29 found
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  1.  76
    Conversational Artificial Intelligence in Psychotherapy: A New Therapeutic Tool or Agent?Jana Sedlakova & Manuel Trachsel - 2022 - American Journal of Bioethics 23 (5):4-13.
    Conversational artificial intelligence (CAI) presents many opportunities in the psychotherapeutic landscape—such as therapeutic support for people with mental health problems and without access to care. The adoption of CAI poses many risks that need in-depth ethical scrutiny. The objective of this paper is to complement current research on the ethics of AI for mental health by proposing a holistic, ethical, and epistemic analysis of CAI adoption. First, we focus on the question of whether CAI is rather a tool or an (...)
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  2.  59
    Suffering is not enough: Assisted dying for people with mental illness.Manuel Trachsel & Ralf J. Jox - 2022 - Bioethics 36 (5):519-524.
    Bioethics, Volume 36, Issue 5, Page 519-524, June 2022.
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  3.  46
    Physicians’ personal values in determining medical decision-making capacity: a survey study.Helena Hermann, Manuel Trachsel & Nikola Biller-Andorno - 2015 - Journal of Medical Ethics 41 (9):739-744.
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  4.  34
    Decision-making capacity: from testing to evaluation.Helena Hermann, Martin Feuz, Manuel Trachsel & Nikola Biller-Andorno - 2020 - Medicine, Health Care and Philosophy 23 (2):253-259.
    Decision-making capacity (DMC) is the gatekeeping element for a patient’s right to self-determination with regard to medical decisions. A DMC evaluation is not only conducted on descriptive grounds but is an inherently normative task including ethical reasoning. Therefore, it is dependent to a considerable extent on the values held by the clinicians involved in the DMC evaluation. Dealing with the question of how to reasonably support clinicians in arriving at a DMC judgment, a new tool is presented that fundamentally differs (...)
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  5.  74
    Emotion and Value in the Evaluation of Medical Decision-Making Capacity: A Narrative Review of Arguments.Helena Hermann, Manuel Trachsel, Bernice S. Elger & Nikola Biller-Andorno - 2016 - Frontiers in Psychology 7:197511.
    ver since the traditional criteria for medical decision-making capacity (understanding, appreciation, reasoning, evidencing a choice) were formulated, they have been criticized for not taking sufficient account of emotions or values that seem, according to the critics and in line with clinical experiences, essential to decision-making capacity. The aim of this paper is to provide a nuanced and structured overview of the arguments provided in the literature emphasizing the importance of these factors and arguing for their inclusion in competence evaluations. Moreover, (...)
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  6.  29
    With great power comes great vulnerability: an ethical analysis of psychedelics’ therapeutic mechanisms proposed by the REBUS hypothesis.Daniel Https://Orcidorg624X Villiger & Manuel Trachsel - 2023 - Journal of Medical Ethics 49 (12):826-832.
    Psychedelics are experiencing a renaissance in mental healthcare. In recent years, more and more early phase trials on psychedelic-assisted therapy have been conducted, with promising results overall. However, ethical analyses of this rediscovered form of treatment remain rare. The present paper contributes to the ethical inquiry of psychedelic-assisted therapy by analysing the ethical implications of its therapeutic mechanisms proposed by the relaxed beliefs under psychedelics (REBUS) hypothesis. In short, the REBUS hypothesis states that psychedelics make rigid beliefs revisable by increasing (...)
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  7.  28
    Evaluation of decision-making capacity in patients with dementia: challenges and recommendations from a secondary analysis of qualitative interviews.Christopher Poppe, Bernice S. Elger, Tenzin Wangmo & Manuel Trachsel - 2020 - BMC Medical Ethics 21 (1):1-8.
    BackgroundEvaluation of decision-making capacity to consent to medical treatment has proved to be difficult in patients with dementia. Studies showed that physicians are often insufficiently trained in the evaluation of decision-making capacity. In this study, we present findings from a secondary analysis of a qualitative interviews with physicians. These interviews were initially used to assess usability of an instrument for the evaluation of decision-making capacity. By looking at difficult cases of decision-making capacity evaluation in patients with dementia, we provide recommendations (...)
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  8.  22
    The Doctrine of Informed Consent Doesn’t Need Modification for Supported Decision Making.Manuel Trachsel & Paul S. Appelbaum - 2021 - American Journal of Bioethics 21 (11):27-29.
    In their fine overview of supported decision making for persons with dynamic cognitive and functional impairments “at the margins of autonomy,” Peterson, Karlawish, and Largent query whether...
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  9.  40
    Disclosure of incidental constituents of psychotherapy as a moral obligation for psychiatrists and psychotherapists.Manuel Trachsel & Jens Gaab - 2016 - Journal of Medical Ethics 42 (8):493-495.
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  10.  57
    Compulsory Treatment in Chronic Anorexia Nervosa by All Means? Searching for a Middle Ground Between a Curative and a Palliative Approach.Manuel Trachsel, Verina Wild, Nikola Biller-Andorno & Tanja Krones - 2015 - American Journal of Bioethics 15 (7):55-56.
  11.  78
    The notion of free will and its ethical relevance for decision-making capacity.Tobias Zürcher, Bernice Elger & Manuel Trachsel - 2019 - BMC Medical Ethics 20 (1):1-10.
    Obtaining informed consent from patients is a moral and legal duty and, thus, a key legitimation for medical treatment. The pivotal prerequisite for valid informed consent is decision-making capacity of the patient. Related to the question of whether and when consent should be morally and legally valid, there has been a long-lasting philosophical debate about freedom of will and the connection of freedom and responsibility. The scholarly discussion on decision-making capacity and its clinical evaluation does not sufficiently take into account (...)
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  12.  43
    Einwilligungsfähigkeit: inhärente Fähigkeit oder ethisches Urteil?Helena Hermann, Manuel Trachsel & Nikola Biller-Andorno - 2016 - Ethik in der Medizin 28 (2):107-120.
    ZusammenfassungDie Bestimmung der Einwilligungsfähigkeit von Patienten beinhaltet weitreichende ethische und rechtliche Implikationen. Ausreichende Klärung des Begriffs ist daher unerlässlich. Solche Bemühungen gelten vorwiegend der Definition von Kriterien hinsichtlich relevanter mentaler Fähigkeiten. Grundlegendere Aspekte werden kaum explizit besprochen, so die Frage, ob Einwilligungsfähigkeit eher eine inhärente Fähigkeit oder ein ethisches Urteil bezeichnet. Zentral bei dieser Unterscheidung ist der Stellenwert ethischer Überlegungen die Zulässigkeit fürsorglicher Bevormundung betreffend. Geht man von einer inhärenten Fähigkeit aus, schließen solche Überlegungen an die Beurteilung von Einwilligungsfähigkeit an. (...)
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  13.  21
    Towards a broader understanding of agency in biomedical ethics.Rodrigo López Barreda, Manuel Trachsel & Nikola Biller-Andorno - 2016 - Medicine, Health Care and Philosophy 19 (3):475-483.
    With advances in medical science, the concept of agency has received increasing attention in biomedical ethics. However, most of the ethical discussion around definitions of agency has focused either on patients suffering from mental disorders or on patients receiving cutting-edge medical treatments in developed countries. Very little of the discussion around concepts of agency has focused on the situation of patients suffering from common diseases that affect populations worldwide. Therefore, the most widely-used definitions of agency may be not appropriate to (...)
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  14.  18
    Killing the Pain and Battling the Lethargy: Misleading Military Metaphors in Palliative Care.Manuel Trachsel - 2016 - American Journal of Bioethics 16 (10):24-25.
  15.  16
    Palliative Psychiatry for Severe and Enduring Anorexia Nervosa Includes but Goes beyond Harm Reduction.Anna L. Westermair, Daniel Z. Buchman, Sarah Levitt & Manuel Trachsel - 2021 - American Journal of Bioethics 21 (7):60-62.
    Bianchi et al. argue that for some patients with severe and enduring anorexia nervosa approaches that do not aim for complete clinical recovery are ethically warranted. We believe tha...
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  16.  19
    (1 other version)Oxford Handbook of Psychotherapy Ethics.Manuel Trachsel, Jens Gaab, Nikola Biller-Andorno, Şerife Tekin & John Z. Sadler (eds.) - 2019 - New York, NY: Oxford University Press.
    Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge, including self-determination or autonomy, decision-making capacity and freedom of choice, coercion and constraint, medical paternalism, boundaries between health and illness, insight into illness and the need for therapy, dignity, under- and overtreatment, and much more. The Oxford Handbook (...)
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  17.  43
    Accounting for Intuition in Decision-Making Capacity: Rethinking the Reasoning Standard?Helena Hermann, Manuel Trachsel & Nikola Biller-Andorno - 2017 - Philosophy, Psychiatry, and Psychology 24 (4):313-324.
    A patient’s decision-making capacity or competence is among the prerequisites for valid consent to medical treatment, and is regarded as the gatekeeping element in ensuring respect for patients’ self-determination. The issue is especially relevant in the case of vulnerable persons, such as patients who are cognitively or mentally impaired, and where medical decisions carry far-reaching consequences. As a grounding principle, DMC is a priori assumed, and challenged only when substantial doubts arise owing to observed or assumed deficiencies of the capacities (...)
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  18.  23
    How to Strengthen Patients’ Meaning Response by an Ethical Informed Consent in Psychotherapy.Manuel Trachsel & Martin Grosse Holtforth - 2019 - Frontiers in Psychology 10:451789.
    In the present contribution, we argue that all health care professionals and particularly psychotherapists should provide a plausible rationale for their treatment including an etiological model and a model of unique and common change mechanisms. The provision of a plausible rationale has two goals: (1) meet the ethical challenge of informed consent, and (2) to improve treatment outcome by fostering the meaning response. In the course of the ethical and a legal obligation of psychotherapists to obtain patients’ informed consent before (...)
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  19.  25
    The Road to Ixtlan in Neuro-Degenerative Diseases Is Paved with Palliative Cobblestones.Christopher Poppe & Manuel Trachsel - 2023 - American Journal of Bioethics Neuroscience 14 (2):134-136.
    While the developers of the “Ixtlan Basic Kit” promise a curative treatment taking advantage of increased neuroplasticity for targeting the underlying neurological causes of Alzheimer's disease and...
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  20.  25
    Against Over-Protectionism: Riskier Decisions Require Clearer Evidence of Capacity But Don’t Call for Stricter Criteria.Paul S. Appelbaum & Manuel Trachsel - 2022 - American Journal of Bioethics 22 (10):53-55.
    In their article, Pickering, Newton-Howes, and Young argue that “a person who is considering or has already made a decision which appears seriously harmful to that person should in some case...
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  21.  16
    Kommentar I zum Fall: „Seelische Notlage und später Schwangerschaftsabbruch“.Anna Lisa Westermair, Charlotte Wetterauer, Jan Schürmann & Manuel Trachsel - 2023 - Ethik in der Medizin 35 (2):305-307.
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  22.  38
    Shedding Light on Implicit Processes and the Inherent Vagueness of Decision-Making Capacity.Helena Hermann, Manuel Trachsel & Nikola Biller-Andorno - 2017 - Philosophy, Psychiatry, and Psychology 24 (4):333-335.
    We are grateful to Paul S. Appelbaum and Wayne Martin for their thoughtful remarks on our paper. Among the various aspects that we might address and refute in return, we have decided to focus on just two issues that we believe have potential to advance the debate. According to Appelbaum, the “assessment of an intuitive process is being predicated on a patient having the ability to reflect on determinants of which he may be completely unaware.” In this passage, he points (...)
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  23.  21
    The Affordable Care Act and Recent Reforms: Policy Implications for Equitable Mental Health Care Delivery.Joelle Robertson-Preidler, Manuel Trachsel, Tricia Johnson & Nikola Biller-Andorno - 2020 - Health Care Analysis 28 (3):228-248.
    Controversy exists over how to ethically distribute health care resources and which factors should determine access to health care services. Although the US has traditionally used a market-based private insurance model that does not ensure universal coverage, the Patient Protection and Affordable Care Act in the United States aims to increase equitable access to health care by increasing the accessibility, affordability, and quality of health care services. This article evaluates the impact of the ACA on equitable mental health care delivery (...)
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  24.  18
    Ethics of telepsychiatry versus face-to-face treatment: let the patients make their autonomous choice.Manuel Trachsel & Jana Sedlakova - 2022 - Journal of Medical Ethics 48 (1):32-33.
    There is robust scientific evidence from meta-analyses in psychotherapy research that common factors such as the alliance between patients and therapists, empathy, goal consensus/collaboration, positive regard/affirmation and genuineness have a much greater effect on the overall psychotherapy outcome than the so-called specific factors like particular treatment methods or ingredients of therapy.1 The current evidence base also suggests that the effects of telepsychiatric treatment are comparable with those of face-to-face treatment, not only regarding clinical outcome parameters but also with respect to (...)
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  25.  16
    Informed consent in psychotherapy: a survey on attitudes among psychotherapists in Switzerland.Manuel Trachsel, Yvonne Nestoriuc, Jens Gaab, Marc Inderbinen, Martin Grosse Holtforth & Klara Eberle - 2021 - BMC Medical Ethics 22 (1):1-10.
    BackgroundThe legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists’ attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.Methods155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent. ResultsAmong the surveyed psychotherapists, there was a high consensus on important information that should be communicated (...)
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  26.  20
    Kommentar I zum Fall: „Unter welchen Umständen darf man psychiatrische Patient*innen zum Leben zwingen?“.Manuel Trachsel & Anna Westermair - 2021 - Ethik in der Medizin 33 (1):121-123.
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  27.  20
    Mit zweierlei Maß: Die mangelnde Verbindlichkeit von Patientenverfügungen bei untergebrachten Personen mit psychischen Störungen in der Schweiz.Manuel Trachsel & Nikola Biller-Andorno - 2016 - Ethik in der Medizin 28 (3):239-247.
    ZusammenfassungEinwilligungsfähige volljährige Personen mit psychischen Störungen interessieren sich vermehrt für die Möglichkeit, eine Patientenverfügung zu verfassen. Während in der Schweiz Patientenverfügungen grundsätzlich als verbindlich gelten, müssen Patientenverfügungen bei einer unfreiwilligen Unterbringung in einer psychiatrischen Klinik im Behandlungsplan lediglich berücksichtigt werden. Das eigentliche Ziel einer Patientenverfügung – die antizipative Selbstbestimmung – wird damit in Frage gestellt. Aus ethischer Perspektive ist festzuhalten, dass Patienten mit psychischen Störungen die gleichen Rechte haben sollten wie Patienten mit somatischen Erkrankungen, so dass sich die Frage stellt, (...)
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  28.  31
    The whole spectrum of psychiatric ethics in a standard work: John Z. Sadler, W. Van Staden, and K.W.M. Fulford . 2015. Oxford Handbook of Psychiatric Ethics . Oxford University Press, Oxford. 1712 pp., Price: £175.00, ISBN: 978-0199663880.Manuel Trachsel & Jakov Gather - 2017 - Medicine, Health Care and Philosophy 20 (1):151-152.
  29.  1
    Ethical concerns in caring for persons with anorexia nervosa: content analysis of a series of documentations from ethics consultations.Anna Lisa Westermair, Stella Reiter-Theil, Sebastian Wäscher & Manuel Trachsel - 2024 - BMC Medical Ethics 25 (1):1-10.
    Caring for patients with anorexia nervosa (AN) is associated with high levels of moral distress among healthcare professionals. The main moral conflict has been posited to be between applying coercion to prevent serious complications such as premature death and accepting treatment refusals. However, empirical evidence on this topic is scarce. We identified all 19 documentations of ethics consultations (ECs) in the context of AN from one clinical ethics support service in Switzerland. These documentations were coded with a sequential deductive-inductive approach (...)
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