Knowing One s Medical Fate in Advance
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Modern medicine is now in a position to make advanced prognoses that chart the entire course of illness and recovery. Paradoxically, this is coupled with a new dimension of uncertainty for the patient, i.e. coming to terms with discovering they have an increased risk of a particular disease and deciding what appropriate steps to take. In this publication, renowned experts in their fields discuss these issues. The certainty and uncertainty of one’s fate are discussed from both methodological and epidemiological perspectives, using examples of diseases for which treatment and prognosis have dramatically changed. Despite profound insights into the human genome, personalized genetically tailored medicine still lies in the future. Religious, spiritual and philosophical dimensions are discussed, as are the ways in which they may help people cope with these new insights into their future, e.g. the promise of an afterlife. This publication aims to bridge the different fields dealing with this area by addressing the challenges faced and encouraging dialogue. It will be of interest to all readers who deal with ethical problems of prognosis, particularly in medicine, as well as to theologians and sociologists.



Publié par
Date de parution 22 juin 2012
Nombre de lectures 0
EAN13 9783805596503
Langue English
Poids de l'ouvrage 1 Mo

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Knowing One’s Medical Fate in Advance: Challenges for Diagnosis and Treatment, Philosophy, Ethics and Religion
Knowing One’s Medical Fate in Advance
Challenges for Diagnosis and Treatment, Philosophy, Ethics and Religion
Georg Pfleiderer     Basel
Manuel Battegay     Basel
Klaus Lindpaintner     Newark, Del.
4 figures, 2 in color, 2012
Prof. Dr. Georg Pfleiderer Faculty of Theology University of Basel Hospital Epidemiology Missionsstrasse 17a CH-4055 Basel Switzerland
Prof. Dr. Manuel Battegay Division of Infectious Diseases and University Hospital Basel Petersgraben 4 CH-4031 Basel Switzerland
Prof. Dr. Klaus Lindpaintner SDIX 111 Pencader Drive Newark, DE 19702 USA
This book was generously supported by the ‘Freiwillige Akademische Gesellschaft’, and the ‘Schweizerische Akademie der Medizinischen Wissenschaften (SAMW)’

Library of Congress Cataloging-in-Publication Data
Knowing one’s medical fate in advance: challenges for diagnosis and treatment, philosophy, ethics and religion/ editors, Georg Pfleiderer, Manuel Battegay, Klaus Lindpaintner.
p.; cm.
Includes bibliographical references and index.
ISBN 978-3-8055-9649-7 (hard cover: alk. paper) –– ISBN 978-3-8055-9650-3 (e-ISBN)
I. Pfleiderer, Georg. II. Battegay, Manuel. III. Lindpaintner, Klaus.
[DNLM: 1. Patients––psychology. 2. Prognosis. 3. Genetic Predisposition to Disease––psychology. 4. Religion and Medicine. 5. Truth Disclosure. W 85]
Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents® and Index Medicus.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2012 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck GmbH, Ettlingen
ISBN 978-3-8055-9649-7
e-ISBN 978-3-8055-9650-3
Pfleiderer, G.; Battegay, M. (Basel); Lindpaintner, K. (Newark, Del.)
Medical Perspectives
Evolving Therapy and Prognosis in HIV - How Knowing One’s Medical Fate in Advance Can Change Dramatically
Battegay, M. (Basel)
Related to Human Cognition: Is Personalization Feasible and Desirable?
Papassotiropoulos, A. (Basel)
Ethical and Juridical Perspectives
Ethical Decision-Making on Genetic Diagnosis Facing the Challenges of Knowing One’s Medical Fate in Advance
Brahier, G. (Zurich)
Mastering Familial Genetic Knowledge: Shared or Secret? Issues of Decision-Making in Predictive Genetic Testing
Brüninghaus, A. (Hamburg); Porz, R. (Bern)
Predictive Medicine - Changes in Our View of Ourselves and Others
Birnbacher, D. (Düsseldorf)
Current Challenges for the Law: Disclosure Dilemmas in Predictive Medicine
Dörr, B.S. (Zurich)
Religious Perspectives
Fate and Judaism - Philosophical and Clinical Aspects
Gesundheit, B. (Jerusalem)
Modern Medicine and My Future Life: A Christian-Theological Perspective
Pfleiderer, G. (Basel)
Karma, Contingency, and the ‘Point of No Return’: Predictive Medicine and Buddhist Perspectives
Schlieter, J. (Bern)
Author Index
Subject Index
Pfleiderer G, Battegay M, Lindpaintner K (eds): Knowing One’s Medical Fate in Advance. Challenges for Diagnosis and Treatment, Philosophy, Ethics and Religion. Basel, Karger, 2012, pp 1–5
Modern medicine is increasingly bringing the future to the present. Novel diagnostic procedures allow advanced medical prognoses quantifying the future outcome of an illness and its course. Thus, the understanding of the likelihood of therapeutic strategies to succeed or fail in an individual patient is becoming ever more transparent. Individuals are facing the complicated task of transferring these risk assessments to fit their personal life perspectives, develop anticipatory ‘coping strategies’, and, quite often, make concrete decisions and choices about themselves.
How does a person feel when faced with a 20% risk of contracting cancer of the intestine in the next 10-15 years? How do expectant parents deal with a 1:280 chance of having a child with trisomy 21? What are the criteria for responsible decisions in such situations? - Increasing prognostic accuracy of modern medicine, paradoxically, brings about a new dimension of uncertainty for the individual, whether still healthy or already a patient. Prognoses may evolve due to on-going progress in medical research. Examples are the constantly evolving arsenal of new anti-cancer medications, or the fundamental progress seen in treating infectious diseases such as HIV. Questions thus arising with regard to medical ethics are often vexing as an ever-increasing understanding of one’s own medical fate goes hand in hand with continued uncertainty and lack of knowledge. This concerns both the individuals with a certain prognosis and their relatives as well as the medical experts who are called upon to provide advice and council patients and their relatives. Converting a medical prognosis into a subjective understanding and reassessment of life quality may pose existential difficulties.
New-found prognostic technologies may also affect prenatal life. Owing to progress in genetic testing, the possibility of recognizing prenatal health risks before physical signs of disease are visible is now possible. This presents the individual with a plethora of new challenges. Improved ability of looking into the future now allows us to not only prognosticate the course of a disease, but to actually predict future health problems long before any signs or symptoms are apparent.
The future implications of these developments for society, especially of predictive genetic testing, have recently become the focus of active investigation. The challenge of anticipation of one’s future medical problems raises a multitude of fundamental and difficult ethical questions. What answers can specialized modern medical ethics and practical philosophy provide? What legal questions must be considered? And how can the paradigm-shift presented by modern medical diagnostics be integrated into historical and cultural frameworks?
Many people are touched by the religious dimension of their lives. What answers can religion and theology provide to help coping with the prospect of a future about which we know increasingly more, but still remains uncertain? Anticipation of the future is dealt with in many ways by religion, e.g. in the prophesy and hope of the kingdom of God. Can religion provide coping strategies to help overcome the life crises brought about by a medical prognosis, or a predictive test?
The volume at hand is based on a conference convened in Basel in June 2010, organized by Karger Publishers under the auspices of the University of Basel and chaired by the signatories. It was the goal of the conference to bring together specialists from diverse fields of medicine, ethics, philosophy, religious science and theology. The aim was to encourage wide-ranging discussion among a broad audience to generate ideas and approaches towards tackling the implications of the new ‘knowledge of the future’ on societal and individual ethical values. As part of the conference, a workshop organized by Dr. Theol. Gabriella Brahier gave young scientists the opportunity to present their own research on the topic and to share it with distinguished experts. There was also a MA seminar connected with the conference at the Theological Faculty held during the spring semester.
The volume contains most of the papers given at the conference in revised versions. The book also provides transcripts/summaries of the question-and-answer sessions following the presentation of each paper (with the exception of the paper by A. Brueninghaus and R. Porz).
The volume is divided into three sections: ‘Medical Perspectives’, ‘Ethical and Juridical Pe

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