The Specific Role of
European Specialists on Prevention and Cure of Environmentally-Related
Diseases
Giorgio Berchicci
It is
likely that the picture of Naples with urban waste scattered everywhere has
got a symbolic character for the problems that our World is bringing face to
face today. On the one hand, rubbish hip is a symbol of well-being
indicating how much money was spent. On the other hand rubbish hip is also a
symbol of an economic policy where all industrial products finish in waste
and where increased production is the only consideration. The pollution
seems far from being important, diseases derived from their inappropriate
disposal are hidden, even the Fukujima tragedy is represented as an
unexpected event and the redundancy continue to increase. However, millions
of people continue to live without drinkable water and without adequate food
to eat, if any …
The
U.E.M.S. (Union Européenne des Médicins Spécialistes, Union of European
Medical Specialists) was established in 1958, just one year after the Treaty
of Rome that was signed in 1957, to encourage free movements of people,
services and goods inside Economics European Community
CEE. It is the oldest European medical
association, representing thirty-five membership countries now and with more
than 1.6 million specialists it is the most representative medical
association. It is an international non-profit association under Belgian
law, and the most important requirement is to be an ethic association.
Its
structure is comprised of thirty-eight specialist sections recognized by
European Union and additionally eight Multi Joint Committee
MJC representing those specialties where
the interests of several sections overlap.
The main
aim of the UEMS is to promote the ethical status of medical specialists,
their attitude, skills and knowledge, their so called “competence” and to
improve the contents and harmonization of trainees’ curricula throughout
Europe. We believe that each European citizen should be treated equally with
the same quality of proceedings and care, provided by competent specialists,
found everywhere.
Within
the UEMS organization there are different working groups. One of them
discusses the “Quality in Patient Care”, specifically addresses the sphere
of ethics and produces independent guidelines not only for doctors but also
patient organisations and governments.
The UEMS
has also published numbers of original documents like the “European
Definition of Medical Act” (the first, and still the only one definition of
medical art in Europe), the “Budapest Declaration on Ensuring the Quality of
Medical Care”, the “European Ethical Principles” etc.
But we
should not forget to mention our Council - the European Accreditation
Council for Continual Medical Education (EACCME). The aim of this
organization is to maintain specialists’ knowledge, skills and expertise
with up-to-date
Continuing Medical
Education/Continuing Professional Development (CME/CPD)
which includes also the latest scientific advances in
environmentally-related disorders, and the European Council for
Accreditation of Medical Specialists Qualifications (ECAAMSQ), a web based
system to recognise and improve the professional quality of specialists.
The UEMS
has got also a continuous exchange of ideas and positions with EU
Commission, and particularly with DGs
Sanco and Internal Market, as it is the most important European medical
association dealing to advise with specialist issues and care. The UEMS has
realized a long-standing medical dream in these last months: to have a
centre to represent all European doctors in Brussels. Five floors, 800
square meters, in which all European medical organizations can have their
premises.
This is
only a short introduction to present our association and to explain our
specific role as European specialists in the prevention and cure of
environmentally-related diseases.
After
the disaster of World War II we have got the luck to observe Europe to be
re-born thanks to a very long period of freedom, democracy and peace
resulting in very good national health care systems. Certainly the progress
in technology has also got a particular importance. Scientific researches in
medicine have resulted in huge changes in diagnostics, treatments (both
medical and surgical) and techniques of delivery of care. Many diseases,
till now almost incurable, today can be cured very well. We usually think on
antibiotics therapy, but a great progress has also been made by European
medical specialists in other branches like cardiology, oncology and the
prevention of cancer. Socially minded doctors have led to the denunciation
of cigarette smoke causing lung diseases and also others, they have led to
the battle against drugs, alcohol and obesity. Another continuing battle is
to ensure vaccination against the most dangerous infectious diseases, not
only of children. In occupational medicine, the recognition of occupational
diseases caused by increasing levels of allergy from growing number of
pollutants brings grown up disability. European specialists are playing a
very long and hard battle also on this field, because more pollution has got
more pulmonary diseases and allergy as a consequence. In addition to the
somatic diseases which are strongly related to the environment, another
group of challenges in health care needs must be mentioned, namely mental
disorders. Mental disorders can cause enormous suffering not only to
individuals but also to their families and society. In postmodern societies
mental disorders are causing increasingly inability to work.
The UEMS
and its Sections and Boards have developed training standards to improve
medical treatment and to promote development of the service systems for the
mental well-being of the European citizens and also for many other
specialties like allergology.
Even if
we grew up to ever more sophisticated society, we cannot ignore the
fundamental common needs for clean air, uncontaminated water, well-health,
nutritious food and the ethical use of knowledge.
In the
last forty years medicine has lived through a very important period, rich in
inventions that improved and prolonged our lives. It is supposed that to eat
better, to live in clean, light and airy houses, to have a good workplace
and a to have a good salary means to have the guarantee for a better life
without any diseases of previous centuries. But these advantages have also
brought an increase in obesity, metabolic diseases, allergies and cancers.
European
specialists have always had a very hard battle to win against some terrible
diseases. But thanks to technology doctors have got sophisticated medical
devices to set the diagnosis in as early stage of disease as possible.
RMN, TAC and Scans are able
to discover early stages of cancers and metastases and also allow set up an
accurate diagnosis in most of the common diseases. Advanced therapy and
early diagnosis has permitted European specialists to play (and in some
cases to win) a hard battle against the scourges of cancer, tobacco,
alcohol, cardiac diseases, obesity, allergies, lung diseases etc.
Industrial society needs to be competitive therefore it is faced to produce
more and more. But only a few people are asking themselves where and when it
all brings to an end.
At all
times medicine has to look for the highest standards of care for the
well-being of European citizens. We are sure that medical specialists
practice their profession very seriously and responsibly. They have got
their ethical responsibility dating from Hippocrates to maintain and improve
their knowledge, skills, attitudes and competence. For these reasons we have
established European Accreditation Council for Continual Medical Education (EACCME)
in 2001. This is a system of assessing educational events for the mutual
recognition of credits within all European countries and with an agreement
with American Medical Association (AMA) also with the United States. In many
European states continual medical education is mandatory while in some of
them it is still voluntary but linked to deontological rules.
UEMS has
produced documents over a number of years and also charters to ensure the
highest quality of requirements for specialists based upon the latest
scientific, educational and ethical considerations. The most important is
the “Charter on Continuing Medical Education” (1994). Continuous
Professional Development (CPD) is defined as the educative means of
updating, developing and enhancing how to apply the medical knowledge,
skills and attitudes required in doctors’ daily practice. The UEMS therefore
believes that continuous professional development is essential for ensuring
high standards of medical practice as it is stated in “Basel Declaration” –
Charter on Continuing Professional Development (2001).
Continuing Medical Education/Continuing Professional Development
is related to established specialists. There is also a new UEMS structure
dedicated to both established and young specialists and trainees, European
Council for Accreditation of Medical Specialists Qualifications (ECAAMSQ)
for the recognition of quality of training and practice. This idea is one of
most important issues contained in the document “UEMS Strategy” (2008). Its
aim is to invite the National Medical Associations (NMA),
UEMS Sections and Boards and also National authorities responsible for
accreditation of medical education and training in each of the twenty-seven
member states to reach consensus on:
· the
core essentials that notify the high quality of medical specialist education
and training programmes,
· conveying
the agreed outcome of these deliberations to the European authorities with a
proposal to have these principles formally incorporated into European
legislation,
· offer
and ensure the appropriate tools in order to implement the comprehensive
process of
individual/organizational/institutional Post-Graduate Medical Specialist
Training (PGMST) accreditation at the European level.
To
conclude - at Brussels airport there are two very large advertisements,
side-by-side. The first one says: “The world of tomorrow needs answers
that last - that’s why we’re building them today, with customers all over
the world”. And the second one says: “Materials
for a better life - clean technologies for a sustainable future”.
Both
industries are working in energetic branch with research as the basis of
their work. Similarly, by promoting researches in the UEMS Sections more and
more possibilities are offered to European specialists to discover, to
prevent, to diagnose and to treat new diseases. As we recognized a lot of
them are occupationally and environmentally related.
