publicado em 22/01/2013 às 19h51:00
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The doctor-patient relationship in a time of individualism

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Foto: SBB
José Eduardo Siqueira, a physician and member of the Technical Chambers of Assisted Reproduction and Bioethics Council Regional Medical Paraná
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José Eduardo Siqueira, a physician and member of the Technical Chambers of Assisted Reproduction and Bioethics Council Regional Medical Paraná

Much has been talked about advances in medicine that has, through new therapeutic approaches in the fields of knowledge previously reserved to the territory of science fiction. Paradoxically, we found that, while the company receives promises of long and healthy life, the figure of the doctor becomes less valued and, increasingly, we see society clamoring for humanization of medicine. How to explain this puzzle? Were professionals malformed and without adequate field of new technologies?

The answer seems to be negative. However, it is impossible to deny that the doctor-patient relationship is significantly compromised. Grows more significantly the number of complaints against doctors and adjudicative activity of Boards of Medicine shows that 70% of ethical processes instituted, deriving from inappropriate intersubjective relationship between these actors. It is certain, moreover, that a society dominated by individualism, where human beings lost their status as subjects, bearer of dignity and worthy of respect, there are many factors that can be presented as causing this catastrophe relational.

Some thinkers, among them the Polish sociologist Zygmunt Bauman, define the malaise of postmodernity times as liquid as a result of the dissolution of all solid values ​​that accompanied us throughout our history. Without pretending to exhaust all the complex causes of unsatisfactory doctor-patient relationship, we consider three that seem paramount.

The first, not because it is the most important, but hold greater visibility, is represented by the negative influence that the pharmaceutical companies and medical equipment have on the therapeutic professionals. These facts undoubtedly harmful, do not justify hasty judgments demonization of the aforementioned companies, because the rules imposed by society require them to market competitive attitudes, not always lined with ethics.

The copy of May 5, 2003 the British Medical Journal Magazine was entirely dedicated to exposing conflicts of interest that permeate the relationship between doctors and pharmaceutical companies and equipment. All these facts are well known and monitored responsibly by Medical Boards, who have practiced effective control over possible breaches of conduct of professionals.

The two other factors that will mention below, though less visible, are core elements of the crisis of values ​​prevailing in society today. The first, very well analyzed by thinkers like Ernst Jünger, Martin Heidegger and Hans Jonas, is the society in which the technique occupies a privileged position and live with people subjulgadas the domain of a technological veil, thus assuming the status of an end in itself. In this model, people fail to realize that biotechnology is just an extended arm of science and therefore complementary to the professional reasoning.

It is not known exactly how the fetishization of technique imposes itself upon human psychology and where it is possible to identify the boundary between rational interaction and unjustified overestimation. What is certain is that the fascination with technology dominates the whole society, including doctors and patients, which caused Berkley cunhasse the mantra that seemed most representative of human behavior in postmodernity: I like nice equipments. Inherited from the twentieth century's most extraordinary development of biomedical technology that dominated our minds and hearts, to the point that we underestimate the clinical reasoning, devoting disproportionate credence to biotechnoscience. Bernard Lown, professor emeritus at Harvard Medical School, in The Lost Art of Healing, deplores the excessive emphasis that schools employ medical professionals in training, he said, are mere officers largest science and biotechnology complex managers, disregarding the genuine art of being a doctor. The most disconcerting to this situation is that it seems increasingly remote the possibility of recognizing that technology is obviously good, however, can be harmful if used unwisely and reckless.

The last variable, perhaps the most complex and deserves more attention. These are the moral choices we make petty led by misguided principle that everything should be subordinated to the sovereignty of personal will. Individualization, loss of sense of solidarity, seems to be the most important factor divisive society. The agenda of modern society is hostage to the autocratic control of freedom of individual choice guided by the equation I can - I want - I do, which made us lose the ethical reference fraternity and as a consequence, we left to reflect on three questions Kantian ethics that guide the behavior of every human being: What is man? What should I do? What I may wait for my actions?

Study of UNESCO, held in Brasília, in which respondents were middle-class youth, subjected to an inquiry into the practice of moral values, it was found that, in their perception, humiliate transvestites, prostitutes, beggars and homosexual behavior would be less severe when compared the graffiti from public buildings, public telephones or destruction of signs of transit, 20% of respondents considered unjustifiable any form of punishment due for the outrages imposed on persons mentioned.

Increasingly becomes more necessary to meditate on the question presented by Emmanuel Levinas: How can these guys crave a humanity and membership status if not look on the face or look up so soon? According to the philosopher will be endowed with humanity to the extent that we welcome all those around us as biopsychosocial and spiritual beings and accept the responsibilities arising from this relationship under the aegis of the ethics of face.

Source: CFM
   Palavras-chave:   Doctor patient relationship    Humanization    José Eduardo de Siqueira   
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