Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
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Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Aug 2008
Review[Physicians' responsibility: doctor-patient relationship].
The physician-patient relationship is of fundamental importance not only for individual patients but for the health care system in general and thus also for bioethical reflections. We give an overview on current research and analyses regarding the physician-patient relationship. ⋯ These forms of relationships seem to be promising for several reasons, but might not fit all situations, and suitable for all preferences of patients and physicians in the same way. We conclude with a summary of the current debate and point out some of its shortcomings.
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Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Aug 2008
Review[Ethics in medical education].
Ethics education is a topic of growing importance in the medical curriculum. Medical ethics can be defined as the skilled professional discourse on moral issues in patient care, medical research and the health-care system. Ethical competence comprises conscientiousness and the ability to give reasons for intuitive moral convictions. ⋯ In Germany the compulsory subject "history, theory, ethics of medicine" is predominant in the curriculum, but courses vary greatly between different universities. Further research is needed in the fields of adequate assessment formats and evaluation of final outcomes of ethics education. Interprofessional ethics education (undergraduate and postgraduate) is a major challenge for the future, especially since services for clinical ethics consultation and moral case deliberation are becoming more established in German hospitals.
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Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Aug 2008
Review[Health and justice].
The paper discusses issues of justice related to health and illness. The special normative status of health is justified based on Norman Daniels' theory of just health. As the health status of individuals is not only determined by access to health care services, the relationship between social inequalities and health status is described empirically and evaluated from an ethical perspective. ⋯ Three strategies are presented and ethically evaluated: (1) Increase efficiency ("rationalization"), (2) increase available resources and (3) limit access to services ("rationing"). Especially the pros and cons of implicit vs. explicit ways to limit services are discussed. Finally, the procedural and material ethical criteria for the just distribution of scarce health care resources are presented.