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We have reflected on the importance of communication and the art of interrelating in Medicine. My task now is to talk about the significance and value of reciprocity.
It is our conviction that knowing how to communicate and to enter into a relationship with another – whether this person is a colleague, a health worker, a patient or his/her relatives – requires a step farther: to arrive at a reciprocal relationship.

 

We all know that the term “reciprocity” takes on a specific nuance according to the field in which it is applied. People talk about reciprocity in the sphere of economy, politics, social work, healthcare, etc.
A question thus comes to our minds: what significance does reciprocity have in the field of medicine? Above all, what contribution does it add to communication and interrelationship?
We know that a true and deep relationship of reciprocity implies the other person’s willingness to have an encounter and hence a response from him/her: an “I” and a “you” in dialogue, who reach the point of being in unison in thinking and acting.
It is not only a matter of listening, but of comprehending, “taking in”, which means making one’s own what the other is thinking, feeling, whatever he/she is living through. In short we would say: “To be one with the other”, that is, to make room for the other, to enter – so to say – in the other up to the point of awakening a response from him/her and thus reaching reciprocity.
Yes: “To be one with the other” – just a few little words, but they contain a powerful revolutionary force, capable of radically changing our way of acting and of relating to each other.
These words demand that we create a space for the other person in ourselves, that we set aside our ego, that we somehow annul ourselves. And yet it is just in putting such dynamics into practice that each one finds him-/herself enriched by the other, and therefore more self-fulfilled.
This is the substantial contribution that reciprocity brings.

Today, unfortunately, we are immersed in an individualistic, materialist and consumerist society, where interpersonal relationships are getting more and more impoverished, and the word “reciprocity” is losing its true and profound significance. The term reciprocity today is generally understood as a sort of contract: one gives so that he/she can receive in return.
But the fact is, that it should not be like this.
The human person is essentiality marked by reciprocity, which means by his/her “being for and with” the other. Therefore the creation of authentic interpersonal relationships is innate in the very nature of man, and hence, responds to his needs.

Certainly, it is not easy to arrive at reciprocity; neither is it without cost. Rather, reciprocity is the result of an educational process, which is rooted and evolves in a free and continually renewed choice to accept, respect and value the other in his/her full dignity, recognizing him/her as a brother/sister.
Therefore, it is an art based on mutual respect. And as with all arts, it needs training and a process of self-education. Especially in our field, it demands intellectual humility and the desire to enrich one’s perspective and understanding of facts; it also requires knowing how to lose one’s own opinions in the course of interchange with the other. The other then becomes indispensable for me, since I do not possess all elements and viewpoints to exhaust the reality which we are confronted with.
From respect and mutual esteem, a true and fruitful dialogue can develop – the premise for an authentic experience of reciprocity.

To arrive, therefore, at reciprocity, we must look at the other person as ourselves. It is not enough to know the other, to interiorize the fact the he/she exists, that he/she has some value; rather we need to annul the distance between me and the other so that I can accept the other in his/her humanness, without prejudice or judgment, without setting up barriers. I must want what is good, what is best for the other; allow me to say it in one word: to love the other.
It is a love, however, which is not simply made up of feelings but of the will. As we have said, to love means to make myself one with the “you” who stands before me, to immerse myself in his own thinking, in his reality, without fear of losing a part of me.
A love – let me repeat – which means knowing how to listen, how to comprehend the other person’s point of view and in turn, knowing how to offer our own thinking, our own ideas in a climate of respect, esteem and recognition of the other. It is a love that also makes us ready, disposed and able to take the risk of it not being reciprocated.
I would like to conclude by considering briefly the implications offered by reciprocity in the variegated universe of medicine, as you may already have intuited from what has been said here.

Clinical relationships could be revived, the informed consent would be more responsible and shared; the interdisciplinary initiative could become a more useful and constructive goal to pursue with the consequent benefits for all, patients and doctors alike.
Furthermore, reciprocity could furnish the ideal context for discussing and promoting the ends of Medicine. This is so much more necessary today when the dizzying pace of the bio-technological revolution, unprecedented and without precise ethical references, puts at stake the values and objectives of life itself.
Reciprocity in clinical practice also leads to concrete and responsible action that opens itself up to a deeper understanding of Medicine’s limits.
Among other things the dynamic in the interchange of ideas increases each one’s knowledge, and helps the medical team to be attentive to everyone’s interests while discussing clinical cases or in scientific research, with all of its problems in the fields of bioethics and biotechnology.
Moreover, the approach of reciprocity is of great value in doctor-patient relationship, where the inter-relational aspects play an important role.
In this manner, medical etiquette would no longer be mere action, but above all, communication, a relationship that becomes reciprocal. Between the doctor and the patient who feels highly valued, recognized and treated as a person who is seen as an integrated being, as a whole person who demands respect. The relationship established will not be an active-passive relationship, but one of participation and reciprocity, along with all the advantages this will bring.

These are but a few flashes to give us a picture of the advantages to be gained in the world of medicine and for all humanity if the paradigm of interrelationships were always that of reciprocity.
Utopia, perhaps? I don’t know. Difficult, yes, but not impossible.

by ANNA FRATTA

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