The Role of Moral Imagination in Patients' Decision-Making

This article reviews recent developments within a number of academic disciplines pointing toward an increasing importance of imagination for understanding morality and cognition. Using elements from hermeneutics and metaphor theory, it works toward a framework for a more context-sensitive understanding of human agency, especially focusing on moral deliberation and change. The analytic framework is used to analyze the story of a patient making tough decisions in the context of prenatal diagnosis. We show how a relatively stable outlook on the world, here called the "baseline of choice,” is challenged by unexpected events and how imaginative processes enter into the active creation of a new moral order. The ensuing interpretation is then placed within a broader philosophical landscape. John Dewey's notion of "dramatic rehearsal” is put forward as one particularly promising way of understanding moral imagination, deliberation, and decision-makin

Nichtkonjugierte acenhaltige Polymere durch Ringöffnende Metathesepolymerisation

Acene sind in der organischen Elektronik weit verbreitet, da sie die erforderlichen molekularen elektronischen Eigenschaften mit einer bevorzugten Festkörperstruktur verbinden. Das Ziel der vorliegenden Arbeit war es Pentacen- und Tetracenderivate in Polymere aus der ringöffnenden Metathesepolymerisation (ROMP) zu integrieren, um so neue n-halbleitende Materialien für flüssigprozessierte Dünnschichttransistoren zu erhalten. Es wurden pentacenhaltige Polymere mit verschiedenen Verknüpfungen zwischen Polymer-rückgrat und Acenen hergestellt und ihre Eigenschaften u.a. durch die Verwendung in elektronischen Bauteilen untersucht. Alle pentacenbasierten Polymere bilden nach der Rotationsbeschichtung amorphe Filme, die in Dünnschichttransistoren für amorphe Materialien typische Lochmobilitäten von 10^-6–10^-5 cm^2/Vs aufwiesen. Durch die Variation der Verknüpfung von Polymerrückgrat und Pentacen konnte innerhalb dieser Serie die Mobilität mehr als vervierfacht werden. Die pentacenhaltigen Monomere wurden hinsichtlich ihrer Festkörperstruktur untersucht. Für TIPS-Pentacen führt die Susbtitution eines Isopropylrestes der Triisopropylsilylgruppe durch Norbornadien zu einem verbesserten Kristallwachstum, wohingegen diese Substition für TIPS-Tetraazapentacen negative Folgen hat. Dünnschichttransistoren mit der Pentacenverbindung zeigten hohe Lochmobilitäten bis zu 1 cm2/Vs. Aufgrund der kleinen kristallinen Domänen wurden jedoch für das Tetraazapentacenderivat nur geringe Elektronenmobilitäten bis zu 10^-3 cm^2/Vs gemessen. Ein tetracenbasiertes Polymer konnte in eine organsiche Leuchtdiode (OLED) integriert werden und zeigte eine höhere Lichtausbeute von L = 0.06 cd/A (7 V), verglichen mit L = 0.01 cd/A (12 V) für eine ähnliche OLED mit Triisopropylsilylethinyl-(TIPS)-tetracen. Diese Verbesserung wird durch die amorphe Struktur des emittierenden Polymerfilms verursacht. Unterschiedlich substituierte Teracene und Diazatetracene der Monomersynthesen wurden genutzt um Effekte auf die Festkörperstruktur und die optischen Eigenschaften zu untersuchen. Für TIPS-Dibrom- und TIPS-Diioddiazatetracen wurden in ihren Kristallen schwache Halogen-Stickstoff-Bindungen gefunden, die das Packungsmotiv beeinflussen. Im Gegensatz zu dem für TIPS-Diazatetracene typischen Ziegelmauermotiv, wurden für die Dihalodiazatetracene Fischgrätenmuster gefunden. Mit dieser Arbeit wurde gezeigt, dass Acene in ROMP-Polymere für organische elektronische Bauteile integriert werden können. Durch die Variation der Verbindung zwischen Acen und Polymer und/oder durch Variation der Acene wurden vielversprechende Materialien zugänglich. Zudem konnten die Vorläufermoleküle der Monomere genutzt werden um gewünschte Festkörperstrukturen von Pentacen- und Tetracenderivaten zu erzeuge

Consultoria em Ética Clínica na Suíça

A realização de Consultorias em Ética Clínica tem sido reduzida, muitas vezes, a uma simples aplicação de um método de análise de casos baseados em princípios. A consultoria seria reduzida a uma simples avaliação de um conflito entre princípios. A proposta de uma abordagem baseada em uma Deliberação de Caso Moral pode ser uma alternativa importante, onde o consultor atua como facilitador e não tomando decisões que cabem aos profissionais de saúde

Research Ethics 2.0:New Perspectives on Norms, Values, and Integrity in Genomic Research in Times of Even Scarcer Resources

Research ethics anew gained importance due to the changing scientific landscape and increasing demands and competition in the academic field. These changes are further exaggerated because of scarce(r) resources in some countries on the one hand and advances in genomics on the other. In this paper, we will highlight the current challenges thereof to scientific integrity. To mark key developments in research ethics, we will distinguish between what we call research ethics 1.0 and research ethics 2.0. Whereas research ethics 1.0 focuses on individual integrity and informed consent, research ethics 2.0 entails social scientific integrity within a broader perspective of a research network. This research network can be regarded as a network of responsibilities in which every stakeholder involved has to jointly meet the ethical challenges posed to research. (C) 2017 S. Karger AG, Basel</p

What does coercion in intensive care mean for patients and their relatives? A thematic qualitative study

Background: The need for an ethical debate about the use of coercion in intensive care units (ICU) may not be as obvious as in other areas of medicine, such as psychiatry. Coercive measures are often necessary to treat critically ill patients in the ICU. It is nevertheless important to keep these measures to a minimum in order to respect the dignity of patients and the cohesion of the clinical team. A deeper understanding of what patients and their relatives perceive during their ICU stay will shed different light on intensive care management. Patients' experiences of loss of control, dependency and abandonment may lead to a new approach towards a broader approach to the concept of coercion in intensive care. The aim of our research is to explore the experiences of patients and relatives in the ICU and to determine when it might be possible to reduce feelings and memories of coercion. Methods: We conducted and analysed 29 semi-structured interviews with patients and relatives who had been in the ICU a few months previously. Following a coding and categorisation process in MAXQDA™, a rigorous qualitative methodology was used to identify themes relevant to our research. Results: Five main themes emerged: memory issues; interviewees' experiences of restricting measures and coercive treatment; patients' negative perception of situational and relational dependency with the risk of informal coercion; patients' perceptions of good care in a context of perceived dependency; progression from perception of coercion and dependency to respect for the person. All patients were grateful to have survived. However, coercion in the form of restraint, restriction of movement, and coercive treatment in the ICU was also acknowledged by patients and relatives. These included elements of informal coercion beyond restraints, such as a perceived negative sense of dependence, surrender, and asymmetrical interaction between the patient and health providers. Conclusions: To capture the full range of patients' experiences of coercion, it is necessary to expand the concept of coercion to include less obvious forms of informal coercion that may occur in dependency situations. This will help identify solutions to avoid or reduce negative recollections that may persist long after discharge and negatively affect the patients' quality of life. Keywords: Autonomy; Coercion; Ethics; Formal–informal; Intensive care unit; Patient experiences