Appunti per una pianificazione terapeutica condivisibile

The article underlines the key importance of rebuilding, within a medical relationship, the physician-patient alliance. This in contrast with the one-directional model where the patient gives “directives” to the doctor and in contrast with a bureaucratization of the medical relationship, as well as with euthanasic views. Such alliance is able to prevent the patient from making decisions driven by his/her psychological conditions or by more or less explicit pressures to refuse healthcare therapies because of their related costs and caring burden. The text highlights the need of not considering the therapeutic effort and the palliative approach as alternatives, and the importance of not drawing conclusions on the individual patient’s life expectation just on the basis of statistical data (especially, considering e.g. the so called “surprise question”). Moreover, the reasons are suggested why in this context start considering medical activity without consent as a crime would be counterproductive. Finally, concerns about the recent decline in the average life expectation in Italy are expressed, as they may be due to a lowering in the protection of the constitutional right to health.