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Themes for discussion and disagreement

Adolfo Saadia0

DOI: 10.1590/S0102-76382005000300002

I develop this theme by debating concepts and propose that this should be the start of a discussion to identify common themes for all our countries, for physicians and for the health of the population, which is the objective of our profession.

A long time ago who wrote these lines was worried about recovering the memory of our American ancestors in medical science. It is necessary to remember that, starting from our universities and hospitals, scientific models for the medical practice and research were initiated and developed, showing the way for generations of professionals, not only in our Latin-American countries, but also in countries of other continents. An example of this is the Argentinean hygienist and famous neurosurgeon, Ramon Carillo, who died in Brazil in 1956. He taught his concepts, developed half a century before in Brazil using a sanitary system, which was an example to the doctors and professors who were the pioneers of the current cardiovascular surgery, including Zerbini, Albanese, Jatene, Favaro, amongst many others.

This concern to emphasize many unfair lapses in memory is to recall the conditions of the medical humanism which was the tradition for our universities and our mentors; unfortunately this has been forgotten in recent times in exchange for a new manner of working. Thus, the use of technology and the economic resources necessary for progress has changed values that should have remained untouched: the medical-patient relationship, without social discrimination, with sufficient time for good communications and sympathy, which is the best therapy along with so many other compassionate acts.

Many physicians only remember these situations when they, for reasons of health, need a friendly and comforting word of the physician who attends them.

To recover the memory is to highlight the life and the creative work of our mentors who developed what is today our surgery, in a vertiginous step forward that they could never imagine.

Some of the procedures that today are simple routine, were extremely complicated techniques developed over long hours in the surgical center, not so long ago.

In our Countries, the aforementioned names and many others in the health system are recent history and are the culture of the current and future generations.

They should not only be recognized for what they represent in the development of surgery, as they essentially formed a model of ethics in medicine but also the Ethical-Moral values left to us by our mentors, that are now lost in a confusion of values changed by others who should have left them alone.

We must educate not only the techniques of work, but also the culture and discernment, in a way that we are not stuck in the scheme that distorts our own criteria, mixed up in information difficult to depurate or with a language which makes us lose the primitive richness and our idioms.

The information must allow the elaboration of rational thought and not only an obscure and bogus promotional selection.

These concepts are not intended to be neo-chauvinism, but, as I affirmed before, to recover native traditions that are of great value to our cultural patrimony.

In my talks with Domingo Braile, I proposed to him that the medicinal and surgical publications should include chapters related to these themes, which are simply an important part of the Anthropological Medicine and the Ethics of our times.

Health and life, ideas and creativity allow us to do a little. A lot of what we have in this continuous band that is life always revolves around previous facts and cannot be predicted.

In our way of thinking, we must be conscious of the importance that our social participation can have, polishing our lack or reasoning, the fatigue and the individualism so common in intellectual people and transform them in humanistic thought and, why not, in dreams of utopia moving us intuitively towards the future that today appears as a vertiginous light of new creations.

In these concepts there can not be greediness, corruption, impunity, authoritarianism of those that have the power but do not have the capacity of self-criticism or the ability to correct mistakes, which are symptoms of ignorance, mother of social vices that make us react and hold back the development.

Our most fierce enemies are impunity and corruption, the enemies of democracy and of progress, which can only be opposed to Ethics, without concern for the sector: economical, political or professional.

Ethics must be the only guiding light because it will allow us to understand the true democracy to solve the inequality with justice and without greediness. It is the only correct way to provide real human rights.

I am convinced that these themes must not stay circumscribed to the medical profession, because we are immersed in the same problems as all of society.

I am also certain that many people do not agree that in a scientific journal these matters should be considered. We need, in disagreement, to improve our democracies that started and debate the different opinions in these forums, but with ardent debate. This is the proposal.

NB: In our journal the "Argentinean Journal of Cardiovascular surgery"- Argentinean College of Cardiovascular Surgery - we created a chapter dedicated to themes related with the Ethics and Anthropological and Bioethical Medicine since its first edition.

*Cardiovascular Surgeon. Titular Member of the Argentinean Medical Association and of the Argentinean Society of Surgery. Emeritus Member of the Argentinean College of Cardiovascular Surgery (ACCVS). Member of the Editorial Board of the "Argentinean Journal of cardiovascular Surgery"and of the Periodical Bulletin of the ACCVS
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