Ethics in care

Editor-in-Chief and Editorial Director, in a “Laborcare Journal” article, talk about “ethics in care”

By Gianluca Favero and Mariella Orsi

This issue of Laborcare Journal we can consider it a moment of reflection on what we consider to be the foundations of a shared Ethics in Care and we do so through two significant events that took place in 2016: the VII Seminar of the Pontignano Group held in Fiesole last June and the “Give Me Space” Conference organized by the Spazio Etico Association held in Empoli on November 12.

These were two moments in which Health and Social Professionals found themselves reflecting, albeit with different approaches and methodologies, on aspects of care that, unfortunately, continue to be the patrimony of a few health professionals and connoisseurs of the subject, rather than being part of the daily work of Care.

The Pontignano Group-promoted within the framework of the Regional Bioethics Commission of Tuscany in 2001 and named after the place where it periodically meets in a kind of Consensus Conference-is made up of practitioners and experts active in the field of palliative care, coming from different professional areas (health, socio-anthropological, philosophical, legal and voluntary).

On an almost annual basis, the Group meets to discuss the ethics of end-of-life care, delving into the issues of the dying process in hospitals and hospices, home-based palliative care, the training of practitioners, spirituality, and the importance of adequate and effective social communication.

Following the evolution of the debate that, for years now, has been developing with regard to the improvement and expansion of end-of-life care, the group of practitioners has drawn up various documents starting from the formulation of a “ Pontignano Charter,” approved in 2002, in which general principles were enunciated, to the latest documents in which the centrality of the person in whatever type of intervention and situation he or she is, the relevance of Advance Dispositions and the need to implement the culture related to the end of life has been reaffirmed.

Since 2013, the File Foundation has taken over as the Promoting Entity of the group and has supported the implementation of the last 2 editions of the seminar, in September 2013 and June 2016, which led to the development of a document called the “Charter of Fiesole” (from the location where the group met).

The mandate of the last Seminar was to reflect on how much, still today, there is in many health care professionals a great difficulty in “putting in place, in the context of the care relationship, opportunities for confidential dialogue with the sick person in order to facilitate the explication of his or her desires regarding how, where and with whom to live the final phase of his or her life” as it is enunciated, precisely, in the Fiesole Charter.

This recalls the aforementioned Florence Charter which recalls the importance of relationship understood as care by stating, in point 5, that “time devoted to information, communication and relationship is time for care” .

In the article “How Medicine Exploded Rationality at the Expense of Humanity” (published in “Saluteinternazionale.info” which, by kind permission of the journal, we are publishing in this issue) the author, Andrea Lopes Pegna, emphasizes how devoting time to relationship is generally considered outside of “doing.”

“Certainly in our Health System there are daily objective difficulties to be able to establish a doctor-patient relationship that privileges listening (…) The quality of this relationship “between doctor and patient has never been evaluated as it should and has always been considered as a result of an individual doctor’s initiative. On the other hand, the university has almost never considered the communication between the physician and the patient as a teaching topic believing that
the correct relationship arises only from medical practice ….”

And it is precisely on the binomial “space – time” (to dialogue and take care of both the treated and the caregivers) that the reports of the Conference “Give me space” organized by the Association for Cultural and Social Promotion “Ethical Space” which aims to promote the circulation of ideas and professional culture among those who work in the world of personal care.

The Ethical Space can be defined as a “meeting place of experiences” within which issues concerning the emotions that accompany the work of care can be discussed, returning, in this way, the word to the experience of health care workers by dedicating time to reflection: an action, this one, in contrast to the rhythms that corporate organization imposes.

Giancarlo Brunetti-who participated as a speaker at this Conference-writes, “Time of care is made of an intangible substance that cannot be simply quantified in minutes and seconds; it is a human dimension that must be perceived and experienced with awareness if we want it not to get out of hand and be lost.”

More and more, issue after issue, editorial after editorial, we realize that to the now well-known “doing – knowing how to do, being – knowing how to be” it is necessary to add “staying – knowing how to stay” by identifying as an ethical value the ability to accompany the person even when it may seem – and many physicians still say it – “there is nothing more to be done” because, those, are the days when “there is still a lot to be done!”

(Gianluca Favero and Mariella Orsi)

• It is possible to view the full issue of the magazine at http://www.laborcare.it”
• Read other published articles

Source

• Laborcare Journal (Editorial No. 12)

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• Image digitally created by spazio + spadoni