Internação psiquiátrica compulsória por transtornos relacionados ao uso de substâncias psicoativas: uma análise da realidade de Belo Horizonte pela ótica da bioética da proteção

Abstract

This dissertation analyzes judicial actions involving compulsory psychiatric hospitalization related to disorders arising from the use of psychoactive substances that were processed in the District of Belo Horizonte between 2013 and 2024, from the perspective of the bioethics of protection. The research adopts a juridical-comprehensive and juridical-propositional approach. Based on a survey conducted through the Electronic Judicial Process system of the Minas Gerais Court of Justice, a final sample of 52 civil actions with concluded proceedings and diagnoses related to psychoactive substance use was selected. Data were collected and analyzed using a specific research instrument composed of 39 variables, allowing for a systematic assessment of the procedural, evidentiary, and decisional aspects of the cases. From a theoretical standpoint, the study examines the foundations of the bioethics of protection, particularly the distinction between vulnerability, susceptibility, and vulneration, as well as the criteria used to differentiate protective actions from paternalistic practices. From a normative perspective, the research analyzes the legal framework governing mental health, consent to health treatments, and psychiatric hospitalizations, with particular emphasis on Law nº 10.216/2001, Law nº 13.840/2019, the Statute of Persons with Disabilities, the Civil Code, ministerial ordinances, and resolutions issued by the Federal Council of Medicine. The empirical analysis revealed significant shortcomings in the handling of these proceedings, including conceptual imprecision regarding psychiatric hospitalization, insufficient direct and up-to-date medical evaluations, referrals to technically inadequate institutions, deficiencies in ensuring adversarial proceedings and the right to a full defense, and delays in judicial responses. It is concluded that such failures undermine the protective potential of judicial intervention, bringing it closer to paternalistic practices or, in some cases, exposing the individuals involved to situations of risk. Finally, the dissertation presents proposals aimed at strengthening the protective character of compulsory psychiatric hospitalization, in accordance with the applicable ethical and normative parameters.