opinion a statement stating that “the project does not apply to the evaluation of the Research Ethics Committee, since it is a research that uses freely accessible information and because it uses a database, whose information is aggregated, without the possibility of individual identification, in a manner similar to the provisions of CNS Resolution No. 510, of April 7, 2016”.

RESULTS

Step 1

In the state of Ceará (CE), data were collected in loco, due to the ease of access of the research team.

The TJ of Acre (AC), Amapá (AP), Amazonas (AM), Pará (PA), Rondônia (RO), Roraima (RR), Alagoas (AL), Bahia (BA), Maranhão (MA), Rio Grande do Norte (RN), Distrito Federal (DF), Mato Grosso (MT), Espírito Santo (ES), Minas Gerais (MG), São Paulo (SP) and Rio Grande do Sul (RS) returned contacts via email, corresponding to 59.2% of the total.

For the TJ of Tocantins (TO), Sergipe (SE), Paraíba (PB), Pernambuco (PE), Piauí (PI), Goiás (GO), Mato Grosso do Sul (MS), Rio de Janeiro (RJ), Paraná (PR) and Santa Catarina (SC), direct telephone contacts were made to the ombudsmen, as well as to the sectors responsible for the information technology service of the courts. In addition, systematic searches were carried out on websites. In all cases, it was possible to compose perspectives for the three items of interest at this stage.

The result of the first stage of the study is summarized in Tables 1 and 2. Table 1 characterizes the existing databases of information systems in each TJ of the UFs of the country, as well as those that are intended for the registration of physical processes (old databases) and the registration of virtual processes (modern databases).

Table 1
Number and specification by federation unit and region of Brazil of the databases in State Courts of Justice, 2021.
Table 2
Description and frequency of systems of the State Courts of Justice, 2021.

The TJ of Acre reported that it uses only electronic processes, presenting three virtual databases, while the TJ of Sergipe indicated having only one database that serves for protocol and monitoring of processes, both physical and virtual. The TJ of Alagoas, Mato Grosso do Sul and Rondônia presented two databases, indicated for both physical and virtual processes, one for first-degree processes and another for second-degree ones. The TJ of Amazonas presented three databases, also indicated for protocol and monitoring of physical and virtual processes.

On the other hand, Rio Grande do Sul, Maranhão and the Distrito Federal (DF) reported bases in each typology, seven in total. The state of Piauí counted two databases for physical processes and six for virtual ones, totaling eight databases. The other TJ have different operating characteristics, from which one can follow the physical and virtual processes (Table 1).

The advancement of electronic systems for the modality of virtual processes to the detriment of the records of physical processes was verified, the fact justifies the repetition of some bases in relation to physical and virtual processes. For example, in the state of Amazonas, there is the E-SAJ and Projudi system, which can both be used to monitor physical and virtual processes.

In the country, 141 databases were identified in the states and DF, 44 (31.2%) for physical processes and 97 (68.8%) for virtual ones (Table 1). There is a predominance of virtual bases in all regions of the country, with emphasis on the Northeast and South regions (Table 1).

A total of 123 databases were found in the TJ, with emphasis on the South and Northeast regions (Table 1). When disregarding the existence of duplication of databases, a total of 48 systems were found throughout the country (Table 2). The most frequent systems were: PJE1G (n = 17; 13.8%), PJE2G (n = 13; 10.5%), Projudi (n = 16; 13%), SEEU (n = 12; 9.7%) and E-SAJ PG (n = 10; 8.1%).

Stage 2

Responses were obtained to the requests of the TJ of Amapá (AP), Pará (PA), Rondônia (RO), Roraima (RR), Alagoas (AL), Ceará (CE), Maranhão (MA), Rio Grande do Norte (RN), Sergipe (SE), Distrito Federal (DF), Espírito Santo (ES), Minas Gerais (MG), São Paulo (SP) and Paraná (PR).

With the information of 14 participating courts of justice, it was noticed that the branch for protocols of actions related to health is established by the CNJ, based on the System of Unified Procedural Tables (Sistemas de Tabelas Processuais Unificadas - TPU), established by Resolution No. 46 of 2007 of the CNJ.

Based on the answer to question [A] according to the classification established by the CNJ table, there are differences in the form of registration and protocol when it comes to public or private health. In addition, the competence to process causes related to public health refers to special courts and courts of the public treasury, which judge civil lawsuits of interest to the state and municipalities, while for private health there are special civil courts. Such details are important for the extraction of reports and future research designs.

In another perspective already brought by question [B], in a common way, the legal operators responsible for the distribution of lawsuits incur error by classifying them in various subjects, such as, for example, “obligation to do (lawsuit that aims at a provision of one person in relation to another). Although the judicial unit has the possibility to readjust the action, this aspect reflects a competence gap to be filled.

It was also mentioned that there are no specific rules linking competence to matters. The update/correction, however, can be done at any time by internal users of the system, with different profiles, such as protocol, distribution, notaries and/or offices.

Finally, question [C] revealed that in the TJ both the distribution sector and court notaries and the technical support centers of the Judiciary (NAT-Jus) can make adequacy/compatibility, correcting any registration errors.

The TJ of Roraima complemented the information that NAT-Jus “collects” the data, consolidates them, and monitors health actions, especially in tributary and childhood courts, considering the context on request basis. Even if the subject is not “health”, the court analyzes according to the subject, indicating greater rigor in relation to the information available from health actions.

One also found the websites of the TJ do not have a standardized data interface for the provision of processes related to public health, and there are also different obstacles to accessing this type of information. No information was found on how the content of the processes should be made available in the database, leaving at the discretion of each court how to make its data available on the various subjects, such as the processes of judicialization of public health.

Also as a result of this research, it was recognized that the greatest difficulty found in the activity of collecting data on health processes arises from problems in the access models (Judiciary Systems), in the availability and organization of the websites of the various state TJs, i.e., there is no uniformity for proper access, which requires the development of a system that reaches the demands in order to guarantee, in fact, the access of all legal operators, as well as society, including health researchers.

DISCUSSION

The study allowed additional evidence that the large number of databases that store individual and collective actions involving SUS makes it difficult to carry out more substantiated and comparative analyses. There is a technical limitation for the systematic extraction of data compiled in each system, in addition to the lack of integration between them, compromising the planning, decision-making and development of health research. One also observed that these systems, in more than a hundred, are still of limited access to law operators and researchers, both in the field of law and in the health sciences, particularly Public Health, with potentially negative impacts for academic research in these fields of knowledge.

Although the computerization law of the judicial process No. 11,419 of 2006 and Bill No. 5,828 of 2001 have in their original proposal the prediction that each body of the legal system would develop software necessary for the use of the digital process, creating its own access base and which could be accessed from anywhere on the planet1212. Diniz D, Machado TRC, Penalva J. A judicialização da saúde no Distrito Federal, Brasil. Cienc Saude Colet. 2014;19(2):591-8. https://doi.org/10.1590/1413-81232014192.23072012
https://doi.org/10.1590/1413-81232014192...
; this administrative autonomy of each TJ, previously without a guiding legislation, generated multiplicity of systems in the courts with lack of uniformity in the databases and interfaces between information in the courts, evidenced in this study.

In 2005, the CNJ, the administrative and procedural control body of the legal system, established the statistics system of the Judiciary Power (Resolution No. of August 4, 2005), making it mandatory for the country’s TJ to send consolidated data on processes and sentences rendered to be centralized in the Council1818. Brasil. Conselho Nacional de Justiça. Resolução Nº 4 de 16 de agosto de 2005. Cria o Sistema de Estatística do Poder Judiciário e dá outras providências. Diário Oficial da União. 23 ago 2005 [cited 2021 Mar 27];Seção 1:64. Available from: http://cnj.jus.br/atos-normativos?documento=188
http://cnj.jus.br/atos-normativos?docume...
. However, studies show there are limited concrete advances until the completion of this research1919. Conselho Nacional de Justiça. PJe: equipe do CNJ discute adesão da Justiça fluminense à plataforma. Brasília, DF: Agência CNJ de Notícias; 2019 [cited 2021 May 26]. Available from: https://www.cnj.jus.br/pje-equipe-do-cnj-discute-adesao-da-justica-fluminense-a-plataforma/
https://www.cnj.jus.br/pje-equipe-do-cnj...
,2020. Repette PFR, Sell D, Bastos LC. Judiciário como plataforma: um caminho novo e promissor. Rev Eletron CNJ. 2020 [cited 2021 May 26];4(1):175-88. Available from: https://www.cnj.jus.br/ojs/index.php/revista-cnj/issue/view/5/4
https://www.cnj.jus.br/ojs/index.php/rev...
, the different databases limit the production of information that translates reality, reducing the potential for jurisdictional provision99. Oliveira FL Cunha, LG. Os indicadores sobre o Judiciário brasileiro: limitações, desafios e o uso da tecnologia. Rev Direito GV. 2020;16(1):e1948. https://doi.org/10.1590/2317-6172201948
https://doi.org/10.1590/2317-6172201948...
. Therefore, compromising the description and broad and precise understanding of the phenomenon of health judicialization, as well as the planning of public policies by the Executive Branch11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
,1313. Conselho Nacional de Justiça; Programa das Nações Unidas para o Desenvolvimento. Judicialização e sociedade: ações para acesso à saúde pública de qualidade. Brasília, DF: CNJ; 2021 [cited 2021 Oct 16]. Available from: https://www.cnj.jus.br/programas-e-acoes/forum-da-saude-3/judicializacao-e-sociedade-acoes-para-acesso-a-saude-publica-de-qualidade/
https://www.cnj.jus.br/programas-e-acoes...
.

The automation of the legal system was rethought with the emergence of the electronic judicial process, proposal for integration of databases, and strategic management of information from the judiciary power2121. Conselho Nacional de Justiça. Processo Judicial Eletrônico (PJe), 2020. Brasilia, DF: CNJ; 2020 [cited 2021 Jul 27]. Available from: https://www.cnj.jus.br/programas-e-acoes/processo-judicial-eletronico-pje/implantacao-do-pje/
https://www.cnj.jus.br/programas-e-acoes...
. It currently represents an important tool standardized by the ordinary Judiciary, a fact verified in this study, based on the finding that it is used by almost 20% of the country’s TJ, reinforcing its strategic implementation as a public policy of the Legal System provided for in CNJ Resolution No. 185 of 20132222. Conselho Nacional de Justiça. Resolução Nº 185 de 18 de dezembro de 2013. Institui o Sistema Processo Judicial Eletrônico - PJe como sistema de processamento de informações e prática de atos processuais e estabelece os parâmetros para sua implementação e funcionamento. Brasília, CNJ; 2013 [cited 2020 Nov 14]. Available from: https://atos.cnj.jus.br/atos/detalhar/1933
https://atos.cnj.jus.br/atos/detalhar/19...
.

This scenario points out that the use of judicial databases is a powerful tool for faster and more qualified procedural processing2020. Repette PFR, Sell D, Bastos LC. Judiciário como plataforma: um caminho novo e promissor. Rev Eletron CNJ. 2020 [cited 2021 May 26];4(1):175-88. Available from: https://www.cnj.jus.br/ojs/index.php/revista-cnj/issue/view/5/4
https://www.cnj.jus.br/ojs/index.php/rev...
and conducting empirical research in health11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
. However, it was noted that its existence by itself does not guarantee easy access, without being subject to personal, structural and social limitations, in view of the multiplicity, inconstancy and lack of uniformity, in addition to limiting access to the data of the possible analyses, making impossible a series of interfaces between the different bases to overcome possible inconsistencies11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
,99. Oliveira FL Cunha, LG. Os indicadores sobre o Judiciário brasileiro: limitações, desafios e o uso da tecnologia. Rev Direito GV. 2020;16(1):e1948. https://doi.org/10.1590/2317-6172201948
https://doi.org/10.1590/2317-6172201948...
,1313. Conselho Nacional de Justiça; Programa das Nações Unidas para o Desenvolvimento. Judicialização e sociedade: ações para acesso à saúde pública de qualidade. Brasília, DF: CNJ; 2021 [cited 2021 Oct 16]. Available from: https://www.cnj.jus.br/programas-e-acoes/forum-da-saude-3/judicializacao-e-sociedade-acoes-para-acesso-a-saude-publica-de-qualidade/
https://www.cnj.jus.br/programas-e-acoes...
.

Another concern refers to the limitation of access for people who do not work in the field of law; based on the findings of this study and experience of linked data collection, it is inferred that the existence of structural barriers consistently limits the wide access to empirical data, objects of research on the judicialization of public health, a fact intensified by the wide variety of databases in the Legal System.

The importance of the proposal to consolidate databases in the Judiciary Branch promotes alignment with the sustainable development objective of Agenda 2030, number 16, which deals with a society with universal access to Justice, with effective and inclusive institutions at all levels2323. Organização das Nações Unidas. Transformando Nosso Mundo: a Agenda 2030 para o Desenvolvimento Sustentável. Brasília, DF: ONU; 2015. [cited 2021 Aug 30]. Available from: https://www.undp.org/content/dam/brazil/docs/agenda2030/undp-br-Agenda2030-completo-pt-br-2016.pdf
https://www.undp.org/content/dam/brazil/...
,2424. Conselho Nacional de Justiça, Comitê Interinstitucional. Propostas de Indicadores da Agenda 2030 do Poder Judiciário (LIODS). Brasília, DF: CNJ; 2020 [cited 2021 Aug 21]. Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/08/df16d3f36b0278af465368355a01329d.pdf
https://www.cnj.jus.br/wpcontent/uploads...
.

Another important aspect is the classification and protocol of actions related to health (“types” of matters that are the subject of litigation), due to the fact that some courts use as standard the subjects of the CNJ’s unified procedural table. However, there are other ways to proceed to branching, as can be seen from the response of the TJ of Minas Gerais.

The protocol of health actions represents relevant information, considering the large number of studies on health judicialization that require empirical data from the courts for research purposes11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
,99. Oliveira FL Cunha, LG. Os indicadores sobre o Judiciário brasileiro: limitações, desafios e o uso da tecnologia. Rev Direito GV. 2020;16(1):e1948. https://doi.org/10.1590/2317-6172201948
https://doi.org/10.1590/2317-6172201948...
,1111. Peçanha LO, Simas L, Luiza VL. Judicialização de medicamentos no Estado do Rio de Janeiro: evolução de 2010 a 2017. Saude Debate. 2019;43 (Nº Espec 4):61-70. https://doi.org/10.1590/0103-11042019S406
https://doi.org/10.1590/0103-11042019S40...
,1313. Conselho Nacional de Justiça; Programa das Nações Unidas para o Desenvolvimento. Judicialização e sociedade: ações para acesso à saúde pública de qualidade. Brasília, DF: CNJ; 2021 [cited 2021 Oct 16]. Available from: https://www.cnj.jus.br/programas-e-acoes/forum-da-saude-3/judicializacao-e-sociedade-acoes-para-acesso-a-saude-publica-de-qualidade/
https://www.cnj.jus.br/programas-e-acoes...
,1414. Vieira FS. Direito à Saúde no Brasil: seus contornos, judicialização e a necessidade da macrojustiça. Brasília, DF: IPEA; 2020 [cited 2021 Oct 16]. (Texto para Discussão; nº 2547). Available from: https://www.ipea.gov.br/portal/index.php?option=com_content&view=article&id=35360
https://www.ipea.gov.br/portal/index.php...
. In this study, the question of whether it is possible to file health actions in other matters was answered “yes” by most courts. Although the use of the managerial entitled “health processes” is regulated, many representatives classify demand differently. For example, in the public treasury there are processes classified with the managerial “obligation to do or not to do”, when in fact they are health processes (supply of medicines). The reasons for this imprecise classification may be related to the recent adoption of new policies for health actions, including the adoption of a specific classification (Box), which has shown limitations due to erroneous registrations referring to the ‘subject’ when distributing the process11. Instituto de Ensino e Pesquisa. Judicialização da saúde no Brasil: perfil das demandas, causas e propostas de solução. Brasília, DF: Conselho Nacional de Justiça; 2019 [cited 2021 Oct 17]. (Série Justiça e Pesquisa). Available from: https://www.cnj.jus.br/wpcontent/uploads/2019/03/66361404dd5ceaf8c5f7049223bdc709.pdf
https://www.cnj.jus.br/wpcontent/uploads...
,1111. Peçanha LO, Simas L, Luiza VL. Judicialização de medicamentos no Estado do Rio de Janeiro: evolução de 2010 a 2017. Saude Debate. 2019;43 (Nº Espec 4):61-70. https://doi.org/10.1590/0103-11042019S406
https://doi.org/10.1590/0103-11042019S40...
,1313. Conselho Nacional de Justiça; Programa das Nações Unidas para o Desenvolvimento. Judicialização e sociedade: ações para acesso à saúde pública de qualidade. Brasília, DF: CNJ; 2021 [cited 2021 Oct 16]. Available from: https://www.cnj.jus.br/programas-e-acoes/forum-da-saude-3/judicializacao-e-sociedade-acoes-para-acesso-a-saude-publica-de-qualidade/
https://www.cnj.jus.br/programas-e-acoes...
,1414. Vieira FS. Direito à Saúde no Brasil: seus contornos, judicialização e a necessidade da macrojustiça. Brasília, DF: IPEA; 2020 [cited 2021 Oct 16]. (Texto para Discussão; nº 2547). Available from: https://www.ipea.gov.br/portal/index.php?option=com_content&view=article&id=35360
https://www.ipea.gov.br/portal/index.php...
.

Box
Answers on the process of protocol and monitoring of health processes in the databases of the Courts of Justice of the States.

Such a scenario points to a risk to the actual number of health judicialization processes in the courts already researched1111. Peçanha LO, Simas L, Luiza VL. Judicialização de medicamentos no Estado do Rio de Janeiro: evolução de 2010 a 2017. Saude Debate. 2019;43 (Nº Espec 4):61-70. https://doi.org/10.1590/0103-11042019S406
https://doi.org/10.1590/0103-11042019S40...
, even though the courts respond that it is possible to make the adjustment. The inaccuracies and inclusions of inaccurate data are questioned, a fact found in the answers provided in the Box.

The limitations of the study refer to the degree of accuracy and systematization of information related to the information systems of the legal system that were formally returned by the TJ. Despite these issues, the national scope and the differentiated approach with interface from different perspectives in the field of Law and Collective Health reinforce its relevance, given the unprecedented and strategic character for the country.

CONCLUSION

The multiplicity of information systems in the Brazilian Judiciary makes their use more complex for analysis with a view to health research, constituting an obstacle to the more effective updating of the Executive’s public policies. Additional efforts are needed not only to standardize, but also to improve the flows and structure of judicial databases, expanding access and transparency, seeking a transdisciplinary look at research in the fields of Law and Collective Health.

The lack of standardization in the organization of data or public access systems to the various TJs (and their statistical data) hinders the empirical research of health judicialization, which is fundamental for the elaboration of public policies. While the electronic database platforms of the Judiciary are not offered in a unified manner, in an equal manner, the virtualization of the processes will not be able to guarantee the expansion of access to Justice information, on the contrary, it may intensify the disparity between public and private access to Justice.

The future must be the digital process and, if it is to be effective, it must be carefully instituted, with analysis of results, failures and improvements, adapting operators and society as a whole. There is a huge potential for analysis and qualification of public policies, not only linked to the health sector. It is noteworthy that this movement demands strategic social policies that promote unrestricted access by society and health researchers, within the limits of current laws, including based on easily accessible data on their websites.

Therefore, the need for strategic improvement is reinforced to standardize the electronic systems used by the Legal System to govern judicial processes and empirical research in health, given that the configuration adopted limits and hinders research and analysis that can even guide the creation of public policies aimed at identifying and controlling the phenomenon of health judicialization.

REFERENCES

  • Funding: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes/PROAP – PhD scholarship to AFF). Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico do Estado do Ceará (FUNCAP - master’s scholarship for NRNA). Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq – research productivity grant 2 for ANRJ).

Publication Dates

  • Publication in this collection
    29 Aug 2022
  • Date of issue
    2022

History

  • Received
    06 Sept 2021
  • Accepted
    31 Oct 2021
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