Abstracts fra Bibliotek for Læger 3/2002

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Grundlaget for medicinsk etik.

Niels Kristoffer Jensen:

The Foundation of Medical Ethics.

Bibl Læger 2002; 194: 208–31.

Ethics and morals are founded on an understanding of »the good,« which may be looked upon as an intuition or as an empirically understood entity. In the latter case we have the so-called »naturalistic fallacy, « of Moore. Problems of ethics are altruism and universality. Principle based ethics as variants of consequentialism, deontological ethics and prima facie ethics as opposed to casuistry and virtue theory are commented. Casuistry is seldom mentioned in the ethical literature, but the author of this article gives some credit to casuistry. Some statements of The Danish Ethical Council concerning medical ethical problems are surveyed. It is concluded that the principles advocated in the statements are principles of autonomy, charity, solidarity, justice and »the good life.« Some selected Danish ethical authors are also surveyed. They reach mostly at various principles not far from The Ethical Council. Some add a special principle of responsibility. Further is mentioned wulnerability, which, however, is problematic in relation to repair of human defects. It is concluded that as ethics to a certain extent are relative to time and place, casuistry may have a role to play in medical ethics. New problems cannot be honestly solved merely with reference to existing norms and principles, but must be analysed in accordance with the casuistic method.

 

Etisk vurdering inden for lægevidenskab og bioteknologi

Mette Ebbesen:

Ethical assessment within medical science and biotechnology.

Bibl Læger 2002; 194: 232–59.

Over the last twenty years a revolution has taken place within biotechnology. In this connection it is not granted that we should apply all methods available. The improvement within biotechnology and medical science causes many ethical questions to arise. These questions can be difficult to answer. This paper is meant as a help to illuminate ethical questions in connection with medical science and biotechnology. First, some ethical theories that can be used to investigate general ethical affairs are presented. It is shown how one can deduce some ethical principles from the ethical theories. Compared to the ethical theories, the ethical principles are more convenient to use in connection with medical science and biotechnology. These ethical principles are part of a theory presented by the two American bioethicists Tom Beauchamp and James Childress. In this paper some of the shortcomings and points for discussion that have been pointed out in connection with Beauchamp & Childress’ theory are investigated. Finally, as an example of the application of the four bioethical principles an ethical assessment of human somatic gene therapy is set forth.

 

»The necessary kind of inhumanity«. Fire betragtninger over fremstillinger af dissektion.

Mikkel Jessen:

The necessary kind of inhumanity. Four reflections on illustrations of dissections.

Bibl Læger 2002; 194: 260–9.

This study examines four illustrations from the archive of The Museum of Medical History. The illustrations demonstrate the daily work of the anatomist, the dissection, corresponding the historical time and context. According to the study the illustrations are reflecting different self-concepts of the anatomist.

Rembrandt’s painting The anatomy Lesson of Dr. Tulp (1632) is depicting the anatomists’ guild. It is depicting Dr. Tulp demonstrating the muscles of the hand. Dr. Tulp was a member of a religious/medical tradition which regarded the human hand as the supreme instrument first bestowed by God. Rembrandt is depicting the guild’s concepts of the art of anatomy as a pathway to the knowledge of God. In Enrique Simonet’s painting La autopsia (1890) an anatomist is studying a woman’s heart. The painting depicts a positive and scientific approach towards dissection. The dead can reveal the mystery of the human body. The painting is a tribute to the scientist, the anatomist, and the positivistic approach. The photograph (1908–1913) is demonstrating a rite-de-passage where students have arranged a smoking skeleton to dissect a torso. The writer interprets this arrangement as a part of the process where the future doctors learn to cross social and personal boundaries, the necessary kind of inhumanity, and in the end become professionals.

 

Bibliometri og scientometri for læger

Jens F. Rehfeld:

Bibliometry and scientometry for physicians.

Bibl Læger 2002; 194: 270–8.

Bibliometry is a discipline that provides quantitative measures of the literature in its general and broadest sense. Scientometry is a narrower bibliometric discipline comprising the application of bibliometric methods to the scientific literature, which includes also medical research publications. Over the last decade new bibliometric methods have been introduced to measure and evaluate the quantity and impact of scientific literature, including not least the medical papers in international journals. Bibliometric methods are now widely used by governments, libraries and scientists all over the world. Today three major bibliometric methods are used in scientometry: (1) Measurement of the number of scientific papers; (2) measurement of the number of citations in the scientific literature; (3) quantitation of journal impact factor scores. This review describes the methods, and discusses the problems and pitfalls that occur, when bibliometric measurements are used in a non-professional way to quantitate quality.

 

Forsidebillede: Rembrandt van Rijn, »De anatomische les/Doktor Tulps anatomilektion« (1632).