Bioethics as a Pathogenic Factor in the Historical Evolution of Dermatology in Las Tunas, 1970–2025

Abstract

Background: Dermatology in Las Tunas has undergone a developmental process that reflects the historical transformations of Cuban medicine. Analyzing this trajectory through the lens of bioethics offers a critical perspective for understanding manifestations of cognitive-emotional blindness and cognitive-emotional-existential scarcity.

Objective: to interpret the historical evolution of Dermatology in Las Tunas from the perspective of bioethics—viewed as a realm of "pathogenic reason"—while considering its manifestations in clinical care, teaching, and research.

Methods: A qualitative study was conducted using the historical-logical method, covering the period from 1970 to 2025 and defining three stages: general medicine without specialization (1970–1980), consolidation of the specialty (1980–2019), and the computerization of health processes (2020–2025). The research involved interviews with specialists, a review of documents, and the cross-referencing and triangulation of sources. For the trend analysis, the theory of the ethical-humanistic trend was applied, incorporating the categories of "pathogenic reason," "cognitive-emotional blindness," and "cognitive-emotional-existential scarcity."

Results: the findings demonstrate a shift frompaternalistic models toward more person-centered practices; however, expressions of pathogenic reason persist, associated with the dominance of the biomedical paradigm, limitations on patient autonomy, insufficient ethical scrutiny of technological innovations, and limited incorporation of the tenets of Latin American and Cuban Critical Bioethics.

Conclusions: the bioethical interpretation made it possible to identify manifestations of cognitive-emotional blindness and cognitive-emotional-existential scarcity, as well as opportunities to strengthen a dermatological practice that is critical, humanist, and committed to human dignity.