From Physicians’ Professional Ethos towards Medical Ethics and Bioethics: A German Perspective on Historical Experiences and Lasting Commitments

Preface
Contents
About the Authors
Chapter 1: Introduction
	1.1 Initial Impediments to Ethical Reflection in Medicine
		1.1.1 Toellner
		1.1.2 Löther
		1.1.3 Luther
	1.2 The Culture of Dialogue in Medical Ethics and Bioethics
		1.2.1 Spaar
		1.2.2 Patzig
		1.2.3 Hübner
	1.3 The Institutionalization of Expertise in Medical Ethics and Bioethics
		1.3.1 Günther
		1.3.2 Wuermeling
		1.3.3 Siep
		1.3.4 Mattheis
	1.4 The Focus on Responsiveness to Patients
		1.4.1 Hahn
		1.4.2 Wedler
	1.5 Concluding Remarks
		1.5.1 Moral Challenges Inherent in Medical Professionalism as Such
		1.5.2 Moral Complexities Involved in the profession’s East- and West-German Settings
		1.5.3 Persistent Ambiguities in the Pursuit of the Patient’s “Good”
	References
Part I: Initial Impediments to Ethical Reflection in Medicine
Chapter 2: The History of Medicine as Inspiration for Medico-Ethical Reflection in Germany: Memories from the Free Zone of Historiography
	2.1 Prologue
	2.2 The Physician’s Ethos as Subject of the History of Medicine and as a Challenge for the Self-image of That Academic Discipline
		2.2.1 Medical Literärgeschichte (Historical Erudition) and Professional Ethos as Prerequisites for Medicine as an Academically Respectable Field
		2.2.2 Scientific Standing as Exclusive Criterion for Ethically Responsible Practice in Medicine
		2.2.3 The Complementarity of Ethical and Historical Reflections on Medical Practice
	2.3 Medicine, Medical Ethics, and the History of Medicine After the Demise of National Socialism in Germany
	2.4 The Role History of Medicine Played for Focusing on Medical Ethical Issues
		2.4.1 Medicine-Historical Attempts to Come to Terms with the National Socialist Past of Medicine
		2.4.2 The Genesis of Institutional Advisory Boards
	2.5 Epilogue
	References
Chapter 3: Human Genetics Between the Physician’s Ethos and Bio-politics: From Eugenics to Human Gene Technology
	3.1 Introduction
	3.2 Conceptual Bases for the Bio-political Misuse of Genetics
		3.2.1 Social Darwinism
		3.2.2 Racism
		3.2.3 Eugenics
	3.3 Race Hygiene as a Policy of Inhumanity in Germany up to the End of World-War-II
		3.3.1 Roots in the Nineteenth Century
		3.3.2 The Weimar Republic
		3.3.3 National Socialism
	3.4 The Soviet Block in the Grip of Lysenkoism
		3.4.1 Bases of Lysenko’s Success in the Soviet Union
		3.4.2 Lysenkoism in the GDR
		3.4.3 The Demise of Lysenkoism
	3.5 Genetics in the German Democratic Republic After Lysenko
		3.5.1 Genetic Counseling
		3.5.2 Gene Technology
	3.6 Concluding Remarks: Ethics of Science
	References
Chapter 4: The Development of Doctors’ Ethics Into Medical Ethics in the German Democratic Republic and Its Impact on Medical Education
	4.1 Medicine and the Physician’s Ethos in the Post-World-War-II Soviet Occupation Zone
		4.1.1 The Political Situation in the Eastern Part of Germany
		4.1.2 Ideological Re-orientation
	4.2 Physicians’ Ethics in the Context of Socialist Moralizing
		4.2.1 The Integration of Moral Concerns Into ML Teaching
		4.2.2 Accommodation of Physicians’ Ethical Concerns Within ML
		4.2.3 Integration of a Socialist Deontology for Physicians Into Medical Education
	4.3 The Development of Medical Ethics in the GDR
		4.3.1 Difficulties that Stood in the Way of Establishing Medical Ethics in the GDR
		4.3.2 Ways of Overcoming These Difficulties
	4.4 The Liquidation of Socalist Medical Ethics in the GDR
		4.4.1 Hopes and Opportunities for Further Development
		4.4.2 The Impact of communism’s Overturn
	4.5 Conclusion: The proprium of Socialist Medical Ethics
	References
Part II: The Culture of Dialogue in Medical and Bio-ethics
Chapter 5: Socialist Policy as the Basis of the Physician’s Ethos in the German Democratic Republic: Humanist Ideals and Economic Realities
	5.1 Introduction: A Review from the Perspective of the Twenty-First Century
	5.2 Humanist Traditions Inherent in the Workers’ Movement at the Origin of a Newly Conceived Relationship Between Physicians and Patients
	5.3 Achievements and Difficulties of Socialist Health and Social Policy
	5.4 Sustainable Ideas and Reasons for the Failure of Socialist Social Policy
	5.5 Conclusion: Remaining Values for the Twenty-First Century
	References
Chapter 6: Bioethics and the Defence of a Culture of Liberalism: Philosophical Rationality in the Spirit of Modesty
	6.1 Personal Circumstances That Motivated and Shaped My Turn to Medical Ethics
		6.1.1 My Experience as Father of a Medical Student
		6.1.2 My Own Philosophical Orientation
		6.1.3 My Ethical Formation as Son of My Father
	6.2 My Views About the Role of Philosophy in Bioethics
		6.2.1 Institutionalizing an Academic Discourse About Ethics in Medicine
		6.2.2 Efforts Toward a Societal Discourse on Values and Norms
			6.2.2.1 Distinguishing Objective from Subjective Interests
			6.2.2.2 Safeguarding the Theoretical Possibility of the Public Value Discourse
	6.3 Concluding Remarks
	References
Chapter 7: Contributions by Protestant Theology to Medical Ethics and Bio-Ethics in Germany
	7.1 Medical Ethics and Medical Progress
	7.2 Theological Ethics and Medical Progress
	7.3 From the Physician’s Ethics to Medical Ethics
	7.4 Interdisciplinary Agents of the New Discourse
	7.5 Different Traditions of Intellectual History
	7.6 Medical Ethics at Protestant Theological Faculties
	7.7 Aids to Orientation by the Protestant Church in Germany
	References
Part III: The Institutionalization of Expertise in Medical and Bio-ethics
Chapter 8: Legal Duties, the Physician’s Ethos, and Ways of Dealing with Damage Resulting from Medical Treatment in the German Democratic Republic
	8.1 Introduction
	8.2 Professional Duties
		8.2.1 The Obligation of Medical Accuracy
		8.2.2 Information
		8.2.3 Obligations of Confidentiality
	8.3 Procedures for Addressing Damages from Medical Interventions
		8.3.1 Violation of Physicians’ Obligations According to the Material Responsibility of the Healthcare Institution
			8.3.1.1 Basic Principles
			8.3.1.2 Implementation
		8.3.2 Damages Without Physician Culpability
			8.3.2.1 Basic Principles
			8.3.2.2 Consequences
	8.4 Conclusion
	References
Chapter 9: A German Path Toward Bioethics
	9.1 My Own Path
	9.2 The Concept of Bioethics
	9.3 The German Academy of Ethics in Medicine
	9.4 The “Generally Recognized Principles of the Physician’s Ethos”
	9.5 The Quest for Trustworthiness
	References
Chapter 10: Philosophy and Ethical Advisory Boards in German Medicine
	10.1 Introduction
	10.2 Philosophical Ethics and the Law
	10.3 Philosophical Ethics and the Ethos of the Medical Profession
	10.4 Recent Developments and Problems of Ethical Advisory Boards
	References
Chapter 11: The Development of Medical Ethics Institutions in West Berlin
	11.1 The Beginnings of an Ethics of Medical Research: Awareness Versus Implementation
	11.2 First Steps Towards Ethics Education Among Physicians
	11.3 Medico-Ethical Policymaking in Berlin
		11.3.1 Research Ethics
		11.3.2 Ethics for Medical Practice
		11.3.3 The Propagation of Living Wills
		11.3.4 Ethics Committees
	11.4 Looking Back and Looking Ahead
	References
Part IV: The Focus on Responsiveness to Patients
Chapter 12: Ethical Challenges of the Dying Patient: Managing Cooperation Between Physicians and Caretakers
	12.1 Introduction
	12.2 External Influences Framing Care for the Dying in East and West Germany
	12.3 Differences in Public Discussion About Changed Settings for Medical Care
		12.3.1 The Federal Republic of Germany
		12.3.2 The German Democratic Republic
	12.4 Different Responses to the Challenges of Death and Dying in East and West
	12.5 Conclusion
	References
Chapter 13: Ethical Elements in Thure von Uexküll’s Psychosomatic Thought
	13.1 Introduction: The Project of a Foundational Reform of Medicine
	13.2 Ulm as Reform University
		13.2.1 Reform of the Study of Medicine
		13.2.2 Founding of the Deutsches Kollegium für Psychosomatische Medizin
		13.2.3 The Struggle Against the Creation of a New Medical Sub-discipline
		13.2.4 Foundation of an Academy for Integrated Medicine
	13.3 Recourse to Theory
		13.3.1 The Sources of von Uexküll’s Theory
		13.3.2 Criticism of the Theory
	13.4 The Aftermath
	References