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Biomedical subjects

H ten Have

Publications and source records attributed to H ten Have.

At least 19 recordsLinked to original sources
PubMed2007

Unesco's Global Ethics Observatory.

The Global Ethics Observatory, launched by the United Nations Educational, Scientific, and Cultural Organization in December 2005, is a system of databases in the ethics of science and technology. It presents data on experts in ethics, on institutions (university departments and centres, commissions, councils and review boards, and societies and associations) and on teaching programmes in ethics. It has a global coverage and will be available in six major languages. Its aim is to facilitate the establishment of ethical infrastructures and international cooperation all around the world.

Databases, Factual↗
PubMed2006

Education of ethics committee members: experiences from Croatia.

OBJECTIVES: To study knowledge and attitudes of hospital ethics committee members at the first workshop for ethics committees in Croatia. DESIGN: Before/after cross-sectional study using a self administered questionnaire. SETTING: Educational workshop for members of hospital ethics committees, Zagreb, 2003. MAIN OUTCOME MEASUREMENTS: Knowledge and attitudes of participants before and after the workshop; everyday functioning of hospital ethics committees. RESULTS: The majority of the respondents came from committees with at least five members. The majority of ethics committees were appointed by the governing bodies of their hospitals. Most committees were founded after the implementation of the law on health protection in 1997. Membership structure (three physicians and two members from other fields) and functions were established on the basis of that law. Analysis of research protocols was the main part of their work. Other important functions-education, case analysis, guidelines formation-were neglected. Members' level of knowledge was not sufficient for the complicated tasks they were supposed to perform. However, it was significantly higher after the workshop. Most respondents felt their knowledge should be improved by additional education. Their views on certain issues and bioethical dilemmas displayed a high level of paternalism and over protectiveness, which did not change after the workshop. CONCLUSIONS: The committees developed according to bureaucratic requirements. Furthermore, there are concerns about members' knowledge levels. More efforts need to be made to use education to improve the quality of the work. Additional research is necessary to explore ethics committees' work in Croatia especially in the hospital setting.

Attitude of Health Personnel↗
PubMed2001

Euroscreen 2: towards community policy on insurance, commercialization and public awareness.

The project Euroscreen 2 has examined genetic screening and testing with particular reference to implications for insurance, commercialization through marketing of genetic tests direct to the public, and issues surrounding raising public awareness of these and other developments in genetics, including the practical experiment of a Gene Shop. This paper provides a snapshot of the three year project. The study group's work included monitoring developments in different European countries and exploring possibilities for regulation in insurance and commercialization together with public attitudes to regulation. The success or failure of different strategies is not independent of public awareness. Exploration of policy, however, also requires examination of fundamental concepts such as solidarity and geneticization.

Attitude to Health↗
PubMed2000

Common threads? Palliative care service developments in seven European countries.

Since the late 1960s hospice and palliative care services have been developing in many European countries. Although attention has been given to patterns of development in specific national contexts, so far we lack a comparative understanding of how these services are organized and delivered. Such a comparison poses certain practical and methodological difficulties. It does, however, allow a wider view of the current provision of palliative care in Europe, together with a consideration of implications for the future. We report on an analysis of palliative care developments in seven European countries which gave attention to early origins, patterns of provision, and structural and policy integration. We conclude that, despite different processes of development, the emergent discipline of palliative care now finds its most congenial home within the structures of the formal health care system. Accordingly, inequities between the seven countries can be more clearly identified, posing continuing challenges to policy makers and planners who operate with a European perspective.

Europe↗
PubMed1999

The concept of abnormality in medical genetics.

This paper explores usage of the concept of abnormality in medical genetics and proposes directives for more careful usage of this concept. The conceptual difficulties are first explored, then a model is developed to assess actual usage, followed by analysis of a sample of genetic textbooks and genetics literature. It appears that fact and valuation are often intermingled, that reference standards used to define 'genetic abnormalities' are often not clear and that the concept of abnormality is often used independent of the degree of certainty with which the altered genetype develops into a (seriously) harmful phenotype. On the basis of these findings it is argued that more restraint and more careful use of the concept of genetic abnormality of medical genetics is appropriate as well as more agreement on the use of reference standards.

Congenital Abnormalities↗
PubMed1998

Genetic screening and ethics: European perspectives.

Analysis and comparison of genetic screening programs shows that the extent of development of programs varies widely across Europe. Regional variations are due not only to genetic disease patterns but also reflect the novelty of genetic services. In most countries, the focus for genetic screening programs has been pregnant women and newborn children. Newborn children are screened only for disorders which are treatable. Prenatal screening when provided is for conditions for which termination may be offered. The only population screening programs for adults are those for thalassaemia carrier status in Cyprus, Greece and Italy. Social responses to genetic screening range from acceptance to hostility. There is a fundamental tension between individual and community in the debates in various European countries about implementation of screening programs. Opposition to genetic screening is frequently expressed in terms of arguments about "eugenics" with insufficient regard to the meaning of the term and its implications. Only a few countries have introduced explicit legislation on genetic screening. Legislation to address discrimination may provide more safeguards than legislation protecting genetic information itself.

Adult↗
PubMed1998

Geneticization: the Cyprus paradigm.

Geneticization is a broad term referring to several related processes such as a spreading tendency to use a genetic model of disease explanation, a growing influence of genetics in medical practice, and the slow changing of individual and societal attitudes towards reproduction, prevention and control of disease. These processes can be demonstrated in medical literature on preventive genetic screening and counselling programs for beta-thalassaemia in Cyprus, the United Kingdom and Canada. The preventive possibilities of the new genetic and diagnostic technologies have been quickly understood and advocated by health professionals, and their educational strategies have created a web of social control, in marked contrast to the alleged voluntary decision-making process and free choice. Genetic diagnostic technologies have led to considerable changes in control and management of beta-thalassaemia, and have generated a number of unresolved incongruities.

Abortion, Induced↗
PubMed1997

Ownership of genetic material and information.

As a result of the International Human Genome Project genetic information is rapidly multiplying. To avoid some of the problems regarding the availability and use of genetic information, it is sometimes suggested to apply the concept of ownership. This article focuses on the clarification of the status of genetic material and genetic information, obtained as a result of screening and counseling of individual patients. First, some philosophical theories of ownership are examined for a justification of the use of the concept of ownership with regard to the human body. Next, arguments with regard to ownership of the human body are examined. The results of this analysis are applied to genetic material and genetic information.

Ethics, Medical↗
PubMed1997

Genetic screening: a comparative analysis of three recent reports.

Three recent reports on genetic screening published in the United Kingdom, Denmark and the Netherlands are discussed. Comparison of the Dutch report with the Danish and the Nuffield reports reveals that the Dutch report focuses on the aim of enlarging the scope for action, emphasising protection of autonomy and self-determination of the screenee more than the other two reports. The three reports have in common that the main concern is with concrete issue such as stigmatisation, discrimination, protection of the private sphere and issues linked with labour and insurance. Some potential long term consequences, however, tend to be neglected or underestimated. These omissions are pointed out.

Advisory Committees↗
PubMed1992

Equity and solidarity: the context of health care in The Netherlands.

The current debate on health care resource allocation in the Netherlands is characterized by a social context in which two values are generally and traditionally accepted as being equally fundamental:solidarity and equity. We will present an outline of the distinctive features of the Dutch health care system, and analyze the present state of affairs in the resource allocation debate. The presuppositions of the political call for constraint and (renewed) government supervision and the role of the specific value context in recent proposals for reconstruction of the Dutch health care system will be evaluated.

Attitude to Health↗
PubMed1989

An experimental case-conference programme for obstetrics and gynaecology clinical students.

Since the founding of the University of Limburg (1974), in The Netherlands, an innovative medical curriculum has been guided by educational principles of problem-orientation, continuous assessment, student initiative and attitude development. The teaching of medical ethics was built into the preclinical curriculum from the start. However, the clinical years remained largely unaffected, and only recently has an effort been made to extend the educational philosophy to this more or less traditional part of medical education. Within this context, an experiment of clinical ethics teaching was introduced in the Obstetrics and Gynaecology (Ob/Gyn) clerkships. The objectives, methods and results of this experimental programme are described in this paper. The success of the teaching is based on three features of the programme: 1) its student-centred approach; 2) the programme is designed in a way similar to regular patient conferences; 3) the programme is taught by a team consisting of both clinician and ethicist. Before starting a longitudinal programme of ethics teaching during the clinical years, it proved very helpful to experiment with a well designed and evaluated pilot programme.

Curriculum↗
PubMed1988

[The legitimacy of the nursing home for somatic diseases in health care. A cultural-sociological approach].

The Dutch nursing home for somatic patients is analysed in the perspective of sociology of culture. Not only the values and the meaning which the nursing home pretends to offer, are investigated, but also the expectations that patients have of nursing homes. Legitimacy is the crucial concept in this respect. The nursing home is legitimate if it meets certain expectations of the patients. Corresponding to the Advice of the Dutch Central Advisory Body for Health on task and function of nursing homes, it is shown, that nursing homes are not legitimate in the strict meaning described above. On the contrary the nursing home has primarily been a political factor intended to stabilize our ageing society. Close co-operation with community care is pleaded in order to understand the unique situation of every chronically ill patient or older disabled person, and to meet his needs as well as possible.

Aged↗