2023-07-13 12:36:00
In recent days, an intense debate has been generated in the medical field, due to the Health Reform Bill, specifically in its article 123, which established the obligation of doctors to guarantee the cure of patients.
This proposal aroused controversy because, although the article was modified, it confirmed a panorama of ignorance on the subject by decision makers and patients. This allows us to reflect on the fundamental question: Can medicine cure everything?
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To begin with, it is important to recognize that medicine has advanced significantly throughout history, achieving notable advances in the prevention, diagnosis, treatment, palliation, and rehabilitation of various diseases.
However, it is essential to clarify that this and other health professions are focused on the means and not on the guaranteed results, that is, those who practice must do everything possible to reach the best outcome in the treatment of their patients’ disease. , but this does not mean that they can ensure the cure of all diseases, partly because most cannot be cured.
Despite scientific and technological advances, there are currently limitations inherent to the disease and the human body that can be understood from the Natural History of Disease (HNE). The HNE establishes the process or course of all diseases, which can be days or years.
This process begins with a period called prepathogenic, in which people are at risk of acquiring the disease, but do not yet have it.
Once the disease is acquired, four pathogenic periods follow, ranging from small changes without any symptoms (subclinical pathogenic), the presence of initial symptoms (prodromal), the clear and evident presentation of the disease (clinical) and the consequences. of the disease as the last period (resolution).
In this sense, the final period of a disease can go from healing (complete disappearance of the disease without traces or consequences of it), to chronification, the generation of sequelae, disability, incapacity or even death.
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In this sense, it should be clarified that there are very few diseases that current medicine can cure —with the exception of some infectious conditions and nutritional disorders— since in our country, the majority of patients suffer from chronic diseases (those that, from their diagnosis, remain for life and whose treatment is focused on the control and prevention of complications, such as high blood pressure or diabetes mellitus), and even conditions that can apparently be resolved in an operating room, but that can leave sequelae.
Given the lack of knowledge that is forged around HNE, on the part of health professionals and the population in general, it is necessary to improve the elements of health education and for health at the following levels: Primary prevention, focused on intervene risk factors that cause disease; Secondary prevention, aimed at making an early diagnosis and timely treatment of diseases and tertiary prevention, aimed at rehabilitating or returning patients to the best quality of life in their environments.
In this sense, and with regard to the unrealistic article that proposed guaranteeing the cure of patients, although fortunately it was modified, it left aside the adequate socialization of the reasons that made it unfeasible, because only when in society it is As expectations toward medicine and health professionals are reassessed, it becomes possible to recognize healing as a desired goal and value preventive medicine, comprehensive care, quality of life, chronic disease management, and palliative care with proper expectations.
Column References:
Colombian Congress. Law 1164. 2007 Hernández E. Primary care and social determinants in health in the training of human resources in Colombia for the improvement of the population’s health [Tesis doctoral]. Alicante: Miguel Hernández University, 2017.
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