Three cultures

Abstract

Medicine is currently experiencing a universal crisis, which threatens the prestige and image of the individual physician and questions the very ethical and professional values of the profession. The author argues that at the root of this crisis, which is particularly pronounced in Portugal, is a profound conflict between the traditional professional culture - based, on the one hand, on traditional Hippocratic values and, on the other, on corporatism rooted in the Middle Ages -, a new entrepreneurial culture that creates conflicts of interest that were previously ignored, and a political culture that intervenes more and more not only in managerial processes but also in the process of defining the rules for ethical and disciplinary behaviour. The emergence of new paradigms for the medical profession and the consequences of the interaction of these three cultures force doctors to seek new solutions in order to be able to unite and harmonize them without diluting the fundamental ethical values of medicine and at the same time guarantee continuous scientific and technical progress and clearer socio-political intervention. Only thus can the profession succeed in overcoming an identity crisis and it must beware the mistake of merely regarding it as the result of unfounded persecution of a professional group with an impeccable tradition.