In an Era of Commercialism Medicine is Losing its Identity as a Healing PracticeSummary: Modern medicine follows more and more market criteria. Economic considerations might be very important for medicine, but they must not become the leading one. Clearly medicine has another task, another duty, another mission than to invest money, namely to help people in need and to assist those who cannot help themselves. Since personal involvement of doctors is completely devaluated with the actual incentive scheme we must develop new schemes to reward exactly those colleagues who contribute to make medicine an experience of personal care. If the physician now is becoming a businessman instead of a personal doctor, this will lead to a situation where he doesn’t give any other promise than not to act against the contract. But the main need of the patient, his longing for a human person whom he can trust, this need cannot become part of a contract. Especially in our time medicine has to fight for the core of its identity. Medicine is a profession which can only remain a profession if it succeeds in preserving the liberty of doing what medicine demands and not what economics demands. This liberty is not a privilege but a duty – necessary for the patients of the future.
Summary: An ongoing qualitative study at the Charité Berlin is examining the experience of family physicians with moral conflicts and the potential need for ethical advice. We analyze a case report from this interview study by using a principle-oriented approach. During an out-of-hours service, a family physician is being called to see an 85 years old, previously unknown patient in a nursing home, who is suffering from angina. On arrival, the patient apparently has just passed away. The family physician is confronted with the decision whether or not to start resuscitation. No details about the patient are known. The nurse does not know whether an advance decision has been laid down. The family physician decides against resuscitation, but is unsure about this choice when reflecting on the case afterwards.We identify criteria for a retrospective ethical reflection of the case. The assessment of the medical indication and of the patient‘s will seems crucial. However, without any knowledge of the patient‘s preferences this proves to be insufficient. The recommendation of resuscitation guidelines to always begin with resuscitation if in doubt seems hard to follow without a clear idea of any goal of therapy that is realistically attainable. The application of the ethical principles in health care, as formulated by Beauchamp und Childress (respect for autonomy, nonmaleficence, beneficence, and justice), can help to reach a responsible decision in the best interest of the patient.
280 Konzepte/Theorie Ethische Kon?ikte um die Jugendgesundheitsuntersuchung (J1) Ethical Con?icts Associated with Adolescence’ Health Check-up Autor...
280 Konzepte/Theorie Ethische Kon?ikte um die Jugendgesundheitsuntersuchung (J1) Ethical Con?icts Associated with Adolescence’ Health Check-up Autor...
