Chapter 001. The Practice of Medicine (Part 8)

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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. ...

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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]