Chronic illnesses such as diabetes, hypertension, heart disease, and chronic obstructive pulmonary disease (COPD) are among the leading causes of death and disability worldwide. While medical treatments are essential, long-term outcomes for these conditions largely depend on prevention and lifestyle management—consistent medication use, proper nutrition, physical activity, stress reduction, and regular medical follow-ups.
As breakthroughs in gene editing technologies like CRISPR* become more accessible, future doctors will be expected not only to understand the molecular mechanisms of disease but also to navigate the ethical terrain of modifying human DNA. Questions surrounding germline editing, the potential for genetic inequality, and the commercialization of genetic technologies will become everyday clinical concerns. Physicians must balance the promise of precision medicine with caution, ensuring equitable access and maintaining a patient-centered, ethically sound approach to care.
Simultaneously, the rise of artificial intelligence is rapidly redefining the role of the physician. AI systems now outperform human clinicians in certain diagnostic tasks, reshaping how decisions are made and challenging doctors to interpret and humanize machine-derived insights. While these systems may increase efficiency and reduce error, they also introduce new ethical dilemmas, including data privacy breaches, algorithmic bias, and the erosion of patient-clinician relationships. Rather than being replaced, doctors must evolve—transitioning into roles that emphasize empathy, judgment, and advocacy in collaboration with intelligent systems.
Beyond the clinical environment, doctors are increasingly confronted with the mental health crisis exacerbated by the digital age. Social media, despite its benefits for connectivity, has been strongly linked to increased rates of depression, anxiety, eating disorders, and cyberbullying, especially among youth. Physicians, particularly in primary care and pediatrics, are now expected to manage the fallout of a hyper-connected world that erodes self-esteem and distorts reality. The challenge is compounded by the fact that these digital influences lie outside the reach of traditional medical interventions. Medical professionals must, therefore, become not only clinicians but also educators and public health advocates, guiding families through the digital landscape and pushing for healthier online ecosystems. Moreover, they must guard against the medicalization of social distress—recognizing when issues stem more from structural and societal problems than individual pathology. At the interpersonal level, this demands a nuanced approach to patient communication, cultural competence, and the ability to navigate the psychosocial complexities that increasingly define patient experiences.
On a broader ecological scale, the effects of climate change are becoming impossible to ignore. Rising global temperatures, extreme weather events, food insecurity, and the spread of vector-borne diseases are already manifesting in clinics and hospitals around the world. This is not a distant concern; the health of the biosphere is directly linked to human health, with vulnerable populations bearing the brunt of environmental degradation. Medical professionals must respond not only by treating environmentally linked illnesses but by addressing the root causes. This includes advocating for sustainable healthcare practices, such as reducing hospital carbon footprints and championing telemedicine, while also considering the health implications of urban design, air quality, and food systems. Physicians must also take part in policy discussions that intersect health and the environment, elevating their voices beyond the clinic to push for systemic change that protects public health in the face of ecological collapse.
Crucially, these challenges are not isolated but exist along a continuum—from the molecular level, through interpersonal relationships, to the ecological and planetary. A child with asthma may have a genetic susceptibility, exacerbated by pollution in their environment, compounded by stress and bullying from social media, and managed by a healthcare system increasingly reliant on AI.
“Future doctors must be trained to understand this interconnected web of factors influencing health. This requires a shift in medical education away from compartmentalized thinking toward systems-based and transdisciplinary approaches. ”
Medical curricula must integrate genomics, bioethics, climate science, artificial intelligence, and the humanities, producing graduates who are not only clinically competent but ethically grounded, ecologically aware, and socially attuned.
To prepare for this future, medical education must be radically reimagined. Students must learn to navigate ethical dilemmas as rigorously as they learn to interpret lab results. They must be fluent in digital health technologies and able to critique them from both clinical and ethical perspectives. They must know what literature to believe in; what evidence is applicable to patients and how they will be able to make use of research findings. Interdisciplinary collaboration with computer scientists, sociologists, environmental experts, and mental health professionals must become the norm. Doctors must be trained not just as healers but as advocates and leaders who can shape policy, influence technology design, and engage communities in co-creating solutions to complex health problems. Additionally, the medical profession must prioritize its own wellness. With burnout, depression, and moral injury on the rise, fostering resilience and mental well-being among doctors is essential if they are to care for others sustainably.
In conclusion, the physician of the future is being called to do far more than diagnose and treat diseases. They must act as navigators of technological disruption, guardians of ethical integrity, stewards of the environment, and champions of mental and social health. The task is monumental, but so is the potential for transformation. By embracing a holistic, systems-thinking approach to health—one that honors the delicate interplay between DNA, data, community, and climate—future doctors can rise to meet the moment. They will need courage, compassion, and a commitment to justice as they carry the immense responsibility of safeguarding not only individual patients but the future of humanity and the planet itself.
*CRISPR (pronounced "crisper") stands for Clustered Regularly Interspaced Short Palindromic Repeats. It is a powerful tool for genome editing—a method that allows scientists to precisely alter DNA in living organisms, including humans, animals, and plants.
As the population ages and the incidence of chronic diseases rises, the demand for high-quality palliative care has grown exponentially. Integral to the delivery of effective hospice and palliative care are gadgets, tools, and mechanical aids that assist in symptom management, promote comfort, reduce caregiver burden, and facilitate communication. These technologies serve not only to enhance the quality of care but also to empower patients to maintain autonomy and dignity in their final stages of life.
Palliative care addresses physical, emotional, spiritual, and psychosocial needs, often delivered in conjunction with curative treatments, while hospice care is typically reserved for patients expected to live six months or less and have chosen to forego curative treatment (World Health Organization, 2020). Both disciplines prioritize patient-centered care and symptom relief, which can be significantly enhanced through the appropriate use of assistive technologies.
Many terminal illnesses, such as advanced cancers or neurodegenerative diseases, impair speech or cognition. Communication tools become vital in preserving patient autonomy. Speech-generating devices (SGDs), also known as augmentative and alternative communication (AAC) devices, allow non-verbal patients to express needs and preferences. Eye-tracking systems and tablet-based apps like Proloquo2Go or Grid 3 have revolutionized communication for patients with ALS or stroke (Beukelman & Mirenda, 2013). However, these are not yet readily available in the country. We can still use, however, whiteboards, or pen and paper, in order to communicate and help our patients express themselves.
Loss of mobility is common in terminal illness. Mechanical aids help reduce discomfort and prevent complications such as bedsores. Specialized wheelchairs with posture control and recline functions support patient mobility and reduce fatigue. Devices like Hoyer lifts allow safe transfer of non-ambulatory patients, reducing risk of injury to caregivers and patients alike. Tools such as Sara Stedy or other sit-to-stand systems help patients maintain mobility for longer, boosting morale and circulation.
Immobility increases the risk of pressure ulcers and contractures, particularly in bedridden patients. Dynamic air mattresses with alternating pressure relieve pressure points are proven to reduce the incidence of pressure ulcers (McInnes et al., 2015). Foam supports maintain body alignment and help prevent complications like aspiration or joint stiffness. Automated beds that gently rotate patients at programmed intervals reduce caregiver burden and prevent sores.
Breathlessness is a common and distressing symptom in terminal conditions such as COPD, heart failure, or cancer. Portable or stationary oxygen devices provide relief from dyspnea and improve comfort at home. Devices such as CPAP or BiPAP may be used in palliative settings to reduce work of breathing, though ethical considerations must be taken into account for end-stage use (Gonzalez-Bermejo et al., 2018). Low-tech tools like fans directed at the face can also effectively reduce the sensation of breathlessness through trigeminal nerve stimulation (Bausewein et al., 2008).
Effective symptom control depends on timely and accurate medication administration. Automated pill dispensers ensure adherence by alerting patients when it's time for a dose, reducing the risk of under or overdosing. Syringe drivers or continuous subcutaneous infusion pumps deliver a constant dose of pain relievers or antiemetics, particularly when oral administration is no longer feasible (NHS Specialist Pharmacy Service, 2019). Some tools track adherence and transmit data to healthcare providers or caregivers for remote monitoring.
Digital health platforms enable the provision of palliative care even in remote or home-based settings. Applications like Zoom allow virtual consultations, enabling multidisciplinary care teams to follow up with patients without requiring travel. Gadgets like smartwatches or biosensors monitor vital signs (heart rate, oxygen saturation, activity levels) and alert caregivers to changes in condition (Broadbent et al., 2020). Other applications like MyPal or PalliSupport record patient-reported outcomes and help tailor treatment plans.
Dysphagia and appetite loss are common in terminal illness. For patients requiring enteral nutrition, programmable feeding pumps deliver a controlled flow of nutrients. Tools like weighted spoons or nosey cups assist those with swallowing difficulties or tremors.
Maintaining emotional well-being is as important as managing physical symptoms. Devices that play calming sounds, white noise machines, or aromatherapy diffusers can help manage anxiety and promote sleep. Emerging research supports the use of VR to provide distraction therapy or fulfill "bucket list" experiences for terminally ill patients (Niki et al., 2019). Digital legacy tools like SafeBeyond or LifeTales allow patients to leave video messages and memories for loved ones.
“The integration of these tools in palliative care has shown numerous benefits.”
The quality of life is improved by reducing symptom burden and discomfort. Increased autonomy and dignity in patients who can express their needs or manage some aspects of care is also achieved by the manipulation or utilization of tools and gadgets. Reduced caregiver stress is also seen especially when mechanical aids assist with physically demanding tasks. Continuity of care, especially in underserved areas through telehealth solutions and the use of the internet, resolves issues on lack of access to specialists.
However, the adoption of technology must always be balanced with ethical and psychosocial considerations. The risk of over-medicalization, depersonalization, or loss of human contact must be mitigated. The patient’s wishes, cultural values, and cognitive capacity should guide decisions on using assistive devices (Broom et al., 2015). Despite the potential, there are barriers to widespread use of these technologies such as cost, training, access and infrastructure. Rural areas may lack the internet or power infrastructure to support these tools. Some patients, especially older adults, may be hesitant to use unfamiliar technology due to fear or ignorance of its benefits.
Gadgets, tools, and mechanical aids play an increasingly essential role in hospice and palliative care, offering comfort, improving quality of life, and supporting caregivers. From basic communication boards to sophisticated remote monitoring systems, these technologies allow care to be more responsive, individualized, and compassionate. Nonetheless, their use must always align with the core principles of palliative care: respect for patient autonomy, holistic care, and dignity in dying.
As technology evolves, future innovations may continue to redefine the boundaries of comfort and care at the end of life.
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Beukelman, D. R., & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs (4th ed.).
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Broom, A., Kirby, E., Good, P., Wootton, J., & Adams, J. (2015). The art of letting go: Referral to palliative care and its discontents. Social Science & Medicine, 138, 9–16. https://doi.org/10.1016/j.socscimed.2015.05.029
Gonzalez-Bermejo, J., Morélot-Panzini, C., & Similowski, T. (2018). Non-invasive ventilation in palliative care. Annals of Palliative Medicine, 7(3), 343–354. https://doi.org/10.21037/apm.2018.05.02
McInnes, E., Jammali-Blasi, A., Bell-Syer, S. E. M., Dumville, J. C., & Cullum, N. (2015). Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews, (9), CD001735. https://doi.org/10.1002/14651858.CD001735.pub5
NHS Specialist Pharmacy Service. (2019). Syringe Driver Drug Compatibility Charts. https://www.sps.nhs.uk
Niki, K., Okamoto, Y., Maeda, I., Mori, I., Shima, Y., Matsuda, Y., ... & Morita, T. (2019). A novel palliative care approach using virtual reality for improving various symptoms of terminal cancer patients: A preliminary prospective study. Journal of Palliative Medicine, 22(6), 702–707. https://doi.org/10.1089/jpm.2018.0348
World Health Organization. (2020). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care
The story of Ruth the Moabite isn’t just a tale of ancient loyalty—it’s a living guide for how to love, serve, and honor our mothers at the end of their lives. When we combine her example with the compassionate principles of palliative and hospice care, we are invited into a sacred calling: to walk with our mothers through their final days with grace, dignity, and love.
