Rivista per le Medical Humanities

Franco Zambelloni
rMH 15, 2010, 11-16

Truth, but not at all costs

Everyday life is commonly punctuated by many little lies, partly imposed by courtesy duties and social conventions. Throughout the history of ideas, the terms “truth” and “lie” have been variously interpreted in their nuances. The lie is not an evil in itself, always and absolutely deplorable. What determines its moral bearing is the intention prompting the decision to lie or to tell the truth. In healthcare, in the doctor-patient relationship, and from the standpoint of an ethics of responsibility, if the intention is to benefit, or simply not to harm, the patient, then the lie deserves no moral sanction.

Alberto Bondolfi
rMH 15, 2010, 17-20

Telling the truth to the patient: a complex but indispensable task

The essay highlights the relation between the concepts of biomedicine in general and of the doctor-patient relation and the perception of a duty of veracity towards the patient. Some historical scenarios are summarily considered, in order to understand the challenges this duty poses to medical practitioners today.  

Giņ Rezzonico
rMH 15, 2010, 21-25

Into illness and back again

What is presented here is a report of the author’s trip through the different stages of his illness experience. The account of the phases of the therapeutic process, from diagnosis to surgical intervention and rehabilitation, is paralleled by a reflection on the changes induced by the illness at all levels of life and everyday experience. Illness changes us, but not in substance: what remains is the possibility of choosing how to face so complex an experience, forcing a reconsideration of one’s self and future. An open and true testimony unveiling the fears, angst and hopes in the face of a severe and sudden diagnosis.

Sara Rubinelli
rMH 15, 2010, 26-32

Critical thinking as a manifestation of health literacy

This article dwells on the role of critical thinking – the mental process of reflection in view of a judgement – among the features of health literacy. In the light of the growing quantity of health communication projects, aimed at persuading the addressee, critical thought becomes an important instrument to uncover the fallacies in these discourses. By re-proposing the educational trail known in antiquity as Trivium, this text underscores the importance of the Humanities, especially Rhetorics, the theory of argumentation and persuasion, as a conceptual repertoire for the education of the individual.

Paolo Pelli
rMH 15, 2010, 33-37

The patient's assent to medical treatments

That between doctor and patient is an unequal relation, with the patient in a position of dependence. Assent to medical treatment and the adequate information, which is its necessary precondition, safeguard the position of the patient in order to keep her relation to the doctor within the boundaries set by the legislation. Concretely, the patient’s assent is disciplined by the norms on the protection of personality and on the mandate. In case of interventions without assent and information of the patient, the doctor responds of the damages caused even if the rules of the art have not been infringed. The Federal Tribunal’s recent legislation and jurisprudence show a more marked tendency than in the past to acknowledge the fundamental right of each and every individual to personal freedom and self determination as an autonomous value and not just as a function of the protection of bodily integrity.

Virginio Pedroni
rMH 15, 2010, 38-49

Truth and philosophy

This essay deals with “truth” as a perennial philosophical topic. The reader will be lead through all its different conceptions: from an absolute concept of truth as “correspondence” between fact and discourse, to an epistemic and relativistic one, in which truth corresponds to the modalities of access to it – following Nietzsche’s saying: “There are no facts, only interpretations”. Relativism questions the realist intuition of the existence of a single true (real) world, in which things exist independent from the modalities by which we describe them. The present essay will explore the relation between truth and language, face the issue of relativity and question the very value of truth or, vice versa, of (self) deception.

Marco Borghi
rMH 15, 2010, 75-80

Medical responsibility, a progress not by accident but nevertheless uncertain

The exercise of medical art and biomedical research provide a paradigmatic and perhaps unique instance of the role of ethics as a pillar of the right and of the symbiotic, if at times traumatic, interaction among these two disciplines, as it is expressed in the process of determination of fundamental choices that the legislator is called to make, in the controversial juridical role of ethical committees, in the denounce of the recurring risk of conflicts of interest between doctor and patient and in the juridical praxis that constantly and concretely defines the limits of the doctor’s responsibilities.

Daniele Cattaneo
rMH 15, 2010, 81-86

Insuring against risk?

The development of the Swiss Social Security system can be followed sector by sector, or through a wider view. This essay will examine some cases in which various social insurers may fail taking responsibility (e.g. off-label use of medicaments, polypragmasia, whiplash injury). The aim is to highlight the necessity for a reform of the Social Security system, informed by a greater respect for the principle of solidarity, and the need for an involvement of all the categories of actors in the fight against abuses.