Client Participation in Moral Case Deliberation: A Precarious Relational Balance

Moral case deliberation (MCD) is a form of clinical ethics support in which the ethicist as facilitator aims at supporting professionals with a structured moral inquiry into their moral issues from practice. Cases often affect clients, however, their inclusion in MCD is not common. Client participation often raises questions concerning conditions for equal collaboration and good dialogue. Despite these questions, there is little empirical research regarding client participation in clinical ethics support in general and in MCD in particular. This article aims at describing the experiences and processes of two MCD groups with client participation in a mental healthcare institution. A responsive evaluation was conducted examining stakeholders’ issues concerning client participation. Findings demonstrate that participation initially creates uneasiness. As routine builds up and client participants meet certain criteria, both clients and professionals start thinking beyond ‘us-them’ distinctions, and become more equal partners in dialogue. Still, sentiments of distrust and feelings of not being safe may reoccur. Client participation in MCD thus requires continuous reflection and alertness on relational dynamics and the quality of and conditions for dialogue. Participation puts the essentials of MCD (i.e., dialogue) to the test. Yet, the methodology and features of MCD offer an appropriate platform to introduce client participation in healthcare institutions

Doctor can I buy a new kidney? I've heard it isn't forbidden: what is the role of the nephrologist when dealing with a patient who wants to buy a kidney?

Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments. In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient (and, with several caveats, of the donor) may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles (beneficence, non-maleficence, justice and autonomy) to the donor and recipient parties

Automatische Warenschau - Utopie oder mögliche Realität?

It can be said in summarizing, that, on the one hand, sensor technology is so far developed today that automatic fabric inspection can more than ever be regarded as feasible. In addition, the electronic hardware and software available offers every possibility of solving the problems more successfully than before. The following advantages stem from the use of pattern recognizing methods in textile fabric inspection: -The visual inspection process, which has hitherto been of a subjective nature, is becoming objectifiable, and therefore capable of standardisation. -Producer and customer can instruct the system together, unnecessary complaints due to different evaluation standards being prevented in this way. -Use of the system reduces inspection documentation at no great expense, e.g. in fault accumulation card form, etc. These inspection results can be made accessible to a computer-assisted QS system as computer data, and also to a product planning system. The premises for putting effici ent systems into effect are good, even when marginal economic conditions are included in the calculation. More essential than fresh research are managers who are willing to make decisions, are aware of the risks, are entrepreneurial in the positive sense, and do not, in line with the general spirit of the age, play to the gallery more as "do- nothings" (in terms of the opportunities offered by Germany, the seat of innovation)

Stereo-image normalization of voluminous objects improves textile defect recognition

The visual detection of defects in textiles is an important application in the textile industry. Existing systems require textiles to be spread flat so they appear as 2D surfaces, in order to detect defects. In contrast, we show classification of textiles and textile feature extraction methods, which can be used when textiles are in inhomogeneous, voluminous shape. We present a novel approach on image normalization to be used in stain-defect recognition. The acquired database consist of images of piles of textiles, taken using stereo vision. The results show that a simple classifier using normalized images outperforms other approaches using machine learning in classification accuracy