Looking back on the last forty years of development in the area of life sciences, talk of a real ‘knowledge revolution’ cannot be avoided. This not only but chiefly applies to biological-medical areas whose development of new methods and combination of biological and mathematical-physical discoveries has led to a consolidation and specification of knowledge that was unforeseen just a few centuries ago.
Knowledge of biological mechanisms, for example those of the human body, does not stop at the level of organs and cells but on the level of inner cellular micro and nanostructures. Cascades of biochemical reactions between proteins and individual molecules make it possible today to recognise functional connections on a molecular-medical basis and then to classify these in diagnostics and therapeutics.
We have begun to understand and influence life processes on the level of interaction between individual molecules, that is, on a micro or nano level. This includes the description of genetic structure and its entirety in the genome, the question of what conditions are necessary for genetic heritage to be transformed into biologically effective molecules, and cell renewal. These all has various consequences, which first have to be understood in general terms and then transformed into action. It also means, however, that the very popular public debate on conventional medicine and personal medicine should have long since been replaced by molecular medicine and its related form of individualised medicine. The tension curve that has to be managed in medicine by the patient, but even more so for the doctor, is bigger and more challenging than ever.
Keeping up with the standards and new discoveries in pathophysiology, diagnostics and preventative cures for diseases on the one hand and the not declining demand of patients for a holistic view of their personal illness records – these are challenges that require much more that an improved technological and scientific training for those working in the medical field.
In addition to this, the simultaneously growing abundance of information that patients have via the internet make it in no way easier to remain clear on the patient’s situation. Freely accessible information, as desirable as it might be for the enlightened patient, is at the same time a source of great anxiety and uncertainty. Seen in this way, giving information to patients is no longer the sole responsibility of the doctor, but it is virtually becoming a feat of integrating all the different sources of information accessible to the patient.
However, to return to molecular medicine: the fact that we can already determine our individual genome today not only leads to whole new possibilities of timely, individually tailored preventative medicine but also leads to new risk-benefit considerations. The fact that we can recreate organ and cell functions, or will be able to in the near future, is a result of this tremendous development in biosciences.
As in Virchow and Koch’s time, discoveries in microbiology or infectology respectively led to revolutions in the entire medical system, molecular medicine will result not only in changes in medical training but also a lasting effect on hospital procedures and structures - a process that, in my opinion, that still lies ahead of us in its entirety.
Existent cancer diseases, the emergence of new infectious illnesses, the stark increase in chronic and degenerative diseases of the circulatory system, the musculoskeletal system and also of the brain – all of these can only be improved, prevented or eventually cured using the most modern biomedical methods. The ever-growing advance into the micro and nano areas of our lives can nevertheless only be realised if we develop a new understanding at the same time for the overall state of the individual and of the need that exists in larger communities.
Prof. Dr. Dr. h. c. Günter Stock,
President of the Berlin Brandenburg Academy of Sciences
