ABSTRACT

The purpose of this text is to bring contributions from the ethics of care to the practices of Primary Health Care based on the legacy of Maria de Lourdes Pintasilgo (1930-2004), Prime Minister of Portugal, from July 1979 to January 1980. Through the use of narrative record, aspects of the life trajectory of the politician are brought through the testimony of an important partner in fights, as well as theoretical and documentary contributions, which are part of the Caring for the Future Foundation's collection, which sought sustained improvement of quality of life and the defense of basic rights. The parliamentarian had significant political participation in European and the United Nations Organizations Forums proposing actions that would combat social inequality and the oppression of women. Inspired by feminist ethics, she understood care as the cornerstone of her actions. She valued the unique experiences of people and communities as the main parameter for strengthening social participation and the effectiveness of human rights. Finally, she expressed a way of doing politics in which ethical commitment and respect for oneself, others, and the environment marked her way of being in the world.

KEYWORDS
Empathy; Ethic; Primary Health Care; Affection; Social psychology

Introduction

This text aims to present reflections on the ethics of care, emphasizing some theoretical-conceptual incursions which contribute to the construction of social public policies, especially in the health area. The triggering of these reflections was the development of a research on the ethics of care and practices in Primary Health Care, called: 'Ethics of care and construction of rights: psychosocial welcoming in family health practices in situations of social exclusion'.

In many years of work in teaching, research and extension in a public university, related to the practices of the Family Health Strategy (FHS), the issue of care production has been an important marker of the quality of the bonds established in the territory between the different social actors involved, especially among health professionals with each other, those with the community and with community leaderships and service users.

Attention to the bonds happens due to the privilege of a look at reality through the lens of intersubjectivity, that is, to those psychosocial characteristics that outline the modes of sociability and health practices. The reference of socio-historical psychology has contributed to the understanding of subjectivity built from the interaction of subjects with their social environment¹1 Bock AMB, Gonçalves MGM, Furtado O, editores. Psicologia sócio histórica: uma perspectiva crítica em psicologia. São Paulo: Cortez; 2007., in addition to deepening the discussion of processes of politicization of health practices, especially about the apprehension of power relations in the territory, and the forms of community mobilization, consequently, in facing the consequences of social exclusion²2 Sawaia BB. Transformação social: um objeto pertinente à psicologia social? Psicol Soc [internet]. 2014 [acesso 2019 maio 18]; 26(esp2):4-17. Disponível: http://dx.doi.org/10.1590/S0102-71822014000600002.
http://dx.doi.org/10.1590/S0102-71822014... ^,33 Martín-Baró I. Crítica e Libertação na Psicologia: estudos psicossociais. Rio de Janeiro: Vozes; 2017., especially in those territories of the Santos Coast, where the rates of social vulnerability are very high, expressed by the increase of violence of all kinds and extreme poverty⁴4 Silva CRC, Mendes R, Moraes RCP, et al. Participação social e a potência do agente comunitário de saúde. Psicol Soc [internet]. 2014 [acesso em 2019 maio 18]; 26 (esp2):112-23. Disponível em: http://dx.doi.org/10.1590/S0102-71822014000600012.
http://dx.doi.org/10.1590/S0102-71822014... ^,55 Anhas DM, Rosa KRM, Silva CRC. Afetividade e Práxis Transformadora na Pesquisa Qualitativa. Psicol Soc [internet]. 2018; [acesso em 2019 maio 18]; 30: e173315. Disponível em: http://dx.doi.org/10.1590/1807-0310/2018v30173315.
http://dx.doi.org/10.1590/1807-0310/2018... .

The activities we carry out in these territories focus on the practices of the Community Health Worker (CHW) due to its insertion in the community, enabling the development of researches and teaching and extension actions that focused on the community, its needs and, then, adaptations to the services offered by the FHS⁶6 Mendes R, Frutuoso MFP, Silva CRC. Integralidade como processo intersubjetivo de construção de práticas em território de exclusão social. Saúde debate [internet]. 2017 [acesso em 2019 maio 18]; 41(114):707-7. Disponível em: http://dx.doi.org/10.1590/0103-1104201711403.
http://dx.doi.org/10.1590/0103-110420171...

7 Frutuoso MFP, Mendes R, Rosa KRM, et al. Gestão local de saúde em território de vulnerabilidade: motivações e racionalidades. Saúde debate [internet]. 2015 [acesso em 2019 maio 18]; 39(105):337-49. Disponível em: http://dx.doi.org/10.1590/0103-110420151050002003.
http://dx.doi.org/10.1590/0103-110420151... ^-88 Samudio JLP, Brant LC, Martins AC F, et al. Agentes comunitários de saúde na atenção primária no Brasil: multiplicidade de atividades e fragilização da formação. Trab Educ Saúde [internet]. 2017 [acesso em 2019 maio 18]; 15(3):745-70. Disponível em: http://dx.doi.org/10.1590/1981-7746-sol00075.
http://dx.doi.org/10.1590/1981-7746-sol0... .

In this line, the gender bias has been very evident, since the vast majority are women living in the same locality where they work, as it is a prerogative to act as CHW⁹9 Brasil. Ministério da Saúde, Gabinete do Ministro. Portaria nº 2.436, de 21de setembro de 2017. Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes para a organização da Atenção Básica, no âmbito do Sistema Único de Saúde (SUS) [internet]. Brasília, DF: República Federativa do Brasil; 2017 [acesso em 2019 maio 18]. Disponível em: http://bvsms.saude.gov.br/bvs/saudelegis/gm/2017/prt2436_22_09_2017.html.
http://bvsms.saude.gov.br/bvs/saudelegis... . The exercise of this professional activity often meets the search for reconciliation between the tasks as housewife and obtaining income for the family, in fact, many of them breadwinners and examples of emancipation for other women in the community¹⁰10 Silva CRC, Mendes R, Moraes RCP, et al. Participação social e a potência do agente comunitário de saúde. Psicol Soc [internet]. 2014 [acesso em 2019 maio 18]; 26(esp2):112-23. Disponível em: http://dx.doi.org/10.1590/S0102-71822014000600012.
http://dx.doi.org/10.1590/S0102-71822014... ^,1111 Barbosa RHS, Menezes CAF, David HMS, et al. Gênero e trabalho em saúde: um olhar crítico sobre o trabalho de agentes comunitárias/os de Saúde. Interface (Botucatu) [internet]. 2012 [acesso em 2019 maio 18]; 16(42):751-65. Disponível em: http://dx.doi.org/10.1590/S1414-32832012000300013.
http://dx.doi.org/10.1590/S1414-32832012... . Based on this, we consider that the questions about the practices of this health professional can be better understood by the ethical-political dimension, that is, by the attitude towards oneself and the other, in the context of welcoming production and qualified listening.

In this sense, the reference of the ethics of care has proved to be a fruitful support, as it places care as the center of public policies for facing health as a commodity¹²12 Boff L. O cuidado necessário: na vida, na saúde, na educação, na ecologia, na ética e na espiritualidade. Petrópolis: Vozes; 2012.^,1313 Pintasilgo ML. Para um novo paradigma: um mundo assente no cuidado. Antologia de textos de Maria de Lourdes Pintasilgo. Porto: Afrontamento; 2011.. Furthermore, the ethics of care, in its feminist component, extends the scope beyond care as an eminently feminine characteristic, which weakens its political character¹⁴14 Zirbel I. Uma teoria político-feminista do cuidado [tese]. Florianópolis: Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas, Programa de Pós-Graduação e, Filosofia; 2016. 324 p. [acesso em 2019 maio 18]. Disponível em: https://repositorio.ufsc.br/xmlui/handle/123456789/167820.
https://repositorio.ufsc.br/xmlui/handle... .

The outline for this complex discussion about the ethics of care is based on different aspects, highlighting the philosophical perspectives of Leonardo Boff¹²12 Boff L. O cuidado necessário: na vida, na saúde, na educação, na ecologia, na ética e na espiritualidade. Petrópolis: Vozes; 2012.^,1515 Boff L. Saber Cuidar: ética do humano-compaixão pela terra. 20. ed. Petrópolis: Vozes; 2014. and feminist ethics in its search for articulation between care and justice¹⁶16 Keller J, Kittay EF. Feminist Ethics of Care. In: Garry A, Serene J, Khader AS, editores. The Routledge Companion to Feminist Philosophy. Abingdon: Routledge; 2017. p. 540-55.^,1717 Kuhnen TA. O princípio universalizável do cuidado: superando limites de gênero na teoria moral [tese]. [Florianópolis]: Universidade Federal de Santa Catarina; 2015. 383 p. [acesso em 2019 maio 18]. Disponível em: https://repositorio.ufsc.br/xmlui/handle/123456789/132604.
https://repositorio.ufsc.br/xmlui/handle... . However, the main reference came with the political proposals of Maria de Lourdes Pintasilgo (1930-2004) (MLP), focus of this text. The discovery of the thought of this politician, the first Portuguese prime minister woman from July 1979 to January 1980, made it possible to instigate referrals to the discussion about the politicization of care in health practices.

Thus, this text has the main function to present and disseminate aspects of MLP's life and work and to raise her contributions to the construction of social public policies, specifically for the public health area, based on the ethics of care.

Methods

MLP has left a significant legacy of her ideas and policy proposals, which can be found in the acquis of the Caring for the Future Foundation, institution founded by herself in 2001¹³13 Pintasilgo ML. Para um novo paradigma: um mundo assente no cuidado. Antologia de textos de Maria de Lourdes Pintasilgo. Porto: Afrontamento; 2011.^,1818 Fundação Cuidar o Futuro [internet]. Lisboa: Cuidar o Futuro; 2019 [acesso 2019 maio 18]. Disponível em: https://fundacaocuidarofuturo.pt/fundacao/.
https://fundacaocuidarofuturo.pt/fundaca... . According to MLP,

However, the common thread for us to learn a little about life and work of MLP, as well as texts written by her and her commentators/interpreters, was the story of a person very close to her, Dr. Margarida Santos (MS), currently president of the Caring for the Future Foundation, which has known her since university studies and accompanied her for most of her life trajectory. The purpose of interviewing MS was to understand ideals and political actions of MLP through aspects of her daily life trajectory, rather than listing her accomplishments recorded in academic and/or journalistic documents and texts.

In this sense, there were three meetings with MH at the Foundation's headquarters, marked by her great sympathy and availability, which were recorded in field diaries aiming at the production of a narrative about such MS experience with MLP. These notes took the form of a text that was later returned and revised by her own comments, generating the final version of this narrative¹⁹19 Capozzolo AA, Casetto SJ, Imbrizi JM, et al. Narrativas na formação comum de profissionais de saúde. Trab Educ Saúde [internet]. 2014 [acesso em 2019 maio 18]; 12(2):443-56. Disponível em: http://dx.doi.org/10.1590/S1981-77462014000200013.
http://dx.doi.org/10.1590/S1981-77462014... ^,2020 Muylaert C, Sarubbi Jr V, Gallo P, et al. Entrevistas narrativas: um importante recurso em pesquisa qualitativa. REEUSP [internet]. 2014 [acesso em 2019 maio 18]; 48(esp2):184-9. Disponível em: http://www.revistas.usp.br/reeusp/article/view/103125.
http://www.revistas.usp.br/reeusp/articl... .

The construction of a mosaic of affects and itineraries

The discovery of MLP and her legacy came from a research internship at the Center of Philosophy of the University of Lisbon under the mentorship of Professor Maria Luisa Ribeiro Ferreira, through whom it was possible to obtain initial contributions on the ethics of care, especially by feminist aspect²¹21 Ferreira MLR. A dinâmica da razão na filosofia de Espinosa. Lisboa: Fundação Calouste; 1997..

Scholar of Spinoza, the Professor approaches the ethics of care through the valuation of affects as an important dimension for the work of reason itself. Spinoza's thought helps us understand the role of desires in the life impulse of subjects and their role in the constitution of reason. The idea is not to establish a mechanistic relationship between reason and affect, but to understand that desire, as Ferreira²¹21 Ferreira MLR. A dinâmica da razão na filosofia de Espinosa. Lisboa: Fundação Calouste; 1997.⁽⁴⁵³⁾ states,

According to Carrilho²²22 Carrilho MMR. A fundamentação filosófica das noções de cuidado e de responsabilidade no pensamento de Maria de Lourdes Pintasilgo [tese]. Évora (PT): Universidade de Évora; 2015. 458 p. [acesso em 2019 maio 18]. Disponível em: https://core.ac.uk/download/pdf/62470382.pdf.
https://core.ac.uk/download/pdf/62470382... , desire, for MLP, gave rise to

In the first meetings with Professor Maria Luisa, I was pleased to meet Maria Fernanda Henriques, professor at the University of Évora and a feminist scholar. She brought other references about MLP, especially due to her involvement with the Caring for the Future Foundation and the Grail. This latter Catholic institution is born with the proposal to defend women's rights.

In addition, Professor Maria Fernanda has organized a special issue of MLP magazine 'Ex aequo'²³23 Dossier: Maria de Lourdes Pintasilgo, cinco anos depois. Ecos de Palavras dadas. Ex aequo [internet]. 2010 [acesso em 2019 maio 18]; 21:5-185. Disponível em: http://www.scielo.mec.pt/scielo.php?script=sci_issuetoc&pid=0874-556020100001&lng=pt&nrm=iso.
http://www.scielo.mec.pt/scielo.php?scri... which deals with different aspects of her life and work. Right at the presentation of this magazine issue, she said about MLP:

Care, as a cornerstone of MLP practices, was the result of changes and refinements of her thinking, since, in the 1960s, she advocated love as the basis for understanding the nature of human relationships. The issue of care strengthens as a more recent strand of her thinking in the 1980s. It catalyzes a repertoire in which feminist ethics provides the necessary argumentation to ground caring as a universal attribute, such as the need for all to care and be cared for¹³13 Pintasilgo ML. Para um novo paradigma: um mundo assente no cuidado. Antologia de textos de Maria de Lourdes Pintasilgo. Porto: Afrontamento; 2011.^,2222 Carrilho MMR. A fundamentação filosófica das noções de cuidado e de responsabilidade no pensamento de Maria de Lourdes Pintasilgo [tese]. Évora (PT): Universidade de Évora; 2015. 458 p. [acesso em 2019 maio 18]. Disponível em: https://core.ac.uk/download/pdf/62470382.pdf.
https://core.ac.uk/download/pdf/62470382... .

In this sense, Ramos²⁴24 Ramos MIS. Para um novo paradigma: um mundo assente no cuidado. Antologia de textos de Maria de Lourdes Pintasilgo. Ex aequo [internet]. 2013 [acesso em 2019 maio 18]; 27:152-5. Disponível em: http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S0874-55602013000100012&lng=pt&nrm=iso.
http://www.scielo.mec.pt/scielo.php?scri... emphasizes that one of the action axes of MLP referred to women, equality and parity democracy. This axis represents a fruitful starting point for MLP as, while valuing a female culture, even unintentionally matching the male model, she brings, in this discussion, the importance of care inspired by a female model.

In this line, she expands the form of human action, regardless of gender. As a result, she forges new ways of doing politics and governance.

Right at the beginning of her report on the life trajectory of MLP, MS highlighted two guiding factors in her practices: one refers to the struggle for women's rights; and another, the fight against social inequality. In turn, this feminist reference was initially recalled by the impasses experienced by MLP as a chemical engineer, graduated in 1953 by the Higher Technical Institute, a place where she had a predominantly convivial relationship with men.

This resourcefulness accompanied the trajectory of MLP in other spaces of power, predominantly male. In 1975, through Decree-Law nº 47/75 of February 1st, she implements, as Minister of Social Affairs, the Commission for the Feminine Condition, according to report of MLP²⁵25 De Souza MR. Cronologia da vida e obra de Maria de Lourdes Pintasilgo. Ex aequo [internet]. 2004 [acesso em 2019 maio 18]; 12:45-57. Disponível em: https://exaequo.apem-estudos.org/files/2017-11/artigo-11-maria-r.-souza.pdf.
https://exaequo.apem-estudos.org/files/2... :

In the 1990s, MLP chaired the Independent Commission on Population and Quality of Life (ICPQL), under the aegis of the United Nations, with the main objective of developing a new vision on international issues of populations based on the human rights framework and socioeconomic conditions. In 1998, ICPQL published the 'Caring for the Future' report, which expressed concerns about the relationship between preserving the environment and improving the living conditions of people in socially vulnerable situations. They are still current questions regarding sustainable development related to poverty eradication²⁶26 Objetivos de Desenvolvimento Sustentável. Transformando nosso mundo: a Agenda 2030 para o Desenvolvimento Sustentável [internet]. 2015. [acesso em 2019 maio 18]. Disponível em: https://nacoesunidas.org/wp-content/uploads/2015/10/agenda2030-pt-br.pdf.
https://nacoesunidas.org/wp-content/uplo... .

Rego²⁷27 Rêgo MC. Um pensamento novo. Ex aequo [internet]. 2005 [acesso em 2019 maio 18]; 12:139-48. Disponível em: https://exaequo.apem-estudos.org/files/2017-11/artigo-19-maria-do-ceu-rego.pdf.
https://exaequo.apem-estudos.org/files/2... highlights with much esteem and some nostalgia the role of MLP in the International Committee of Experts to discuss structural changes in Europe from the perspective of the role of women. Human rights were expected to be problematized as to how they benefit people, especially women, that is, it was sought to rearticulate civil, social and political and economic rights, and these meanings are associated with changes in the world of work.

The obstacles to the innovations proposed in this line refer to injustices and differentiations between male and female, including differences in remuneration, as well as the social roles of both. This Committee of Experts report, of 1991, points out the perversity of part-time work approval for women, as many made such an option to try to reconcile family and home-care functions, creating more burdens. It also refers to the need for a discussion of the life plans of families. Rego²⁷27 Rêgo MC. Um pensamento novo. Ex aequo [internet]. 2005 [acesso em 2019 maio 18]; 12:139-48. Disponível em: https://exaequo.apem-estudos.org/files/2017-11/artigo-19-maria-do-ceu-rego.pdf.
https://exaequo.apem-estudos.org/files/2... recalls MLP expression of the fundamental right to care: caring is the basis of social action, as it seeks attention to the concrete needs of individuals and groups.

According to MS, her friend was never intimidated by the different types of oppression, especially because she held positions traditionally held by men: it is important to note MS's emphasis on the main strategy that MLP used to obtain subsidies for the development of her projects, that is, to consult people where they lived directly through what she called public hearings. The proposal for public hearings was described in the project document entitled: Listening to the present, caring for the future: honoring Maria de Lourdes Pintasilgo; event commemorating the 40th anniversary of the institutionalization of the Commission for Women's Condition – currently the Commission for Citizenship and Gender Equality. According to the MS report, hearings took place as follows:

The predisposition of MLP to being together and listening to each other is notorious. This attitude brings us rich elements about processes of social participation as a tool for building citizenship, based as a parameter of modes of socialization and citizen coexistence²⁷27 Rêgo MC. Um pensamento novo. Ex aequo [internet]. 2005 [acesso em 2019 maio 18]; 12:139-48. Disponível em: https://exaequo.apem-estudos.org/files/2017-11/artigo-19-maria-do-ceu-rego.pdf.
https://exaequo.apem-estudos.org/files/2... .

In this sense, the report of MS, as well as of others, revealed MLP's concern with maintaining ties with people despite the tribulations of public life. She struggled to be present in the lives of those close to her, especially at the most difficult times. She reported, deeply moved, the companionship of MLP at some of these moments.

According to Rocha-Cunha²⁸28 Brasil. Ministério do Desenvolvimento Social, Secretaria Nacional de Assistência Social, Departamento de Proteção Social Básica. Concepção de convivência e fortalecimento de vínculos [internet]. Brasília, DF: Ministério do Desenvolvimento Social; 2017 [acesso em 2019 maio 18]. 77 p. Disponível em: http://www.mds.gov.br/webarquivos/publicacao/assistencia_social/Cadernos/concepcao_fortalecimento_vinculos.pdf.
http://www.mds.gov.br/webarquivos/public... , the idea of politics advocated by MLP is associated with the issue of people's well-being, including with a view to caring for new generations. Politics proves to be a field for facing challenges that encompass deep discussions, highlighting this idea of changing the world of life. There is a bolder perspective of change that encompasses the senses and meanings that govern people's way of life.

We note that there is an experience of emptying politics in the postmodern era in which the protagonists of politics, including social organizations, come in the wake of a crisis of State legitimacy, expressed by representative politics, for which people no longer feel represented³⁰30 Gohn MG. Movimentos sociais na contemporaneidade. Rev Bras Educ [internet]. 2011 [acesso em 2019 maio 18]; 16(47):333-61. Disponível em: http://dx.doi.org/10.1590/S1413-24782011000200005.
http://dx.doi.org/10.1590/S1413-24782011... . There is also an exacerbation of a financial capitalism in which people become the objects of a perverse mechanism of devaluation of life. Rocha-Cunha speaks of an anguish generated in a crazy routine²⁹29 Rocha-Cunha S. Dilemas & problemas do político numa era de vencedores: duas derivas (in)tempestivas a propósito de alguns pensamentos de Maria de Lurdes Pintasilgo. Ex aequo [internet]. 2005 [acesso em 2019 maio 18]; 12:127-38. Disponível em: https://exaequo.apem-estudos.org/files/2017-11/artigo-18-silverio-cunha.pdf.
https://exaequo.apem-estudos.org/files/2... . In paraphrasing H. Arendt, man is thrown back on himself as in a soliloquy that isolates him from his achievements as a human race, resulting in a heightened sense of powerlessness²⁹29 Rocha-Cunha S. Dilemas & problemas do político numa era de vencedores: duas derivas (in)tempestivas a propósito de alguns pensamentos de Maria de Lurdes Pintasilgo. Ex aequo [internet]. 2005 [acesso em 2019 maio 18]; 12:127-38. Disponível em: https://exaequo.apem-estudos.org/files/2017-11/artigo-18-silverio-cunha.pdf.
https://exaequo.apem-estudos.org/files/2... ^,3030 Gohn MG. Movimentos sociais na contemporaneidade. Rev Bras Educ [internet]. 2011 [acesso em 2019 maio 18]; 16(47):333-61. Disponível em: http://dx.doi.org/10.1590/S1413-24782011000200005.
http://dx.doi.org/10.1590/S1413-24782011... .

The promotion of good encounters enables the strengthening of social participation, and its weakening is associated with the predominance of sad affects, according to the referential of Spinoza¹1 Bock AMB, Gonçalves MGM, Furtado O, editores. Psicologia sócio histórica: uma perspectiva crítica em psicologia. São Paulo: Cortez; 2007.; This is so because the spaces of social movements should be places of cultivation of friendship and exchange of experiences among people³¹31 Ferreira MLR, editor. As teias que as mulheres tecem. Lisboa: Colibri; 2003., because the social movement, seen as a place of seeking justice, implies that people worry about each other. The absence of affection would be the basis of indifference among people regarding pain. The turning to the human has on affection its basis, since changing life means valuing compassion and complicity among men. This affection immediately gives rise to a transformative action, since giving voice and listening to another opens new paths¹⁵15 Boff L. Saber Cuidar: ética do humano-compaixão pela terra. 20. ed. Petrópolis: Vozes; 2014.^,3232 Sawaia B. As artimanhas da exclusão: análise psicossocial e ética da desigualdade social. 14. ed. São Paulo: Vozes; 2014.

33 Ortega F. Genealogias da amizade. São Paulo: Iluminuras; 2002.^-3434 Técnico Lisboa. Prémio Maria de Lourdes Pintasilgo 2017 [internet]. Lisboa: Técnico Lisboa; 2017. [acesso em 2019 maio 18]. Disponível em: https://tecnico.ulisboa.pt/pt/noticias/campus-e-comunidade/premio-maria-de-lourdes-pintasilgo-2017/.
https://tecnico.ulisboa.pt/pt/noticias/c... .

MLP, since she was 14 years old, according to MS, when she was in Secondary school, was involved with groups of students; and at the university, also with the student's guild. In 1956, she participated in the Catholic University Youth and was vice president of the International Grail Foundation, from 1963 to 1968. MLP faced several obstacles with more conservative church wings, yet it is an entity that maintains an identity of its own.

From the perspective of the defense of human rights, MLP, according to Ramos²⁴24 Ramos MIS. Para um novo paradigma: um mundo assente no cuidado. Antologia de textos de Maria de Lourdes Pintasilgo. Ex aequo [internet]. 2013 [acesso em 2019 maio 18]; 27:152-5. Disponível em: http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S0874-55602013000100012&lng=pt&nrm=iso.
http://www.scielo.mec.pt/scielo.php?scri... , asked about the relevance between what is provided for by law and the possibilities of its realization. She perceived the issue of human rights as an often abstract reference to people, that is, it reflected little on people's daily lives, especially those who suffer from prejudice and discrimination.

In this discussion, the issue of power has become an important axis for the materialization of rights, especially with regard to the power over things and people, inaugurating, in this perspective, the relationship between men and nature. Furthermore, the issue of the environment enters into the perspective of a compromised citizenship, which also implies duties, using the notion of responsibility of Hans Jonas³⁵35 Jonas H. O princípio responsabilidade: ensaio de uma ética para a civilização tecnológica. Tradução Lisboa M, Montes LB. Rio de Janeiro: Contraponto, PUC-RJ; 2006..

In this line, quality of life was an important theme for MLP and brought together reflections and criticism of a neoliberal way of life that aroused individualism and the commodification of life. According to Ramos²⁴24 Ramos MIS. Para um novo paradigma: um mundo assente no cuidado. Antologia de textos de Maria de Lourdes Pintasilgo. Ex aequo [internet]. 2013 [acesso em 2019 maio 18]; 27:152-5. Disponível em: http://www.scielo.mec.pt/scielo.php?script=sci_arttext&pid=S0874-55602013000100012&lng=pt&nrm=iso.
http://www.scielo.mec.pt/scielo.php?scri... , there was concern about the importance of science and technology as a form of mediation of human relations and ethical-moral values. Mediation by technique would bring a difference between knowing and 'knowing how to do', including the need for scientific and technological literacy.

These questions bring us back to the importance she gave to the responsibility of people for the world they are creating and leaving for the new generations. According to MLP, this responsibility would paradoxically lead us to freedom. In the ethics of responsibility, would be the root of freedom. MLP criticized the excess of technologization of our modern society which, combined with the neoliberal model, makes people more individualistic and less concerned with others and the environment. Based on Hans Jonas³⁵35 Jonas H. O princípio responsabilidade: ensaio de uma ética para a civilização tecnológica. Tradução Lisboa M, Montes LB. Rio de Janeiro: Contraponto, PUC-RJ; 2006., she advocated for co-responsibility by establishing a two-way relationship in which people should care about the legacy they leave for new generations.

In the report of MS, while MLP proved to be an extraordinary figure, determined and sure of her ideals, there were also moments of greater fragility in which she had to protect herself. Especially when working at the Secretariat of the International Grail Movement, from 1964 to 1969, (at that time vice president) in Paris, she returned to Portugal to take care of her health. In those moments, MLP enjoyed visiting the outskirts of Lisbon enjoying nature, especially the pine forests, and crocheting.

Embroidery, according to MS, was also a way for MLP to energize for her struggles. MS says that, in a tribute to our character in the city of Fafe, there was an exhibition of her personal belongings. In it, they exposed her embroideries that, for MS, represented much of her personality due to the concentration, firmness and precision that such activity required. This metaphor can reveal an intimacy, that, at the same time humanizes, regarding the need for self-care and, at the same time, strengthens the principles of a plot for an ethical-political commitment to collective well-being.

This reminder of MS about embroidery gives rise to a rich image of a typical female universe activity, while reinforcing an important human characteristic for the exercise of attentive and sensitive care. Moreover, this activity of embroidery reveals the need to make firm and precise lashings to produce a strong web.

In this sense, we give ourselves the freedom to paraphrase the proposal of Ferreira³¹31 Ferreira MLR, editor. As teias que as mulheres tecem. Lisboa: Colibri; 2003. when in her text 'The webs of affections' mentions Spinoza regarding the situation of women in politics. For Spinoza, ethics, being the warp for understanding the constitution of the first substance, would provide an understanding of the modes of existence of beings. As the author puts it: “Deciphering the infinite web of modes is an arduous task. It is achieved by those who have penetrated the fullness of the substance”³¹31 Ferreira MLR, editor. As teias que as mulheres tecem. Lisboa: Colibri; 2003.⁽¹⁹⁴⁾. To conclude, leaving an image of the maxim that guided the practices of MLP, we evoke Ferreira's speech about this articulation between Spinoza and the female condition:

Final considerations

The perspective of practices in primary care, especially in the FHS, places us more intensely in people's daily experiences. Even in territories marked by social exclusion, the health issue is much more complex because social determinations raise a broader understanding of health and its relationship to people's way of life.

A better understanding of the meanings and senses of care provides us with clues to the problematization of a professional attitude based on welcoming and sensitive listening. Thus, in addition to a normative, technical guidelines, we consider that the ethical-political dimension gives rise to the problematization of care, as far as, by socio-historically contextualizing health actions, it denaturalizes them.

Into this perspective, we consider it appropriate to value and disseminate the public policy proposals referenced in the thinking and life trajectory of MLP. The former prime minister of Portugal built an important legacy based on actions that combat social inequality, raising the flag of human rights, specifically in defense of women. More than the struggle for equal rights, she had the vision that the female universe could bring new answers to questions from a society undermined by the fraying of human relations, exacerbated competitiveness and consumerism.

Acknowledgments

To Maria Luísa Ribeiro Ferreira, Full Professor of Modern and Contemporary Philosophy at the University of Lisbon, Faculty of Letters. Dedicated to female and gender studies.

To Fernanda Henriques, Emeritus Professor, from the Philosophy area, of the University of Évora. She created and was Director of the Master in Gender Issues and Education for Citizenship.

To Dr. Margarida A. Santos, President of Caring for the Future Foundation.

References

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