Technology, medicine and society: a role-playing of covenants and contrasts.

Abstract

In the context of a quick medical progress and of a massive presence of technology that goes with it, we have the need to consider the Medicine in relation to the whole society. There are contrasts between the need of an efficient and universal primary medicine and the high cost of the services, between the results that we can theoretically reach and the limited resources, between the individual expectation and the impossibility of defeating every sort of disease. Callahan - one of the fathers of the North American bioethics - underlines the necessity to promote a medicine which is sustainable at a social and at an economical level. In order to reach it, the fundamental category is the concept of limit. We have to ponder all the priorities of the whole society. If we take in account the limited resources, the higher cost of the medical sector limits the investments in another sector.

Besides, the difference between the rich and the poor (within the same country or between Northern and Southern countries) demands a concrete attention which also requires a strongest effort to amplify the minimum health care, and not only specialist interventions for acute pathology. The proposal is to elaborate a different pattern of medical progress. First of all, it should weigh not only the individual benefits but also the effects on the population’s health. Secondly, it should individuate the importance of the social, economical and cultural conditions in this field. Finally, it should be able to be satisfied with the achieved level in the improvement of the people’s health, taking in account that nowadays the duration of life is the longest in the history.

All this has to face a double dimension. On one hand, it has to keep in mind the existing relation with the strategies and the logic of the market. Although the market is the natural ally of the technological progress and of the demanding services required, it can not be regarded as the only guide of the public sector. On the other hand, it has to remind that the starting point of view, liberal or communitarian, leads to results in the planning of the political and social organisation which are very different.

In conclusion, the acceptation of the limit in Callahan’s proposal guides to shape a hierarchy of values, but, at the same time, it requires a sound ontological foundation which is able to stand over to a biological-mechanical view of the issue.