The future of medicine – ethics, research, counselling

The new world order is a world of equity, human rights, human dignity, the alleviation of poverty and of closing the gap between the “haves and have nots”, Medical Research Council president Professor William Makgoba told a gathering of doctors.

Addressing about 200 doctors at a SA Medical Association summit on the future of medicine, Makgoba said the microchip, the computer and the DNA revolution together with the Human Genome Project and HIV/AIDS have brought the questions of ethics, counselling and research to the fore.

“The way we teach and learn anatomy, physiology, pathology, psychiatry and surgery will no longer be the same. Future practitioners will no longer be carrier of stethoscopes, but people grounded in research, ethics and counselling.”

Makgoba said the practice and training of future health practitioners would change fundamentally. “Genetic counselling will become part of basic education. The treatment of disease will change in two ways ‘€“ prevention will become more important than intervention and fitness/well-being centres will become more important than hospitals because the nature of the disease will become individualised,” Makgoba said.

He said almost all the socio-economic improvements of post-independent Africa were being reversed if not wiped out by the HIV/AIDS epidemic.

“The AIDS epidemic will become a force for galvanising the nation, to crystallising our collective wisdom for we face a common future and destiny. We have to critically look at the gender power relationships, our sexuality and morality as a society and our ethics.”

Makgoba said South Africa’€™s healthcare system was unfair, inefficient and unresponsive. He said more black researchers needed to be trained to address some of the problems, but added that a humane and enabling environment needed to be created to allow people to stay on and train in the research field.

“If we are to educate and retain black scientists, the current higher education climate has to fundamentally change so that blacks can find hope and inspiration within these institutions. It is important that they find a home in which to grow, to explore and expand and an environment in which to be free to express their creative talents and perspectives. Blacks have to be given this essential power.”

A more cynical Makgoba commented that South Africa had become good at two things: “Preparing people for heaven and training medical students for the export market – to work in the backstreets of London, New York and Sydney.”

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