Issues 25-1

Issue 18: Sass, Hans-Martin: Benachteiligte Patientengruppen im Blick der medizinischen Ethik. 1st edition: 1989; 2nd edition: February 1990

Disadvantaged Patient Groups and Clinical Ethics Clinical Ethics represent the value oriented approach of medical institutions, serving as the fundamental basis among physicians, nurses, administrators and patients for using medical technology and treating patients according to moral values and principles. Clinical ethics which transforms traditional medical ethics into the modern institutional setting can also be called Paracelsian Ethics as the Paracelsian ethos was based on research and knowledge in natural science, emphasized medical experience, and cared for the patient as persons, not treating isolated diseases. Disadvantaged groups of patients in the presence of high tech-medicine and medical progress can be divided into three groups: (1) disadvantaged groups because of governmental interventions, such as some groups in Controlled Clinical Trials, and all groups having rare diseases for which development and research on new drugs is too costly due to existing regulation, (2) disadvantaged groups because of inherited bodily or mentally handicaps or because of lifestyle related health damage, such as alcoholics and drug addicts, (3) disadvantaged groups because of lack of public and medical interest, including degenerative diseases such as Alzheimer's Disease or Morbus Parkinson and those terminally ill. Clinical Ethics call for a long term concept of clinical therapy from primary care to highly specialized acute treatment and long term post acute consultation and care. In the absence of effective technology in some cases and in the presence of superefficient technology in others, the only means to treat patients as persons, not just their diseases, is a new reemphasis on Paracelsian Clinical Ethics as corporate medicine will depend as much on Clinical Ethics as on technical progress.