Clinical Ethics Consultation – a Particular Form of Valuation

Clinical ethics consultation is a relatively young field of expertise that supports ethically reflected decision-making. This process shakes up the existing hierarchy in two ways; first, by involving further perspectives in a structured and transparent way, and, second, by shifting the focus to a more comprehensive, interdisciplinary view. A major challenge for those providing clinical ethics consultation is building trust, which involves being considerate towards the needs of patients, relatives and healthcare professionals as well as towards customs and organizational culture. As this service emphasizes the relational aspect of medical care, it is difficult to realize within existing institutional frameworks. This paper explores how clinical ethics consultation developed and changed over the past few decades alongside an evolving understanding of respect for patient autonomy within an ethics of care approach. One of the most influential images related to clinical ethics consultation marks the beginning of this era, however, it also signifies some of the limitations and challenges of the practice still valid nearly 60 years after the first clinical ethics committee had been installed.Clinical ethics consultation is a relatively young field of expertise that supports ethically reflected decision-making. This process shakes up the existing hierarchy in two ways; first, by involving further perspectives in a structured and transparent way, and, second, by shifting the focus to a more comprehensive, interdisciplinary view. A major challenge for those providing clinical ethics consultation is building trust, which involves being considerate towards the needs of patients, relatives and healthcare professionals as well as towards customs and organizational culture. As this service emphasizes the relational aspect of medical care, it is difficult to realize within existing institutional frameworks. This paper explores how clinical ethics consultation developed and changed over the past few decades alongside an evolving understanding of respect for patient autonomy within an ethics of care approach. One of the most influential images related to clinical ethics consultation marks the beginning of this era, however, it also signifies some of the limitations and challenges of the practice still valid nearly 60 years after the first clinical ethics committee had been installed

'Gutachterei': Beiträge der Medical Humanities zu Ambivalenzen der Begutachtung

Die Beiträge des Bandes beschäftigen sich mit Begutachtungspraktiken verschiedener Epochen und zeigen die Entwicklung des Gutachtens als einen Prozess auf, der zunehmend der Diskussion, Ausverhandlung und dem Einfluss von Wissen und Gegenwissen um soziokulturelle Normen unterliegt. Ausgehend von der Annahme, dass der Medizin in der Klassifikation, Bewertung und Einschätzung bzw. in der Subjektivierung von Einzelnen und Gruppen eine besondere Bedeutung zukommt, rückt insbesondere jenes Verhältnis in den Fokus, das durch die Tätigkeit des Gutachtens zwischen und für Menschen hergestellt wird.Die Beiträge des Bandes beschäftigen sich mit Begutachtungspraktiken verschiedener Epochen und zeigen die Entwicklung des Gutachtens als einen Prozess auf, der zunehmend der Diskussion, Ausverhandlung und dem Einfluss von Wissen und Gegenwissen um soziokulturelle Normen unterliegt. Ausgehend von der Annahme, dass der Medizin in der Klassifikation, Bewertung und Einschätzung bzw. in der Subjektivierung von Einzelnen und Gruppen eine besondere Bedeutung zukommt, rückt insbesondere jenes Verhältnis in den Fokus, das durch die Tätigkeit des Gutachtens zwischen und für Menschen hergestellt wird

A first glimpse at the transcriptome of Physarum polycephalum

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

First insights into structure-function relationships of alkylglycerol monooxygenase

Alkylglycerol monooxygenase is a tetrahydrobiopterin-dependent enzyme that cleaves the O-alkyl-bond of alkylglycerols. It is an exceptionally unstable, hydrophobic membrane protein which has never been purified in active form. Recently, we were able to identify the sequence of alkylglycerol monooxygenase. TMEM195, the gene coding for alkylglycerol monooxygenase, belongs to the fatty acid hydroxylases, a family of integral membrane enzymes which have an 8-histidine motif crucial for catalysis. Mutation of each of these residues resulted in a complete loss of activity. We now extended the mutational analysis to another 25 residues and identified three further residues conserved throughout all members of the fatty acid hydroxylases which are essential for alkylglycerol monooxygenase activity. Furthermore, mutation of a specific glutamate resulted in an 18-fold decreased affinity of the protein to tetrahydrobiopterin, strongly indicating a potential important role in cofactor interaction. A glutamate residue in a comparable amino acid surrounding had already been shown to be responsible for tetrahydrobiopterin binding in the aromatic amino acid hydroxylases. Ab initio modelling of the enzyme yielded a structural model for the central part of alkylglycerol monooxygenase where all essential residues identified by mutational analysis are in close spatial vicinity, thereby defining the potential catalytic site of this enzym

Physarum nitric oxide synthases: genomic structures and enzymology of recombinant proteins

Physarum polycephalum expresses two closely related, calcium-independent NOSs (nitric oxide synthases). In our previous work, we showed that both NOSs are induced during starvation and apparently play a functional role in sporulation. In the present study, we characterized the genomic structures of both Physarum NOSs, expressed both enzymes recombinantly in bacteria and characterized their biochemical properties. Whereas the overall genomic organization of Physarum NOS genes is comparable with various animal NOSs, none of the exon–intron boundaries are conserved. Recombinant expression of clones with various N-termini identified N-terminal amino acids essential for enzyme activity, but not required for haem binding or dimerization, and suggests the usage of non-AUG start codons for Physarum NOSs. Biochemical characterization of the two Physarum isoenzymes revealed different affinities for L-arginine, FMN and 6R-5,6,7,8-tetrahydro-L-biopterin

Catalytic residues and a predicted structure of tetrahydrobiopterin-dependent alkylglycerol mono-oxygenase

Alkylglycerol mono-oxygenase (EC 1.14.16.5) forms a third, distinct, class among tetrahydrobiopterin-dependent enzymes in addition to aromatic amino acid hydroxylases and nitric oxide synthases. Its protein sequence contains the fatty acid hydroxylase motif, a signature indicative of a di-iron centre, which contains eight conserved histidine residues. Membrane enzymes containing this motif, including alkylglycerol mono-oxygenase, are especially labile and so far have not been purified to homogeneity in active form. To obtain a first insight into structure–function relationships of this enzyme, we performed site-directed mutagenesis of 26 selected amino acid residues and expressed wild-type and mutant proteins containing a C-terminal Myc tag together with fatty aldehyde dehydrogenase in Chinese-hamster ovary cells. Among all of the acidic residues within the eight-histidine motif, only mutation of Glu137 to alanine led to an 18-fold increase in the Michaelis–Menten constant for tetrahydrobiopterin, suggesting a role in tetrahydrobiopterin interaction. A ninth additional histidine residue essential for activity was also identified. Nine membrane domains were predicted by four programs: ESKW, TMHMM, MEMSAT and Phobius. Prediction of a part of the structure using the Rosetta membrane ab initio method led to a plausible suggestion for a structure of the catalytic site of alkylglycerol mono-oxygenase

Geneva Statement on Heritable Human Genome Editing: The Need for Course Correction

As public interest advocates, policy experts, bioethicists, and scientists, we call for a course correction in public discussions about heritable human genome editing. Clarifying misrepresentations, centering societal consequences and concerns, and fostering public empowerment will support robust, global public engagement and meaningful deliberation about altering the genes of future generations

Lost and Found - Evolution im Zeitalter der Genomik

Evolution von Organismen, oder allgemeiner ausgedrückt von Systemen, beinhaltet als wesentliche Elemente Veränderung und Entwicklung. Auch der Begriff der Evolution selbst unterliegt dieser Transformation, einer gedanklichen Evolution, die neuere wissenschaftliche Erkenntnisse integriert. Bis heute hält sich jedoch die Vorstellung vertikaler Hierarchien hartnäckig im großen System des Lebendigen. Genomik, ein noch relativ junger Wissenschaftszweig, liefert allerdings eine Reihe anderer Einsichten. Nachdem bisherige Auffassungen zur Evolution zunächst in der durch Genomik generierten Datenflut verloren zu gehen schienen, entstehen nun neue Konzepte, die kurz zusammengefasst Folgendes verdeutlichen: die Komplexität lebender Systeme ist durch lineare Kausalitäten nur unzureichend erklärbar. Ganz im Sinn nicht nur wissenschaftlicher Ergebnisse, sondern auch des Zeitgeists, zeigt heutige Evolutionsforschung die weitreichende Vernetzung und Ko-Evolution verschiedener Entitäten auf. Im Aufsatz werden diese Zusammenhänge mit Ergebnissen der neueren Forschung illustriert. Dabei wird auch untersucht, inwiefern die Interpretation experimenteller Daten von kulturell verankerten Perspektiven abhängt.Evolution of organisms or, more generally of systems, comprises the essential elements of variation and development. It thus is the basis of transformation. Also the notion of evolution itself is subject to transformation, an evolution of thought which in the ideal case integrates new knowledge contributed by science into existing perspectives. Till today, however, the idea of vertical and monocausal hierarchies persists in our understanding of the living world though genomics, a relatively young branch of science, provides a number of other insights. Despite the fact that notions on evolution first seemed to get lost in the data floods that genomics generated new concepts on evolution emerge from such research. In short revised concepts based on genomics (and other omics) emphasize the following: the complexity of living systems is insufficiently explained by linear causations. Not only in the sense of scientific results but also in line with the current Zeitgeist, todays evolution research show the far-reaching inter-connectivity and co-evolution of various entities. In this essay, I highlight some of these connections elucidated by current research. In this context, I also examine in what way culturally anchored perspectives affect the interpretation of research data.(VLID)174610