Annals of Bioethics & Clinical Applications 

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Is a Medical Vocation Possible Today? Is a Christian Medical Vocation Possible Today? 

Pilar Nunez Cubero M1,2*  

1Department of Bioethics, Comillas Pontifical University University, Spain 2Department of Philosophy, Ramon Llull University, Spain 

*Corresponding author: M Pilar Núñez Cubero, Department of Bioethics, Comillas Pontifical  University & Department of Philosophy, Ramon Llull University, Spain, Email: pnunezcubero@ 


Volume 5 Issue 2 

Received Date: June 02, 2022 Published Date: June 13, 2022  DOI: 10.23880/abca-16000234 

The “Mater Care” Group, which brings together the  Obstetricians and Gynecologists of the International  Federation of Catholic Medical Associations, was pleased to  dedicate its biannual session in 2019 to the analysis of the  decision to be a doctor today, wondering if it is still a vocation,  as it has always been considered, or has become an attraction  to the development and application of new technologies and  the management of other values that give more importance  to the success of the technique than to the humanization of  patient care. It was not in vain that Mgr. Redrado, OSJD wrote:  our Hospitals are, today, temples of science and technology,  and many times they are not focused on the patients but  on other interests, to the point that research seems to go  beyond them. The big question that arises is: Should we do  everything that science and technology offers us today? Does  science have limits? We must do what can best serve people  and especially the sick [1]. 

We have to ask ourselves: if we have not passed from the  spirit of the Good Samaritan, to that of a “cyber doctor”, or to  that of a transhumanist for whom everything is allowed as  long as he manages to eliminate all suffering and achieve a  life without death and, if The time has not come to reflect on  the need to move from evidence-based medicine to a patient centered medical art, to a totally person-centered medicine. 

Current Situation Medicine, Science &  Society in the Third Millennium 

Years ago every vocation was a call, linked to Christianity,  the call of God. Martin Luther and John Calvin emphasized  the importance of all work as something to which a person  was called by God. There was an idea that everyone’s work –  in our case, medicine was a God’s calling. 

The characteristics of a call of this type mean that a  medical career has less to do with personal fulfillment  and more with a response to a need and a requirement to  contribute to the common good. A mentality centered on “us”  or “Society”, instead of on me, on the SELF. 

Thinking of this generation, some believe that today  this attitude seems to have been lost… Among students,  residents, young doctors, the conversations about Medical  Career seem to focus on oneself: How much money am I going  to earn? How much prestige am I going to achieve? What  lifestyle will I be able to have? Am I going to perform? Some  time ago the medical profession has ceased to be a liberal  profession to follow an administrative model, even governed  by agreement. The issue that worries the most seems to be  the “I”. Before, medicine was the means to help people, now  it is not. This is tied to a broader sociological environment  that emphasizes personal self-actualization and individual  autonomy over collective well-being. 

Robert Bella in his book (Habits of the Heart) writes: “we  have put our own good, as individuals… ahead of the common  good.” (“We have put our own good, as individuals… above  the common good”) and this is an especially acute problem  in medicine, since we are not taking care of people’s finances  or products, but rather we are taking care of people in a  moment of vulnerability. Medicine is a position where you  get money and prestige. It is an easy activity to seek personal  gain, but it is a particularly dangerous profession, in which 

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seeking such possibilities can have repercussions and lead  to inappropriate care of the vulnerable people to be served. 

An upward path is given: When medicine is sought only  for personal fulfillment, we see our patients as mere objects  rather than people in need. If patients are presented to us as  cases that do not bring us interest for our academic careers…,  they become annoying, annoying, and we use them without  interest, because their questions do not bring us any benefit,  unless we can make some publication with their case to  enhance the resume. They are patients who are not worth  our time. We do not see in them people in need of help, nor  do we see ourselves as public servants, rather the patients  become a secondary point of interest, even an obstacle to our  goals. 

If we think like this…We Will Be Doctors, Not Caregivers

If we want a truly caring generation of doctors, we  have to change the culture of “me and medicine” to one of  “medicine and patients” and our helping role. Bellah wisely  says, we have to return to “the idea of medical work as a  contribution to the good of all, and not merely as a means to  our own progress.” 

If today we deeply reconsider the reason for medicine,  perhaps we will find in our hearts a genuine desire to always  be there for our patients. 


It will be necessary to establish the difference between  PROFESSION and VOCATION 

•  Profession is a type of job that requires deep, modern  training and practical experience or skills. Practice as a  professional, really means that one has to do what others  think you are capable of doing, with competence, and for  that you deserve respect. Depending on the workplace  and its type, it can be presented in different ways, and  professional work is normally sealed with one form of  contract or another. 

•  Vocation is the occupation to which one strongly feels the  need to dedicate oneself, regardless of earning money or  other benefits. The personal vocation should be what  one feels driven to do because that gives a deep meaning  to his life. A type of work that you feel compelled to do  and to which you spend most of your time and energy 

To work in medicine, one should have a vocation for it.  Vocation that implies being “rigorously scientific, deeply  human, and ethically correct”, since it is the ideal destiny, the  specific mission that each person has to be and to do in their  own life, something in us that struggles to be fulfilled and  that collides with our environment –soul, body, social world,  nature- so that they allow it to “be”, to carry out its mission  (Ortega y Gasset). A call to a certain way of existing, what we  feel “have to be”, the task or project of existence that must be  carried out. 

The first sign of personal vocation is LOVE, which fights  and overcomes the difficulties against it, which try to keep  him from dedicating himself to it and fulfilling his vocation,  as the unavoidable personal task. 

Medical Vocation 

The Medical Vocation supposes that inner desire and  that love against all difficulties, since it needs all levels of  interpretation (literal, moral, allegorical, and analogical) to  achieve a true DOCTOR-PATIENT ENCOUNTER. 

In the first meeting, the doctor has to evaluate the  patient’s situation, the plausibility of his terms, the  inaccuracies in his expression and the narrative fidelity, for  the benefit of the patient and to create empathy. And at the  same time explore the patient’s values. Without forgetting  that the human person is a unit, not a conglomerate of 5  components 

After the first meeting, he has to follow the path of  reason to get to know the truth: the reality of the patient in  the physical, mental, social, spiritual and emotional (Zubiri),  always confronted with a system of references , to point out  some possibilities of diagnosis and differential diagnosis and  checking the veracity of these possibilities (evidence)

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And after that, come to the path of morality to contrast if  there are some values in conflict and if there were, respecting  personal autonomy, allowing the patient to participate  in deliberation and decision “without forgetting that an  emotional situation can lead the patient to an axiological  blindness” and that it will be necessary to give him time to  deliberate and arrive at the correct decision. 

Physicians, in the exercise of their profession, cannot  forget their moral principles, neither at the time of their  medical acts, nor at the time of manifesting them. Their  bioethical training should not be based only on Principles,  but also and, mainly, on the virtues, especially prudence, not  as caution but as Phronesis or practical wisdom (Pellegrino),  keeping in mind a great sense of duty, since often it is well  known what can be done, but what one has the DUTY to do  is ignored. 

The autonomy of the patient requires respect, but not  discharging all responsibility on him, as a moral, autonomous  and responsible subject must be included in the process  of deliberation and decision-making in everything that  concerns him. It will be necessary to jointly analyze the facts,  reflecting on the values that are at stake, to deduce the duties  to be followed: 

The moral conscience has to guide and give an orientation  on the moral decision. It is about a type of conscience that  can guide us in the most difficult decisions because it in  the subjectivity of DUTY, where ethical decisions have to be  made, knows that Medicine is a science of probability and  not a science of certainty, and without forget that all moral  conscience is manipulable. 

The Legislation and the Codes of Medical Ethics have  to incorporate the conscientious objection of doctors for  ethical, moral and religious reasons, in order to guarantee  the freedom and independence of professionals, without  neglecting to consider that there are pathological consciences  due to laxity or because of their rigidity, and without  forgetting that Conscientious Objection is PERSONAL. 

The Medical Vocation Today Asks 

Love for medical work, Love for the patient, Competence,  Dedication and so when what one wants to do and what one  must do coincide, peace and joy are produced: “you enjoy  with and in medical work”. 

The Christian Medical Vocation is identified with the  image-model of the Good Samaritan 

Vocation of the Christian Lay Physician, and  of Catholic Health Personnel 

He asks “to see daily tasks as an opportunity to get closer  to God, to fulfill his will, and to serve others by bringing them  closer to God.” Christifideles Laici 52 and giving a coherent  testimony of it with life. “A baptized Christian who is truly  baptized in his heart, living and fulfilling his profession  wherever in the world he lives and exercises his profession,  can be a true Christian.” 

Christifideles Laici invites the following fields of action: •  Promote the dignity of the person; 

•  Protect the inviolable right to life; 

•  Recognize religious and family freedom in their social  environment; 

•  Act with Charity as inspiration and support for solidarity; •  Accept the duty of every person to express themselves  in politics; 

•  Consider the centrality of the person in the social and  economic sphere; 

•  And evangelize the culture both at a general level and  each culture in particular. 

•  The Pope, Francisco, thus addressed health workers  “treat the sick as a person, not as a number” (June, 2019). •  Take care of the defense, respect and promotion of life. •  The health system and treatments have changed  radically, not only due to technological advances, but  also because more serious problems of an ethical nature  have appeared. 

•  Any medical practice or intervention on the human  being must be carefully evaluated on whether it respects  life and human dignity. 

•  Appreciates the “irreplaceable service” to the most  vulnerable or most needy people based on illness, age or  marginalization. 

Look at your patient; learn to call him by name. Be open to  the unpredictable”.

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Each person is unique and unrepeatable; contemplating  the humanity of Christ teaches us that every individual is  not a number, but a person, unique and unrepeatable”. The  efficiency of the Corporation and the reduction of costs often  put the needs of the patient in second place, rather than  accompanying them throughout their illness. 

Christian professionals are encouraged to devote  particular attention to spirituality. So that this fundamental  dimension of the person, so important but often forgotten  in our time, is once again valued and appreciated, especially  for those who live with the disease and for all those who are  close to those who suffer”.  

CHALLENGES posed to the medical vocation, Christian  or not, by Modern Medicine and Contemporary Society. The  challenges of modern medicine and society to the medical  vocation focus on the value of life and human dignity from  beginning to end (abortion, euthanasia…) 

•  Consider the value and application of Prenatal Genetic  Diagnosis or PGD and Systematic or Screening Diagnosis,  SGD, when authors, such as Savulescu, claim that parents  have a moral obligation to perform Genetic Diagnosis  of their embryos and make a selection of the embryos.  Themselves. 

•  The creation of embryos for the purposes of reproduction,  research or treatment. 

•  Cloning to obtain stem cells. You cannot eliminate a life  to save another life. 

•  Assisted reproduction, up to what limits… Up to  surrogacy? 

•  Transhumanist and post humanism (can and should  man be changed?) 

•  The robotic. Can robots and cyborgs treat and care for  the patient? 

•  The Society of maximum well-being, the greatest well being, for whom? For everyone? 

•  Gender situations, for whom? Why? 

•  Ethics, Law, Legislation and Policy 

Transhumanist, why and for whom? There is a difference  between trying, improving and wanting to change man 

Gender Situations and Theories: Queer Theories… The greatest possible Well-being, physical, intellectual,  social, emotional, spiritual, economic, occupational,  environmental… For whom? For each and every one? 

The Autonomy of the Patient, can the patient demand  a treatment that is not medically indicated? Change from  a Paternalistic Medicine to an Autonomist or Deliberative  Model. 

Bureaucracy a New World Order 

•  A techno-liberal globalization 

•  A technical globalization of the community •  Genetics and germ line therapy 

•  The Hybridization “Machine-Man” (Cyborg) •  Artificial Intelligence (not different from Humans)  Kurzweil 

•  Converging Technologies: NBIC 

•  Transhumanism and Posthumanism 

•  A New Humanity (Avatar 2045) 

Politicization & Commercialization the 4th Industrial  Revolution. 

Ethics and Law “Legislation” 


Do we have to do everything that science and technology  offer us?. What should we do…? What is necessary to serve  people, the sick? LAW: Can the Law compel the withdrawal  of a treatment and lead the patient to his death?. 

Is it possible to legislate to impose the “Reproductive Right”  including the end of a pregnancy?

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Conscientious objection is based “on the personal need not  to act against one’s own ethical conviction” 

The choice to object must be made with respect and humility,  without becoming a reason for pride or vanity. In these situations, it is essential to exchange reasons and  dialogue “especially with those who hold different positions”,  always avoiding condemnation. Today it seems that our  hospitals are temples of science and technology, and they  are not focused on the sick, even in some cases the research  goes beyond the individuals… the sick. The doctor will often  have to remain in a democratic disagreement, remaining  in conscientious objection when many of the decisions go  against our values, and against a Christian vision of man and  life. 

The demand for coherence about life could lead, in  extreme cases, to the greatest and supreme testimony of  martyrdom, as the martyrs of the 19th century in Korea  show us…, and now, it can lead us to lose our jobs. 


Is Medicine a possible vocation today? Yes, it is always  possible to heal and care for the people who live in our world,  real people and Cyborgs. Serving the most vulnerable… the  poor, the refugees, the homeless, as well as those living in  developing countries, the least advantaged You will always  have the poor with you, and whenever you have a desire you  can do them good, (Mk 14, 7) 


Full text of the Geneva Declaration, October  2017 Physician’s Promise 

•  I SOLEMNLY PROMISE to dedicate my life to the service  of humanity; 

•  ENSURE above all for the health and well-being of my  patient; 

•  RESPECT the autonomy and dignity of my patient; •  MONITORING with the utmost respect for human life; •  DO NOT ALLOW considerations of age, illness or  

disability, creed, ethnic origin, gender, nationality,  political affiliation, race, sexual orientation, social class…  to come between my duties and my patient; 

•  KEEP AND RESPECT the secrets entrusted to me, even  after the death of the patient; 

•  EXERCISE my profession conscientiously and with  dignity and in accordance with good medical practice; •  PROMOTE the honor and noble traditions of the medical  profession; 

•  GIVE my teachers, colleagues, and students the respect  and gratitude they deserve; 

•  SHARE my medical knowledge for the benefit of the  

patient and the advancement of health; 

•  TAKE CARE of my own health, well-being, and abilities to  provide health care of the highest standard; 

•  NOT TO USE my medical knowledge to violate human  rights and civil liberties, even under threat. I MAKE  THESE PROMISES solemnly and freely, under my word  of honor. 

A Code or Constitutional Charter for Physicians:  Professionalism 

Rev Chile Infect 2004; 21(1): In February 2002, a very  interesting document was published simultaneously in the  Lancet1 and Annals of Internal Medicine 2 journals. It is  the proposal for a new Code or Constitutional Charter for  the medical profession, which proposes the ideals to which  “all medical professionals can and should aspire [1].” The  document is the product of several years of joint work by three  very important institutions dedicated to internal medicine  and, to a large extent, regulating it: the American Board of  Internal Medicine, the American College of Physicians and  the European Federation of Internal Medicine. Despite this  origin, its scope reaches all medical disciplines. The Code  consists of an introduction or preamble of its foundations  [2], followed by the proposal of three basic principles and  ten commitments. 


Professionalism is the basis of medicine’s contract with  society. 

The word “professionalism” in the Spanish language  does not reflect the content of that Constitutional Charter,  but it is universally accepted, probably because in English it  better expresses the content of this document. In any case,  this Charter or Code establishes principles and commitments  that are specific and exclusive to the medical profession. All  doctors should know the content of this Code and try to put  it into practice. Medical journals, specialty societies, and  medical schools should be involved in the effort to spread  these ideas [3-6]. 

Fundamental Principles  

•  Principle of Primacy of the Welfare of the Patient:  Altruism contributes to trust and a good doctor patient relationship. Market forces, social pressures  and administrative requirements cannot violate this  principle. 

•  Principle of Patient Autonomy: Physicians must  be honest with patients and empower them to make  informed decisions about their treatment. 

•  Principle of Social Justice: Physicians must actively  work to eliminate all discrimination in health care, 

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whether for reasons of ethnic or racial, gender,  socioeconomic, religious or any other social category. 

Professional Responsibilities or  Commitments 

•  Commitment to Professional Competence: Doctors  must learn all their lives. 

•  Commitment to Professional Competence: Physicians  must learn a lifelong commitment to honesty with  patients. Physicians must ensure that patients are fully  and honestly informed before agreeing to treatment;  should be able to decide on the course of therapy. 

•  Commitment to Maintaining Appropriate  Relationships with Patients: Physicians should never  take sexual advantage of their patients, obtain personal  financial gain from them, or use them for any other  private purpose. 

•  Commitment to Patient Confidentiality: Satisfying the  commitment to confidentiality is more important today  than ever before, given the widespread use of electronic  information systems to collect patient data. 

•  Commitment to a Better Quality of Care: The doctor  must work with other professionals to reduce errors,  increase patient safety, avoid excessive use of resources  and optimize health care. 

•  Commitment to Improving Access to Care: Physicians  must individually and collectively strive to reduce  barriers to equitable health care. 

•  Commitment to a Fair Distribution of Limited  Resources: Physicians must commit to working  with other physicians, hospitals, and economists to  develop cost-effective care guidelines. The professional  responsibility of physicians for an appropriate allocation  of resources requires scrupulously avoiding superfluous  tests and procedures. 

•  Commitment to Maintain Trust in the Face of  Conflicts of Interest: Physicians have an obligation  to recognize, alert the general public, and deal with  conflicts of interest. Relations between the industry and  opinion leaders must be transparent. 

•  Commitment to Scientific Knowledge: Physicians  have a duty to safeguard scientific standards, promote  research and create new knowledge, ensuring its proper  use. 

•  Commitment to Professional Responsibilities. Physicians are expected to participate in self-regulatory  processes, including rectifying and disciplining members  who have failed to meet professional standards. 


1. (2002) Medical Professionalism in the new millennium:  a physicians’ charter. The Lancet 359(9305): 520-522. 

2. ABIM Foundation, ACP-ASIM Foundation, European  Federation of Internal Medicine (2022) Medical  professionalism in the new Millennium: a Physician  Charter. Ann Intern Med 136(3): 243-246. 

3. Blank L, Kimball H, McDonald W, Merino J (2003) Medical  professionalism in the new Millennium: a Physician  Charter 15 Months Later. Ann Intern Med 138(10): 839- 841. 

4. In short, the practice of medicine in the modern era is  subject to great real or virtual challenges, in all cultures  and societies. 

5. These challenges center on increasing inequalities  between the legitimate needs of patients, the resources  available to meet those needs, the increased reliance  on market forces to transform health systems, and the  temptation of healthcare professionals to forget their  traditional commitment, the priority of the patient’s  interests 

6. To maintain fidelity to the social contract during this  turbulent time, physicians need to reaffirm their active  dedication to the principles of professionalism, which  requires not only a personal commitment to the well 

being of their patients, but also a collective effort to  improve healthcare systems. Health for the good of  society.