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BIOETHICAL DILEMMAS OF PHYSICIANS AND NURSES IN THE PREVENTION OF PRIMARY HEALTH CARE IN CITIES FROM BOGOTA AND VALLEDUPAR, COLOMBIA

In Primary Health Care (PHC) resolving bioethical issues requires a thorough understanding of reality and the dynamics of the system, community, economic and social situation in which it operates. The PHC strategy is comprehensive, goes beyond the health system to engage in economic, political and cultural local and national levels, respecting human rights, its environment and its values. The interest of this study was to determine knowledge and perceptions of health professionals regarding the premises of PHC, as well as the barriers and bioethical dilemmas common to practice in the first level care from prevention, in the cities of Bogotá and Valledupar. We conducted a reflection from the concept of quality of life and sustainable development. This is a descriptive study, using qualitative methods. The instruments were applied to health professionals working in institutions of primary health care; the participants were selected by a willingness to participate in the study, and the relevance of the work of primary care. Institutions were chosen by random sampling. As instruments, a questionnaire and hypothetical dilemmas were used. A qualitative analysis was conducted using specialized computer software (ATLAS / ti). Professionals are unaware that the PHC system is based on assumptions; however, they are in agreement with most of them. They disagree with the idea that PHC defines access to the specialized level of care and that practitioners should address problems beyond the clinical work. They were found to be divided into the impact of traditional curative approach and the integration of the health system as part of an economic and social development. Most professionals do not know the bioethical principles, so the process of decision making is left to third party. There were no major differences when analyzing the results by city. Before the implementation of the law of Social Security Reform in Colombia, it is necessary a transformation in medical education and bioethics. Training should encourage a change of attitudes in the professionals, not only in PHC but throughout the health field, focusing on the importance of prevention, emphasizing the professional role in this system, and the motivation to engage with the community beyond the simple doctor-patient relationship. Investing in health is a way to accelerate growth, sustainable development, understood as a process of progressive change in the quality of human life.