President of Ipatimup
While President of Ipatimup and member of the Board of Directors of i3S, it is hard for me to find a project to which I am best suited than “Knowing disease: Patients first”. Firstly, because I participated in the genesis of the original idea, as one of the four members of the European team who participated in the bilateral USA/Europe meeting on these issues that took place in 2008 in Sirmione, Italy. Secondly, and most importantly, because I have repeatedly witnessed the goodwill, enthusiasm and competence that Paula Silva, João Arriscado Nunes, Rui Mota Cardoso and many other professionals of the São João Hospital Centre and IPO-Porto have dedicated to this Project.
Health Sciences in general are well known for their trend towards “Interdisciplinarity” and this Project represents a superb example of such reality. The quality of the professionals involved in the different phases of the Project made it possible to wisely bring together patient organisations, psychologists, medical doctors, nurses, sociologists and nutritionists. Furthermore, possibly without being aware of it, these professionals applied the five principles that Deletic and Wong postulated in their seminal paper: “How to catalyse collaboration”*. In this way, Paula Silva and her team were able to reach the aims they had set out to achieve. For my part, I can only thank them and await the implementation results.
*The five principle for those of you who are interested: 1. Forge a shared mission; 2. Develop T-shaped researchers; 3. Nurture constructive dialogue; 4. Give institutional support; 5. Bridge research, policy and practice (Nature 525:315-317, 17 September 2015).
Rui Mota Cardoso
Carl Friedrich von Weizsäcker, a German medical doctor and philosopher, defined what he considered to be the “fundamental medical act” in medicine: “a Man is ill, possessed by discouragement, feels the need to be helped and therefore calls for the medical doctor. i
This call for help goes beyond the fight for physical integrity. It is the patient’s individuality that is at risk, is reacting and in distress; the patient asks for help in order to protect his/her physical integrity, as well as his/her physiologic, social, moral, spiritual and human wholeness. This call for help intends to preserve autonomy, already lost in the act of needing help, to protect self-determination and the right to know and decide. In fact, to defend his/her dignity.
In sum, patients seek (1) Physical, physiologic and social integrity; (2) Safety, perhaps the most anguishing need; (3) Control of the situation and stress cause by it; (4) Information and decision-making; (5) Dignity; and (6) Autonomy, the major sign of a healthy individual.
If a medical doctor faces a disease, the patient faces a drama. Accordingly, the clinical act treats the disease while it treats the patient. And this type of care implies entering thepatient’s world of pain, understanding his/her fears, beliefs, weaknesses and resiliencies, respecting his/her autonomy and providing tools for self-control.
“Knowing disease: Patients first” has this dual objective.
i von Weiszaecker. Artz und Kranker. Stuttgart. 1942.