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121.
Maio G 《Theoretical medicine and bioethics》2002,23(1):45-53
An ethical conflict arises when we must performresearch in the interest of future patients,but that this may occasionally injure theinterests of today's patients.In the case of cognitively impaired persons, thequestion arises whether it is compatible withhumane healthcare not only to treat, but alsoto use these patients for research purposes.Some bioethicists and theologians haveformulated a general duty of solidarity, alsopertaining to cognitively impaired persons, as ajustification for research on these persons. Ifone examines this thesis from the theory ofjustice according to John Rawls, it is revealedthat such a duty of solidarity cannotnecessarily be extrapolated from Rawls'conception of justice. This is at least true ofRawls' difference principle, because accordingto the difference principle only those measuresare justifiable which serve the interest of therespective least well off. Those measures whichwould engender additional injury for the leastwell off could not be balanced by any utilityaccording to Rawls.However, John Rawls' difference principleis subordinate to the first principle,which is that each person has an equalright to the most extensive basic libertycompatible with the same liberty for others.These primary goods are determined by thefreedom and integrity of the person.This integrity of decisionally impaired personswould be in danger if one would abstain fromresearch and thus forego the increase inknowledge related to their disease. Thus onecould conclude, at least from Rawls' firstprinciple, that society must take on a duty toguarantee the degrees of freedom forcognitively impaired persons and thus alsosupport the efforts for their healing. 相似文献
122.
Launis V 《Science and engineering ethics》2000,6(3):299-310
In the bioethical literature, discrimination in insurance on the basis of genetic risk factors detected by genetic testing
has been defended and opposed on various ethical grounds. One important argument in favour of the practice is offered by those
who believe that it is not possible to distinguish between genetic and non-genetic information, at least not for practical
policy purposes such as insurance decision-making. According to the argument from indistinguishability, the use of genetic
test information for insurance purposes should be permitted, because genetic test information is no different from non-genetic
medical information in any relevant respect, therefore it would be inconsistent to prohibit the former whilst permitting the
latter. This paper discusses and defends this argument and suggests a new, more tenable foundation. 相似文献
123.
124.
Dr. John B. Averitt D.Min. 《Pastoral Psychology》1977,26(1):37-47
The beginning point of ministry to those persons suffering from renal failure and turning to hemodialysis in order to sustain life is a sensitive understanding of the total dialysis experience. The minister or chaplain who visits a hemodialysis unit only occasionally will be more effective in bringing his skills to the task by understanding the unique dynamics of the physical, emotional and spiritual adjustment of those who depend on this relatively new therapy. The specific elements of this ministry in terms of those closely involved, professional care givers, families, and patients, are discussed with attention to the factors that tend to make ministry to the hemodialysis patient unique.This article is the result of a one-year chaplain residency at the Veterans Administration Hospital in Nashville, Tennessee, in partial fulfillment of clinical requirements for the D. Min. degree in Pastoral Theology and Counseling at the Divinity School, Vanderbilt University, Nashville, Tennessee. 相似文献
125.
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127.
Prof. Dr. med. M. Ermann 《Forum der Psychoanalyse》2005,21(1):3-13
Zusammenfassung Die Psychoanalyse wurde mit dem Ziel konzipiert, Verdrängungen dem Bewusstsein zugänglich zu machen und dadurch die Kindheitsamnesie aufzuheben (Freud 1937). Mit der Ausweitung des psychoanalytischen Behandlungsspektrums auf präödipale Störungen und Verbreitung der Objektbeziehungstheorie entwickelte sich allerdings eine alternative Behandlungsstrategie, die Therapie der emotionalen Erfahrung. Der damit verknüpfte Dualismus führte lange zu einer Kontroverse über eine einheitliche psychoanalytische Behandlungstechnik. Nur langsam setzte sich die Erkenntnis durch, dass angemessene Deutungen und ein entwicklungsfördernder Umgang mit der Übertragung zwei therapeutische Ansätze darstellen, die nicht voneinander zu trennen sind.Vor dem Hintergrund der neueren Gedächtnisforschung zeigt sich, dass beide Ansätze sich einerseits ergänzen, andererseits aber auch gegensätzliche Pole im Indikationsspektrum der psychoanalytischen Praxis repräsentieren. Die Einsichtstherapie der klassischen Analyse hat das episodische, explizite Gedächtnis als Bezugspunkt und in dieser Weise auch weiterhin Gültigkeit. Demgegenüber bezieht sich die Therapie der emotionalen Erfahrung auf implizites Erfahrungswissen, das den Kern der Patienten mit einer Entwicklungspathologie ausmacht.In dieser Arbeit wird die implizite psychoanalytische Behandlungspraxis im Umgang mit archaischen Ich-Zuständen erläutert. Dabei wird die Bedeutung der bekannten Behandlungskonzepte Objektverwendung, Metabolisierung und containment hervorgehoben.
Nach einem Vortrag zum 50-jährigen Bestehen des Lou Andreas-Salomé Instituts in Göttingen am 30.10.04.
相似文献
Explicit and implicit psychoanalytical practice
Psychoanalysis was conceived with the aim of making suppressed experiences available to the consciousness and by means of this, reversing childhood amnesia. In the course of the extension of the psychoanalytical treatment spectrum to pre-oedipal disturbances and the increasing influence of the object relation theory an alternative therapeutic strategy, the therapy of emotional experience, was developed. The related dualism led to a long-lasting controversy about a uniform psychoanalytical technique. The insight that adequate interpretations and beneficial handling of the relationship are two therapeutical approaches which have not to be separated from each other, has been accepted slowly.Against the background of recent memory research it turns out that on the one hand both approaches supplement each other, but on the other hand they are contrasting poles in the indication spectrum of psychoanalytical practice. The therapy of insight of classical psychoanalysis has the explicit memory as a reference point and is therefore still valid. On the contrary, the therapy of emotional experience refers to implicit experience which is the core of developmental pathology.In this paper the implicit psychoanalytical practice, dealing with archaic ego states, is discussed, referring to such well-known concepts as object use, metabolization and containment.
Nach einem Vortrag zum 50-jährigen Bestehen des Lou Andreas-Salomé Instituts in Göttingen am 30.10.04.
M. ErmannEmail: |
128.
Prof. Dr. M. Franz H. Balló C. Heckrath C. Schneider N. Schmitz M. Löwer-Hirsch B. West-Leuer M. Hirsch J. Ott 《Psychotherapeut》2005,50(5):318-327
Background
11 out of 35 male employees of a central alert team with rescue coordination function developed a tinnitus disorder. This clinical case-study highlights the psychodynamic background of this accumulation.Methods
Employees were investigated by psychometric questionnaires and semistructured psychodynamic biografical interviews. Additionally aspects of group dynamics and organisational structure were assessed.Results
All staff members reported adverse work conditions. Medical and psychometric examination of the tinnitus patients did not reveal severe pathological findings. The interviews identified psychodynamic conflicts dealing with autonomy and regulation of self-esteem. All tinnitus patients reported a very adverse or punitive father relation and difficulties in performing a stabile male role and self-image. Group dynamics was dominated by paranoid and regressive tendencies complicated by maladaptive coping, crude perception of external facts and a pronounced experience of aggressive impulses.Conclusion
The remobilisation of infantile powerlessness, ineffectiveness and helplessness triggered by adverse work conditions and the introduction of a new culture of personal responsibility within the work organisation together with an impaired coping of separation conflicts enforced by traumatic aspects of the relation with the father may have promoted the tinnitus symptomatology. Additionally, due to the missing awareness of the importance of such group dynamical processes the employers contributed to an increasing psychosocial distress, which promoted the accumulated manifestation of tinnitus as a conflict expressive symptom. 相似文献129.
Zusammenfassung Eine positive therapeutische Beziehung wird therapieschulenübergreifend als wichtige Voraussetzung für den Therapieerfolg angesehen. Meist wird jedoch in Studien lediglich die schriftliche Patienteneinschätzung erfasst. Nonverbale Aspekte der Interaktion zwischen Patienten und Therapeuten werden kaum untersucht. Aus einer Studie zur Vorhersage des Erfolgs stationärer Fokaltherapie werden affektive Interaktionsprozesse im Erstinterview exemplarisch zwischen einer erfolgreichen und einer nicht erfolgreichen Behandlung mit mikroanalytischen Verfahren (facial action coding system, FACS) verglichen. In der nicht erfolgreichen Therapie waren die mimischen Affektäußerungen reziprok; Therapeutin und Patientin zeigten ähnliche vorherrschende (sog. Leit-)Affekte. Erfolgreicher waren die Behandlungen, wenn die Therapeuten komplementäre Affektmuster zeigten. Implikationen für Behandlungstechnik, Supervision und Weiterbildung werden diskutiert. 相似文献
130.