Thinking about old age, our own and others’, always places us in an uncomfortable place where the ideas of pain, suffering and decline are present and haunting us; however, it is unavoidable to reflect on the subject as the world population ages and new techniques emerge to lessen its physical, social and psychological effects.

To begin this year 2024, we present this interesting topic and others such as the discussions around gender from an intergenerational perspective and the necessary reflection on the training processes of medical students, as well as the continued emphasis on palliative care as a fundamental ethical option at the end of human life.

The first article in this issue, by Dr. Rodríguez and Dr. Santos, presents the results obtained from a study of their own, carried out in the city of Mérida, Mexico, where intergenerational dialogue was explored, especially on current issues such as gender.

The study was carried out among fifty teachers and trainers and fifty students and reflected not only the expected differences but also the possibility of finding points of agreement and moving from the paradigm of war to that of dialogue.

It should be noted that the theoretical starting point of this study was Engelhardt’s notion of “moral strangers”, which refers to those with whom dialogue is not possible due to differences in moral content or modes of reasoning; however, based on the argument about the possibility of intercultural dialogue, the authors affirm that intergenerational dialogue is possible, and therefore, this work demonstrates, with objective results, that it is possible to build bridges that allow communication even between apparently different points of view.

The second article is a profound and serious analysis of the issue of aging, its current approach and the influence exerted by different religious traditions in its treatment and focus.

Thus, the author starts from the fact that, by 2050, the population over 60 years of age will be 20% of the world population and establishes the hypothesis that this segment of the population will be less inclined to profess any religious belief and, therefore, to accept what they teach about pain and suffering.

It then explores what the three monotheistic religions conceive of as pain and suffering and compares them with some of the actual experiences of older adults in experiencing these two conditions.

Finally, the author analyzes the current trends in pain control, which are often unsuccessful and end up leading the patient to request new techniques, among which some offered by the transhumanist movement may be viable and represent an important paradigm shift in gerontology, as well as in the role currently played by religion in the management and coping with pain and suffering.

The third article, by Drs. Vázquez, Mota and Argüelles-Nava, shows us the crude reality in which medical students live and work in Mexico and how they are subjected to multiple violations and abuses that must change urgently, since this mistreatment affects the medical care, they provide to patients. Thus, the common thread of the article is the close relationship between human rights and health and how the affectation of the former has repercussions on the latter and vice versa.

In order to prove that the training of physicians does not meet ethical standards and respect for human rights, the authors argue three factors: (a) the current regulations that do not consider them within formal employment and, therefore, entitled to rights and benefits under the law, (b) the artisanal education that leaves them exposed in their training and, at the same time, exposes patients who receive their care without the proper supervision of an already trained physician, (c) the impact of students in the care provided that has been recorded as complaints or allegations of malpractice by the patients attended.

The fourth article presented in this issue takes up the subject of old age and the importance of the community as a factor in dealing with it. Dr. Gómez Álvarez articulates the idea of institutionalized old age as a mechanism for acceptance of the aging process. But this, he says, must be accompanied by community-building mechanisms that support the person and generate social networks that link him or her to other peers.

One of these mechanisms can be the practice of spirituality. To this end, the author proposes a conception of spirituality that allows to unite the public sphere of the person with the private one, which places him/her in a necessary relationship with others with whom he/she can build a sense of transcendence that conforms community and provides affective and social support.

It is also worth highlighting the proposal to live this spirituality among those who work in the care of the elderly, since it is manifested in works, in such a way that the service they provide is already a way of living in a community open to transcendence. This becomes, in the author’s words, an “active prayer”.

Finally, it is analyzed how in this implementation of a shared spirituality, some bioethical principles such as beneficence, solidarity and subsidiarity are present.

The fifth article, by Drs. Muñoz and Becerra, addresses palliative care as an integrative care that provides support and quality of life in times of suffering and contributes to the good of the person. They highlight the potential of palliative care to address the spiritual and psychological sphere of the human person, which allows them to seek transcendence, something that naturally occurs in a patient diagnosed with a terminal illness.

In addition, the authors analyze the application of bioethical principles in the practice of palliative care to reaffirm that palliative care provides comprehensive care and, therefore, is an ethical proposal that should always be offered.

The two reviews included in this issue are significant in that they deal with medical action. The first, by Dr. Gómez Álvarez, presents the book Eutanasia y el final de la vida. A critical reflection, a book of eight chapters ranging from the conceptual definitions of euthanasia and derived terms to the enumeration of arguments for and against, including an analysis of the Spanish proposal on the subject. A review that invites to deepen and broaden the view about euthanasia.

The second review, by Francisco José Ballesta, narrates the booklet La palabra que cura (The word that heals) in which four words used in the medical field are analyzed: medicine, therapy, drug and surgery, where the author, Raffaelo Cortina, unravels their deepest meanings after having become disenchanted with the figure of informed consent, which has been reduced to a mere bureaucratic procedure; in this sense, the review invites us to recover the true meaning of the words used in the “cure” of people.