“More like a support tool”: Ambivalences around digital health from medical developers’ perspective

Against the background of the increasing importance of digitization in health care, the paper examines how medical practitioners who are involved in the development of digital health technologies legitimate and criticize the implementation and use of digital health technologies. Adopting an institutional logics perspective, the study is based on qualitative interviews with persons working at the interface of medicine and digital technologies development in Switzerland. The findings indicate that the developers believe that digital health technologies could harmonize current conflicts between an increasing economization of the health care system and professional–ethical demands. At the same time, however, they show that digital technologies can undermine the demand for medical autonomy, a central element of the medical ethos.

SELF-RESPONSIBILITY AT ORDINATORS UNDER CONDITIONS PANDEMIC COVID-19

The article discusses the features of the medical ethos of residents of the Federal State Budgetary Educational Institution of Higher Education of the Tver State Medical University of the Ministry of Health of Russia. Some of the basic components that form the ethos of a doctor are indicators of the degree of freedom, responsibility, discipline, self-discipline and self-responsibility. In this regard, a psycho-diagnostic study was carried out aimed at determining the external and internal modes of responsibility of residents in the context of the COVID-19 pandemic. The processing, analysis and interpretation of empirical data was carried out on the basis of the Center for Psychological Support of the Federal State Budgetary Educational Institution of Higher Education of the Tver State Medical University of the Ministry of Health of Russia. The study made it possible to conduct a qualitative analysis, determine the degree and forms of discipline. Egoism, individualism, mercantilism are secondary qualities that regulate, discipline the activities of a specialist. The experience of the current challenges of the COVID-19 pandemic requires strengthening the humanitarian, bioethical and general cultural components in the training of medical workers at all levels, both through the assimilation of abstract principles and through interactive forms such as social and psychological trainings, master classes, etc.

Eugenics between Darwin’s Εra and the Holocaust

Heredity and reproduction have always been matters of concern. Eugenics is a story that began well before the Holocaust, but the Holocaust completely changed the way eugenics was perceived at that time. What began with Galton (1883) as a scientific movement aimed at the improvement of the human race based on the theories and principles of heredity and statistics became by the beginning of the 20th century an international movement that sought to engineer human supremacy. Eugenic ideas, however, trace back to ancient Greek aristocratic ideas exemplified in Plato’s Republic, which played an important role in shaping modern eugenic social practices and government policies. Both positive (prevention and encouragement of the propagation of the fit, namely without hereditary afflictions, i.e. socially acceptable) and negative (institutionalization, sterilization, euthanasia) eugenics focused on the encouragement of healthy and discouragement of unhealthy reproduction. All these practices were often based on existing prejudices about race and disability. In this article, we will focus on the rise of eugenics, starting with the publication of Origin of Species to the Holocaust. This examination will be multidisciplinary, utilizing genetics, legal history and bioethical aspects. Through this examination, we will discuss how provisional understandings of genetics influenced eugenics-based legislation. We will also discuss the rise of biopolitics, the change of medical ethos and stance towards negative eugenics policies, and the possible power of bioethical principles to prevent such phenomena.

Where is the Hoechst Insulin?: The Role of Diabetics and Their Doctors as Consumers During the German Democratic Republic’s Autarkic Policy of ‘Making Free From Disturbance’, 1961–1966

Summary This article examines the treatment of the chronic disease, diabetes mellitus, during and immediately after the German Democratic Republic (GDR)’s autarkic policy of Störfreimachung, literally translated as ‘making free from disturbance’. I look specifically at an insulin favoured by East German diabetes specialists and their patients delivered from the West German pharmaceutical company, Hoechst AG, and the consequences of preventing this insulin from being imported. By using insulin as a case study, a medication necessary for the survival of insulin-dependent diabetics, the article offers a close analysis of the complex relationship between ordinary citizens, medical professionals and the ruling Socialist Unity Party (SED) following the building of the Berlin Wall. I argue that the intense focus on the issue of consumption in the competition between the GDR and West Germany shaped both the attitude of the SED and those responding to the policy of Störfreimachung. The SED regime and leading health officials espoused a highly ‘productionist’ medical ethos that was somewhat at odds with their growing desire to meet increasing consumer demands. This collision opened up ideological contradictions, which provided an opportunity for those on the receiving end of the policy to discredit it, and, by extension, justify the continued use of their preferred choice of insulin from Hoechst. I draw, in particular, on patient Eingaben (petitions) and reports by district diabetologists in order to uncover this trend.

Problem uporczywej terapii w świetle filozofii człowieka

The problem of medical futility, which combines the issues of euthanasia, is one of the most difficult matter of medical ethics. The theraphy becomes futile when a patient is in an agonizing state and none of the extraordinary actions can restore the life processes, which are coming to the end. The documents of Catholic Church state that actions which do not serve human life any more should be stopped so that let a man in agony die with dignity. However, under any conditions it is allowed to cause death of a man in active or passive way. Euthanasia is not only against the medical ethos but also the content of the medicine which serves the human life. The author of the article defines the conception of medical futility at the level of anthropological philosophy and notices that in practice the designation of the moment, when we deal with the medical futility, belongs to the doctors who depends on his empiric knowledge and wisdom.