Medicalization of life risks to expropriate man from his own death. Dying is the last act of life. There is no good or bad death. That, as Epicurus remarks, is «nothing to us, because when we are there is no death, and when there is death, then we are not». There is instead a good or a bad life. Even its last moments are part of life. Eubiosia, which means good life, is at equal distance from both the therapeutic obstinacy and euthanasia. Eubiosia is a response to the deepest fears of the dying person: the fear of loneliness and that of the physical pain. At a community level, taking care of the patient, who is at the death's door, by giving him/her palliative treatments within a family context, helps the person to take possession of himself/herself and to live also the last phase of his/her life with dignity.
La bioetica clinica è etica applicata e si occupa dei problemi morali che sorgono al “letto del malato” e nella pratica clinica. Il consulente bioetico deve essere in possesso di una duplice competenza, quella specifica (expertise) in etica applicata e quella più generale di tipo relazionale (counseling). Oltre a svolgere funzioni deliberative o di supporto tecnico alle questioni morali in rapporto ai casi clinici e funzioni di informazione, documentazione e formazione nell’ambito della comunità socio-sanitaria, il Sevizio di bioetica dovrebbe prendersi cura (counseling) delle singole persone coinvolte, dei loro dilemmi morali, del disagio esistenziale e dei problemi di senso. Deve aiutare il paziente a concettualizzare il dolore. Il consulente bioetico può offrire il supporto tecnico, valoriale, relazionale, perché i diretti interessati possano prendere le opportune decisioni morali. Il counselling etico-filosofico può operare una svolta culturale profonda, perché pone la persona malata al centro dell’impegno socio-sanitario. ---------- Clinical ethics is mainly applied ethics. It deals with moral problems, rising at the bedside and in a real-life ethical practice. The bioethical consultant should possess two main competences: one competence is specific, and we may define it “expertise”; the other one is more broad in scope and it shows an intrinsic relational nature, and we will refer to it as “counselling”. Bioethical Consultation in the NHS (National Health System) should take care by counselling the individual persons involved about their moral dilemmas, their existential malaise, and their questions over the sense of life. Bioethical consultation should help patients to conceptualize their suffering. The bioethical consultant, as a consequence, could offer technical (meaning ethical), value-based, and relational support, in order to allow people to take decisions in life, that is, being more conscious of the sense that these decisions will take in their life as a whole. Philosophical-ethical counselling could provide a radical cultural change in the way medical care is conceptualized in health systems, in so far as persons are the centre of the engagement of the NHS.
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