SUMMARY

Health is a core issue in the culture of welfare and the expectations that citizens have on their potential health are largely determined by culture. The interaction between genetics and environment will modulate the response of our body throughout life. In the same way that we are what we eat, what we drink and what we breathe, we are also what we think. Perceptions determine our thinking and our behavior, and this has an effect on health. How these perceptions are generated in our society? Largely through the media.

The globalized media society is founded on a revolution in communication technologies that let you transmit any information anywhere in the world in real time. Thanks to the Internet, the centers of knowledge production are permanently connected. The networked society has contributed exceptionally to the acceleration of time, and also to an unprecedented acceleration in the production of scientific knowledge.

One of the most significant changes affects the socialization of knowledge. The media have become the main vehicle of transmission of new knowledge to society. In the field of biomedicine, this means that the new knowledge is now directly travelling from the laboratory to society, and changing so fast that society has little time to assimilate the implications of new discoveries.

In recent years, the stunning advances in the field of biology have allowed us to enter areas that seemed unaffordable. Research on cloning, cellular reprogramming, tissue engineering, nanotechnology and neuroscience increase by leaps and bounds the ability to work on the body. It is natural for them to awaken great expectations. But the extreme competition in which teams operate leads them to communicate findings in an increasingly early stage. And for the advances reached in the laboratory to be provided with an informative value, they are often presented before the public, not in its current reality (a molecule with therapeutic potential, identification of a new genetic mechanism), but as its future potential form (a new treatment, a new therapeutic target). They are the future of medicine, which often fail to materialize or, if certain, they do not do it on schedule, as seen in the case of gene therapy.

This way of communicating and the hagiographic form, almost epic, in which medical research is often presented, create false expectations in society, not just with regards to the individual possibilities of healing but also to the possibilities of medicine in general. The parallel emergence of a new type of patient that is more informed, more demanding and has a lesser frustration capacity, greatly complicates the relationship between doctor and patient and promotes a climate of collective anxiety from which a new industry focused on health trade is meant to profit.

The possibility of intervening in the basic processes of biology has created new ethical dilemmas and fundamental changes in culture, such as our relationship with the chance and the future. Never before has a person had so many choices. And so much need of being advanced. Not long ago, tradition and social rules led the lives of people to such an extent, that many life decisions were environmentally conditioned. Now, we can choose almost anything and the advances in biology place us at the doors of even being able to make choices on our bodies that till now were determined by chance. Preimplantation diagnosis enables to choose among different embryos, those that are free from a specific genetic abnormality. It is not difficult to imagine that as the level of knowledge gets higher, decision opportunities will increase. Today, it would be possible to choose the sex of a baby. Until now, the limit for the intervention has been established on its therapeutic purposes, but it is also likely that with advancing knowledge and changing social perception these boundaries will move. Will it be possible one day to choose a custom-made child? The liberal eugenics, one that seeks the perfection of the individual, is already the subject of intense debate in academic circles.

What underlies the new culture based on the possibilities of science is a desire to control chance. In an increasingly complex society and with greater uncertainty, the desire to control and anticipate the future is conditioning the social response to phenomena that were previously largely governed by chance. We have clearly seen it regarding three recent global health threats: the asian atypical pneumonia (SARS), avian influenza and influenza A.

Some features of the global media society exacerbate the negative consequences of these threats. In this society, highly important concepts for location, such as center and periphery, near and far, real and hypothetical get diluted. The immediate communication enables to live as close threats, ones that may be distant. When an event captures global attention tends to grow like a snowball by the media effect, so any health threat perceived as serious can cause a tsunami of reactions across the globe, as we have seen in recent health crises. The media, with their tendency toward spectacle, to present as certainties mere hypotheses and always placed in the worst case scenario, powerfully contribute to create a dynamics that generates alarm. As we have seen in recent crises, fear of the pandemic can cause more damage than the pandemic itself.

The need to anticipate the future in a political structure whose key decision-making process is immediateness often leads to implement preventive policies that are often excessive or unjustified. The fear of being blamed for not having been advanced conditions the decisions of politicians whose individual horizon is measured by terms of office. The new culture of emergency frequently leads to compulsive and many times mistaken decisions among which the ones related to health are telling examples.

The dialectic between the individual and society frequently arises in the health field as a conflict. The culture of prevention has, undoubtedly, brought about very positive results when it comes to health and life quality improvement. But there is also an unhealthy prevention. The obsession with health, to prevent suffering or disease, may become a new social disorder. A disorder of the consumer culture. We consume health as anything else and eventually we end being health consumers consumed by our own obsession.