[History in the public communication of specialist scientific societies: history marketing].

History is nowadays used as an economic factor. The past is therefore specifically targeted and cultivated, which for specialist scientific associations and societies often fullfils totally different functions in comparison to the open market, although the techniques and requirements are similar. Within medical specialties these facts are often still unknown.

[Establishment of university departments of urology in North Rhine-Westphalia: the Aachen model].

The foundation of university departments of urology in postwar East and West Germany faced some opposition by some university professors of surgery who wanted to preserve the unity of their discipline. In North Rhine-Westphalia, heads of municipal hospitals or senior members of university hospitals' staff often received the first chaired professorships of urology.

Matter, metaphors, and mechanisms: rethinking cell theories.

This study analyzes the logical structure of classical cell theory (CCT) by pointing out that CCT conceives the properties of organic cellular matter as supervenient to successively emerging states of quasi-crystalline atoms. This concept supports the design of a metaphorical space the intelligible components of which display an explanatory structure in accordance with the contemporary complex-systems approach of mechanisms. These findings support the thesis of an explanatory turn within the life-sciences due to a conflict between anti-classificatory (Buffon), analogous (Wolff, Reil, Weber), and causal-mechanical (Kepler) strategies of explanation.

[Cost-conscious medical decisions. Normative guidance within the conflicting demands of ethics and economics].

Background: Under the current conditions in the health care system, physicians inevitably have to take responsibility for the cost dimension of their decisions on the level of single cases. This article, therefore, discusses the question how physicians can integrate cost considerations into their clinical decisions at the microlevel in a medically rational and ethically justified way.

Discussion: We propose a four-step model for "ethical cost-consciousness": (1) forego ineffective interventions as required by good evidence-based medicine, (2) respect individual patient preferences, (3) minimize the diagnostic and therapeutic effort to achieve a certain treatment goal, and (4) forego expensive interventions that have only a small or unlikely (net) benefit for the patient.

[Changing the therapeutic goal in critically ill patients. Ethical analysis of a surgical case].

We report on a 32-year-old patient, who developed septic shock, toxic shock-like syndrome, and multiple organ failure following nectrotizing fasciitis. Amputations had to be performed on all extremities. Subsequently, she developed secondary sclerosing cholangitis.

[Ethical decisions in surgery. Foundations for a principle-oriented case discussion].

Background: Due to advanced medical interventions, the multitude of beliefs in our society, and increasing economic pressure, difficult ethical decisions are also part of the surgical care of patients.

Question: How can health care personnel address the ethical challenges in a structured, well-founded ethical manner?

Materials And Methods: Based on the four principles of biomedical ethics beneficence, nonmaleficence, respect for autonomy, and justice, we present a model for the step-wise ethical evaluation of difficult cases.

Results: The principle-based model of ethical case discussions consists of five steps: 1) In the medical analysis of the case, the available management strategies are identified, including a detailed description of their benefits and risks.

[Does ethics pay off? Need and perspectives of value management in hospitals].

The economic pressure on German hospitals has increased considerably over the last years, mainly because of the introduction of a flat-rate payment system, and it will most likely further increase under the current demographic and political conditions. The growing dominance of economics in the inpatient sector increases the pressure on hospital staff and results in an increased volume of care (with sometimes inappropriate overtreatment) and uncontrolled rationing and a continuous struggle to maintain the quality of patient care. This development is not only alarming from an ethical perspective, but also impairs the hospital's economic performance.

[Rationing in German health care with particular consideration of oncology: view points of German stakeholders--a qualitative interview study].

Aim: Germany is at the beginning of a discussion about possible rationing in the health-care system. Cancer treatment, which is often cost-intensive but not always cost-effective, is frequently considered as a field for rationing.

Methods: Against this background, we conducted semi-structured, guideline-based interviews with different stakeholders of the German health-care system and analysed them with the help of grounded theory techniques.

Information, consent and treatment of patients with Morgellons disease: an ethical perspective.

Morgellons is a medically contested diagnosis with foremost dermatological symptoms. Patients experience fibers emerging from the skin, together with a range of other somatic, psychiatric, and neurological complaints. Within the medical community, it is generally held to be a variation of delusional parasitosis/delusional infestation, which is usually treated with antipsychotics.

[Sexually transmitted diseases: the impact of stigma and taboo on current medical care].

Sexually transmitted diseases (STD) are probably the most tabooed diseases we know. The many taboos and the related stigmata shape patients' lives and significantly influence health care policies, medical research, and current problems in medical ethics. To better understand these complex influences, the still powerful taboos and related metaphors associated with illness and disease are analyzed within their cultural and historical background and concerning the actual impact on patient care and research.

[Cancer screening from the perspective of public health ethics].

Cancer screening programs aim at reducing the tumor-related morbidity and mortality by early detection of malignant tumors or precancerous lesions. The basic ethical dilemma in cancer screening is, however, that many people have to be exposed to the burdens and risks of the intervention for a few people to benefit from early cancer diagnosis. This article discusses under which conditions it is ethically acceptable to offer or even recommend cancer screening.

[German-Japanese scientific exchange in urology in the early 20th century].

This paper analyzes the importance of the German language and German culture and institutional development of urology in Japan in the early 20th century, starting from the development of the medical school for Japanese in Germany and their function in the process of modernization of the Meiji period (1868-1912). Examples of bi-directional German-Japanese relations in medicine, which also included an integrated knowledge transfer, are shown. The study is based mainly on Japanese and German sources about Japanese physicians in Germany as well as contemporary publications in German and international medical journals.

[Urological diseases in a "general practice" in the 17th and early 18th centuries].

Of national medicohistorical importance was the town physician Johannes Franc (1649-1725). His diary written in Latin gives - among other diseases - an overview of urological diseases affecting citizens in Ulm around 1700. It also allows a look into the "workshop" of a scholar who studied contemporary medicine in comprehensive manner.

[Indication: scientific and ethical basis of medical practice].

The medical indication provides a rational foundation for treatment decisions. An indication can be defined as the reasonable professional judgement that a medical procedure is suitable and useful to reach a specific therapeutic goal with a certain probability. An indication includes empirical, causal and purposive considerations and justifications, and a scrutiny of the individual case.

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"Staining is the Best Policy". Visualization in the work of Paul Ehrlich. For nearly all of his life, the biomedical scientist Paul Ehrlich dedicated himself to work on dyes and staining at the interface between so-called color-chemistry and histopathology.

[A debate of the legal regulation of organ transplantation in West and East Germany (1960 - 1989). A comparative study].

The debate on the legal frameworks of organ transplantation in Germany began in the 1960s with the upcoming of new medical treatments. Since there were two German States at that time, the Federal Republic of Germany (FRG) and the German Democratic Republic (GDR), the process of the discussion on the way to legislation took place under two very different circumstances. In 1975 the GDR implemented a decree regarding the legal aspects of organ transplantation.

[Ethical and theoretical medical comments on the desire and reality of individualised medicine].

Starting from an epistemological position of individualized medicine this article deals with the ethical analysis of this complex topic. The need for evidence-based decisions--as opposed to interest-driven decisions--is emphasised. Based on the argument of social justifiability it can be first stated as an intermediate result that genome-based research, which aims to promote individualisation of medicine, does not exclude research that uses other diagnostic markers, and the appropriate ethical standards can be applied.

[Biologism controversy: ethical implications for psychiatry].

Current biological psychiatry, it is frequently claimed by its opponents, is "biologistic" and unduly narrows psychological disorders to neurobiology and molecular biology. They deem a complete neuroscientific reduction of the mental phenomena to be impossible because of the impossibility of reducing certain phenomena, such as the individual subjective experience. If such a reduction is nevertheless undertaken it is ultimately to the disadvantage of the patients.

[Prophylaxis and therapy of post-traumatic stress disorder with propranolol: evidence and ethical analysis].

The beta-antagonistic agent propranolol is increasingly being used in clinical trials for the prophylaxis and treatment of post-traumatic stress disorder (PTSD). This article discusses the evidence for the effectiveness of propranolol in the prophylaxis and treatment of PTSD and the ethical implications of research on these treatment approaches. The efficacy of a prophylactic or therapeutic use could not be shown during the last decade.