The Basic Clinical Applications of Ozone Therapy

Medical ozone is a mixture of ozone and oxygen, prepared via silent electrical discharge, within a concentration range of 0.05 volume % O₃ to max. 5.0 volume % O₃.

In order to exclude its toxic effect on the pulmonary epithelium, the medical ozone/oxygen mixture is administered so that exposure of the respiratory tract is avoided at all times, i.e., without the disturbing effects of its odor.     

Empirische Methodologien und Methoden der angewandten und der empirischen Ethik

Definition of the problem This paper deals with the question of adequate methodologies and methods to conduct empirical research and integrate empirical knowledge in the field of biomedical ethics. Arguments It starts with reflections about the main subject matter of ethics, the human being as a bio-psycho-social creature and its morals, and argues that social sciences are the adequate basic empirical science in the field of ethics in general. The next paragraph considers theory of science perspectives of the relationship of ethics, empirical findings, methodologies and theories and examples of the integration of empirical findings into ethical deliberations. Reasons for the tension between social science and ethics are scrutinized which are different in the yet to be defined field of empirical ethics compared to traditional applied ethics. Conclusion How a bio-psycho-social ethics that incorporates these criteria into its own body of work could look like is finally depicted.     

Moral und Abhängigkeit

Definition of the problem:

Being satisfied with one’s work depends on professional autonomy, which is attributed to the medical profession to a high degree, combined with specialized knowledge and moral authority for vital questions. That is why physicians enjoy a high reputation. At the beginning of a person's medical career, moral competence is developed nearly completely, but specialized knowledge must be learned. Hospitals, in which further medical education regularly takes place, are still traditionally hierarchically organized today. Unfortunately, feudalistic or military structures hinder autonomous moral decisions and cause structural irresponsibility.

Arguments:

Obstructions and pressure by superiors, financial restrictions, arrogance and trying to make one's mark are shown in typical conflict situations. Stress, discontent, moral conflicts and illness, even including burn out are possible. Commitment and creativity by employees are prevented and mistakes cannot be constructively managed. Thus, patients may suffer unreasonably or be hurt.

Conclusion:

There is a risk to subordinate moral principles under other interests, not only with subordinates but also with superiors. Ways to create a culture that promotes autonomy among physicians and between different professions are discussed. Therefore it is necessary to institutionalize communication based on a reciprocal high regard in a team with people treated as equal partners, who are then able to discuss moral questions in a discourse.     

Die therapeutische Interaktion als moralische Vorgabe

Definition of the problem

Hospitals serve the general purpose to improve the health of patients. Health care professionals are a necessary means to achieve that end but have their own more specific professional ends. What is the due relationship between those kinds of ends with respect to the organisation of hospitals?

Arguments

Individual health care in hospitals is delivered by professionals who are dependent upon the hospital??s human, administrative and technical facilities. As organised social entities, hospitals use professionals as the means to an end we normally call health of patients. More precisely, the professional task consists in a specific, namely, therapeutic interaction, an asymmetric relationship between morally equals. Professionals have to explore, interpret and pursue patients?? interests according to their consent. From a moral perspective, this interaction should be kept free from distortion through external incentives which divert the professional??s intrinsic motivation. Although a professional responsibility, the individual professional would be overcharged with this organisational task.

Conclusion

The profession has a responsibility to protect and foster professional behaviour of its members including participation in organising hospitals and the individual professional should engage in organising the profession as a collective agent.     

Zum Umgang mit ?kulturellen Fragen“ in der klinischen Ethik am Beispiel der Hymenrekonstruktion

Definition of the problem This paper illustrates a critical discussion of culture-related issues in clinical ethics with the example of hymen reconstruction. Arguments (1) To specifically discuss “culture-sensitive” issues in clinical ethics might perpetuate an essentialist understanding of culture. Instead this paper argues for a dynamic understanding of culture and generally context-sensitive, pluralist clinical ethics; (2) clinical ethics mainly focuses on the individual patient-physician relationship and public health ethics and global health ethics concentrate more on structural dimensions of health and health care. However, the interconnections should be acknowledged more systematically; (3) “migration” is often subsumed under “culture” as a bioethical issue. But the topics are not coextensive, instead both areas involve specific bioethical questions. More bioethical research is needed especially in the area of migration. On the basis of these three general aspects the paper discusses hymen reconstruction. It is argued that by performing the operation the physicians might perpetuate structural injustice and false anatomic beliefs, but that in some individual cases the operation can help prevent significant harm for the woman. Conclusion There has been an increasing awareness for “cultural” issues in health care and bioethics. It will be an ongoing challenge to perform “culture sensitive” health care without falling prey of essentialist othering and stereotyping. This paper argues for a general context sensitivity in a diverse, globalized world, where the connection of the individual health care to the structural circumstances are recognized. This understanding lays the ground for the argumentation of the specific case of hymen reconstruction.