La atención y los cuidados y el empobrecimiento moral de la medicina

CAMBRIDGE – Para los economistas, la atención y los cuidados son una “carga”, para los psicólogos clínicos, un “proceso de recuperación”, los investigadores de los servicios de salud los ven en términos de costos y los médicos como cuestión de competencia clínica. Pero para muchas personas, los cuidados son un componente fundamental de la experiencia moral. Es una práctica de reconocimiento, imaginación empática, testimonio, responsabilidad, solidaridad y la forma más concreta de asistencia. Este aspecto moral es el que hace que quienes prodigan la atención y los cuidados, y en ocasiones incluso quienes los reciben, se sientan más "presentes" – y por lo tanto más plenamente humanos.

Pero además de la enfermería calificada, los esfuerzos de rehabilitación que llevan a cabo los terapeutas ocupacionales y físicos y la asistencia práctica de los trabajadores sociales y de quienes prestan ayuda a domicilio, los cuidados, especialmente para las víctimas de catástrofes de salud y de enfermedades terminales, tienen relativamente poco qué ver con la práctica contemporánea de la medicina.

Para ilustrar lo anterior, recurro a mi experiencia personal de dar cuidados a mi esposa, que sufre de un trastorno neurodegenerativo grave que ha afectado su memoria y sus funciones motoras y ha restringido su independencia. La despierto en las mañanas, le ayudo a bañarse y a vestirse, preparo el desayuno y le ayudo a que se alimente. Le ayudo a caminar, a sentarse en una silla y a subir a nuestro auto. Estoy con ella casi todo el tiempo para impedir que se lastime porque no puede ver ni desplazarse seguramente por la calle ni en nuestra propia casa.

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