Bioethics and immigration: the UniCamillus experience

Paper of Laura Pacifici Noja and Alessandro Boccanelli, Professors of UniCamillus, selected at The Migration Conference 2020

Over the last few years we have been witnessing many changes and transformations of he Society. For exemple in one hand immigration is a social phenomenon that is increasingly acquiring a relevant, permanent and structural configuration. This complex phenomenon of migratory movement from Developing countries to the Western countries even has an important influence on the Italian reality of the last few years. On the other hand the current Medicine is heavily influenced by different phenomenon and now it is increasingly supported by new disciplines like Ethics and Bioethics, disciplines that deals with the new problems emerging in the biological and medical sciences.
UniCamillus, International Medical University recently established in Rome and inspired by Camillo de Lellis, universal patron of the sick, nurses and hospitals who laid the foundations of modern health care system between the 16th and 17th centuries, holds a course in Moral Philosophy that has created a link between the fundamental principles of Athenaeum-internationality, humanitarian mission and inclusive medicine- and the new ethics challenges.
The World Health Organization (WHO) has long been committed to supporting member states in improving the quality of education and training of health workers through an evidence-based approach to which we must add, as soon as possible, a method based on bioethics oriented to the understanding different cultures, preparing healthcare professionals for a culture of hospitality and solidarity in the perspective of transcultural medicine and in the necessary observance of ethics and the law.
Following the pattern laid down by WHO, the challenge of UniCamillus University is to train health professionals who can also contribute to improving the conditions of their country. In the future the UniCamillus project could also be useful as a contribution to limiting irregular immigration flows, a condition of which one of the cause can be found in many countries related to the lack of health care programs and to the insufficient educational background .
At the UniCamillus University the methods of selecting students are also very friendly even if extremely strict in terms of quality. The University gives non-EU students the opportunity to take the test at the degree course of their interest. Once admitted, the student will receive an admission letter from the University to be issued to their Embassy in Italy, to which they will then also have to deliver the High School Degree and indicate the accommodation where they will settle down during the academic year. Throughout this process, the student is assisted remotely by the University offices. Naturally, the Italian consulates of the various countries do an excellent job of verifying credentials also to assess their real motivation of students and full awareness to undertake the study path offered by UniCamillus. The University, also in Italy, assists students in carrying out all administrative processes, from requesting a residence permit, to the health card, to enrolling in the national health service. Once enrollment at the University is defined, all non-EU students obtain a residence permit, tax code and other types of documents required for their stay.

The “Moral Philosophy” course of UniCamillus, Medical University of Rome, wants to give students a global vision of Medicine. One of the challenges of the course is to guide students, from the first year of the course, towards a vision of medicine strongly focused on the patient and human relationship without any kind of distinction. The course intends to deepen the role of information exchange through narrative medicine and highlight the necessary empathic relationship, the importance of respecting different cultural approaches and the ethical adaptation of doctor-patient communication in the digital age. The course also wants to address the importance of multidisciplinary collaboration, the difficulties in approaching rare diseases and research in this field, the need to develop international collaboration projects in consideration of many factors at the same time as the globalization of knowledge, inequality of resources and migration. The methodological goal confronts the challenges posed by western technological-scientific societies in order to understand if, and how, it is possible to face them and on the basis of which ethical-anthropological assumptions and criteria.
In this perspective UniCamillus University provides a significant number of grants and scholarships for deserving and highly motivated non-EU students who do not have sufficient financial resources. More specifically, the formula used for non-EU students is the “loan of honour”, that is completely repaid if, after having achieved the degree, the professional returns to his own country (or in a similar one) to practice for at least three years. This system helping students to return to their countries of origin can contribute to interrupt the vicious cycle- lack of health care programs and insufficient educational background/unemployement/ irregular immigration flows- and quite the contrary improve the global conditions of life.
Scholarships are financed also by the support of national and international organisations that are engaged in humanitarian activities or that wish to support future physicians, nurses, obstetricians and technicians who will address health emergencies that still affect a substantial part of the world.

Work method
UniCamillus, hence, is a “foreign policy initiative through health” which in line with its humanitarian mission offers courses that are aimed at training doctors and healthcare professionals, making them capable of operating at an international level in order to meet the healthcare needs of less privileged countries. During the study plan of the various Degree Courses offered by UniCamillus, particular emphasis is given to the interrelationships existing between the contents of the basic sciences and those of the clinical sciences with specific attention being paid to the interdisciplinarity of Medicine.
Having inserted a course of “Moral Philosophy” in the first year of medicine is functional to give, from the beginning to the medical future, a basic vision on which to then insert the biological and technology knowledge to prevent them from becoming these, and not the human relationship, the protagonists of the doctor-patient relationship all over the world.
The 120 students, Italian and foreigners- from Africa, Asia, Middle East and Haiti-, of the “Moral Philosophy” course were divided into 17 working groups, each of which was assigned a theme.
Some of the topics covered have been: “Health in the Globalization Era,Female Genital Mutilations, The Complexity of Health Organization, Health and Migration,HIV, Infective Diseases and Vaccinations”. The group’s tasks consisted in carrying out research on the topic, preparing the classroom exhibition, presenting the work with pre-established and uniform graphics, discussing the project in the classroom with an expert invited to each occasion and answering questions from fellow students. After the lecture given by the students themselves, the group was required to prepare a paper.

In a sector characterized by constant and rapid evolution, the course of Moral Philosophy tried to provide the students the ability to understand the main problems they will face as doctors. The course also intended to provide a training program aimed at ensuring, through specific focus, the most current and relevant issues in the field of health and ethics. The idea was to allow students to face the personal commitment required by an ethical approach in the different situations in which they may find themselves exercising their medical profession. The result was satisfying on the one hand because the experience was a first time for all. In fact, students had to make the effort to analyze, digest and re-elaborate for the other students, their principles and values on their chosen topics. On the other hand, they found themselves evaluating the work done by their peers, perceiving the existence of many points of view.