Bioethica Forum最新文献

{"title":"Les soins aux personnes migrantes, aux «sans voix» - Nécessité d’une clinique transculturelle","authors":"Jean-Christophe Martin","doi":"10.24894/bf.2010.03010","DOIUrl":"https://doi.org/10.24894/bf.2010.03010","url":null,"abstract":"Début 2010 a été présenté Clinique de l’exil, dont la plupart des auteurs sont des collaborateurs/trices des associations Appartenances, oeuvrant en Suisse dans le domaine de la santé mentale des migrants. Suite à huit ans passés outremer au début de sa carrière, celui qui rédige ces lignes a été marqué par les défis de la relation thérapeutique avec des patients dont les cadres de références sont différents des nôtres, ceci d’autant plus qu’ils ont passé par de lourdes épreuves. Le journaliste Laurent Bonnard a eu ce commentaire lors de la présentation: «J’ai trouvé cette lecture d’un très grand intérêt mais en suis sorti furieux – contre moi-même – de ne pas mieux me souvenir que ces choses existent». En réalité, il ne va pas de soi de faire face quotidiennement au fait que beaucoup des personnes «échouées» dans nos pays, par la force des courants qui les ont ballottées et leurs tentatives de s’en sortir, ont vécu des trajectoires aussi dramatiques. Qu’elles ont passé souvent par des violences majeures, torture, viol, deuils liés à la guerre, déstructurations familiales et sociales. On est pris par l’envie de ne pas en entendre plus. On peut survivre à ces atrocités, les personnes qui consultent le démontrent, mais comment survit-on?","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"39 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":"125159546","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":"Stärkt der neue «Grundversorgungsartikel» der schweizerischen Bundesverfassung das «Recht auf Gesundheit»?","authors":"T. Gächter, Martina Filippo","doi":"10.5167/UZH-115906","DOIUrl":"https://doi.org/10.5167/UZH-115906","url":null,"abstract":"Since 2014, the Swiss Federal Constitution contains a provision which obliges the state to ensure primary health care which is adequate, accessible to all and of high quality. The provision should particularly strengthen family medicine and primary care. lt cannot however, be taken as a constitutional guarantee of access to health care. Nevertheless, such a claim is already foreseen in the fundamental right to assistance when in need.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"17 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":"132188241","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":"Klinische Ethikkultur in der Intensivmedizin – Erfahrungen aus dem UniversitätsSpital Zürich","authors":"T. Krones, E. Liem, Settimio Monteverde, Christine Rosch, Reto Schüpbach, P. Steiger","doi":"10.24894/bf.2018.11026","DOIUrl":"https://doi.org/10.24894/bf.2018.11026","url":null,"abstract":"","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"14 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":"116062171","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":"Aging and loneliness. What does it mean to grow old alone?","authors":"Laura Gold","doi":"10.24894/bf.2011.04018","DOIUrl":"https://doi.org/10.24894/bf.2011.04018","url":null,"abstract":"not all elderly people suffer from loneliness and some may recover from it. A 2009 publication [2] found that loneliness speeds the effects of aging and motor function decline in older adults. The study analysed the relationship between participation in social activities and motor function decline in 906 older adults without dementia, Parkinson’s disease or stroke, followed for about 5 years. The results showed that each point decrease in a person’s social activity score was associated with a 33% faster rate of motor function decline and a 65% higher risk of disability as well as a 40% increase risk of death. My collaborators and I, a multidisciplinary team including doctors, nurses, nursing assistants, social workers, physiotherapists, occupational therapists, a dietician and psychologists, have the privilege of developing caring relationships with these patients. Not only treating their medical problems but also helping them deal with other aspects of aging, such as loneliness and social isolation among others. We either provide regular care at home or in our day hospital where patients not only participate in therapeutic groups (mobility, memory, nutrition, management of substance dependency) but have the opportunity to develop relationships with their peers. Finally, we also enable them, if possible, to die at home if they so wish, providing them with comprehensive care until the end of their lives. It is a deep satisfaction for loved ones to have been able to respect their wishes in the best circumstances possible. Loneliness and social isolation are major determinants of global health status in any age group, particularly the older adult. Health care policies should integrate this concept into the traditional medical model of disease.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"12 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":"116451315","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":"Règles de consentement pour l’utilisation d’échantillons biologiques à des fins de recherche dans le cadre de la HSCT en Suisse","authors":"S. Romagnoli, Peter Bürkli, J. Halter","doi":"10.24894/bf.2012.05032","DOIUrl":"https://doi.org/10.24894/bf.2012.05032","url":null,"abstract":"","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"96 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":"122512870","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":"Ethik und Präimplantationsdiagnostik: Ein Beitrag zur Diskussion in der Schweiz","authors":"C. Rehmann-Sutter","doi":"10.24894/bf.2008.01018","DOIUrl":"https://doi.org/10.24894/bf.2008.01018","url":null,"abstract":"Ethics and preimplantation diagnosis: a contribution to discussions in Switzerland The concept of preimplantation genetic diagnosis (PGD) was conceived not just following a technological logic of feasiblity, but also for moral reasons. Compared to the termination of a pregnancy after prenatal diagnosis, PGD with selective embryo transfer is a lesser burden and in this sense it has ethical advantages. Two concrete cases highlight partly unexpected circumstances arising in practice, and underline how diverse our moral perceptions of PGD can be. Single cases cannot ground general normative solutions; nevertheless, they can point to moral contradictions in existing governance. This article argues that a ban of PGD on grounds of embryo protection and avoidance of eugenics is not an equitable answer to the needs and interests of those involved. This result is in line with reflections of the Swiss National Advisory Commission on Biomedical Ethics, whose opinions of 2005 and 2007 are summarized.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"26 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":"122728125","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":"Training facilitators of Moral Case Deliberation: a successful experience with external health care professionals in the sessions and in feedback to the trainees","authors":"Kih Pasman-de Roo, M. Stolper, G. Widdershoven, A. Molewijk","doi":"10.24894/bf.2016.09014","DOIUrl":"https://doi.org/10.24894/bf.2016.09014","url":null,"abstract":"Moral Case Deliberation (MCD) is a form of clinical ethics support that focuses on concrete moral problems in practice [1]. A group of health care professionals together investigates a moral question in a concrete case from their own practice, guided by a trained facilitator. Cases are diverse, ranging from whether or not to involve the family of a client in decisions about treatment to whether or not to follow an agreed arrangement concerning the care for a client when the situation seems to ask for acting otherwise. The facilitator guides the group stepwise through the joint moral inquiry which is set up as a dialogue. Compared to other forms of clinical ethics support [2], the focus is not on the moral knowledge and expertise of the facilitator, but on the moral experience of the participants and their reflections. The facilitator does not give advice, but helps the health care professionals in the group to reflect on their own values and norms and to jointly develop a better understanding of the ethical issues of the case at hand. Although the facilitator of MCD may be a trained philosopher or ethicist, the facilitator role can be performed by a health care professional as well. Both on theoretical and on practical grounds, we deem it important to train health care professionals as facilitators of MCD. Theoretically, this fits in with the presupposition that fostering moral reflection (in the form of MCD) does not require theoretical ethics expertise. Practically, the number of ethicists available is not sufficient to answer the growing demand in health care organizations. Based on these theoretical and practical considerations, we have developed a program which aims to train health care professionals as facilitators of MCD [3]. The trainees learn to practice the role of MCD facilitator by exercising and reflecting on their experiences within training sessions and in their own team or health care institution [3, 4]. The training entails an experiental learning style, in which the trainees investigate what it means to be a good facilitator by jointly reflecting on their experiences; this fits well with the dialogical learning process within MCD itself, in which the MCD participants investigate and learn what is morally good to do. In the Netherlands, we have Abstract","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"55 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":"124784775","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":"«Tierversuche sind nützlich. Also sind sie ethisch gerechtfertigt.»","authors":"Angelika Martin","doi":"10.24894/bf.2012.05008","DOIUrl":"https://doi.org/10.24894/bf.2012.05008","url":null,"abstract":"","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"14 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":"128350632","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":"Lost decisional capacity – lost chance of Advance Care Planning?","authors":"R. Jox","doi":"10.24894/bf.2016.09028","DOIUrl":"https://doi.org/10.24894/bf.2016.09028","url":null,"abstract":"Comprehensive models of Advance Care Planning (ACP) have been discovered as a more meaningful and effective alternative to the classic advance directive (living will) [1, 2]. This continuity of a new model replacing the old one is already suggested by the linguistic anaphora (both terms begin with the word “advance”). In Switzerland as in Germany and other European countries, ACP projects are being implemented that focus on facilitating anticipated care and treatment decisions of persons who are willing and able to engage in such conversations. These are often elderly citizens, persons with chronic organ diseases or cancer, individuals with an elevated educational background, a firm rooting in the majority culture and a well-developed socio-economic situation. Strikingly, this development risks to neglect the vulnerable persons of society, the less educated, the cultural minorities, the poor, the lonely and, most importantly, those that have already lost their decision-making capacity. There seems to be a generally accepted assumption that it is too late for ACP once the person has already progressed into a state of decisional incapacity: lost capacity, lost chance for ACP. Yet, is this true? In this viewpoint, I intend to show that this assumption is wrong and that, in fact, we need to extend ACP to those individuals who have lost decision-making capacity [3]. In a first step, I will show that there is a huge and rising need for this kind of “ACP by proxy”. In a second step, I will sketch the concept of this form of ACP and uncover both the analogies and differences to ACP with fully autonomous persons. As a third step, I will present the multifaceted ethical justification of ACP that applies equally well to persons without decisional capacity. In the fourth and last step, I will outline an agenda of research and policy proj ects that should be addressed to fully develop ACP.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"11 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":"127187659","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":"Développement d’un comité d’éthique clinique dans un hôpital universitaire suisse","authors":"J. Chevrolet","doi":"10.24894/bf.2008.01005","DOIUrl":"https://doi.org/10.24894/bf.2008.01005","url":null,"abstract":"Development of a clinical ethics committee in a Swiss university hospital Ethics consultations in hospitals are largely a product of the 1970s in the United States. In the early 1980s, a survey in the US showed that only one percent of the hospitals had at that time a functioning ethics committee, whereas ten years later, in the mid 1990s, an estimate indicates that a large majority, probably more than ninety percents of the large American hospitals had created such committees. These committees are beginning to proliferate also in Europe, with unequal success in different countries, and assuming different roles and modalities of functioning. In this article, we present these differences and we place in perspective some difficulties and concerns observed in the past years. We then analyze the development over almost fifteen years of the clinical ethics committee of the University Hospitals of Geneva (Switzerland) and compare its functioning with the published information on these instances.","PeriodicalId":263926,"journal":{"name":"Bioethica Forum","volume":"53 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":"127272538","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}