14 December 2001
The document sets out to explore the bioethical issue of the aims of medical science and its limits. The ICB urges intensification of a constant dialogue between medicine and society, first of all with the sick themselves, who must be informed and made conscious of the possibilities, but even of the risks intrinsically linked to medical progress. The opinion highlights the importance of a greater awareness of the complexity of the phenomena which medical science deals with and the inevitable dose of empiricism that characterizes its continual evolution, in order to avoid on the one hand miraculous expectations and on the other unscientific positions.
The increasingly important role that medicine plays in modern society implicates for physicians, apart from an obvious professional responsibility, also the duty to carry out constant self-examination regarding one’s principles and methodologies. The shift in terms of importance that has come about in recent years, from the physician in favour of the patient brings the Committee to hope for a balance between the autonomy of the patient and the responsibility of the physician, determining in this way, the so-called therapeutic alliance. According to the ICB the aim of medicine to provide comprehensive care must be continuously brought to the direct attention of the community as a primary ethical problem. Purposefully, the ICB reiterates its position supporting healthcare policies based on the principles of solidarity and fairness.
Modern scientific medicine – in its fight against illness requires increasingly vast public and private resources to allocate to research – it cannot afford to operate, as it did in the past, by means of unreasonable and imprudent attempts. Experimentation being necessary, the informing of the patient assumes particular importance, in order to achieve free and conscious consent, even as regards the acceptance of risk.
The ICB considers of bioethical importance the identification of ethically acceptable limits to medical services even in the light of the distinction between “medical act” and “therapeutic treatment” which is becoming increasingly ephemeral as is seen by the spread of cosmetic surgery, which is also often liable to the risk of serious complications. Therefore, the public and law–makers need to give serious thought to the choice between acceptance of such practices in respect of freedom of treatment – despite the frequent risk of falsification and deception – and their direct verification through in depth and objective analysis and further experimental tests. In this process, bioethical analysis must undertake to critically examine the boundaries between scientific medicine and other medical practices, as well as the real possibilities and limits of scientific medicine itself.
Lastly, the ICB reiterates as a first priority the formation of healthcare personnel in the present context, revealing in particular the need for this formation to be of an ethical and deontological nature as well as technical and scientific, principally in order to recognise the sick in their personal and human dimension, even before consideration of the clinical aspect.