The new ethical dilemmas in medicine of the 21st century

This article was exclusively written for The European Sting by Ms. Bárbara Okabaiasse Luizeti, a 20 year old third year medical student from Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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In the field of medicine, the sixteenth century was consecrated with the birth of human anatomy, the seventeenth century called the cradle of physiology, the nineteenth of scientific bases, from advances in chemistry, physics and biology; and the twentieth century was considered the century of innovation, with the inauguration of biotechnology and the discovery of DNA (Deoxyribonucleic acid) by James Watson and Francis Crick in 1953. Nowadays, in the 21st century, the so-called “techno-scientific revolution”. The breadth of the new knowledge of genomics, immunology and nanotechnology, coupled with innovation in the field of fine chemistry, determine the appearance of new vaccines, drugs, surgical techniques, assisted reproduction and gene therapy. Through all these scientific-technological advances, there are three great human utopias: the eternity/longevity, the beauty and pleasure (by the appearance of new drugs that suppress the pain and promote physical and psychic pleasure). Medicine is daily on the frontier of moral responsibilities, determined by the process of increasingly aggressive intervention of man in the biosphere, accelerating its deterioration, and intervention in the very essence of the human being. In addition, during the history of Medicine, there have always been ethical dilemmas, such as the confidentiality and privacy of medical information. However, with the evolution of this science, technological innovations in medical care practice constantly generate new ethical impasses. It is worth emphasizing that in the health sector, innovation should aim to improve the quality of life of people, through the use of products and procedures to prevent diseases or eradicate them. Therefore, the techniques that impose moral and ethical dilemmas must be analyzed by researchers, physicians and medical students in the areas of safety, efficiency, social repercussion and improvement in relation to traditional treatment, that is, to promote a better effect in the process of health and illness of the patient, corresponding to the principle of beneficence. Awareness of an ethics of responsibility must be developed, both at the individual level and at institutional and government levels, exemplified through legal, bureaucratic and protocol regulations. Modern technologies will only be fully justified if they are conditioned to an effective improvement in the quality of life and health of the human being, and not to represent a form of domination and usurpation of the medical culture by the machine, or by subjecting the patient to the ideology of scientism or market logic. It is necessary to critically review the goals and values ​​that govern the medical profession, in addition, it is necessary to abolish the ideology of healing illness or maintaining the patient’s life, at any cost, even after all the biological possibilities for maintenance have been exhausted quality of life. In this regard, Palliative Medicine proposes to reflect on measures related to euthanasia and dysthanasia, as well as to orthothanasia, that is, the humanized medical practice, which allows the natural death, dignified, and without suffering to the patient. There must be a balance between the technical-scientific side and the human values ​​and virtues inherent in the medical profession. About the author Bárbara Okabaiasse Luizeti is 20 years old and a third year medical student. She is working as Vice President of the Miguel Nicolelis Academic Center, LPR-D (Local Officer on Publications and Research Director) and Director of the Nucleus of Scientific Research at IFMSA Brazil UniCesumar. She is the Vice President of the Academic League of Ophthalmology and Otolaryngology of Maringá (LAOOM) and member of the Academic League of Pediatrics of Maringá (LAPEM). She has always been dedicated to helping vulnerable populations from extracurricular projects, and disseminating health information to lay people and academics.