Die Sicht der Präimplantationsdiagnostik aus der Perspektive der Reproduktionsmedizin

Ethik in der Medizin -     

Ethik in der Medizin in Aus- und Weiterbildung aus der Sicht der Philosoph

Ohne Zusammenfassung     

Das Problem der verantworteten Therapieentscheidung in der Neonatologie

Definition of the problem: Physicians and nurses who work in neonatology—as in intensive care at all—are often forced to decide whether to stop or to continue with the treatment of a severely ill patient. The literature provides several decision making instruments, which are meant to help and to rationalize such decisions. Method and conclusion: Two of these instruments (“Schema zur ethischen Urteilsbildung nach dem Muster der aristotelischen Ethik”, Honnefelder 1994; “Nimwegener Methode für ethische Fallbesprechung”, Gordijn 1998) were tested by retrospectively examining two cases of our NICU. Results of our study show that the use of a decision making instrument is basically helpful. But the above mentioned instruments showed also shortcomings when used in the framework of neonatology. Therefore we developed the “Kölner Arbeitsbogen zur ethischen Entscheidungsfindung in der Neonatologie”, which is adapted to the specific needs of neonatology.     

Ethische Aspekte der aktuellen Rechtsprechung in der Substitutionsbehandlung

Definition of the problem

Although maintenance therapy is known to increase the health status and to simultaneously decrease criminal behaviour of opiate-dependent patients, German legal regulations interfere with this therapy by ordaining not only the therapeutic goal (abstinence) but also therapeutic procedures that aim to control patients’ therapeutic compliance. German physicians who did not strictly adhere to these regulations were frequently sentenced to imprisonment.

Arguments

As the article shows, the current regulations mislead in achieving goals like the protection of the community regarding the illegal “marketing” of opioids and simultaneously impact the physician–patient relationship of maintained patients by facilitating control instead of motivation and confidence.

Conclusion

Reaching the goal of protecting the public from illegal and potentially dangerous opiates cannot be achieved by restrictive regulatory frameworks. Necessary control mechanisms regarding maintenance therapy should focus on patients’ health instead of the adherence to abstract legal norms.     

Das Problem der Behindertenselektion bei der pränatalen Diagnostik und der Präimplantationsdiagnostik

Definition of the problem: Are selective abortion and preimplantation diagnosis to be criticized for discriminating against the disabled? Arguments and Conclusions: The answer is often said to depend on the position a person takes concerning the status of the embryo: If the embryo is a subject of human rights, the mother's decision not to accept the embryo (insofar as it may be justified at all) should be made irrespective of the child's disability status if the decision is to be non-discriminating. The following article (i) does not presuppose that the embryo is not a subject of human rights, (ii) argues that the mother is still not to be criticized for letting her decision depend on the disability status because many people consider, and everybody must be allowed to consider, such a status in matters concerning her or his sphere of privacy, (iii) argues that the intuitive reserve against preimplantation diagnosis in the German public debate is rooted in something else than a concern for the rights of the rejected embryo-individuals, and that the problem should be discussed accordingly.     

Stand der Präimplantationsdiagnostik aus Sicht der Humangenetik

Ethik in der Medizin -     

Zur zukünftigen Arbeit der Schriftleitung der Zeitschrift „Ethik in der Medizin“

Ohne Zusammenfassung Claudia Wiesemann (für den Vorstand der Akademie für Ethik in der Medizin) Marcus Düwell (für die Schriftleitung der Zeitschrift „Ethik in der Medizin“)     

Ethik in der Medizin—Schlaglichter aus der Sichtprotestantischer Ethik

Ohne Zusammenfassung     

Empirische Methodologien und Methoden der angewandten und der empirischen Ethik

Definition of the problem This paper deals with the question of adequate methodologies and methods to conduct empirical research and integrate empirical knowledge in the field of biomedical ethics. Arguments It starts with reflections about the main subject matter of ethics, the human being as a bio-psycho-social creature and its morals, and argues that social sciences are the adequate basic empirical science in the field of ethics in general. The next paragraph considers theory of science perspectives of the relationship of ethics, empirical findings, methodologies and theories and examples of the integration of empirical findings into ethical deliberations. Reasons for the tension between social science and ethics are scrutinized which are different in the yet to be defined field of empirical ethics compared to traditional applied ethics. Conclusion How a bio-psycho-social ethics that incorporates these criteria into its own body of work could look like is finally depicted.     

Eine kritische Würdigung der Novellierung der (Muster-)Richtlinie zur Durchführung der assistierten Reproduktion der Bundesärztekammer 2006

Ohne Zusammenfassung     

Lob der Profession

Definition of the problem

The Charter on Medical Professionalism offers a complete synopsis of responsibilities and commitments of physicians towards patients, co-professionals and society. Unfortunately, most members of the medical professions are more or less unaware of the interconnections between them. We try to make them more explicit.

Arguments

We question the assumption that the most important problems besetting modern health care systems are problems of justice. We argue that problems of professional integrity are at least as important. Professions as corporate actors and individually all their members assume specific responsibilities for benefitting society, and professions are encouraged to organise themselves in pursuit of this end. The spectrum of professional moral responsibility includes a responsibility for averting tendencies that can be seen to threaten the moral integrity of the profession. In our view, commercialisation represents such a tendency. The perceived moral integrity of the profession depends upon the moral integrity of the majority of its members.

Conclusion

Individual physicians are co-responsible for the collective operating conditions of their profession which enables them individually to benefit patients.     

Aus der Redaktion

Ohne Zusammenfassung