The jurisdiction of most states presumes that human dignity is unconditional. Yet a last reason for this dignity cannot be furnished by a state jurisdiction. Christian ethics for instance argue on a line beyond strictly rational interpretation: human dignity roots in man's affirmation by God. Beyond a simply negative definition it is essential today to define the conditions of human dignity in a positive way.
There are two different concepts of health which can be formulated: the abstract concept and the concrete concept. In the case of the abstract concept of health, illness appears as an evil which must be eliminated. Illness is not considered an integral part of a healthy organism. In the case of the concrete concept of health, the possibility that illness can occur is a necessary condition of being an organism. The structural connections between these concepts and totalitarian, political thinking will be discussed.
The article describes responsibility as a term with six relations and four different levels. It analyses the conflicts between different addresses, levels and values and emphasizes the need to integrate the responsibilities of the physician. The term "responsibility" provides a more differentiating analytical tool for conflicts in medical acting than the so-called "principles of biomedical ethics".
The more difficult it is to reach consensus as to the ethical framework for action, the greater the challenge to individuals to take the responsibility for the consequences of their actions and to be accountable to others and themselves. First and foremost, both responsibility and accountability imply providing answers to those who question the reasons for an action. Thus, responsibility presupposes that agents must know that their actions will have consequences, that these consequences must be intended, and furthermore, they must be justified as consequences which are known and intended. With reference to a case study, this paper discusses these points on four levels: 1) the medical standards, 2) the integration of the patient's intention and sense of well-being, 3) the institutional framework for action, and 4) the assessment of the action in its relation to the universal question whether it is good for all human beings.
Needs for continuing education in the field of teaching ethics in health professions are increasing. A project group of the Academy of Ethics in Medicine, Germany, developed and tested a model for a "Teachers' Training Course", based on special educational aims. This project--a "workshop for teachers"--is described.
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