Wie hilfreich sind "ethische Richtlinien" am Einzelfall?: Eine vergleichende kasuistische Analyse der Deutschen Grundsätze, Britischen Guidelines und Schweizerischen Richtlinien zur Sterbebegleitung

Zusammenfassung: Entscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende "Ethik-Richtlinien", die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen "Ethik-Richtlinien" bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu "Ethik-Richtlinien" aus Deutschland, der Schweiz und aus Großbritannien herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an "Ethik-Richtlinien" bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formulier

Das Begründungsproblem in der Ethik (Vortragsgrundlage)

Ethik ist eine Teildisziplin der Philosophie, so benannt seit Aristoteles, der Sache nach bereits bei Platon da. Sie ist die methodische Suche nach unrelativierbaren Werten, die das menschliche Handeln – trotz seiner individuellen Verschiedenheit – auf allgemeingültige Weise leiten sollen. Wenn wegen der Unterschiede von Personen und gesellschaftlichen Verhältnissen eine Vielzahl solcher Werte auftreten, dann müssen sie dem Anspruch der Ethik nach doch wieder unter einem übergeordneten Grund zusammenstimmen usw., bis hinauf zu einem unüberbietbar höchsten, umfassendsten Grund. Aufgabe der Ethik ist also die Letztbegründung menschlicher Praxis

Zum Umgang mit "kulturellen Fragen" in der klinischen Ethik am Beispiel der Hymenrekonstruktion

Zusammenfassung: Dieser Beitrag diskutiert "kulturelle Fragen" in klinischer Ethik am Beispiel der Hymenrekonstruktion. Zunächst werden drei grundsätzliche Argumente genannt: 1) Wenn "kultur-sensitive" Themen in klinischer Ethik explizit als solche diskutiert werden, kann das zu einem essentialistischen Verständnis von Kultur beitragen. Stattdessen wird in diesem Beitrag für ein dynamisches Verständnis von Kultur argumentiert und für eine grundsätzlich kontextsensitive, pluralistische klinische Ethik. 2) Klinische Ethik fokussiert häufig auf die individuelle Arzt-Patienten-Beziehung. Public Health Ethik und Globale Bioethik sind dagegen eher mit den strukturellen Bedingungen von Gesundheit und Gesundheitsversorgung befasst. Der Beitrag argumentiert für eine systematischere Verknüpfung dieser verschiedenen Ebenen. 3) "Migration" als bioethisches Thema wird häufig unter "Kultur" subsumiert. Doch diese beiden Themen sind nicht koextensiv, stattdessen umfassen beide Bereiche jeweils unterschiedliche Fragestellungen. Insbesondere im Bereich von "Migration" bestehen in der Bioethik noch Forschungslücken. Auf diesen Ausgangsüberlegungen aufbauend wird die Hymenrekonstruktion aus ethischer Sicht diskutiert und dafür argumentiert, sie nur als ultima ratio durchzuführen. Zugleich sollte über die Unmöglichkeit eines Jungfräulichkeitsnachweises aufgeklärt werden. Es bleibt eine Herausforderung, "kultursensitive" Gesundheitsversorgung zu leisten, dabei jedoch ein essentialistisches Kulturverständnis und Stereotypisierung zu vermeiden. Dieser Beitrag argumentiert für eine grundsätzliche Kontextsensitivität in einer globalisierten, heterogenen Welt, in der die Verbindung zwischen individuellem Handeln und strukturellen Gegebenheiten bewusst wir

Integrated results from the COPERNICUS and GALILEO studies.

OBJECTIVES: To report on the efficacy and safety of intravitreal aflibercept in patients with macular edema secondary to central retinal vein occlusion (CRVO) in an integrated analysis of COPERNICUS and GALILEO. PATIENTS AND METHODS: Patients were randomized to receive intravitreal aflibercept 2 mg every 4 weeks or sham injections until week 24. From week 24 to week 52, all intravitreal aflibercept-treated patients in both studies and sham-treated patients in COPERNICUS were eligible to receive intravitreal aflibercept based on prespecified criteria. In GALILEO, sham-treated patients continued to receive sham treatment through week 52. RESULTS: At week 24, mean gain in best-corrected visual acuity and mean reduction in central retinal thickness were greater for intravitreal aflibercept-treated patients compared with sham, consistent with individual trial results. At week 52, after 6 months of intravitreal aflibercept as-needed treatment in COPERNICUS, patients originally randomized to sham group experienced visual and anatomic improvements but did not improve to the extent of those initially treated with intravitreal aflibercept, while the sham group in GALILEO did not improve over week 24 mean best-corrected visual acuity scores. Ocular serious adverse events occurred in CONCLUSION: This analysis of integrated data from COPERNICUS and GALILEO confirmed that intravitreal aflibercept is an effective treatment for macular edema following CRVO

Rational a priori or Emotional a priori? Husserl and Scheler’s Criticisms of Kant Regarding the Foundation of Ethics

Based on the dispute between Protagoras and Socrates on the origin of ethics, one can ask the question of whether the principle of ethics is reason orfeeling/emotion, or whether ethics is grounded on reason or feeling/emotion. The development of Kant’s thoughts on ethics shows the tension between reason and feeling/emotion. In Kant’s final critical ethics, he held to a principle of “rational a priori.” On the one hand, this is presented as the rational a priori principle being the binding principle of judgment. On the other hand, it is presented as the doctrine of “rational fact” as the ultimate argument of his ethics. Husserl believed that Kant’s doctrine of a rational a priori totally disregarded the a priori essential laws of feeling. Like Husserl, Scheler criticized Kant’s doctrine of a rational a priori, and therefore developed his own theory of an “emotional a priori”. Both of them focused their critiques on the grounding level of ethics. Scheler, however, did not follow Husserl all the way, but criticized him and reflected on his thoughts. At last, he revealed the primary status of a phenomenological material ethics of value

The Rationality of Humility

In this paper I explore humility as a paradigm, with reference to recent debates over the morality and rationality of emotions, and to the relation between religion and emotion. In Ancient Greek ethics, humility did not yet play a role; with the rise of Christianity, however, it becomes one of the cardinal virtues -- only to disappear again with the onset of modernity. Against a culture-pessimistic interpretation of this development, this article begins by characterising the relation between virtue and emotion, before reconstructing the inner rationality of humility and showing how it can be traced through several transformations to a modern ethics of responsibility. Against this background, possible manifestations of the humble attitude in the present are made plausible

Antoni Kępiński’s Philosophy of Medicine – an alternative reading

Antoni Kępiński remains an often read and quoted author even 40 years after his premature death. Usually he is read in the context of his times and his connections with contemporary philosophy. This paper aims to show other aspects of his reflections on psychiatry. His views on the position of psychiatry within medicine, its methods, psychophysical problems, and other issues are compared with current knowledge and current thought paradigms. The goal is to show that while Kępiński was obviously functioning within a different scientific and philosophical paradigm many of his ideas and reflections can still be found within current debates. The important conclusion is to not hold on to the views that Kępiński held himself because he did not know as much as we do, but to see the importance of the debates that he foresaw even then and possibly learn something from his extensive clinical experience

The Changing Face of Economics? Ethical Issues in Contemporary Economic Schools as a Consequence of Changes in the Concept of Human Nature

The last financial crisis combined with some recent social trends (like growing inequality or environmental problems) inspired many contemporary economists to the re-evaluation of actual economic knowledge in the search for solutions to these problems. Modern economic schools (especially heterodox ones) stress the meaning of ethical issues in economics more often. The thesis of the paper is that this revival of the ethical face of present economics depends very strongly on the changing assumptions of human nature within economics and other disciplines which work alongside economics, such as social psychology or business ethics, for instance. In order to prove the thesis, the paper provides an evaluation of current economic schools, especially within the heterodoxy, in search of their ethical aspects, and presents them as a result of the changing assumptions about human beings within those schools. This ethical dimension of human beings manifests itself in different ways, which can be perceived as a result of it being based on different ethical schools and different psychological and philosophical assumptions about human nature. Therefore, the paper also considers the current developments of the view on human beings in contemporary schools of economic ethics

Spinoza today: the current state of Spinoza scholarship

What I plan to do in this paper is to provide a survey of the ways in which Spinoza’s philosophy has been deployed in relation to early modern thought, in the history of ideas and in a number of different domains of contemporary philosophy, and to offer an account of how some of this research has developed. The past decade of research in Spinoza studies has been characterized by a number of tendencies; however, it is possible to identify four main domains that characterize these different lines of research: studies of Spinoza’s individual works, of its problematic concepts, from the point of view of the history of ideas, and comparative studies of Spinoza’s ideas

The possibility for a practical view of ethics: Husserl and Heidegger on the philosophy of law

This contribution centres on the practical view of ethics and its connection with the philosophy of law as it is portrayed in the works of Edmund Husserl and Martin Heidegger. According to these two philosophers, ethics determines both the expectations for human behaviour, as well as their obligations to society. In carrying out this analysis, I consider the function of law and then its regulated function among individuals and the state. Thus, I show how the individual’s orientation in the context of society makes an ethical statement, determined by humans’ actions throughout their existence