Argentina and Colombia are already sure of their place in Brazil from the South American section while behind them Ecuador, Chile and Uruguay are fighting for the two remaining automatic berths.
Ecuador and Chile, lying third and fourth respectively on 25 points each, only need a draw from the match in Santiago De Chile to both progress through and leave fifth-placed Uruguay, who are three points further back, facing an intercontinental play-off against Jordan no matter how they get on against Argentina.
However, Medel insists his side are not willing to settle for just a point from their match as they have their sights set on snatching second spot off Colombia.
"We hope we win on Tuesday in front of our fans to celebrate qualification with them," said the Cardiff midfielder.
"We want to make history by playing in two successive World Cup finals. We want to win because we want to be second in the standings.
"We don't want a draw or even a loss. No question about that."
Ecuador coach Reinaldo Rueda does not expect their opponents to ease off either as Chile look to avenge their 3-1 defeat in Quito earlier in qualifying.
He told reporters: "Chile will not relax at all.
"Chile are dynamic opponents who will demand a lot from us. Their midfield is great."
Uruguay have the comfort of knowing that at the very least they are assured of a place in the play-off match, as the country closest to them in the standings, sixth-placed Venezuela, have already completed their campaign.
La Celeste could still get an automatic berth, but to do so they will have to beat group winners Argentina and hope Chile or Ecuador lose their game heavily.
There are no qualification issues at stake in Tuesday's other two qualifiers, which see eliminated Paraguay at home to Colombia while last-placed Bolivia go to third-bottom Peru.
Peru coach Sergio Markarian has already announced he will be leaving his post after the match, saying: "I've failed to qualify (for the World Cup) and my contract comes to an end so I quit. I'm tired of announcing I would quit if we didn't qualify."