Techno-ethics in the doctor-patient relationship

The IV Conference of Patients organized by SEMI.

Internal medicine doctors of the Spanish Society of Internal Medicine (SEMI) have discussed how it has changed, how it is and where the doctor-pacient relationship in the “IV Conference of SEMI Patients: New patterns in the XXI Century”. This is an event organized jointly by SEMI and by the Francisco Vallés Institute of Clinical Ethics.

During the course of the meeting, there was talk of Rights of patients, of respect for their autonomyof techno-ethics and how the technology has contributed to changing the relationship between doctor and patient, as well as the need to achieve a person-centered and humanistic medicine. In the current context in which we live, it has become clear that technology is a “very useful” tool that has been incorporated into clinical practice so that diagnostic and therapeutic procedures are more precise, but “it should not displace the essence of the doctor-patient relationship that is based on communication, affectivity and shared decision-making”.

The meeting has been inaugurated by Jesus Diez Manglanopresident of the SEMI, and for Arantzazu Alvarez de Arcaya, SEMI coordinator of patient relations and coordinator of the Hospital Medicine Clinical Management Unit of the San Carlos Clinical Hospital. Díez Manglano reiterated at the inauguration that for the medical profession in general and for specialists in Internal Medicine, in particular, “the voice of patients is and must be fundamental” and has emphasized the “comprehensive and holistic vision that characterizes the work of the internist”. Also in that “greater attention and dedication from the clinical field to the end-of-life process is urgently needed”, and in this sense, he recalled the consensus promoted by SEMI-SPMI on good practices in the end-of-life process.

In the words of Arantzazu Álvarez de Arcaya, SEMI patient relationship coordinator: “new technologies have changed the way we relate to each other and this is something that we all must learn to continue making a high value medicine based on affectivity. The challenge is to know how to integrate new technologies to promote humanistic medicine”.

The final stage of life for the patient

During the course of the day, reflections were made on the end of life process, a stage in which patients are in a situation of “great vulnerability”, both physical and psychological and even moral; “Not forgetting the family and those close to them, also very affected by the situation from an emotional and vital point of view.”

The importance of the humanistic medicine and that a clinical practice focused solely on evidence and data should be avoided. “The clinical relationship must be reoriented to effective communication between two people. Technology is important and necessary, as is respecting patient autonomy. However, the optimal thing is that someone is directing the whole process with common sense and clinical reasoning, that is, a good doctor. Otherwise, medicine would be reduced to just data and evidence. It would be reduced to a consumer good far removed from its true foundation: the best health care for patients”.

throughout the different tablesit became clear that technology has broken into our lives and has modified our knowledgeour behaviour and our way of relate. And in the environment in which we currently live, close to technolatry, reflections arise such as whether we should do everything we can do, and how to apply ethics to technology (techno-ethics). Technology solves social problems and, at the same time, is causing the need to rethink how we should act, redefine concepts and review the principles on which we base our actions. “It’s about avoiding the misuse of technology so that it doesn’t interfere with people’s well-being.”

The evolution of the doctor-patient relationship

The classic doctor-patient relationship was based on the charity. That is, thinking about what the doctors believed was the best for the patient, they decided for the patient himself. This created a type of relationship that has been called paternalistic. In the last decades the change has been radical, because the patients rights and, very especially, respect for their autonomy. This has completely transformed the clinical relationship pattern. An information-based model (informative model or pattern) has been proposed, in which doctor and patient exchange information and the patient decides. However, this model has shortcomings, because many patients want, in addition to information, the doctor’s advice. A doctor’s recommendation on what is best for him. This pattern or model has been called deliberative. In the deliberative relationship, doctor and patient exchange information, but also their opinions and assessments about what is best.

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.

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