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Warsaw, 24 March 2007
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http://healthdialogueculture.org/en/congresses.html?start=60#sigProId4df03819d2
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- Written by Flavia Caretta
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Communication and relationships in medicine: state of the art
There have been few changes in the life of man as profound as those which have happened in the biomedical sciences and in medical practice in the last few decades.
Enormous developments in the field of technology have brought about unimaginable progress in diagnostic and therapeutic ability and, consequently, the emergence of new branches of specialized disciplines, created to keep up with the rapid increase of knowledge and the ever more sophisticated methods of bio-technology. This has brought about a fragmentation of knowledge.For this reason, on the clinical level, a patient no longer finds him or herself under the care of just one physician, but of several specialists in different disciplines who frequently collaborate.
download intervention: pdf Caretta_en.pdf
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- Written by Mabel Aghadiuno
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Medical professionalism: a GP's perspective
A really good liver
I remember when I was a medical student the excitement of going round the wards with a keen doctor who would take us to feel a "really good spleen" or listen to an "interesting cardiac murmur".
Like my fellow students in our new, pristine white coats, I was very excited. However, something in me rebelled and a little voice said, "This isn't quite right".
It was not that we did not greet the patient, ask permission to examine and do all that medical etiquette and politeness required. I felt uneasy and could not articulate why.
One day my group was invited by the professor to examine a "really good liver".
We all trotted behind him, got to the patient's bedside and I recognised her distinctive face immediately.
I thought, "This isn't a liver, she's a person - my old teacher".
She had taught me in primary school. It is a lesson that remained with me throughout the rest of medical school and my practice of medicine. Patients have to be seen in their entirety and not as fragmented parts.
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- Written by Massimo Petrini
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Healing the Healer
A subtle uneasiness may be felt by someone who introduces his talk about the art of medicine, when he himself does not have a degree in medicine. It’s like wanting to enter a place without authorization if it weren’t for the 40-years of professional practice in the simultaneous confrontation from the two perspectives:
that of the doctor and that of the patient. And yet, beyond all the legitimizing that comes from scientific learning and a specific profession, the relationship between these 3 – patient, doctor, and the art of healing – pertains to every man and every woman. Getting sick, and therefore becoming a “patient”, is a possibility that is part of human nature, in our mortality and vulnerability.
[1]Cfr. Gensabella Furnari M., Prefazione, in Id. (a cura), Il paziente il medico e l'arte della cura, Rubbettino, Soveria Mannelli 2005, p. 5
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Post-congresso a Mosca
http://healthdialogueculture.org/en/congresses.html?start=60#sigProIdc15a13d8e1
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Health Workers Meetings
From the time the Association was established, it has promoted periodic meetings for doctors and health workers, with the aim of offering moments to exchange ideas and experiences and deepen the specific objective of medical etiquette and healthcare.
Among the topics of discussion: suffering, life in the face of actual challenges, empathy in the relationship with the patient, relationship between health and sickness, the relationship among health workers.
The value of life, the dignity of the human person
Life offers many challenges, both old and new, which impact us almost daily through the challenges that technological progress presents which are difficult to respond to; 
However, there is only one ethical criterion which every single person, civil society, and the sciences – among which there is also Medicine- always have to measure themselves against:
the concept of the human person and the dignity of his/her life. This is the anthropological lens through which one should view the developments of scientific progress and elaborate ethical judgements. Now, science itself emphasizes that the dignity of a person, unique and unrepeatable, is inscribed in the laws of biology, biochemistry, physiology and this can be scientifically demonstrated.
The very dignity of the person, of every person’s life is a value shared by human beings and the point of convergence for all. Doctors and healthcare workers, in particular, are directly summoned to discover the original vocation of Medicine which is to rehabilitate, to heal the human being in his/her wholeness (entirety).
The relationship between health and sickness
The object of Medicine is not sickness, but the sick person. Without the person, sickness would not be understood and healing could not be administered. Healing understood in its full anthropological sense and not only as restitution ad integrum.
It is evident that a biophysical intervention is always of great importance, rather, it is indispensable, but not exclusively, because it is not only a person’s physical being that gets sick: it is the whole person that suffers from sickness, seeks for healing, and at the same time, questions the meaning of illness in his own life. This search for meaning involves the sick as well as his family and the community.
A person is made up of various dimensions: physical, psychological, spiritual: health or healing, like sickness and suffering, cannot but spring forth from the harmony of these dimensions. Therefore, health or healing does not only mean having physical health or functional recovery, but psychological peace, inner strength, courage, acquiring a new equilibrium. In this context, sickness can be seen as a possibility to develop one’s human capacities; in fact, it can be an occasion for emotional and spiritual growth. It can be a teacher of how to accept one’s limits and give value to what is essential.
A person is not to be isolated but inserted in a community and an environment where health is reinforced through the interaction of a complex system that promotes the wellness of a community intent on caring for itself.
Among other things, in the exercise of the health profession, now there is the tendency to use a working guideline based on organizational concepts such as “network” or “integration of services.” 
This proves that the response to health needs can no longer be derived exclusively from an individual’s competency and knowledge, which are certainly fundamental, but from the work of a “body,” that is, a collective action. This is why there is the need of commitment from the community, not only of healthcare personnel, but all of the community’s components - physico-environmental, socio-political, economic, legislative, religious.
They are called upon to support and promote health and life. This assumes that the ethical, religious and political implications continue to develop new innovations in the medical field.
A relationship model in healthcare based on reciprocity
Reciprocity, fraternity, placed at the foundation of interpersonal and inter-community relationships can change every component of the healthcare sector into a subject, a protagonist where each person is projected outward to live for the other, to understand their needs, to share their suffering, or to recognize another person’s competence and give complete trust to him/her.
Such conditions allow for the creation of a truly “therapeutic” health care environment for all:
- for the patient who breathes in a serene, attentive, listening and caring climate in its broadest sense;
- for healthcare workers who feel appreciated and valued for their work performed in a context where professionalism is at its best, and they are stimulated to continuously improve;
- for the administrators who feel their burden of responsibility and decision-making lightened because it is participated in and shared by the others.
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A perspective of Healthcare Interdependence and Cervical Carcinoma
In a world where interdependence seems to be ever more necessary, health care needs to discover ways to develop new frontiers and skills using direct forms of collaboration which can overcome situations of inequality. This way, good healthcare outcomes can be possible and attainable not only in countries with higher healthcare standards.
By means of conventions and the spreading of information about the results of this endeavour, we would like to promote a type of health care based on a new medical etiquette.
It is in this particular framework that the present scientific meeting is being held.
Our objective is to create an opportunity for exchange and dialogue among experts in science, culture and the social sciences regarding the possibility of interdependence and how to promote it.
In this perspective the subject of cervical cancer (considered as the ‘big killer’ in developing countries due to the lack of prevention programs, scarce diagnostic care and inadequate treatment facilities) has been dealt with. Dialogue, active interchange of ideas and proposals present themselves as elements for “new pathways” to know more and better about an existing situation.
Specific Objectives
To underline the aspect of interdependence as an element of collective health and the healthcare system
To emphasize the importance of a collegial, interdisciplinary and inter-professional work-up in order to implement an international healthcare project
To endorse a culture that involves entire human community in making healthcare decisions that are evaluated in terms of efficacy and cost-effectiveness
To foster the creation of collaborative networks among health infrastructures, and public and private entities to promote, establish, develop and support appropriate clinical activities in disadvantaged regions
To highlight the value and contribution of communication technologies in carrying out healthcare activities in countries with limited resources
To propose a model of clinical management and scientific research based on the concept of reciprocity
Programme
Morning session
Health and Development
Moderators: G. Amunni – P.G. Taiti
- International Health Cooperation. The right to what kind of health?
M. Toschi - Health and Culture in the present sociological sphere of the community
M. Nkafu Nkemnkia - Poverty and cervical cancer
G. Scambia - Health care and economic relationships in the international communit
G.A. Cornia - Round-table discussion
Afternoon session
Dealing with Cervical Carcinoma through Know-how and Capacity Building
Moderators: A. Bavazzano – M. Marchionni
- Satellite link-up with Fontem
M. Zanzucchi - Cervical Cancer. The Reality in Cameroon
J.I.R. Leke - Cervical Cancer Management. Limits and Resources in the Framework of Interdependence
P. Benedetti Panici - Experience of the Fontem-Florence Partnership
L. Bazzini – M.G. Fallani - Cervical Carcinoma. From a project of cooperation to an interdependent healthcare framework
L. Falchi - Relationships in Medicine. Dialogue between the healthcare system, society, research and medical humanities
F. Caretta - Round table discussion
- Reflections and working proposals
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Communication as a quality and resource in healthcare service
The essential aspect of a person consists in his/her capacity to relate. In the healthcare environment, where sickness has a strong conditioning effect on relationships between healthcare worker and patient and among health workers, communication becomes a need we cannot ignore. In our society, healthcare workers’ formation is focused on the scientific, technical and care aspects, but there is a need to return to a more unified vision of the person, especially the sick.
There is a growing aspiration to have a cultural overhauling which integrates professional commitment with the human aspect of healthcare in different ambits. The objective of this congress is to deepen the aspects of communication and thus contribute to making it a resource for all healthcare professions. It is an indispensable value that should be developed in medical etiquette.
Programme
- Developing skills in relating and the quality of care: a plus in healthcare
Dr. Flavia Caretta – A. Gemelli University Polyclinic (Rome) - Reciprocity: a value and a hope for the terminally ill
Dr. Valter Giantin – Padova University Polyclinic - Patient-healthcare worker interrelationship: premises and attitudes
Prof. Giuseppe Milan – Faculty of Formation Sciences – Padova University - Communication among health workers: teamwork
Dr. Antonella Deponte – Psychology of Communication – University of Trieste - Clinical studies
- Artistic intermission: “Hinn and Dak’s Sunsets”
Text by Redi Maffino Maghenzani as read by Ugo Sartori (actor)
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Value and prospects of the chronically and the terminally ill
June 2, 2003 - Mestre
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Communication and relational skills in the healthcare planet: possible horizons
October 23, 2004 - Mestre
