“Reflection has disappeared from our society, and that has very serious consequences”

A doctor by profession and an author committed to current ethical issues, Manuel Martínez-Sellés has just published a new essay entitled Verdades incómodas para personas autónomas ( Uncomfortable Truths for Independent People Rialp, 2025).

Martínez-Sellés is a professor of medicine and head of the cardiology department at Gregorio Marañón Hospital in Madrid, and has been president of the Illustrious College of Physicians of Madrid and the Spanish Society of Cardiovascular Infections.

He has received 21 national and international awards for bioethics and cardiology. He is married and has eight children. He participated in the opening of the Fourth Congress on Bioethics held in Madrid in December 2022.

In this interview, he talks about the motivations behind the book, in which he explores fifteen essential topics such as life, death and human dignity, and how a false understanding of these topics may be profoundly distorting the way we live and relate to each other.

Question. You have previously written about topics that could be considered urgent, such as euthanasia and the family. What was the urgency that led you to write this book?

Answer. Indeed, my previous books have focused on very specific topics: the beginning of life, the end of life, and marriage issues, each of which is relevant enough to merit a book. But over time, I have seen how many people in our society have stopped asking themselves whether the messages they take for granted are really true.

In Uncomfortable Truths for Independent People, I bring together fifteen topics that invite reflection. Often, when talking to someone about them, I realise that they have never considered certain things before. When they start to think critically, they realise that many dominant ideas are not true, but they had never made the effort to question whether the ideas they receive are correct or not.

And coming to that conclusion can mean significant changes in one's personal, family and social life. That's why I felt the urgency to write this book: to encourage people to stop, reflect and review the foundations on which they are building their lives, in a society that is increasingly less reflective, absorbed by social media, mobile phones and constant entertainment.

One of the chapters explores the fact that people are reading less and less, and the consequences this has for critical thinking. Or the crisis of loneliness, despite living in a hyperconnected world. I see it in the hospital, where we have patients who no one comes to see.

[destacate]‘If you recognise the truth, it leads you to change the way you act. That's why it's uncomfortable’[/destacate]Q. You mention that many of these truths are uncomfortable. When do you think they started to become uncomfortable and why?

A. Because if you assume that some of these truths are true, that has consequences. Let me give you a very clear example: when does human life begin? There is a study that surveyed nearly 4,000 biologists. Ninety-six per cent responded that life begins at fertilisation. That is a scientific reality. But if we assume that this is true, then we cannot treat that human being as if it were not. We could not conduct research on embryos, or abort them, or freeze them indefinitely for in vitro fertilisation.

The thing is, even though many people know deep down that certain things are true, if they acknowledge it, they would have to change their behaviour. And that is uncomfortable.

Q. At the end of life, we see that euthanasia has been approved in Spain and is now being debated in France. Would you say that we are losing the value of human life in our society?

A. Without a doubt. Although we must also be precise: today, euthanasia in Europe is only practised in Spain and the Benelux countries. Elsewhere, such as in France, there are open debates, but it has not yet been legalised. Globally, only a few countries such as Canada, Colombia and New Zealand allow it. This makes us realise how we have become an exception.

The underlying problem is that we are accepting the idea that human life can lose its value. But all human life has intrinsic dignity. As early as the Hippocratic Oath, 500 years before Christ, both euthanasia and abortion were explicitly prohibited. Truly humane medicine cannot include the act of killing.

[destacate]‘Euthanasia is not helping someone to die; that is what palliative care does, which is the ethical alternative. The language is being manipulated’[/destacate]The only recent precedent for euthanasia is in Nazi Germany. Hitler commissioned Goebbels to launch a campaign to convince society that euthanasia was acceptable. They produced films, such as I Accuse, and posters asking how much it cost to care for a disabled person. With this propaganda, they managed to make society accept the unacceptable. Today we are repeating that history, starting with very specific cases, but euthanasia is already being practised on elderly people with dementia, children with disabilities and people with mental illnesses, i.e. euthanasia is being practised in cases where, by definition, the patient cannot even request it.

Furthermore, euphemisms are used: we no longer talk about ‘euthanasia’, but about ‘assisted dying’, which is a misleading term. Euthanasia is not helping someone to die; that is what palliative care does, which is the ethical alternative. Language is being manipulated to prevent us from questioning what we are really doing.

Q. What long-term consequences do you see if this is not corrected?

A. We are sending the message that some lives are not worth living. That is extremely serious. We are degrading the doctor-patient relationship. And also the perception that sick or elderly people have of their own dignity. We are using a totally biased concept of “quality of life”, as if someone from outside could decide who has the right to live and who does not.

Q. You also talk about the need to cultivate independent thinking. What do you mean by that?

A. The title of the book refers to autonomy in the sense of daring to think for oneself, against the tide. It's not about living in isolation, but about being a free thinker, someone who stops, looks at the facts and draws their own conclusions.

Take pornography, for example: surveys show that children are accessing pornographic content at an increasingly early age, thanks to mobile phones. Another example is consumerism, where a person's value is measured by what they have, not by who they are. All of this creates permanent dissatisfaction, with advertising constantly telling us that we need something more. That's why I say that thinking independently means rebelling against that message and looking for another way of living.

[destacate]‘I support technological advances, but we cannot allow the human component to be lost’[/destacate]Q. What role do new technologies play in all this, such as artificial intelligence?

A. I have a positive view of artificial intelligence and robotics. They are very useful tools that can bring great benefits, including in medicine. I use them myself. But, like nuclear energy, they can be used for good or for bad.

What worries me is that technological development is not accompanied by humanity. If in 40 or 50 years' time I have a serious illness, I want to be treated with the best algorithms, with robotic surgery if necessary, but I also want a human, compassionate doctor who will talk to me. We cannot allow that human component, which is fundamental in medicine, to be lost.

Q. What role models do we need today to move towards a more humane and ethical society? There is talk of a “liquid society”, without certainties or stability, and this seems to directly influence how we understand ethics, truth and even human beings. How can we recover these role models?

A. Each person should look for role models in their own field. In my case, in medicine and bioethics, I admire figures such as Edmundo Pellegrino, considered the father of medical ethics, and Jérôme Lejeune, who discovered that Down syndrome is caused by trisomy 21. But beyond individual role models, as a society we need to cultivate a critical spirit. We live in times when many people no longer even consider whether a message is true or false, and some do not even question it: they simply do not care. This even affects fundamental issues such as sexual identity, which today is perceived more as a feeling than as a biological reality.

I think we have stopped searching for the truth, and in doing so we are contaminating human relationships. A society that is unclear about what is true or good runs the risk of becoming completely disoriented. We need to re-evaluate the search for truth, even when it is uncomfortable, costly or countercultural. Only then can we aspire to a healthier, more humane and more conscious society.

[destacate]‘A society that is unclear about what is true runs the risk of becoming completely disoriented’[/destacate]Q. And on a personal level, what role does faith play in this search for truth?

A. For me, it is fundamental. The last chapter of the book deals precisely with this. Although the entire book is valid for any reader, believer or not, chapter 15 has a special focus: it argues that life is wonderful, and one of the reasons, for those of us who share the faith, is that we believe that everything has been created with love for each one of us. Faith gives us a deep motivation to continue searching for the Truth, with a capital ‘T.’ In my case, I believe that Truth is embodied in a person: ‘I am the way, the truth and the life.’ That conviction drives me every day to continue searching, and also to invite others not to settle for superficiality.

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