THE SILENCE OF WHITENESS IN CLINICAL AND FORMATIVE GUIDELINES OF PRIMARY HEALTH CARE

Abstract

This article analyzes how racial debate, with a focus on whiteness, is presented -- or absent -- in the political, formative, and technical documents that guide the practice of Family and Community Medicine (FCM) in the municipality of Rio de Janeiro (MRJ). A qualitative documentary research was conducted of the following texts: the National Policy for Comprehensive Health of the Black Population (PNSIPN), the National Policy for Basic Care (PNAB), the Competency-Based Curriculum of the Brazilian Society of Family and Community Medicine (SBMFC), and technical protocols of the Municipal Health Secretariat of Rio de Janeiro (SMS-RJ). The results identify a critical disruption between equity policy (PNSIPN) and technical documents: while central-level policy recognizes racism as a health determinant, municipal guidelines and evidence-based formative curriculum operate under a logic of care universalism. Whiteness remains invisible and normative; both silence racism as a social determinant in clinical protocols. Finally, it is concluded that the absence of racial literacy in technical documents, in contrast with PNSIPN, perpetuates institutional racism and the narcissistic pact of whiteness in medical training and practice.

DOI: https://doi.org/10.56238/sevened2026.009-013