Latin American Bases and Perspectives on Person Centered Medicine and Health

Main Article Content

Patrick Wagner
Alberto Perales
Rodolfo Armas
Oscar Codas
Raul de los Santos
Daniel Elio-Calvo
Juan Mendoza-Vega
Meliton Arce
José Luis Calderón
Lucia Llosa
Javier Saavedra
Oscar Ugarte
Herman Vildózola
Juan E Mezzich

Abstract

Background: This paper emerges as part of a process lead by the National Academy of Medicine of Peru in close collaboration with other Latin American National Academies of Medicine, major universities and health professional institutionsObjectives: To describe and substantiate the importance of Person Centered Medicine (PCM) in the Latin American context. Methodology: Review of Latin American scientific literature and experiences on this issue and organization of academic meetings to deliberate on related problems, two preliminary ones in Lima in December 2013 and January 2014, a third one in Buenos Aires at the Second International Congress of Person Centered Medicine with the participation of the National Academies of Medicine of Argentina, Bolivia, Chile and Peru (November, 2014), and a fourth in Lima with the presence of the National Academies of Medicine of Bolivia, Chile, Colombia, Paraguay and Peru (December, 2014). Results: Historical and contemporary, universal and local precedents to the gestation and development of a re-prioritization of medicine in relation to the Person in context are pointed out, articulating for such purpose science and humanism. The concept of Person in medicine from a philosophical point of view, including terminological, historical and human rights dimensions, are discussed. Upon these bases, the central concepts of PCM are considered, emphasizing its pertinence in clinical medicine as well as in public health, clinical care, education, research, and health policies. In regards to clinical education and practice, the PCM concept as a fundamental strategic principle, its programmatic educational applications and its institutionalization at a medical school level are proposed. The importance of ethical training and clinical communication as well as the appropriate use of technology and scientific evidence at the service of the Person are highlighted. Available institutional opportunities for health professional interdisciplinary education as well as Latin American educational perspectives are discussed. Scientific research on PCM is highlighted particularly concerning studies on conceptualization, measurement and diagnosis, including the need to construct narrative complementary instruments. Furthermore, perspectives on health policies centered on the person and the community are considered as well as contributions and recommendations derived from Latin American experience on this topic. Conclusions: PCM values biologic, psychological and socio-cultural scientific advances, processing them within the comprehensive framework of the Person, articulating science as an essential instrument and humanism as the essence of medicine. In contraposition to reductionist epistemological formulations, PCM proposes a medicine informed by evidence and experience and oriented towards the totality of the person.

Article Details

Section
Regular Articles
Author Biography

Juan E Mezzich, Mount Sinai School of Medicine, New York University

Born in Lima, Peru, of Yugoslavian and Peruvian ancestries. Medical graduate of Cayetano Heredia Peruvian University and president of the University Student Association.Psychiatric residency training, M.Sc. in Academic Psychiatry, and M.A. and Ph.D. in Mathematical and Statistical Psychology, all at Ohio State University, and diplomate of the American Board of Psychiatry and Neurology.Professorial positions in psychiatry, sequentially at Stanford University, California, the University of Pittsburgh, Pennsylvania, and the Mount Sinai School of Medicine, New York University.Doctor Honoris Causa at Athens University (Greece), Cordoba University (Argentina), Cayetano Heredia Peruvian University (Peru), and Cluj-Napoca University, Timisoara University and Oradea University (Romania). Honorary Professorships at Cayetano Heredia Peruvian University and University of Belgrade (Serbia), World Psychiatric Association Honorary Fellow, Simon Bolivar Award of the American Psychiatric Association, Past-President of the American Society of Hispanic Psychiatry, honorary member/fellow of several national psychiatric associations, and visiting professor and lecturer at academic institutions over 80 countries across all continents.Earlier academic and international work: Secretary & Chair (1983-1996) and Honorary Chair (2008-) of the WPA Section on Classification and Diagnostic Assessment; member of the ICD-10 Work Group and the DSM-IV Task Force; chair of the US National Institute of Mental Health Group on Culture, Diagnosis and Care; consultant on the development of the Chinese Classification of Mental Disorders (3rd Ed.), the Japanese Modification of ICD-10, the Third Cuban Glossary of Psychiatry, and the Latin American Guide for Psychiatric Diagnosis (GLADP); and director of the 1993-2003 WPA International Guidelines for Diagnostic Assessment (IGDA).Author/coauthor of over 280 scientific journal articles and book chapters (including sections on diagnosis,   epidemiology, and culture in Kaplan & Sadock's and Tasman et al’s Textbooks of Psychiatry), and of 26 books and monographs, including Images of Latin American Psychiatry (2013), Coercive Treatment in Psychiatry (2011), Conceptual Bases of Psychiatry for the Person (2011), Conceptual Explorations on Person-centered Medicine (2010), Psychiatric Diagnosis: Challenges and Prospects (2009), Cultural Formulation: A Reader for Psychiatric Diagnosis (2008), Psychiatry and Sexual Health: An Integrative Approach (2006), Philosophical & Methodological Bases of Psychiatric Diagnosis (2005), Guía Latinoamericana de Diagnóstico Psiquiátrico (GLADP) (APAL, 2004), WPA International Guidelines for Diagnostic Assessment (IGDA) (2003), Cultural Psychiatry: International Perspectives (2001), Culture and Psychiatric Diagnosis: A DSM-IV Perspective (1996), Psychiatric Epidemiology (1994). Editor, Psychopathology, (2002-2010), Deputy Editor-in-Chief (2010-2011) and Editor in Chief (2013-  ), Int’l J Person Centered Medicine,  and editorial board member of 15 other medical journals in the Americas, Europe, Asia, and Africa.WPA Secretary General (1996-2002), Vice-President and President-Elect (2002-2005), President (2005-2008), and Council Member (2008- ). President (2009-2013) and then Secetary General (2013- ) of the International Network , now International College, of Person-centered Medicine.Current Work: 1) Person-centered Psychiatry and Medicine: Organization of the 2008, 2009, 2010 and 2011 Geneva Conferences on Person-centered Medicine, and Conferences in London (2007), Paris (2008), and Uppsala (2008) on Psychiatry for the Person; thematic publication of several monographs and journal editorials & papers, and initiating the International Network for Person-centered Medicine in collaboration with the World Medical Association, the World Health Organization and 25 other international medical and health bodies, 2) International diagnostic systems, particularly ICD-11, Person-centered Integrative Diagnosis, and Latin American Guide for Psychiatric Diagnosis, through monographs, journal papers, and conferences, 3) Culture-informed clinical concepts and procedures, including the Cultural Formulation, the Personal Health Scale, the Multi-ethnic Bicultural Scale, and the Multicultural Quality of Life Index through publications, conferences and research projects.

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