Bioethica Forum最新文献

{"title":"Woyzeck and the birth of the human research subject. Genetic disposition and the nature-nurture debate through the looking-glass of fiction","authors":"H. Zwart","doi":"10.2139/SSRN.2333175","DOIUrl":"https://doi.org/10.2139/SSRN.2333175","url":null,"abstract":"In various writings Michel Foucault has shown how, in the beginning of the 19th century, in settings such as army barracks, psychiatric hospitals and penitentiary institutions, the modern human sciences were 'born' as an ensemble of disciplines (medical biology, psychiatry, psychology, criminology, and the like). From the beginning, the nature-nurture debate has been one of its key disputes. Are human individuals malleable by environmental factors (such as psychiatric treatments or disciplinary regimes), or do they rather display inborn predispositions for delinquency and other forms of antisocial behaviour? In the current era of genetic testing, in behavioural genomics and neuroscience, this issue is as controversial and topical as ever. Buchner’s unfinished drama Woyzeck (written in 1836) is a remarkable anticipation of this debate, staging the birth of the human individual as a research subject. It is the story of a destitute soldier who, according to his superiors, displays errant behaviour and is therefore recruited to serve as a research subject in an experiment. His army physician turns him into a 'case', which can be meticulously monitored and studied so as to record the genesis of a crime. In this paper, Buchner’s unsettling play is analysed in detail as one of the great anticipatory literary documents of the 19th century, exploring the idea of predictive psychiatry and the quest for genetic predispositions: a primal scene as it were of the nature-nurture debate as it unfolds from predictive criminology up to behavioural genomics.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"351 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115972459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postmortale Organspende: Es spricht mehr für die Zustimmungslösung als für die Widerspruchslösung","authors":"E. Pfister","doi":"10.5167/UZH-41426","DOIUrl":"https://doi.org/10.5167/UZH-41426","url":null,"abstract":"","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115379069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent controversies in organ transplantation","authors":"R. Andorno","doi":"10.5167/UZH-39853","DOIUrl":"https://doi.org/10.5167/UZH-39853","url":null,"abstract":"","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121213782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verstehen und Dialog als Ausgangspunkte einer hermeneutischen Ethik","authors":"R. Porz, G. Widdershoven","doi":"10.5167/UZH-34849","DOIUrl":"https://doi.org/10.5167/UZH-34849","url":null,"abstract":"","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129774954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The growth of clinical ethics in a multilingual country: challenges and opportunities","authors":"S. Hurst, S. Reiter-Theil, R. Baumann‐hölzle, C. Foppa, R. Malacrida, G. Bosshard, M. Salathé, A. Mauron","doi":"10.5167/UZH-8083","DOIUrl":"https://doi.org/10.5167/UZH-8083","url":null,"abstract":"The Swiss experience with clinical ethics committees and consultation services is a relatively recent development. When ethics committees offering clinical case consultation were first identified in a 2002 survey, only 18 % of Swiss hos- pitals reported a clinical ethics committee. However, 84 % of these reported offering case consultation. The oldest known clinical ethics committee was founded in 1988, at a psychiat- ric hospital in the German speaking region. The two oldest clinical ethics committees in the French speaking part of the country were founded in 1994, at two major teaching hospi- tals (1). In 2004, only 16 % of physicians reported access to ethics consultation for individual cases (2). Ethics consultation services grew out of locally perceived needs, with locally determined structures and processes. At- tempts at establishing networks between these services are Abstract _French and German abstracts see p. 23 Background: Clinical ethics committees and consultation services are a new development in Switzerland. These services grew out of locally perceived needs, with locally determined structures and processes. They were first listed in a 2002 survey, and the first national meeting of clinical ethics committees took place in 2004. Attempts at establishing bridges and networks between these services are very recent, and are made more difficult by the multi-cultural and multi-lingual structure of Switzerland. Method: We describe how different clinical ethics support services developed in Switzerland, and outline the diversity of structures, languages and cultural sources that these services are based on. Results: Despite differences in models and processes, common elements emerge: reliance on principlism, citizen involvement, interdisciplinarity, as well as the - implicit or explicit - reluctance to rely too strictly on rigid rules or processes for ethics consultation. The multi-lingual and multi-cultural structure of Switzerland results in unique difficulties in setting up a national network. Working in three different languages gives rise to logistical obstacles not present in most other countries. With each language also comes a literature corpus relevant to medical ethics, which is used alongside the English language bioethics literature with different degrees of salience in different regions. Discussion and Conclusion: This environment renders attempts to establish national networking for clinical ethics support services more difficult. However, it also presents what could be unique opportu- nities. Coordinated exchange of experience will grow in importance as challenges continue to face clinical ethics as a whole.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123391043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les medical humanities: un luxe?","authors":"A. Wenger","doi":"10.24894/bf.2011.04050","DOIUrl":"https://doi.org/10.24894/bf.2011.04050","url":null,"abstract":"","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"258 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123065326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing moral case deliberation in Dutch health care; improving moral competency of professionals and the quality of care","authors":"B. Molewijk, E. V. Zadelhoff, B. Lendemeijer, G. Widdershoven","doi":"10.24894/bf.2008.01010","DOIUrl":"https://doi.org/10.24894/bf.2008.01010","url":null,"abstract":"between evaluative meetings. Results: Both qualitative and quantitative results of the 220 questionnaires of 50 MCDs showed that the MCDs were regarded as very useful. Most participants saw the relevance of MCD for their daily work high and judged the quality of the dialogue positively. Their open, straight, constructive communicating and moral sensitivity increased; their presuppositions, prejudices and automatic responses decreased. Discussion: Future implementation research has to find out what the long term impact will be on the quality of care. Therefore, the next step in this project will focus on (methodology for) research on the follow up of outcomes of MCD and the integration of these outcomes with institutional policy issues.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127379542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The right to health in the United Kingdom","authors":"K. Syrett","doi":"10.24894/bf.2015.08031","DOIUrl":"https://doi.org/10.24894/bf.2015.08031","url":null,"abstract":"How far can a right to health be said to exist in the United Kingdom (UK)? The UK is a signatory to the International Covenant on Economic, Social and Cultural Rights and is a state party to the EU Social Charter, and to this extent there may be said to exist a commitment to the health-related rights expressed in those instruments. Furthermore, leading British scholars have emphasised the significance of rights (albeit not the right to health alone); the ‘fathers’ of medical law as an academic discipline in the UK argued that the field was a “subset of human rights law” ([1], 3), while a more recent analysis notes a “strong argument that the conceptual unity of medical law is human rights” ([2], 2). Yet, when we turn from what many might see as statements of aspiration or ‘mere’ academic opinion to the practical reality of delivery of healthcare in the UK, the place of the right to health becomes much less distinct. This is perhaps unsurprising when one considers a broader historical and socio-political context in which the relationship between the individual and the British state was traditionally regulated not through positive rights but rather through negative ‘civil liberties’; freedom and autonomy were, in essence, residual. In the case of healthcare, this manifested itself through an or­ ganisational approach post-World War II; the stateindividual nexus was understood not in terms of rights of access to treatments and services, but rather as a duty placed upon government","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125079914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who’s autonomous now?","authors":"Kjetil Rommetveit","doi":"10.24894/bf.2013.06027","DOIUrl":"https://doi.org/10.24894/bf.2013.06027","url":null,"abstract":"«... society – as distinct from any plurality of individuals – is an abstract and, as such, is subject to our definition, while the individual is the primary concrete, prior to all definition, and his basic good is more or less known. Thus the unknown in our problem is the so-called common or public good and its potentially superior claims, to which the individual good must or might sometimes be sacrificed ...» Hans Jonas 1969 [1]","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125177884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The “Big Five” in 100 Clinical Ethics Consultation Cases","authors":"S. Reiter-Theil, J. Schürmann","doi":"10.24894/bf.2016.09013","DOIUrl":"https://doi.org/10.24894/bf.2016.09013","url":null,"abstract":"Abstract \u0000Background: \u0000 The study aims at shedding light into the practice of \u0000Clinical Ethics Consultation (EC) thereby making a contribution to bet \u0000- \u0000ter understanding its triggers, contents and outcomes. It was carried out \u0000in 2 (out of 3) local University Hospitals. \u0000Material and method: \u0000 100 full ECs (50 ECs conducted at the somatic/ \u0000USB, 50 at the Psychiatric University Hospital/UPK) over 3 years were \u0000analysed on the basis of its rich and highly standardised documentation. \u0000Results: \u0000 Overall, the majority of all ECs (84%) feature ethical issues \u0000referring to at least one of the following 5 topics: coercion (28%), care \u0000management (24%), treatment-plan evaluation (17%), end-of-life care \u0000(16%), or pregnancy / assisted reproduction (12%). \u0000In USB ECs, the top 3 main ethical issues concern end-of-life care (28%), \u0000pregnancy / assisted reproduction (22%), and coercion (20%), followed \u0000by treatment limitation (8%), and care management (6%). The single \u0000most significant main ethical issue in UPK ECs is coercion (34%), fol \u0000- \u0000lowed by care management and treatment-plan evaluation (both 20%). \u0000Discussion: \u0000 The prevalence of end-of-life issues in somatic health care \u0000is in line with previous research, while the evidence for coercion as a \u0000major topic in ECs in general is new. Comparable studies are hardly \u0000available from other European centres, and the existing North American \u0000papers do not display a prevalence of this concern. \u0000Conclusions: \u0000 The thematic shift to a double focus on end-of-life deci \u0000- \u0000sions \u0000and \u0000 coercion and the “big five” themes revealed altogether stim- \u0000ulate the catalogue of clinical ethics education, both for ethics consul \u0000- \u0000tants and health care professions.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123477372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}