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The right to health, understood as comprehensive entitlements and aims that widely transcend medicine, is safeguarded institutionally in many ways. Primarily, states have the obligation to respect, protect and fulfil the human rights. Their activities are complemented by various UN-organisations, especially the WHO, and non-governmental organisations. Moreover, the private sector and informal institutions – such as social capital and health identity – can strengthen or weaken the human right to health.
The concept of illness in health insurance law is broad and is neither intended nor used in practice for limiting services from the perspective of economic efficiency. Limitation and control of services are effected by explicit exclusions and implicit specifications, which influence the scope of services provided and arranged by physicians. In the health insurance system, unlike in the context of private medical treatment, not every physician is allowed to provide every service, quality must be documented, and the remuneration system works against an expansion of services.
The 124th German Congress of Physicians held in May 2021 decided to delete § 16 S. 3 MBO. The Congress gave as reason for the deletion the unconstitutionality of the clause. This article will show that, although the reasons presented by the Congress are insufficient to justify its claim, § 16 S. 3 MBO is still likely to be formally unconstitutional due to the violation of the principle of legal reservations. In the near future it might prompt all German states to remove the prohibition on physician-assisted suicide from the state physician professional code. If this does happen, the core argument of the judgment of BVerfG against the constitutionality of § 217 StGB will no longer hold and leave room for its possible constitutional interpretation. Consequently, the legislature would not need to develop a new protection concept with regard to § 217 StGB, i.e., Section 217 of the German Criminal Code.
It might be a big burden for informal caregivers when a person with dementia is hospitalized. Clinical employees report, that informal caregivers are sometimes more difficult than the patients themselves. In this review options of good communication are discussed, also with focus on good intercultural communication. Based on clinical case studies, particularly challenging situations are being described and analysed in order to show how difficult cases can be solved.
Many persons with dementia spend their last phase of life in a nursing home. The Zurich Life and Death with Advanced Dementia (ZULIDAD) study therefore investigated the situation of Swiss nursing home residents based on a large routine care dataset. Additionally, 126 nursing home residents with advanced dementia in Zurich were studied for three years or until their deaths. The ZULIDAD Round Table consisting of family members, experts and researchers developed as part of the project a guide on „The end of life with dementia“.
In this article, I explore the question of what shifts are emerging in the relationship between health and disease through new AI-based prediction systems. One example of such prediction systems are digital twins for predicting changes in parts of a person’s physical body. In a first step, I discuss possible fundamental determinations of the relationship between health and disease. In a second step, I examine from a theological and philosophical perspective what it means when a digital twin simulates and predicts states of illness vicariously. In a concluding third step, I draw a line to the debates about freedom to illness and show how these debates can help us to think about a responsible approach to digital twins.
Because persons with dementia (PwD) are often multimorbid, they undergo medical treatments frequently. The capacity of PwD to consent to such treatments is often questioned. In many cases, they are categorically judged incapable to consent based on their diagnosis. The S2k guideline „Consent of PwD to medical treatment“ provides a first attempt to summarize the relevant medical, legal, ethical and psychological requirements that should be satisfied in this respect.
Dementia is a main risk factor for delirium in geriatric patients, along with old age and multimorbidity. Very frequently, delirium is superimposed on pre-existing dementia, and unfavourable courses are not uncommon. Nevertheless, remission of delirium is the primary goal of treatment. Ethical questions arise with regard to the scope of medical measures and the consideration of the presumed patient’s will. Decison making may be complicated by uncertainties in prediction of the further course of illness, even if individual prognostic factors are taken into account.