Medicine is soaked with inappropriateness, wastes, conflicts of interest, and many clichés induce professionals and patients to consume more and more healthcare services in the illusion that it is always better doing more for improving health. Moreover, the dominant reductionist cultural model, on which the concept of health and disease is based today, considers man as a machine, investigated by a growing number of specialists, particularly interested in the pathophysiological mechanisms of diseases. The interest is mainly focused on technologies, while the person along with the relations with his/her family and the social environment are completely neglected. The systemic approach adopted by Slow Medicine, on the contrary, teaches us that health and disease are complex phenomena and the life of a person is more than the sum of the chemical reactions that occur in its cells.
The Slow Medicine Manifesto
In 2011 the Slow Medicine Italy movement produced a multilingual document called Il Manifesto di Slow Medicine in which its core values, associated with the practice of measured, respectful and equitable medicine, were defined.
Measured: Doing more does not mean doing better
The dissemination and se of new treatments and new diagnostic procedures is not always accompanied by greater benefits for patients.
Economic interests, as well as cultural and social pressures, encourage both an excessive use of health services and an expansion of people’s expectations beyond what is realistic, what the health system is able to deliver. Not enough attention is paid to the environment or the integrity of the ecosystem.
A measured medicine involves the ability to act with moderation, gradually, and essentially, and uses the resources available appropriately and without waste. A measured medicine respects the environment and protects the ecosystem.
Slow Medicine recognizes that doing more does not mean doing.
Respectful: People’s values, expectations and desires are different and inviolable
Everyone has the right to be what he/she is, and to express what he/she thinks.
A respectful medicine is able to acknowledge and take into consideration the values, preferences and orientations of a person in every moment of life.
Health professionals act with care, balance and empathy.
Slow Medicine recognizes that people’s values, expectations and desires are different and inviolable.
Equitable: Appropriate and good quality care for all
An equitable medicine promotes appropriate care, which is both adequate to the person and circumstances, and proven to be effective and acceptable for both patients and health professionals.
An equitable medicine opposes inequality and facilitates access to health and social services. It overcomes the fragmentation of care, and encourages the exchange of information and knowledge among professionals.
Slow Medicine promotes appropriate and good quality care for all.
Principles of Slow Medicine
In 2014, the Dutch Slow Medicine movement constructed 10 guiding principles of slow practice.
Time for listening, for understanding, reflection, consultation and emotional support. Medical decision making will improve when doctors invest in time and mindful attention.
- Personal, individual
Tailor-made care, proper care, equitable care. Indivualisation instead of generalization. The patient is the measure of things and the patient’s point of view is leading.
- Autonomy and Self Management
Shared decision making, the patient’s values, expectations and preferences are key. This encompasses an embedding of the care program in the patient’s environment; family, neighbours, friends and other resources.
- Positive Healh
New health-defining concept “positive health” (researcher Machteld Huber) focusing on resilience and self management. Shifting the emphasis to health (rather than illness) helps policy makers and politicians to change their approach to health care and disease prevention. This change is urgently needed if we are to maintain high quality care that is also affordable.
Healthy, slow food is the basic medicine to a healthy life. And to keep in physical shape through exercise. Positive thinking can (re)program our brain to stay healthy.
- Quality of life
Doing more does not always mean doing better. Quality over quantity, the acceptance of the inevitable. Doing nothing as a (medical) art.
- Integrative medicine
The best of 2 worlds: regular medicine if necessary. Additional medicine if possible, preferably evidence based. Safety over effectiveness. No metaphores of war, fight, etc but of recovery and equlibrium/balance.
- Safety first: do no harm
Hippocrates’ oath: Primum non nocere and iI dubio abstino.
- Passion and Compassion
Medical peer networks such as Platform ECG en Compassion for Care are aiming to reenter the themes compassion en passion in care. Too much focus on working by the book and control will harm care and working in the care sector.
- Human focused technology
Hi-tech serves humans, not the other way around. New technologies have to be designed to enhance self management and the Slow Medicine objectives.