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Biomedical subjects

H Jochemsen

Publications and source records attributed to H Jochemsen.

At least 19 recordsLinked to original sources
PubMed2000

Professional autonomy and the normative structure of medical practice.

Professional autonomy is often described as a claim of professionals that has to serve primarily their own interests. However, it can also be seen as an element of a professional ideal that can function as a standard for professional, i.e. medical practice. This normative understanding of the medical profession and professional autonomy faces three threats today. 1) Internal erosion of professional autonomy due to a lack of internal quality control by the medical profession; 2) the increasing upward pressure on health care expenses that calls for a health care policy that could imply limitations for the professional autonomy of physicians; 3) a distorted understanding of the profession as being based on a formal type of knowledge and related technology, in which other normative dimensions of medical practice are neglected and which frustrates meaningful communication between physicians and patients. To answer these threats a normative structure analysis of medical practice is presented, that indicates which principles and norms are constitutive for medical practice. It is concluded that professional autonomy, normatively understood, should be maintained to avoid the lure of the technological imperative and to protect patients against third parties' pressure to undertreatment. However, this professional autonomy can only be maintained if members of the profession subject their activities and decisions to a critical evaluation by other members of the profession and by patients and if they continue to critically reflect on the values that regulate today's medicine.

Clinical Medicine↗
PubMed2000

Professional autonomy in the health care system.

Professional autonomy interferes at a structural level with the various aspects of the health care system. The health care systems that can be distinguished all feature a specific design of professional autonomy, but experience their own governance problems. Empirical health care systems in the West are a nationally coloured blend of ideal type health care systems. From a normative perspective, the optimal health care system should consist of elements of all the ideal types. A workable optimum taking national values into account could be attained by governance structures that also introduce elements from other ideal type systems. Thus a normative approach to medical practice guaranteeing an essential degree of professional autonomy for a relationship of trust between the patient and the physician, could be combined with an efficient and equitable allocation of health care resources.

Decision Making, Organizational↗
PubMed1999

Voluntary euthanasia under control? Further empirical evidence from The Netherlands.

Nineteen ninety-six saw the publication of a major Dutch survey into euthanasia in the Netherlands. This paper outlines the main statistical findings of this survey and considers whether it shows that voluntary euthanasia is under effective control in the Netherlands. The paper concludes that although there has been some improvement in compliance with procedural requirements, the practice of voluntary euthanasia remains beyond effective control.

Empirical Research↗
PubMed1998

Dutch court decisions on nonvoluntary euthanasia critically reviewed.

The author critically reviews Dutch court decisions on nonvoluntary euthanasia. First, he examines euthanasia practice in the Netherlands. The author next discusses in detail the 1995 cases of two physicians who were prosecuted for terminating the lives of infants who were severely ill and disabled. The courts accepted nonvoluntary euthanasia and relied on the physicians' defense of necessity. Jochemsen exposes serious flaws in the reasoning of the courts and concludes that newborns with congenital disorders should be given appropriate palliative care. Jochemsen fears that by extending the practice of euthanasia to infants with disabilities the Dutch courts have taken another step toward endangering the lives of all incompetent persons.

Brain Diseases↗
PubMed1994

Euthanasia in Holland: an ethical critique of the new law.

In the Netherlands the government's proposal for the legal regulation of euthanasia, assisted suicide and the termination of a patient's life without request has been approved by Parliament. The defence of this proposal is to a large extent based on a specific interpretation of data about the practice of euthanasia in that country, published in 1991 (the Remmelink Report). This paper discusses both the interpretation of the data and the new law. On the basis of that and other data, the author concludes that many cases of euthanasia, assisted suicide and termination of a patient's life without request remain unnotified and therefore unreviewed by the legal authorities. It is argued that the new law will not guarantee an improvement to this situation. In short, the new law will not protect effectively the lives of patients, and must, therefore, be open to ethical and legal objection.

Ethics, Medical↗
PubMed1981

In vitro synthesis of adenovirus type 5 T antigens. I. Translation of early region 1-specific rna from lytically infected cells.

Translation of early RNA specific for the leftmost early region 1 of adenovirus type 5 DNA in a rabbit reticulocyte cell-free system resulted in the synthesis of proteins with the following molecular weights: 65,000 (65K), 54K, 42 to 34K, 29K, 25K, 19K, and 18K. All of these proteins could be immunoprecipitated with hamster antitumor serum. The 42 to 34K proteins mapped in early region 1a, and those with molecular weights of 65K, 19K, and 18K mapped in early region 1b. The gene coding for the 54K protein may be localized outside of early region 1. We could not map unambiguously the 29K and 25K proteins. The identification of a 65K protein among products synthesized in vitro suggests that this protein may be identical to the 65K major T antigen present in adenovirus type 5-infected and -transformed cells, and this indicates that it is indeed encoded by the viral genome. This protein is encoded by a 23S mRNA. The other early region 1-specific proteins appear to be encoded by mRNA of approximately 13S, except for the 19K protein, which is synthesized with RNA sedimenting at both 13S and 23S.

Adenoviruses, Human↗