Research in Medicine: a particular perspective
Let me - even to prevent this brief contribution to a conference that promises to be so full of ideas and thoughts, will move on paths, rather than discounted, of course - here the reverse concept of courtly "Search".
"The search for truth is more precious to possess," he noted that immediately after Albert Einstein added, "Imagination is more valuable than knowledge." These aphorisms, seemingly contradictory, outlining a speech on the intrinsic value of research that goes beyond its applications "practices" and that, unlike ideology, connotes a natural impulse, the very essence of mankind: curiosity. There are some other fulfillment that can invest Researcher: wealth, power, fame ... but nothing, absolutely nothing, can replace the adventure of discovery, the pleasure of seeing those that were vague inferences become conclusive experiments. Needless to say, especially in a society as complex as ours, that the scientific research in particular, and more medical, certainly can not be reduced to a mere delight of the researcher. Also because the fallout of a scientific discovery can be devastating.
Science - unfortunately or fortunately - is not pure. Science is already animated by an intention technique: watch the world change. "Scientia est potentia," said Bacon. Born hence, the need to reconcile the irrepressible need for a free search with the fallout of this on society, and the start of a whole series of philosophical musings and scientific considerations that are known as bioethics. Born in the seventies by the need to establish contact between scientific and humanistic culture, bioethics has quickly established itself as a vantage point on issues fundamental to the psychological and physical health and identity (birth, life, health, death) and those made more progress from the current biomedical (cloning, biotechnology, genetic medicine ...). Bioethics see the human being as an individual with of specific individual and as part of a system, natural and social, with which it is in continuous interaction. In it meets medicine, biology, ethics, philosophy, law, politics, for a complete analysis and interdisciplinary, respectful of the complexity of the human being. From this point of view of its relevance and its importance is enormous, at a time when science seems to have finally replaced all 'economy and politics as the driving force of history. But with what consequences? What are the risks? What chance of regulation and defense? And, above all, what is the relationship between scientific research and quality of life?
Bioethics is a new science called to respond all this, always placing at the service of man and his balance with the environment.
Bioethics is a young science. He has just over forty years, being born, at least as a term, in 1970, having as its perspective to build a bridge towards science and towards the future. It was groped to bridge the rift that was created between scientific knowledge, very advanced, and the humanistic and ethical, cultural categories related to old and outdated. Just to make this work of renewal and sewing, bioethics was established from the outset as a set of knowledge: the sciences, particularly biology, philosophical, ethical, what giuridico e, in ultima istanza, anche quello teologico. In questi anni, la bioetica si è rivelata una formidabile occasione di dialogo tra tutte queste discipline, partendo da una visione positiva della scienza.
Nessuna epoca della storia ha conosciuto un progresso scientifico neppure lontanamente comparabile, per velocità e risultati, a quello attuale. Inimmaginabili confini sono stati raggiunti e nuove straordinarie prospettive per la ricerca sono state aperte anche in biomedicina, oggetto specifico della riflessione bioetica. Grandi orizzonti si sono aperti anche in ambito terapeutico. Le ricadute tecnologiche di queste scoperte hanno però creato anche circuiti di business non sempre virtuosi. Giorno per giorno emergono sempre nuovi problemi etici, often distressing for the future of society, and a "quality" of life not only "nominally" human. On the other hand, innovation is often not so rapid as to give time for reflection ethical / philosophical really thought out, however, made difficult in our complex society, by contrast divergent anthropological references. Therefore, an urgent request for legislative oversight above, in many areas, an adequate reflection. An example? Theory and practice of human artificial insemination, in our country, where the "trade" is spreading in the absence of any rule. Add the tendency of many exhibition exhibitionist, trend that unfortunately does not save the world scientific and academic, loyal until yesterday, with some exceptions, the principles of confidentiality and measurement. Very often "discovered", real or imagined, is made available to the world not through the scientific journals, but using the media coverage of the major means of communication. The results are often trivialized versions, also with regard to sensitive issues and vital. So, in terms of human cloning, simple working hypotheses have recently been presented in the media as "scientific truth" and acquired as a possibility for solutions to serious ethical questions, prompting confusion in the professionals and illusory hopes for the general public. Even worse when
sensitive bioethical issues, such as the current "case Eluana", or use for scientific research of embryonic stem cells, become grounds for comparison, but not of confrontation, as happened in the referendum in three years ago on assisted procreation, referendum characterized, as is known, a conspicuously absent from the electorate. Absenteeism which - besides, of course, ethical and religious convictions, lack of interest, to resolve difficulties with a yes or no questions undoubtedly complex ... - Has, of course, weighed, still widespread mistrust of science.
From this point of view, what was seen as an "outcry" from the world of research, with the "fallen in the field" of many scientists, including two Nobel Prizes for Medicine in defense of embryonic stem cell research (in some cases, emphasizing their potential for therapeutic purposes) has come to cement large sectors of public opinion in sort of a conflict between science and humanism, a vision of science as a blind mechanism in pursuit, as the only purpose the satisfaction of the delusions of omnipotence of the scientist . To transcend the debate that has (poorly) animated the referendum has certainly contributed to a more limited scientific culture that characterizes our country. Yet we are daily inundated with massive amounts of "scientific" article, from newspapers, television, Internet ... But these items in the claim of making "news" at all costs fall or the demonization of science or the excessive promotion of innovative discoveries and treatments that they do still need several years of further training may be applicable on a large scale. In general
bad habit of depressing lack of communication between companies and research, we are seeing not only in Italy, did you act in a slight reversal, to promote relations of mutual understanding and trust between scientists and the public. This requires, however, in our view, a "Copernican revolution of two points of view of science: the first is to leave your Particular (and corporate economic interests, ideological beliefs rooted) to put in a perspective that considers primary as the general interests of national and international community with a "preferential option" for the categories and peoples and most vulnerable and least represented (at the level of mass media), the second is to make a choice of priorities for action also in the goals of scientific research.
past decades, the medical profession has undergone a radical transformation that has altered other aspects. One of the most important is certainly that about the relationship between doctor and patient, and more generally between medical art and society of the potential users. It is increasingly crediting an idea according to which the physician is a provider of work - as an architect or a plumber - on the market that offers its expertise and that, according to the requests, the physician should tailor its " supply "of services, without pretending to judge or in any way address the question that comes from the patient. A single thesis ends thus be assumed, especially in the biotechnology field: we need to meet any desire transforming medicine into a kind of "medicine of desires" He risks
as a prophylactic course divided into four stages: 1) technology (just think of the endless fields of application of genetic engineering) opens new possibilities, previously unthinkable or impractical, and 2) they want to light previously unpublished, and 3) the desires tend to be considered rights, 4) the battle rages for their legal recognition. Note that in this framework, the management function is exercised not by the law, nor politics, but the technique, which involves the death of the concept of law and therefore ethical. And to quote Hobbes "auctoritas, non veritas facit legem" is the power to dictate law, and no longer a reference to the truth of things.
