1st Congress on the Humanisation of Medicine

1st Congress on the Humanisation of Medicine, held on 9-10 June 2022 at the University of Warsaw, is a continuation of the idea initiated by Professor Kazimierz Imielinski - the founder of the Albert Schweitzer Polish and World Academy of Medicine. Introducing humanisation into medical science, guaranteeing an ethical background, as well as securing the rights of the patient have a significant impact on the success of the treatment process, as well as ensuring appropriate contact between medical personnel and the patient. The aim of the Congress was to address the topic of appropriate communication in healthcare. During the event, experts attempted to identify the weaknesses and strengths of the implementation of humanisation from the perspective of healthcare professionals and patients, also taking into account the role of student and postgraduate education. Panel sessions addressed the following issues, among others:

1. Humanistic approach to the patient by all participants in the therapeutic process,
2. The patient in the health care system, quality of health care and patient safety,
3. Human life phases and the humanisation of medicine,
4. Ethical and legal considerations in patient care,
5. Cultural and spiritual determinants of patient care,
6. Humanising medicine or humanising the health system?

A very interesting topic included in the programme of the Congress was a reflection on the humanisation of medicine, taking into account differences in healthcare for patients at different stages of life. The programme also included a panel during which the invited experts attempted to find an answer to the question of to what extent the wider dissemination of modern technologies represents an opportunity for medicine, and to what extent it is a threat. The Revd Arkadiusz Nowak - President of the Institute for Patient Rights and Health Education - told Pulse of Medicine that there is no doubt that progress in the implementation of information technology is beneficial for patients. However, it is worth considering whether one of the fallouts of this progress is the overly rapid dehumanisation of not so much medicine as the health care system. For example, under the conditions of the COVID-19 pandemic, teleportation became more widespread. The consequence of this trend was a significant reduction in direct contact between doctors and patients. Humanism, especially within medicine, grows out of the basic assumption that man in the natural world is a unique entity and as such deserves respect. It therefore speaks of the special value of man, which is personal dignity (human dignity), which is not ascribed to any other living being. Advances in technology have led to the introduction of new technologies into medicine for both the diagnosis of diseases and therapy. This new reality undoubtedly influences the way in which the medical profession is practised today. With new technologies and new knowledge, a system of fragmented specialities and subspecialities has been created. This existing system of fragmented specialisations, by focusing on a specific disease or diseased organ, has resulted in a shift away from a holistic view of the patient. In this approach, symptoms arising from the personality of the individual patient are underestimated in the essence of the illness. The task of the humanisation of medicine, on the other hand, is to build a medical culture in the broadest sense of the term, including strengthening the authority of the medical profession including:

• understanding the patient's health situation with their individual needs in the context of the family, social and economic situation in which they find themselves,
• Build mutual trust and commitment of both parties to the therapy process,
• Improving communication in the patient-healthcare professional relationship,
• Achieve close cooperation between the patient and the doctor resulting in compliance with treatment recommendations and shared responsibility for the recovery process.

Medicine, in which humanistic values are put into practice, combines three elements:

1. It bases its activities on the best advances in knowledge and skills in all areas that can be useful in maintaining health and saving lives.
2. Ensures access to medical care and service delivery for all patients on the basis of prioritising ethics and humanism before the criterion of financial gain.
3. It integrates objective biological and technical knowledge with the spirituality of suffering and the hope of those who are ill.

For the medical sciences, it seems particularly useful to divide humanism into 3 categories:

• Personal humanism takes the concrete axial entity as the subject of its investigations. In the case of medicine, such subjects are the patient, doctor, nurse, paramedic considered as a shaped IAM in each case, with their individual attitudes and choices, with their self-awareness of attitudes and choices. Personal humanism makes it easier even to define the concept of the medical professional - the humanist, the understanding of which is sometimes quite disappointing. Personal humanism seeks to reveal all the personal qualities of the subject, to detail the qualities of him and him alone. At the same time, precisely because of this, it becomes a means of creating the subjectivity of the patient or doctor, of feeling like a subject, a person.
• Interpersonal humanism operates within the relationships between individuals or groups of individuals. It is in this area that humanism is most often identified with ethics (which is inaccurate and insufficient), and at the same time becomes a field for testing the value of individual IAMs, for confronting the reality of the value of their individual attitudes and choices. Interpersonal humanism attempts to describe complex interpersonal relationships. For example, between a patient and a doctor, but also between a patient and his or her family, or between patients themselves, between doctors themselves and so on. This is where the most valuable qualities of interpersonal relationships are located, such as compassion, mercy, seeking the good of fellow human beings and, at the same time, taking a sober view of people, making the right demands of them and enforcing them properly.   
• Extrapersonal humanism makes not so much people as their actions the object of its interest. This may be in the area of art or science; in this case, it is primarily the area of medical science as such. The tasks of extrapersonal humanism include interdisciplinary research that provides a broad context for perceiving the phenomena of health and illness, including historical, ethical, psychological, sociological, legal or economic contexts. In this view, they play, as it were, a servant role to personal and interdisciplinary humanism.

One of the objectives of the Congress was also to address the need for communication in health care. This topic is particularly important in the current situation in which these relationships may be even more difficult. This is because we are all aware of how important communication is for achieving a therapeutic outcome, although I would not want to narrow this issue down to clinical practice alone. Talking to the patient is a difficult but highly desirable skill. A patient presenting to the doctor comes to the office under great stress related to the disease, expecting specific actions and help. Proper communication should be adapted to the patient's communicative competence while taking into account the psycho-emotional aspect of the illness and treatment process. This is also important for legal reasons: current legislation gives the patient the right to be fully informed about his or her condition and the course of diagnosis and treatment. This right cannot be realised without communication skills.

The Congress on the Humanisation of Medicine addressed not only communication issues, but also the broader aspect of interpersonal relations and the role of professionals and patient organisations in improving the quality of health services and patient safety. Bearing in mind the need to improve communication with the patient and to counteract dehumanisation in its broadest sense, the University of Warsaw, commissioned by the Minister of Health, conducted a survey, the results of which were presented during the Congress. The study assessed the degree of humanisation of medicine in terms of medical professions, therapeutic teams, with particular emphasis on the patient-doctor relationship. In addition, the project assessed the impact of the state of epidemic risk and the spread of the SARS-CoV-2 virus on these relationships. The project covered 100 health care institutions. The study was conducted in five groups of health professions: doctors, nurses, paramedics and other medical and non-medical staff, as well as two groups of patients. As part of the analyses conducted in the above groups, the study also took into account the family context and other personal characteristics of the respondents, strongly emphasising the context of the impact of the pandemic. The survey conducted in medical facilities involved 3,500 medical personnel and 1,500 patients, and the two surveys outside these facilities involved approximately 2,000 Polish adults.

The results of the survey will be available at https://humanizacja.pl/

Igor Grzesiak - Institute for Patients' Rights and Health Education

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