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A epistemologia narrativa e o exercício clínico do diagnóstico

机译：叙事认识论与临床锻炼的诊断

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This study aims to discuss the narrative epistemology contained in the medical practice. It was based upon a bibliographic review and a semiotic analysis of medical charts belonging to The Medical Genetic Center José Carlos Cabral de Almeida/Genetic Department/Fernandes Figueira Institute, a maternal-infant care unity of The Oswaldo Cruz Foundation. All the analysed charts referred to children diagnosed with Down syndrome that are being or were attended in the Down's Syndrome Outpatient of the above cited unity. The article appraises: the question concerning the possible opposition between narrative and science; a review of multiple authors and their works about narrative and medical knowledge; the narrative epistemology contained in the clinical discourse, using as example of such assumption one chart and one pedigree. The conclusion highlights how narrative is important to the process of diagnosis and treatment, and affirms the construction of a plot, by the physician, where biological, social and cultural interactions make themselves present.
机译：本研究旨在讨论医学实践中包含的叙事认识论。它基于书目审查和医学遗传学中心何塞·卡洛斯·卡布拉尔·德阿尔梅达/遗传学系/费南德·菲格雷拉研究所的医学图表的符号学分析，该研究所是奥斯瓦尔多·克鲁兹基金会的母婴护理单位。所有分析过的图表均涉及上述统一的唐氏综合症门诊患者中或正在就诊的唐氏综合症患儿。文章评估：叙事与科学之间可能存在对立的问题;对多位作者及其有关叙事和医学知识的作品的评论;以一种图表和一个谱系为例，说明临床话语中包含的叙事认识论。结论强调了叙事在诊断和治疗过程中的重要性，并肯定了医师在生物，社会和文化互动中所处的情节的建构。

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