Algoritmos versus autonomia: a corrosão dos fundamentos bioéticos no cenário digital da saúde

Abstract

The digitalization of healthcare, while promising greater efficiency and personalization, introduces profound ethical tensions by operating under algorithmic logics that can subvert traditional bioethical principles. This theoretical reflection study aimed to analyze, considering critical bioethics and the philosophy of technology, how the architectures of digital platforms erode the principle of autonomy and challenge the care relationship in healthcare. Through an integrative critical literature review of the Medline, SciELO, and Google Scholar databases, it is argued that this erosion occurs in three interconnected dimensions: the redefinition of autonomy as algorithmic compatibility, the transformation of the therapeutic relationship by engagement metrics unrelated to care, and the colonization of the clinical space by the rationality of dataism. It concludes that this is a structural conflict (mismatch) between the relational ethics of clinical care and the instrumental ethics of platforms, requiring, as a response, a resilient ethical praxis in the field of health, based on critical literacy, advocacy for transparency, and the development of alternative technologies centered on the therapeutic values of the bond and patient safety.

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