In all areas you learn using study material. Painters with canvases and paints, writers with paper, pencils and erasers, carpenters with wood and saw, ecologists exploration of tropical forests and measurement of concentrations of various substances in environment. At veterinarians and doctors the situation is different: they learn because of living beings or, to put it in precise words, using living beings. Although ethics has begun to penetrate these areas, there is a great lack and there will always be much to do. Not all veterinary schools and not all hospitals have academic committees whose mission is to regulate the activities of doctors and veterinarians.
I don’t know if there are monuments or iconic figures of dogs, parrots, elephants or human beings to recognize and honor their work – I wrote the paper – as part of the teaching process of young aspirants and even teachers. Despite my ignorance, I am convinced that the tribute paid by drug for the sick it was weak if not zero, not to mention the inhuman use of sick people and animals as experimental subjects.
In one of the memorable passages of The fish of Camus, a novel now in vogue due to the coronavirus, the doctor Rieux, the central character of the plot, to the question “Where did you learn so much, Doctor?”, he answers, “suffering”. In the process of teaching drug, patients take first place. Then there are the teachers, especially those who teach the profession to the patient and not just the review of laboratory or radiology tests. The next steps are occupied by technology and laboratory; unfortunately, their ubiquity has blurred the importance of the person.
Painting and guitar apprentices have their first meetings with canvases and strings to play with, while medical students practice their first maneuvers, stabbing a vein or receiving a child, with human beings. The same happens with hospital institutions: testing new gadgets on sick people. In both cases, the old adage “wrong is man” applies, but as you read the following, “persevering in error is evil.”
The above questions are not easy. Two ethical concerns dominate the scene. The first. Patients have the right to know, especially in hospitals where teaching is the leitmotif, who is the doctor performing the procedure? Second. Do hospitals have an obligation to explain to patients that they will be the first to use the new device? From the ethics and the evaluation of the autonomy of each person, the answer is yes. However, in practice and especially when paternalism and where POWER OF ATTORNEY among patients does not exist, patients do not usually receive, if it ever happens, such information. The obvious solution is to share the patients’ situation and ensure that students will be accompanied by experienced staff, although in pandemic periods, A real dixit, it is impossible to stop and explain to patients the need for informed consent, the importance of which increases: data about it, your benefits, disadvantages, possible risks and alternatives, your rights and responsibilities ”.
That guide, informed consent, should be extended and applied when maneuvers such as those described are performed on the patient. Patients are teachers; doctors are growing because of them and technology depends on them.
Doctor and writer