Medicine, values and communication

Salvador Casado

Modern medicine has achieved a spectacular development in the last century in parallel with the rest of society. Spurred on by science and technology it has managed to overcome ambitious goals and shines proudly on the basis of its achievements. Unfortunately, there is a long shadow that contains burdens and threats. Inequalities in health, overdiagnosis and overtreatment, iatrogeny, the progressive dependence of citizens on health systems are increasingly present realities.

Illustration by Paula Alvear, from the poems Arconte Enfurecido

On the other hand, private health systems and the enormous conglomerates of pharmaceutical and technological industries based on profit seek interests that are increasingly distant from the common good. In the face of these interests, public health systems are slowly collapsing due to under-funding, cutbacks and the chronic overloading of their professionals. Everyone agrees on the complexity of managing alternatives but no one dares to implement them. Meanwhile, the public health systems are melting like butter as services are outsourced, professionals working conditions get worse or units are reconverted and closed (Public Health and others).

The situation is one of deadlock, since there is no politician who wants to risk taking steps that will not yield a profit in votes, there is no manager who dares with new models, there is no professional who has the possibility to change the entire system and there is no user who does not want more for less. 

For these reasons, it may be necessary to look at the problem from a new perspective.

The current paradigm of the medical sciences has a scientific basis. However, on the one hand we are witnessing a corruption of science manipulated by commercial interests and on the other hand a search for greater efficiency that leaves aside factors as important as the humanists. 

It is true that progress implies increasing economic benefit and well-being, but if we dare to bring ethical progress into the equation we will have to manage to increase compassion. 

It is time to review values. And from among them we must choose what is most valuable so that it serves as a compass and we stop wandering, lost and dazed, within markets that boggle us with their messages and prevent us from clarifying what is truly relevant to us. Axiology has both a personal and a social component, the former being intimate, the latter public. Today, social values are conditioned by the interests of the market, which dominates both the economic and political spheres. 

Individualism and competition benefit, "more is better", consuming everything one can afford, "me first, then the others", lowering prices even if it is to the detriment of producing workers. The winner takes all and the big fish eats the small one. This is the world we have built with a handful of industrial conglomerates that are increasingly powerful. 

Health services will end up being abducted by these conglomerates, which will be able to offer them at a lower cost thanks to the intensive use of technology and the precarisation of health professionals. 

The only thing that can reverse this trend is the social awareness of the value of things. What is the value of health in my life? How would I like to be treated when I am ill? Do I want to be associated with machines, teleoperators or stressed health professionals or by professionals who can dedicate the time of quality care that I need?

But what society will be able to face these challenges without culture, reflection and dialogue? That is why more than just complaining, no matter how justified it may be, it is more and more urgent to favour dynamics that promote correct information, critical vision and awareness.

Ethics, communication and narrative can help. Turning the complexity of the health debate into a language understandable by society in general will determine whether the ship holds out or ends up sinking. 

@doctorCasado

Link to blog "La consulta del Doctor Casado"