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PubMed2004

Bioethics in Germany: debates and infrastructure.

In Germany the public awareness on ethical problems of the application of medicine and life sciences on human beings is very high. It can be observed that German Society is rather sensitive concerning bioethical issues. Politics supports this attitude. Many articles in professional journals as well as in newspapers cover bioethical issues. Conferences and workshops on a professional and an educational level deal with topics on ethics of life sciences and ethics in general. Moreover, in the case of bioethics many different disciplines contribute with relevant considerations to the process of opinion and judgment formation. This paper summarizes the main ethical and legal debates on bioethical issues in Germany, specifies the focus of leading German centres of bioethics and biolaw, and explains the tasks, services and networking of the German Reference Centre for Ethics in the Life Sciences (DRZE) which was founded by the Federal Government.

Bioethical Issues↗
PubMedDate not supplied

Ethics and the European countries in transition--the past and the future.

This paper surveys the situation regarding bioethical issues in the European transitional societies. It aims at exploring past, present and future characteristics of bioethics in the European countries in transitions, analysing similarities, differences and common themes together with the historical development of bioethics. By carefully studying articles published since the early 1990s, one can perceive a number of bioethical issues, varying from specificities for certain countries to similar problems for all transitional European societies. It seems that more than 15 years after the fall of the Berlin Wall, Central and Eastern European societies were able to achieve significant improvements in the development of bioethics. However, looking at the bioethical issues important for European transitional societies, it seems that the invisible wall between eastern and western European societies is still there and that it will take years to remove it.

Bioethical Issues↗
PubMed2004

Ethical issues in Canadian gastroenterology: results of a survey of Canadian gastroenterology trainees.

BACKGROUND: Specialty-specific bioethical education is a mandated component of gastroenterology training programs in Canada, but no gastroenterology-specific bioethical curriculum is available. PURPOSE: To assess the relative importance of a variety of bioethical issues to the practice of gastroenterology. METHOD: A convenience sample of Canadian gastroenterology residents and staff was surveyed at a national meeting for Canadian gastroenterology trainees. They were asked to indicate their opinions of the relative importance of 24 different bioethical issues in their practice of gastroenterology. RESULTS: Respondents made distinctions in the relevance of different bioethical issues to the practice of gastroenterology and there was substantial concordance in the rankings indicated by residents and staff. Truth telling, consent and the capacity to give consent, and consent with regard to specific endoscopic procedures were ranked by both residents and staff as most important to their practice of gastroenterology. In contrast, the issue of euthanasia and assisted suicide was ranked near the bottom of the list by both residents and staff. The results differ in some respects from the key ethical questions identified by opinion leaders in gastroenterology. INTERPRETATION: Gastroenterology residents and staff identify some topics as much more relevant than others to the practice of gastroenterology. It is proposed that this can provide a framework for developing a gastroenterology-specific bioethical curriculum, and that there is an important opportunity for developing a joint program through collaboration among gastroenterology training programs across Canada.

Attitude of Health Personnel↗
PubMed1998

The blossoming of bioethics at NIH.

The establishment of the Department of Clinical Bioethics at the Warren G. Magnuson Clinical Center of the National Institutes of Health (NIH) has coincided with a burgeoning of interest and activity related to bioethical issues at NIH. The department has precipitated a reexamination and revitalization of existing bioethics activities in the Clinical Center and has launched new programs especially in the areas of education and research. In addition, the department contributes to the work of others throughout NIH who address bioethical issues.

Academies and Institutes↗
PubMed2006

Issues in bioethics: ethics in health policy and guidelines in healthcare.

The development of policies in health and healthcare should incorporate ethical premises as well as thoughtful consideration of the values pertinent to the particular society and the goals to be achieved by specific policies. Social inequalities, changing values, and emergent challenges to traditional beliefs, add complexities that require a thorough analysis to compile policies that are fair and equitable. This article provides some recommendations for clinicians, health administrators, policy makers and technocrats who often grapple with complex health issues.

Bioethical Issues↗
PubMed1989

Australian commissions and committees on issues in bioethics.

We examine the role of Australian state and federal committees and law reform commissions in bioethics. Most have been concerned with in vitro fertilization and embryo research. We find deficiencies in the standards of reasoning about the underlying ethical issues raised by these techniques. We suggest stronger representation of those with a background in ethics.

Advisory Committees↗
PubMed2004

Ethical issues in molecular medicine of relevance to surgeons.

The technology associated with the care of surgical patients and the level of sophistication of biomedical research accompanying it are evolving at a rapid pace. Both new and old bioethical issues are assuming increasing levels of prominence and importance, particularly in this age of molecular medicine. The authors explore bioethical issues pertinent and relevant to surgeons. Four specific areas that are exemplary by presenting both major scientific and ethical challenges are briefly addressed: privacy of information, stem cells, gene therapy, and conflict of interest in biomedical research. All of these can be generalized to all surgeons. As bioethical issues today play a greater role in surgical practice than they did even a decade ago, it is hoped that this brief review on ethical issues in molecular medicine will help stimulate present and future generations of surgeons in thinking about the ethical dimensions of their work.

Conflict of Interest↗
PubMed2004

[Documentation and biolaw: achievements and perspectives].

Law is more and more implicated in bioethical issues, as demonstrated by the creation of the word "biolaw". One of the most evident aspects of this discipline lies in the extensive production of documents of different kind and provenance (national laws, EU and international regulations). Hence the necessity and interest of collecting this material, for the purpose of facilitating researches on one or more biolaw issues. For this reason a Centre of Biolaw Documentation has been created by the Catholic University of the Holy Hearth, Institute of Bioethics, Rome, Italy. It has the purpose of collecting and cataloguing legal documents, of every kind and geographical provenance, concerning various bioethical issues.

Bioethical Issues↗
PubMed1999

Bioethics and the newspapers.

Many bioethics questions are resistant to journalistic exploration on account of their inherently philosophical dimensions. Such dimensions are ill-suited to what we may term the internal goods (in MacIntyre's sense) of the newspapers and mass media generally, which constrain newspaper coverage to an abbreviated form of narrative that, whilst not in itself objectionable, is nonetheless inimical to the conduct of philosophical reflection. The internal goods of academic bioethics, by contrast, include attention to philosophical questions inherent in bioethical issues and value-enquiry. The danger for bioethics is that its agenda for reflective enquiry will, if dictated by this abbreviated narrative, be distorted in terms of both range and priorities, to the inevitable neglect of questions having a philosophical dimension to them. This danger can be avoided by a constructive partnership between the media and academic bioethics. The success of this partnership relies on four suggested provisos, for the meeting of which both journalists and academics bear responsibility.

Bioethical Issues↗
PubMed1996

Feminism, law, and bioethics.

Feminist legal theory provides a healthy skepticism toward legal doctrine and insists that we reexamine even formally gender-neutral rules to uncover problematic assumptions behind them. The article first outlines feminist legal theory from the perspectives of liberal, cultural, and radical feminism. Examples of how each theory influences legal practice, case law, and legislation are highlighted. Each perspective is then applied to a contemporary bioethical issue, egg donation. Following a brief discussion of the common themes shared by feminist jurisprudence, the article incorporates a narrative reflecting on the integration of the common feminist themes in the context of the passage of the Maryland Health Care Decisions Act. The article concludes that gender does matter and that an understanding of feminist legal theory and practice will enrich the analysis of contemporary bioethical issues.

Bioethical Issues↗
PubMed2003

Framework for bioethical assessment of an article on therapy.

OBJECT: Frameworks for scientific assessment of articles on therapy published in the medical literature have become available and will likely enhance the quality of medical research that is published in peer-reviewed journals. Comprehensive frameworks do not exist for the assessment of bioethical issues pertaining to research on human volunteers. METHODS: The authors have developed a framework consisting of ethical dimensions or questions that they suggest should be applied to assess the bioethical integrity of articles on therapy. Thirteen questions were developed and discussed in the context of current bioethical principles, and examples were applied where possible. CONCLUSIONS: The simple framework the authors have developed offers a method to assess key bioethical issues surrounding an article on therapy and probably defines the minimum standard to which such articles should be held. Many ethical questions cannot yet be answered based on available information or bioethical theories. The authors are not suggesting that their framework is comprehensive; refinements and individualization of it to fit specific studies are probably required by each clinician-researcher who designs a therapy trial and reports its results.

Bioethical Issues↗
PubMed2001

Other issues.

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Bioethical Issues↗
PubMed2005

Public appraisal of government efforts and participation intent in medico-ethical policymaking in Japan: a large scale national survey concerning brain death and organ transplant.

BACKGROUND: Public satisfaction with policy process influences the legitimacy and acceptance of policies, and conditions the future political process, especially when contending ethical value judgments are involved. On the other hand, public involvement is required if effective policy is to be developed and accepted. METHODS: Using the data from a large-scale national opinion survey, this study evaluates public appraisal of past government efforts to legalize organ transplant from brain-dead bodies in Japan, and examines the public's intent to participate in future policy. RESULTS: A relatively large percentage of people became aware of the issue when government actions were initiated, and many increasingly formed their own opinions on the policy in question. However, a significant number (43.3%) remained unaware of any legislative efforts, and only 26.3% of those who were aware provided positive appraisals of the policymaking process. Furthermore, a majority of respondents (61.8%) indicated unwillingness to participate in future policy discussions of bioethical issues. Multivariate analysis revealed the following factors are associated with positive appraisals of policy development: greater age; earlier opinion formation; and familiarity with donor cards. Factors associated with likelihood of future participation in policy discussion include younger age, earlier attention to the issue, and knowledge of past government efforts. Those unwilling to participate cited as their reasons that experts are more knowledgeable and that the issues are too complex. CONCLUSIONS: Results of an opinion survey in Japan were presented, and a set of factors statistically associated with them were discussed. Further efforts to improve policy making process on bioethical issues are desirable.

Bioethical Issues↗
PubMed2000

Evaluation of a workshop to teach clinical bioethics in the clinical setting.

That the teaching of medical ethics must extend into the clinical years in order for medical students to effectively acquire the knowledge and skills required for dealing with clinical bioethical issues has been widely recognized. A limiting factor has been the lack of physicians able to teach bioethics in the clinical setting. This paper describes the structure and evaluation of a workshop for teaching clinicians how to teach bioethics in the clinical setting. 80 physicians participated in 4 workshops in which they were provided with the ethical principles needed to deal with clinical bioethical issues and appropriate teaching methods. Methods such as paper cases, videotaped standardized patient interactions and live standardized patients were presented. The workshops have been highly evaluated. Post workshop evaluation showed that a significant number of physicians taught ethical issues during rounds and seminars. The frequency of teaching ranged from once per month to one or more times per week.

Attitude of Health Personnel↗
PubMed2002

Issues in bioethics. Teaching medical ethics to health professionals.

New medical technologies, public concern about medical ethics, and the advent of numerous ethical dilemmas in healthcare have led many medical schools to increase their formal teaching of ethics. Ethical issues in healthcare may involve a complex mix of scientific, economic, social, cultural, religious, moral and legal issues. Education in medical ethics will therefore need to be on-going to accommodate changes that periodically occur in healthcare issues, policies, or the changing moral values of the society. This article proposes frameworks within which this process may occur.

Education, Medical↗
PubMed2005

Poverty and inequality: challenges for the IAB: IAB presidential address.

This paper focuses on poverty and inequality in the world today. First, it points out how this topic is a main concern for the IAB. Second, it proposes 'new' theoretical tools in order to analyze global justice and our obligations towards the needy. I present John Rawls's denial that the egalitarian principle can be applied to the global sphere, his proposed weak duty of assistance, and his consideration of endemic poverty as essentially homegrown. In opposition, I focus on Thomas Pogge as representative of a cosmopolitan view who also holds a critical position towards the international systems which allow and cause poverty. I endorse the general normative proposal that defends every human being as an ultimate unit of moral concern, as well as the strategy of moving away from the charity model of bilateral aid to the realm of rights and duties. These ideas should redesign and broaden the normative and practical roles of institutions, and should also help provide a new approach on bioethical issues such as drug patenting or the imbalance in global research and neglected diseases.

Bioethical Issues↗