Chapter 001. The Practice of Medicine (Part 8) pps

The Practice of Medicine Part 8 Medical Ethics and New Technologies The rapid pace of technological advances has profound implications for medical applications far beyond their traditi

Chapter 001 The Practice of Medicine

(Part 8)

Medical Ethics and New Technologies

The rapid pace of technological advances has profound implications for medical applications far beyond their traditional roles to prevent, treat, and cure disease Cloning, genetic engineering, gene therapy, human-computer interfaces, nanotechnology, and designer drugs have the potential to modify inherited predispositions to disease, select desired characteristics in embryos, augment

"normal" human performance, replace failing tissues, and substantially prolong life span Because of their unique training, physicians have a responsibility to help shape the debate concerning the appropriate uses of, and limits that should be placed on, these new techniques

The Physician as Perpetual Student

It becomes all too apparent from the time we graduate from medical school that as physicians our lot is that of the "perpetual student" and the mosaic of our knowledge and experiences is eternally unfinished This concept can be at the same time exhilarating and anxiety-provoking

It is exhilarating because we will continue to expand our knowledge that can be applied to our patients; it is anxiety-provoking because we realize that we will never know as much as we want or need to know

At best, we will translate this latter feeling into energy to continue to improve ourselves and realize our potential as physicians In this regard, it is the responsibility of a physician to pursue new knowledge continually by reading, attending conferences and courses, and consulting colleagues and the Internet

This is often a difficult task for a busy practitioner; however, such a commitment to continued learning is an integral part of being a physician and must be given the highest priority

Research, Teaching, and the Practice of Medicine

The title doctor is derived from the Latin docere, "to teach," and physicians

should share information and medical knowledge with colleagues, with students of medicine and related professions, and with their patients The practice of medicine

is dependent on the sum total of medical knowledge, which in turn is based on an unending chain of scientific discovery, clinical observation, analysis, and interpretation

Advances in medicine depend on the acquisition of new information through research, and improved medical care requires the transmission of this information

As part of broader societal responsibilities, the physician should encourage patients to participate in ethical and properly approved clinical investigations if they do not impose undue hazard, discomfort, or inconvenience

On the other hand, physicians engaged in clinical research must be alert to potential conflicts of interest between their research goals and their obligations to individual patients; the best interests of the patient must always take priority

To wrest from nature the secrets which have perplexed philosophers in all ages, to track to their sources the causes of disease, to correlate the vast stores of knowledge, that they may be quickly available for the prevention and cure of disease—these are our ambitions

–William Osler, 1849–1919

Further Readings

Blank L et al: Medical professionalism in the new millennium: A physician charter 15 months later Ann Intern Med 138:839, 2003 [PMID: 12755556]

Council on Graduate Medical Education: Thirteenth Report: Physician

Education for a Changing Health Care Environment US Department of Health

and Human Services, March 1999

Guttmacher AE, Collins FS: Welcome to the genomic era N Engl J Med 349:996, 2003 [PMID: 12954750]

Ludmerer KM, Johns MME: Reforming graduate medical eduction JAMA 294:1083, 2005 [PMID: 16145029]

Straus SE et al: Teaching evidence-based medicine skills can change practice in a community hospital J Gen Intern Med 20:340, 2005 [PMID:

15857491]