Suchergebnisse

"Background: Supported decision-making (SDM) refers to all types of interventions support persons with impaired decision-making capacity (DMC) in making informed treatment decisions. It encompasses a wide range of interventions, such as enhanced consent procedures, elaborated plain language and involvement of family, friends or peers in the informed consent process. Empirical research showed that SDM can enhance DMC. The UN Convention on the Rights of Persons with Disabilities, which has been ratified by 180 states parties to date, pronounces in article 12(3) that "states parties shall take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity." At the same time, medical ethicists and legal scholars have raised the concern that persons with impaired DMC are more likely to become subject to undue influence under SDM arrangements. Objectives: The aim of this presentation is to provide a conceptual framework to facilitate an ethical evaluation of various forms of supported decision-making. Methods: Empirically informed conceptual analysis. Various SDM interventions are analyzed. Findings: It is necessary to distinguish between input, process and output support. Input support involves influencing factors that are negatively correlated with DMC; process support involves interpreting a person's preferences and carrying out intellectual processing; and output support involves enabling a person to communicate decisions to others. Conclusion: Most forms of input and output support are promising, but ethical issues in relation to framing and interpersonal leverage must be addressed. Forms of process support that involve "outsourcing" decision-making capacities are ethically problematic. "

The article describes the prerequisites for the activation of civil society in Ukraine in the context of the Russian invasion, and reveals the approaches and digital technologies used by the activists. The authors highlight the process of empowerment of civil society, starting from the Euromaidan up until 2023 and identify the impact of the Kremlin's propagandist campaign on the civic sector of Ukraine as well as on the public opinion during 2014 – 2021 (the undeclared Russian hybrid aggression against Ukraine, which preceded the armed invasion). The paper also describes socio-political conditions for the response of civil society to Russian aggression and outlines a continuous slowdown in the processes of democracy building associated with it. Against this background, the activists also elaborated approaches to enhance the efficacy of such a response based on the widespread involvement of civil society using technology. Additionally, the authors reveal the role of technologies in the processes of democratic transformation of Ukraine, with special focus being put on a range of instruments helping public administration bodies in solving key issues that are on the agenda and require the involvement of a broad community: national defence, development of community potential, mutual aid during the war.

If, following Max Weber (1917), we describe our reality of modernized, bu- reaucratic and secularized society as disenchanted (in German: entzaubert), then a number of literary genres, ranging from magical realism to fantasy, aim at playful, literary re-enchantment of the world and therefore represent a strong anti-modernist gesture in the midst of contemporary culture. While pointing to "natural" restrictions of the objective, rational perception of the world and often questioning rationality as such, fantastic elements of literary texts normally aim at sharpening the reader's awareness of the limitations of the customary approach towards reality, thus potentially enabling a new look at social, political and cul- tural problems of the "real" world. Therefore, both the fictions that realistically "describe" or "reflect" the world, and those texts that transfer social and political phenomena to the realms of the uncanny, the grotesque, and the (post)modern mythology, are of importance. The novels "Twelve Circles" (2003-04) and "Voroshilovgrad" (2010) obviously belong to the latter category. These texts are not stereotypical, naturalistic stories about the life of the post-Soviet elite; instead, they offer a postmodern anthology of types, motives, and plots, which, among other elements, also include the de- monic figures of the oligarchs. Despite their structural significance, these figures, however, are not real "characters" of the story, but appear in the form of phan- tasmagoric images, whose agency manifests itself only through the discourses of "money," "power," and "violence:" discourses the oligarchs control and use against the protagonists of the novels.

"Self-binding directives (SBDs) are a special type of psychiatric advance directive in which service users agree in advance to (coercive) treatment they might late refuse during a mental health crisis. SBDs aim to empower and protect service users by enabling them to state their values and to plan their (coercive) treatment in advance in consultation with the treating psychiatrist. SBDs have been widely discussed in the ethics literature. Topics include ethical issues surrounding competence, revocation and the ethical justification of involuntary commitment and treatment based on SBDs. Little empirical research on SBDs has been conducted thus far. The Netherlands is to the best of our knowledge the only country with explicit legal provisions for SBDs. On the 1st of January 2020, the new Dutch Law on Compulsory Mental Health Care (Wvggz) entered into force. The implications of this law for the use of SBDs are still unclear. In this presentation, we will present insights from a qualitative interview study on stakeholders' experiences with SBDs under the new law and their views on the ethical opportunities and challenges of SBDs. Based on the results, we give recommendations for the implementation of SBDs in other European countries. "

"Allocation of health resources towards the treatment of patients with COVID-19 may affect the quality of care for non-COVID-19 patients. Several medical societies representing cancer health professionals have issued statements on priority setting in cancer care in the wake of the Sars-CoV-2 outbreak (1, 2). However, there is a lack of empirical data on how resources are prioritized in cancer care and which criteria are taken into consideration by those involved in decision making. In this paper we will present findings from qualitative interviews conducted with oncologists in Germany between February and July 2021. Transcripts of interviews are analysed following principles of qualitative content analysis based on Kuckartz (3). According to preliminary analysis of the first five interviews conducted three major topics emerge: 1. Experiences with scarcity regarding selected diagnostic procedures and treatment. 2. Material and procedural criteria for priority setting and decisions on deviations of standards of care. 3. Effects of priority setting on coping and psycho-social support. We will discuss findings with regards to their possible contribution to an empirical and normative founded guidance for priority setting in cancer care in times of Sars-CoV-2 outbreak and comparable events. 1. Deutsche Gesellschaft für Hämatologie und Onkologie. Coronavirus-Infektion (COVID-19) bei Patienten mit Blut- und rebserkrankungen. https://www.onkopedia.com/de/onkopedia/guidelines/coronavirus-infektion-covid-19-bei-patient-innen-mit-blut-und-krebserkrankungen/@@guideline/html/index.html 2. Marron JM, Joffe S, Jagsi R et al. Ethics and Resource Scarcity: ASCO Recommendations for the Oncology Community During the COVID19 Pandemic. J Clin Onc. April 28 2020, doi:10.1200/JCO.20.00960 3. Kuckartz, U. (2018). Qualitative Inhaltsanalyse. Methoden, Praxis, Computer¬unterstützung (4th ed.). Beltz Juventa. "

Mit einem Anteil von rund 30% am Endenergieverbrauch und etwa 20% an den CO2-Emissionen haben private Haushalte in Deutschland einen großen Einfluss auf die Umwelt. Gleichzeitig sind private Haushalte ein zentraler Adressat für politische Interventionen zur Bekämpfung des Klimawandels. Vor diesem Hintergrund hat die Politik zahlreiche Maßnahmen zur Verringerung des Energiekonsums und zur Förderung regenerativer Energietechnologien ergriffen. Diese politischen Maßnahmen bedürfen einer sorgfältigen Evaluierung ihrer Effektivität und Kosteneffizienz, um kostspielige Redundanzen durch sich überlappende Instrumente zu vermeiden. Eine solche Evaluation umwelt- und energiepolitischer Maßnahmen erfordert eine umfangreiche Datenbasis. Besonders im Bereich der privaten Haushalte waren solche Daten in Deutschland bislang nicht verfügbar. Die Reagibilität deutscher Haushalte auf Maßnahmen zur Bekämpfung des Klimawandels war daher weitgehend unbekannt. Das Sozial-Ökologische Panel stellt zu diesem Zweck umfangreiche, frei verfügbare Informationen zum Energieverbrauch und Umweltverhalten privater Haushalte bereit. Die Befragung wurde in vier Wellen durchgeführt. Es liegen Daten für die Jahre 2012, 2013, 2014 und 2015 vor. Diese Daten können anhand einer ID aneinander gespielt werden. Darauf aufbauend können ökonometrische Schätzungen und Analysen verschiedener Präferenzindikatoren sowie des Anpassungsverhaltens privater Haushalte an den Klimawandel durchgeführt werden. Dieser Datensatz umfasst die Daten der Erhebung im Jahr 2013 und ist in englischer Sprache gelabelt. Der Datensatz ist auf Deutsch und auf Englisch erhältlich.