Medical humanities and ethics are getting more and more important in Europe as essential disciplines of the core curriculum for health-care professionals. The idea of the physician as a technician shows itself to be unbearable because of the global historical changes we daily face in caring settings. We deal with chronic diseases, which require a sensitive physician/patient covenant and a good performance in communication skills1 because a whole life-style transformation is often necessary. Moreover, citizens are more informed about both the (...) technological progress and their civil rights, so that a shared decision has to be prepared and implemented by exploring the emotional reactions to illness, by explaining the .. (shrink)

The article examines reasons and features of the Italian bioethics movement in itself and in relationship to that in the U.S.A. Research, consultation, teaching are the most requested professional activities. Ethics committees are now established in several places and at different level: national (National Italian Committee for Bioethics), regional (Italy has about twenty regions with some political power), and institutional (research centers, university, main hospitals).

The article briefly analyzes the concept of a person, arguing that personhood does not coincide with the actual enjoyment of certain intellectual capacities, but is coextensive with the embodiment of a human individual. Since in PVS patients we can observe a human individual functioning as a whole, we must conclude that these patients are still human persons, even if in a condition of extreme impairment. It is then argued that some forms of minimal treatment may not be futile for these (...) patients; they may constitute a form of respect for their human dignity and benefit these patients, even if they are not aware of that. Moreover, it is important to consider the symbolic significance of care: while many believe that PVS is a kind of imprisonment, for others providing food and fluids is the only way to testify our proximity to these persons. The best policy would be to provide, as a general rule, artificial nutrition and hydration to PVS patients: this treatment could be withdrawn, after a period of observation and reflection by the family and proxies, on the basis of the proxies' objection to the continuation or of the patient's advance directives specifically referring to this situation. (shrink)