When Health Isn't the Top Priority (Abraar Karan)

Hoje li este texto no Medscape e fiz um comentário sobre ele (que compartilho em seguida). Muito bom para refletirmos!!

By Abraar Karan at http://boards.medscape.com/forums/?128@@.2a59ee2d!comment=1:

During a presentation I attended earlier this week on how we can influence patients’ health through preventative measures and essentially working beyond the clinic, a very interesting notion came up regarding the idea of health versus freedom. As healthcare practitioners, we often focus on health as the number one priority for our patients. However, for patients, I would argue that freedom is far more important than health.

This notion may not be apparently conflicting, so let me explain: in the speaker’s presentation, a central argument was that people can control their health if they control their food consumption. He mentioned that, for instance, in African American communities, it is customary to consume a sweet beverage with a guest. “Why not consume an unsweetened tea instead?”, he questioned the audience. A student quickly responded with the practical answer: offering an unsweetened tea to a guest would be a cultural taboo in his community. For this young man, offering a sweetened beverage to his guest was more important in terms of what made his life meaningful than avoiding a few extra calories. It was his freedom to drink something a little unhealthy, but to enjoy it with a friend, that he valued more than his absolute health outcome, whatever that may end up being over the course of his life.

I noticed this idea of freedom and how important it is many years earlier as well when I worked in Uganda with HIV/TB co-infected patients in a research institute. Women who presented with care were counseled on the high risk of transmission to any future fetus, and were essentially being persuaded to avoid having children, which in terms of halting the spread of the HIV epidemic would seem advisable.

But to view the situation so narrowly is to lose what is humanism — for these women, having a child was central to their existence, far more important than their serostatus. It was apparent to me that of course these mothers would do everything to prevent their baby from contracting the virus, but they weren’t about to avoid having a baby altogether to do so.

And so for all of us future physicians, it is critical that we remember that health is not everything — a person’s clinical outcome is but a fraction of who they are, what they want, and what makes them happiest.

Follow me @SwasthyaMundial for more healthcare reflections!

Meu comentário sobre o texto do Mr. Karan:

Mr. Karan

Wonderful text, congratulations!

Well... Reading your text, I thought about Alma Ata and its health definition as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".

So it is not health against social and psyco; but the comprehension that social and psyco issues are also about health.

Then i believe that health is really everything, but it's our comprehension and practices as medical doctors (or students, like me) of health that always are not so healthy for the patients. The biomedical thinking always let us to those reflexions, but i believe that liberty and all other ethic issues are also about health, and not just disease or physical matters.

I am Medical Student in Brazil and it would be awesome make contact with you, to share some thoughts about Medicine and Society. My e-mail is cslucass@gmail.com feel free to send me a message.

Regards