PINUS Association Symposium: ‘Medicine and the New Paradigms of Science’

The World Health Organization has outlined a new strategy shifting the focus of medicine from the concept of health as lack of illness to the concept of health as psycho-physical wellbeing. Complementary and alternative medicine (CAM) can make a key contribution to human medicine and guarantee the wholeness, integrity and full dignity of patients in their free choice of the proper health treatment, in compliance with Article 32 of the Italian Constitution. Such therapeutic approaches must be rational and can no longer afford to be self-referential. Non-conventional medicines represent a development of medical knowledge and practice. The evolution of medical doctrine at the end of the nineteenth century led undeniably to great medical progress. The methodological and epistemological approaches of complementary medicines are useful in meeting the requirements of the twenty-first century, as stated in the Chart of Medical Professionals, as they widen the diagnostic and therapeutic horizons far beyond the postulates of 130 years ago. CAM is a widely used term, but it has no commonly accepted definition. The definition developed at a 1997 conference of the United States Office for Alternative Medicine of the National Institutes of Health (now the National Center for Complementary and Alternative Medicine, NCCAM) and subsequently adopted by the Cochrane Collaboration and the Ministerial Advisory Committee on Complementary and Alternative Medicine states, Complementary and alternative medicine (CAM) is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being. The World Health Organization defines it as follows: Complementary and alternative medicine (CAM) refers to a broad set of health care practices that are not part of a country's own tradition and not integrated into the dominant health care system. Other terms sometimes used to describe these health care practices include ‘natural medicine’, ‘non-conventional medicine’ and ‘holistic medicine’. In 2002 the FNOMCeO (the Italian National Federation of Medical Doctors and Dentists) issued a ‘Guideline on Non-Conventional Medicines’, thus awarding a medical status to nine disciplines: acupuncture, traditional Chinese medicine, homeopathy, homotoxicology, Ayurvedic medicine, anthroposophic medicine, phytotherapy, osteopathy and chiropractic. On October 20, 2003, the First Consensus Document on CAM in Italy was signed in Bologna at the Consensus Conference on CAM in Italy promoted, organized and chaired by Dr Paolo Roberti within the 43rd National Congress of the Italian Society of Psychiatry. The overall approach of medical strategies applied to suffering patients spurs medicine to grow and develop in terms of integration. Several other countries have already considered the new medicine and named it ‘systemic and integrated medicine’ as it allows one to refocus on a diagnosis-therapeutic approach taking into consideration the human being as a whole, the innate unity of a human being's physical and psychological aspects and psycho-neuro-endocrine-immunological system. Each human being is the ‘one thing’ resulting from the ceaseless interaction of these two levels. It is important to remember this when treating both functional and organic diseases. Medicine normally focuses attention on the biological body, but a patient is more than this and always belongs to a time, a place and a social context and has a personal background. The underlying weft of the disease and an individual's real life ends up being veiled by objective data focusing on the organism. The patient's narrative language and the doctor's scientific language imply two different concepts of the body and grow further and further apart. Hippocrates' perfect match of technique and human values has surrendered to technique, at the expense of the old medical art that looked after the whole person and not only the organs. Humanity, care, closeness, reliability, solidarity and participation have always been professional values that people expect a doctor to embody, but the undoubtedly necessary appearance of specialized medicine and high technology has impoverished the doctor–patient relationship, turning the patient into a clinical case. Quoting Roy Porter, who states that ‘Doctors today can cure us as never before, but the doubt is whether they care for us’, we agree that treating symptoms, diseases and bodies has nothing to do with caring for the person in line with Hippocrates’ sixth Statement: ‘If there is love for the human being than there will also be love for science.’ The aim of the symposium and of all PINUS activities is to invite the scientific community to perform a deeper and more convincing humanization of medicine. This research reflects a widespread phenomenon in Italy: non-conventional medical methodologies. The symposium was inaugurated by the Magistral Lecture ‘Evidence-based complementary medicine in biomedicine’ delivered by Professor Edwin Cooper, who was invited to Ravenna by Paolo Roberti. A round-table discussion with Italian journalists on ‘CAM and the media for proper scientific information’ followed. The other sessions held on May 5–8 were on ‘Anthropology, philosophy and epistemology of medicine’, ‘The description of CAM disciplines’, ‘Relationships between academic medicine and CAM: the integrated treatment of menopausal syndrome and therapy’, ‘Ethics, legislation and the right to health on CAM in Italy’ and ‘Research and formation on CAM’. The detailed program was as follows.