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Biomedical subjects

H M Sass

Publications and source records attributed to H M Sass.

At least 37 records · Page 2Linked to original sources
PubMed1993

Using stories to assess values and establish medical directives.

While still developing in Germany, a consensus has emerged in the United States on the use of advance directives for guiding future medical decision making. This article outlines three phases in the evolution of advance directive forms--the legal phase, the checklist phase, and the story phase. The story-based approach is discussed as the best method for assessing patient values and incorporating them into advance directives, and a story-based advance directive form, which has been developed and tested during the past two years, is presented.

Advance Directives↗
PubMed1993

[Ethics in epidemiology].

Progress in epidemiology was instrumental for recognising health risk factors and emphasising health protection and health risk prevention; it may contribute to a Copernican turn in setting new priorities in health care politics and health care ethics, in redefining health, disease, and individual health literacy and responsibility. This paper reviews recent national and international activities to formulate a Code of Ethics for Epidemiologists and evaluates central bioethical principals for epidemiologists.

Epidemiology↗
PubMed1992

Right not to know or duty to know? Prenatal screening for polycystic renal disease.

New dimensions in different ethical scenarios following genetic information require new medical-ethical Action Guides for physician-patient interaction. This paper discusses the ambiguity in moral choice between a "right not to know" and "a duty to know", regarding parental decision-making pro or contra selective abortion following prenatal screening for autosomal dominant polycystic kidney disease (Potter III) and related public policy issues.

Abortion, Legal↗
PubMed1992

Criteria for death: self-determination and public policy.

'Whole brain death' criteria have found support in Western cultures in regard to post-mortem organ donation and the termination of care for patients meeting these strict criteria. But they are of minimal use in Asian cultures and in the ethics of caring for the persistent vegetative patient. This paper introduces a formula for a global Uniform Determination of Death statute, based on the 'entire brain including brain stem' criteria as a default position, but allowing competent adults by means of advance directives to choose other criteria for determining death during the process of dying.

Bioethics↗
PubMed1990

Ethical considerations in phase I clinical trials.

Medical ethics has developed methods of differential ethics for a more rigid integration of bioethical reasoning into biomedical research. Due to high levels of risk and uncertainty in phase I trials, established principles of medical ethics need a specific assessment in order to provide for better moral design and moral monitoring of trial procedures, a better translation of medical health status data into individual quality of life criteria, and strong support for trust-based cooperation between physician, research team and patient. Existing bioethical questionnaires and detailed methodological research in differential ethics could be improved further.

Antineoplastic Agents↗
PubMed1990

Bioethics: its philosophical basis and application.

Contemporary medicine involves a lot more than technologies that now permit effective medical intervention where none was possible before. Among other things, changes in technology have been accompanied by changes in social and cultural attitudes that are having major effects on health care and medical practice. This article provides a brief overview of many of the more important changes and their relationship to developments in the field of medical bioethics.

Beneficence↗
PubMed1989

Brain life and brain death: a proposal for a normative agreement.

This paper reviews moral and cultural assessments which led to the definition of brain death and calls for a similar normative consensus regarding the moral recognition and legal protection of embryonal life related to criteria of brain life. This paper differentiates between cortical brain life I, i.e., the first existence of post-mitotic stationary neurons forming the early cortical plate (54th day post conception), and cortical brain life II, i.e., the beginning of cortical neuro-neuronal synapses (after the 70th day p.c.). The latter are preconditional for establishing the communicative network within the cortex and with subcortical structures. The paper conservatively calls for a tentative moral consensus that could recognize brain life I, i.e., the 54th day p.c., as a stage prior to which embryo research generally would be acceptable in accordance with principles similar to those which led to the acceptance of brain death. Other developmental stages such as fertilization, nidation, viability, as well as the 'potentiality' principle are less significant for the moral recognition of early human life.

Beginning of Human Life↗
PubMed1989

Blue-ribbon commissions and political ethics in the Federal Republic of Germany.

The paper presents an overview of political and professional committees in the Federal Republic of Germany dealing with issues of biomedical ethics. The prevailing tendencies of paternalistic attitudes, the worst-case-scenario argumentation method, and the unfortunate practice of applying general principles rather than mid-level principles in the assessment of concrete challenges in treatment and regulation are analyzed.

Advisory Committees↗
PubMed1987

Moral dilemmas in perinatal medicine and the quest for large scale embryo research: a discussion of recent guidelines in the Federal Republic of Germany.

This paper reports on recent regulations and guidelines in the Federal Republic of Germany bearing on perinatal medical ethics, embryo research and trophoblast biopsy. Some of the regulations are defensive responses to new moral opportunities. In contrast, this paper calls for a more aggressive moral cost-benefit assessment of high technology medicine, which would include large-scale research on embryos prior to the fiftieth day post-menstruation.

Abortion, Induced↗
PubMed1983

Reichsrundschreiben 1931: pre-Nuremberg German regulations concerning new therapy and human experimentation.

This is the first re-publication and first English translation of regulations concerning Human Experimentation which were binding law prior to and during the Third Reich, 1931 to 1945. The introduction briefly describes the duties of the Reichsgesundheitsamt, which formulated these regulations. It then outlines the basic concept of the Richtlinien for protecting subjects and patients on the one hand and for encouraging New Therapy and Human Experimentation on the other hand. Major issues, like personal responsibility of the physician or researcher, teaching of ethics of research and therapy, and research and therapy on vulnerable populations, are compared with the regulations in the Nuremberg Code and subsequent regulations influenced by the Nuremberg Code.

Codes of Ethics↗
PubMed1983

Justice, beneficence, or common sense?: The President's Commission's Report on access to health care.

The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research published in March of 1983 its Report, Securing Access to Health Care: The Ethical Implications of Differences in the Availability of Health Services. Concluding that there are "ethical obligations" on behalf of society which are balanced by individual obligations, the Report provides an ethical framework for ensuring "ultimate responsibility" of the Federal government to arrange for equitable access to health and to a fair share of cost. In doing so the Report neither makes justice nor beneficence the prime moral principle in public health care, it rather calls for a common sense approach in "approximating adequacy". But how to define equality without creating uniformity in a society rich in its diversity, including attitudes towards health?

Advisory Committees↗