Nephrologists between power and vulnerability in times of technology

The doctor-patient relationship is often discussed from the perspective of patient vulnerability. Little attention is given to the vulnerability of nephrologists in their professional practice, a reality often affected by profound cultural transformation arising from technological development. Nephrology is based on research and procedure instrumentalization, both permeated with technology. In addition, the relationship between nephrologists and institutions is governed by market rules. Recent data showed a shortage of new nephrologists and the need to improve the technical training of new professionals, foster the establishment of interventional nephrology, and attract more graduating physicians to this medical specialty. Bioethics offers a different perspective on the issue, since it takes the subjective concerns of medical doctors and the social environments they participate in into consideration in order to enhance their ethical autonomy. These ideas may be discussed as part of undergraduate or specialization programs, thus reinforcing the acknowledgement of vulnerability as a condition and of the relevance of adopting a reflective attitude toward the events of everyday life that interact with the morality of nephrologists, so that risks are adequately faced having bioethical parameters as a reference.