Clinical ethics committees (CECs) have been developing in many countries since the 1980s, more recently in the transitional countries in Eastern Europe. With their increasing profile they are now faced with a range of questions and challenges regarding their position within the health care organizations in which they are situated: Should CECs be independent bodies with a critical role towards institutional management, or should they be an integral part of the hospital organization? In this paper, we discuss the organizational context (...) in which CECs function in Europe focusing on five aspects. We conclude that in Europe clinical ethics committees need to maintain a critical independence while generating acceptance of the CEC and its potential benefit to both individuals and the organization. CECs, perhaps particularly in transitional countries, must counter the charge of “alibi ethics”. CECs must define their contribution to in-house quality management in their respective health care organization, clarifying how ethical reflection on various levels serves the hospital and patient care in general. This last challenge is made more difficult by lack of consensus about appropriate quality outcomes for CECs internationally. These are daunting challenges, but the fact that CECs continue to develop suggests that we should make the effort to overcome them. We believe there is a need for further research that specifically addresses some of the institutional challenges facing CECs. (shrink)
Institutions in France are not yet well prepared to respond to allegations of scientific misconduct. Following a serious allegation in late 1997. INSERM,* the primary organization for medical and health-related research in France, began to reflect on this subject, aided by scientists and jurists. The conclusions have resulted in establishing a procedure to be followed in cases of alleged misconduct, and also in reinforcing the application of good laboratory practices within each laboratory. Guidelines for authorship practices and scientific assessment must (...) also be considered. Even though each institution must remain responsible for responding to allegations of scientific misconduct within its doors, INSERM would like to see national, European, and international co-ordination about the methods of such response. (shrink)
In vitro fertilisation (IVF) daily practice reveals that couples are willing to take greater risks than doctors if there is a higher chance of pregnancy. Arising from this is a frequently addressed issue regarding the embryo transfer strategy: single or double embryo transfer? The dilemma is faced by patients, as well as physicians, who are caught between the possibility of no pregnancies at all and facing the prospect of iatrogenic twin gestation. How could the couple's preferences concerning how many children (...) they would like be taken into account in determining the number of embryos transferred? How should the physician exercise his medical responsibility towards his patients and the unborn child? An effective approach could be to enhance a couple’s autonomy by advocating a medical beneficence that incorporates patients’ values. This can be achieved through a case-by-case approach in a deliberative process of decision-making which includes real patient-centred communication. (shrink)
Jean-Philippe Deranty, Beyond Communication: A Critical Study of Axel Honneth's Social Philosophy Content Type Journal Article Category Book Review Pages 497-500 Authors Jørgen Pedersen, The Centre for the Study of the Sciences and the Humanities, Bergen, Norway Journal Critical Horizons: A Journal of Philosophy & Social Theory Online ISSN 1568-5160 Print ISSN 1440-9917 Journal Volume Volume 11 Journal Issue Volume 11, Number 3 / 2010.
This essay works to set up a debate between the German philosopher Manfred Frank and the French philosophers Philippe Lacoue-Labarthe and Jean-Luc Nancy. At stake in the debate is the concept of freedom. The essay begins by explaining Frank's subject-based concept of freedom and then it presents the perfectly opposed non-subjective ontological concept of freedom that Lacoue-Labarthe and Nancy forward. In the end, in the interest of threading a way through this impasse, and following the cue of these three philosophers, (...) we turn to the early German Romantics Novalis and Friedrich Schlegel to help us reconceptualise freedom. Following their cue, I draw on the strengths of Frank and Lacoue-Labarthe and Nancy while avoiding their dangerous extremes. (shrink)