The Federal Public Ministry (MPF) recommended that a doctor working at the Francisca Xavier Basic Health Unit in Feijó (AC) not deny, condition, postpone, or interrupt the care of indigenous patients due to lack of CPF, National Health Card, or any other document. The recommendation was issued after the refusal to attend indigenous people from the Madijá people who had gone to the unit on October 26, 2026.
According to the MPF document, the indigenous people had been brought to the unit for medical care previously coordinated with the municipal health authorities, within the Txai Project. At the location, patients without a CPF would not have been attended to.
The unit's coordination informed that the orientation was to carry out the care with registration in a physical file when it was not possible to carry out the electronic registration. However, the doctor initially refused to attend the patients, claiming that there were too many and that the care would take a long time. The Municipal Health Department confirmed the refusal to the MPF and informed that it had already instructed the unit to carry out the care.
The recommendation establishes that the doctor must record the care of indigenous patients in a physical file whenever it is not possible to make the electronic registration. The MPF warns that non-compliance may lead to the adoption of judicial and administrative measures to investigate responsibilities in the penal, civil, administrative, and professional-ethical spheres.
Possible criminal consequences
The document clarifies that the refusal to provide care to indigenous patients may, depending on the circumstances, constitute the crime of ethnic discrimination or prejudice, as provided for in Article 20 of Law No. 7.716/89. Possible occurrences of the crimes of omission of assistance and of conditioning of emergency medical-hospital care, as provided for in Articles 135 and 135-A of the Penal Code, may also be evaluated, depending on the clinical condition of the patients.
The recommendation does not state that these crimes have been proven. It indicates legal hypotheses that may be the subject of investigation, according to the facts and circumstances identified. In the professional field, the Public Ministry highlights that the Code of Medical Ethics prohibits the discrimination of patients and requires the preparation of a medical record for each person attended. The Regional Council of Medicine of Acre will receive a copy of the document for information and adoption of the appropriate measures.
Measures for the Municipal Health Department
The Public Ministry also recommended to the Municipal Health Department of Feijó that, within ten days, formally instruct all municipal professionals, including doctors, nursing staff, community agents, receptionists and staff of the registration sectors, about the right of indigenous people to care even without documents.
The department must prove that each professional received the instructions and relevant technical documents. Within five days, a notice must be posted in the reception areas of all health units in the municipality, informing that the absence of documentation does not prevent the care of indigenous patients.
The municipal agency should also inform the Public Ministry (MPF) within ten days if the administrative procedure announced to investigate the refusal at the UBS Francisca Xavier has been initiated, and subsequently communicate the results.
The doctor and the municipal secretary of Health have five days to inform whether they comply with the recommendation, report the measures adopted, or provide the reasons for any non-compliance.
Care cannot depend on CPF
The Public Ministry (MPF) emphasizes that the right to health is universal and that the absence of CPF, National Health Card, or other document cannot be used as a barrier to access to the Unified Health System (SUS). The norms cited in the recommendation provide alternatives for recording care when it is not possible to perform electronic registration, including the use of a physical record.
The document also highlights the need for specific attention to indigenous peoples of recent contact, whose social, cultural, and geographical conditions require that health services be organized in a way that is appropriate to their realities. The requirement of documentation as a prerequisite for care, according to the technical guidelines cited by the Public Ministry (MPF), contradicts the current regulations.
The recommendation was signed by Prosecutor Luidgi Merlo Paiva dos Santos. The document warns that non-compliance may result in legal measures, including in the face of new occurrences attributable to the omission of the responsible parties.