The paper describes how ethics consultation can be valuable to health professionals, patients and their families in understanding and evaluating ethical values and their consequences in a particular situation. Ethics consultation as it is practised at the university hospital of Freiburg is a special professional service offered by members of an academic institution.The practical approach and the goals are illustrated by a case study showing the difficulties of deciding about the limitation of intensive care medicine after heart surgery in the (...) setting of maximum treatment. Here, the ethics consultation was initiated by the relatives of the patient who wanted a decision to withhold further life-sustaining treatment.Following the experiences in Freiburg, it is concluded that clinical ethicists have to cover a variety of relevant fields of knowledge, need special analytical skills, and should have professional competence in counselling, including conflict mediation or crisis intervention. (shrink)

The issue of abortion has evolved since 1967. In this paper, the shift in the discourses of abortion are discussed. The article suggests that abortion is used as a “back-up” method of family planning and that this is broadly acceptable. Although there is little public opposition to abortion as such, there are influences that undermine abortion provision as it now exists. Growing concern about the status of the fetus shapes a number of debates. For example the issue of what the (...) fetus feels during abortion influences abortion practice. Advances in technology and the increase in knowledge about the unborn fetus will not change a woman's decision about having a late termination. The article concludes with the idea that a woman is a moral, civilised human being that deserves the right to make decisions about her reproductive life. (shrink)

A number of developments in the medical field have changed the debate about the ethics of abortion. These developments include: advances in fetal physiology, the increase in neonatal intensive care and the survival rates of premature infants. This paper discusses the idea of selective termination and the effects that these decisions have on disabled people of today. It presents a critique of the counselling services that are provided for the parents of a disabled fetus and discusses how this is viewed (...) from a social perspective. The article ends with an argument that the mother deserves to be autonomous in the decision of abortion. The easiest and most fair way to develop her autonomy is to consider the relationship between a professional and a mother as an expert–expert relationship. Here both parties are considered experts in diagnostic information, treatment options, possibilities, and their history, family roots, philosophy and way of life, respectively. (shrink)