You will learn in all areas with study material. Painters with canvases and paint, scribes with paper, pencils and erasers, carpenters with wood and saws, environmentalists exploring rainforests and measuring the concentrations of different substances in the environment. The situation differs for veterinarians and doctors: they learn through living things, or, to put it in precise terms, with the help of living things. While ethics is beginning to permeate these areas, there is a lack of them, and there will always be much to do. Not all veterinary schools or hospitals have academic committees charged with regulating the activities of doctors and veterinarians.
I don’t know if there are monuments or iconic figures from dogs, parrots, elephants or humans to recognize and honor their work – I wrote work – as part of teaching young aspirants and even teachers. Despite my ignorance, I am convinced that the tribute given by the medicine for the sick, it was sparse, if not zero, without forgetting the inhumane use of sick people and animals as test subjects.
In one of the memorable passages of The fish van Camus, a novel now in vogue because of the coronavirus, the doctor Rieux, the central character of the plot, to the question: “Where have you learned so much, doctor?”, he answers, “from suffering”. While teaching the medicine, the sick take the first place. Then follow the professors, especially those who teach the subject next to the patient and not just assess laboratory or radiological tests. The following steps are taken by technology and the laboratory; unfortunately their ubiquity has blurred the importance of the person.
Painting and guitar students make their first encounters with canvases to paint and strings to play, while medical students practice their first maneuvers, pricking a vein or having a baby, with people. The same thing happens with hospital settings: they test their new gadgets on sick people. In either case, the old adage “to err is human” applies, but as we read the lines below, “to persist in error is devil.”
The above questions are not easy. Two ethical concerns dominate the scene. First. Do patients have the right to know, especially in hospitals where teaching is the leitmotiv, who is the doctor performing the procedure? Second. Are hospitals obliged to explain to patients that they will be the first to use the new device? From ethics and appreciating the autonomy of each person, the answer is yes. In practice, and especially when the paternalism and where the empowerment of patients does not exist, patients, if it ever happens, do not receive such information. The obvious solution is to share the situation with patients and assure them that students are supervised by experienced staff, although in times of pandemic, A truism dixit, it is impossible to stop and explain to patients the need for informed consent, the importance of which is increasing: information you have received about this, the benefits, the inconveniences, the possible risks and the alternatives, your rights and duties ”.
This guideline, informed consent, should be expanded and applied when performing maneuvers as described on the patient. Patients are teachers; doctors are growing thanks to them and the technology depends on them.
Physician and writer