Resumo

GONZALEZ PEREZ, Ubaldo. El concepto de calidad de vida y la evolución de los paradigmas de las ciencias de la salud. Rev Cubana Salud Pública [online]. 2002, vol.28, n.2, pp.157-175. ISSN 0864-3466.

Medicine emerged as a pragmatic response to the need of relieving pain, suffering and disability, but when it developed in interaction with the predominant conceptions of the rest of disciplines and technologies, its paradigms were also developed. Research and medical interventions moved from the disease of an individual at critical state and with disturbing symptoms to educational actions for preserving the health of the community. Great landmarks in the approaches to causality in medicine were the observations made by the Greek doctors about the importance of air, waters and places for the health and diseases as well as the ideas of Renaissance utopists when they predicated the possibility of creating a better society and a healthier life by providing higher quality lifestyles. Raminici also presented another transcendental approach when he spoke about the influence of the way of life of dunghill cleaners on the genesis of their diseases. All this brought the attention to working environment, housing, hygiene and hunger and hence famous physicians and economists performed studies on the living conditions of workers and impoverished sectors to explain the diseases and epidemics that hit the industrial development areas in Europe during the 17th and 18th centuries. This gave rise to the development of social medicine, social hygiene and public health, and from that moment on, it was clear that hunger and wars could kill and cause illness in more people than the bacteria did, because the role of the quality of life for health and disease had been finally understood. Regardless of this advanced conception, the first accomplishments of chemotherapy and the microscopic identification of biological agents brought about progress but at the same time a naive optimism that set out the unlimited possibilities of the chemotherapeutical drugs. The development of the drug industry was subjected to the interests of the market, leading some medical sectors and population sections to biologicism at all costs that made them believe that the solution of health problems and disease depend on the production and use of efficient drugs. The technologies aimed at intensive therapy, transplantation and cloning were led by the hand by the market, so, once again the danger represented by sudden changes in the way of life, environmental pollution and the poor quality of life caused by excessive development, excessive consumption and social insecurity was neglected. Recognizing these mistakes may be attenuated by making good use of (determinar) to study the quality of life in a context of integration of biological conditions with environmental, economic-social, psychological and ethical factors. This means to assume a conception within the paradigm of health to face the present society's problems.

Palavras-chave : QUALTY OF LIFE; LEGISLATION HEALTH; HEALTH SERVICES.