Prefácio

Prefácio ao n. 47 da Revista da Faculdade de Direito da UFRGS

Entre decisão e juízo : poder constituinte e controle de constitucionalidade em Hannah Arendt

O presente trabalho tem por objetivo refletir sobre o poder constituinte e o controle de constitucionalidade nas democracias liberais representativas, sob fundamento na teoria política de Hannah Arendt. Para tanto, o problema delineia-se sobre a concepção da autora acerca dos legitimados ao poder constituinte e ao controle de constitucionalidade, não titularizados por somente um ator político, mas pelo povo e pelo Poder Judiciário, respectivamente. Ou melhor, o problema objeto desta pesquisa é apurar se há uma contradição na teoria constitucional arendtiana em atribuir o poder constituinte ao povo, através da fundação constitucional, e entregar o controle de constitucionalidade ao Judiciário, enquanto instituição não eleita. Seu deslinde é realizado a partir do desenvolvimento de quatro hipóteses. A primeira diz com a adesão de Arendt à teoria constitucional norte-americana, na qual o poder é atribuído ao povo e a autoridade à Constituição, cuja garantia de guarda é da Corte Constitucional, como forma de controle da tirania a partir da distinção das fontes legitimadoras do poder e do Direito. A segunda tem por cenário o posicionamento da autora sobre a Revolução Francesa e a subsequente formação de governos tirânicos, a partir da ideia de concentração do poder e da autoridade no povo, como vontade una e soberana da nação. A terceira hipótese abrange a tirânica concentração do poder no soberano, tendo a vontade do líder como fundamento da ordem constitucional e a quarta perpassa a análise da inquietude arendtiana acerca do fenômeno da apolitização nas democracias representativas, a impactar as escolhas reproduzidas através do voto. Tendo por referência tais hipóteses, desenvolveu-se a pesquisa com fundamento em paradigmas fundamentais arendtianos, quais sejam, política, autoridade, revolução e fundação, bem como em suas reflexões sobre o constitucionalismo setecentista norte-americano e francês. Finalmente, após o estudo do controle de constitucionalidade propriamente dito, na estrutura de poder arendtiana, deduziu-se, embora com ressalvas, não haver contradição na opção de imputá-lo a um tribunal constitucional, em garantia não somente da separação de poderes, mas do acesso à atuação política pelas minorias, como controle da tirania da maioria e viabilização da ideia arendtiana de política.This work presents reflections on constituent power and constitutional control in representative liberal democracies, based on Hannah Arendt’s political theory. The problem is based on the author's conception of those who are legitimated for constituent power and the constitutional control, not securitized by one political actor, but by the people and by the Judiciary, respectively. Or rather, the problem of this research is to determine if there is a contradiction in Arendt's constitutional theory in assigning the constituent power to the people through the constitutional foundation, and to give constitutional control to the Judiciary, which is not an elected institution. The problem is demarcated from the development of four hypotheses. The first says Arendt's adheres to the American constitutional theory, in which power is assigned to the people and authority to the Constitution, whose guarantee of custody is of the Constitutional Court, as a form of control of tyranny from the distinction of the sources that legitimize power and Law. The second is the author's position on the French Revolution and the subsequent formation of tyrannical governments, based on the idea of concentration of power and authority in the people, as the sovereign will of the nation. The third hypothesis covers the tyrannical concentration of power in the sovereign, with the will of the leader as the basis for constitutional order. The fourth analyzes Arendt’s restlessness regarding the phenomenon of a-politicization in representative democracies, impacting the choices made through voting. With these hypotheses as references, the study was based on some of Arendt’s fundamental paradigms, namely, politics, authority, revolution and foundation, as well as in her reflections on American and French eighteenth-century constitutionalism. Finally, regarding the study of constitutional control itself, inside Arendt’s structure of power, the study found, although with reservations, that there is no contradiction in imputing it to a constitutional court, guaranteeing not only the separation of powers, but access to political action by minorities, as an instrument of control of the tyranny of the majority, proving the viability of Arendt’s idea of politics

Entre decisão e juízo : poder constituinte e controle de constitucionalidade em Hannah Arendt

O presente trabalho tem por objetivo refletir sobre o poder constituinte e o controle de constitucionalidade nas democracias liberais representativas, sob fundamento na teoria política de Hannah Arendt. Para tanto, o problema delineia-se sobre a concepção da autora acerca dos legitimados ao poder constituinte e ao controle de constitucionalidade, não titularizados por somente um ator político, mas pelo povo e pelo Poder Judiciário, respectivamente. Ou melhor, o problema objeto desta pesquisa é apurar se há uma contradição na teoria constitucional arendtiana em atribuir o poder constituinte ao povo, através da fundação constitucional, e entregar o controle de constitucionalidade ao Judiciário, enquanto instituição não eleita. Seu deslinde é realizado a partir do desenvolvimento de quatro hipóteses. A primeira diz com a adesão de Arendt à teoria constitucional norte-americana, na qual o poder é atribuído ao povo e a autoridade à Constituição, cuja garantia de guarda é da Corte Constitucional, como forma de controle da tirania a partir da distinção das fontes legitimadoras do poder e do Direito. A segunda tem por cenário o posicionamento da autora sobre a Revolução Francesa e a subsequente formação de governos tirânicos, a partir da ideia de concentração do poder e da autoridade no povo, como vontade una e soberana da nação. A terceira hipótese abrange a tirânica concentração do poder no soberano, tendo a vontade do líder como fundamento da ordem constitucional e a quarta perpassa a análise da inquietude arendtiana acerca do fenômeno da apolitização nas democracias representativas, a impactar as escolhas reproduzidas através do voto. Tendo por referência tais hipóteses, desenvolveu-se a pesquisa com fundamento em paradigmas fundamentais arendtianos, quais sejam, política, autoridade, revolução e fundação, bem como em suas reflexões sobre o constitucionalismo setecentista norte-americano e francês. Finalmente, após o estudo do controle de constitucionalidade propriamente dito, na estrutura de poder arendtiana, deduziu-se, embora com ressalvas, não haver contradição na opção de imputá-lo a um tribunal constitucional, em garantia não somente da separação de poderes, mas do acesso à atuação política pelas minorias, como controle da tirania da maioria e viabilização da ideia arendtiana de política.This work presents reflections on constituent power and constitutional control in representative liberal democracies, based on Hannah Arendt’s political theory. The problem is based on the author's conception of those who are legitimated for constituent power and the constitutional control, not securitized by one political actor, but by the people and by the Judiciary, respectively. Or rather, the problem of this research is to determine if there is a contradiction in Arendt's constitutional theory in assigning the constituent power to the people through the constitutional foundation, and to give constitutional control to the Judiciary, which is not an elected institution. The problem is demarcated from the development of four hypotheses. The first says Arendt's adheres to the American constitutional theory, in which power is assigned to the people and authority to the Constitution, whose guarantee of custody is of the Constitutional Court, as a form of control of tyranny from the distinction of the sources that legitimize power and Law. The second is the author's position on the French Revolution and the subsequent formation of tyrannical governments, based on the idea of concentration of power and authority in the people, as the sovereign will of the nation. The third hypothesis covers the tyrannical concentration of power in the sovereign, with the will of the leader as the basis for constitutional order. The fourth analyzes Arendt’s restlessness regarding the phenomenon of a-politicization in representative democracies, impacting the choices made through voting. With these hypotheses as references, the study was based on some of Arendt’s fundamental paradigms, namely, politics, authority, revolution and foundation, as well as in her reflections on American and French eighteenth-century constitutionalism. Finally, regarding the study of constitutional control itself, inside Arendt’s structure of power, the study found, although with reservations, that there is no contradiction in imputing it to a constitutional court, guaranteeing not only the separation of powers, but access to political action by minorities, as an instrument of control of the tyranny of the majority, proving the viability of Arendt’s idea of politics

Prefácio

Prefácio ao n. 47 da Revista da Faculdade de Direito da UFRGS

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk