Theoretical Medicine

, Volume 7, Issue 3, pp 305–317 | Cite as

Some aspects of medical ethics from the perspective of bioengineering

  • H. Thoma
Article

Abstract

The problem of ethics in medical care as seen from the bioengineering results from the almost incredible technological achievements based on scientific research: On the one hand there is inadequate handling of technology and fear on the part of the patient; on the other hand there is admiration on the part of the physicians and the nursing staff. This article will survey the points of criticism concerning ethical behavior and will present and evaluate general problems of mechanization in medical care. General phenomena of human interaction, and especially problems related to medical care, will be discussed. It will be necessary to develop clinical medical technology, aiming primarily at ‘realizing the patient's concern’. After analyzing these concerns, it is necessary for the clinical medical engineer to develop an ‘invisible’ technology. Criteria for such an ‘invisible’ technology (function, design, automatic control, methods of implantation, whether chronic application is necessary) are being demonstrated by particular devices (artifical heart, functional electro-stimulation, diaphragmatic pace-maker).

Key words

Medical ethics Man-machine interaction Clinical medical technology Ethical lapses High technology Intensive care Artificial organs Artificial heart Transplantation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. [1]
    Illhardt, F. J.: 1985, Medizinische Ethik, Springer-Verlag.Google Scholar
  2. [2]
    Debakey, M. E. and Debakey, L.: 1983, ‘The ethics and economics of high-technology medicine’, Compr. Ther. 9 (12) 6–16.Google Scholar
  3. [3]
    Fletcher, J. C.: 1983, ‘Cardiac transplants and the artificial heart: Ethical considerations’, Circulation 68 (6) 1339–43.Google Scholar
  4. [4]
    Wooley, F. R.: 1984, ‘Ethical issues in the implantation of the total artificial heart’, N. Engl. J. Med. 310 (5) 292–6.Google Scholar
  5. [5]
    Cohen, C. B.: 1977, ‘Ethical problems of intensive care’, Anesthesiology 47 (2) 217–27.Google Scholar
  6. [6]
    Robinson, J. S.: 1975, ‘Psychologische Auswirkungen der Intensivpflege’, Z. Anaesthesist 24, Heft 9.Google Scholar
  7. [7]
    Schimikowski, P.: 1980, Experiment am Menschen, Enke-Verlag.Google Scholar
  8. [8]
    Manth, J. M.: 1977, ‘Der Kranke und die Maschine’, Münchn. Med. Wochenschr. 119 (51–52) 1639–40.Google Scholar
  9. [9]
    Caplan, A. L.: 1982, ‘To mend the heart: Ethics and high technology. 3: The artificial heart’, Hastings Cent. Rep. 12 (1) 22–4.Google Scholar
  10. [10]
    Annas, G. J.: 1983, ‘Consent to the artificial heart: The lion and the crocodiles’, Hastings Cent. Rep. 13 (2) 20–2.Google Scholar
  11. [11]
    Gorovitz, S.: 1984, ‘The artificial heart: Question to ask and not to ask’, Hastings Cent. Rep. 14 (5) 15–7.Google Scholar
  12. [12]
    Annas, G. J.: ‘Allocation of artificial hearts in the year 2002: Minerva v. National Health Agency’, Am. J. Law Med. 3 (1) 59–76.Google Scholar
  13. [13]
    Girstenbrey, W.: 1984, ‘Was “Baby Fae” unlehven muß’, Fortschr. Med. 102 (45) Suppl. 12–3.Google Scholar
  14. [14]
    Thoma, H., Benzer, H., Bunzel, B., Hummel, G., Mutz, N. and Pauser, G.: 1979, ‘Organisation von Studenten zur psychischen Betreuung schwerstkranker Patienten’, Wiener Med. Wochenschrift.Google Scholar
  15. [15]
    Hummel, G.: 1981, Psychische Betreuung Schwerstkranker, Anspruch und Wirklichkeit eines Modells an der medizinischen Fakultät der Universität Wien, Inauguraldissertation an der Med. Fakultät der Albert Ludwig Universität Freiburg/Breisgau.Google Scholar
  16. [16]
    Thoma, H.: 1976 ‘Kriterien der klinisch orientierten Medizintechnik’, Österr. Ges. f. Biomed. Technik 21.Google Scholar
  17. [17]
    Stöhr, H., Eckersberger, F., Horcher, E., Losert, U. and Thoma, H.: 1980, Miniaturisierung einer automatischen Steuerung für künstliche Herzen mit Hilfe eines Mikrocomputers, 14. Jahrestagung der Deutschen Ges.f.Biomed.Technik, Berlin.Google Scholar
  18. [18]
    Stöhr, H., Schmallegger, H., Thoma, H. and Navratil, J.: 1976, ‘EKG-Telemetrie ohne Batterien — drahtlose Energieversorgung, Medex 76’, Biomed. Technik 21.Google Scholar
  19. [19]
    Thoma, H., Losert, U., Prodinger, A., Schima, H. Stöhr, H. and Wolner, E.: 1985, First Animal Experiments With a Fully Implanted Control and Drive Unit for the Total Artificial Heart, 5th World Congress International Society for Artificial Organs, Chicago.Google Scholar
  20. [20]
    Thoma, H., Holle, J., Frey, M., Losert, U., Stöhr, H. and Wolner, E.: 1980, Muscular Energy for Driving a Total Artificial Heart? BIOMED 80, Second Mediterranean Conference on Medical and Biological Engineering, Marseille.Google Scholar
  21. [21]
    Holle, J., Moritz, E., Lischka, A. and Thoma, H.: 1974, ‘Die Karussellstimulation, eine neue Methode zur elektrophrenischen Langzeitbeatmung’, Wiener Klinische Wochenschrift 86, 1.Google Scholar
  22. [22]
    Schwanda, G., Stöhr, H. and Thoma, H.: 1981, Communicationsystems for Handicapped: A Videocontrolled Device, 2nd Internat. Workshop Innsbruck, Austrian Society for Artificial Organs.Google Scholar

Copyright information

© D. Reidel Publishing Company 1986

Authors and Affiliations

  • H. Thoma
    • 1
  1. 1.Laboratory for Biomedical Engineering and Physics, 2nd Surgical ClinicUniversity of ViennaViennaAustria

Personalised recommendations