Neurosurgery and Medical Ethics PDF
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I I I I I I I I I I I I Acta Ne urochirurgica Supplements Editor: H.-J, Reulen Assistant Editor: H.-J, Steiger Neurosurgery and Medical Ethics Edited by H. August van Alphen Acta Ne urochirurgica Supplements 74 Springer-Verlag Wien GmbH H. August van Alphen, M.D., Ph.D. Departmenl of Neurosurgery, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands Thi~ work is subject to copyright. All rights are reserved, whether the whole or pan of the material is concerned, specifically those of translation, reprinting. re-use of illustrations, broadcasting. reproduction by photocopying machines or similar means, and storage in data banks. @ 1999 Springer-Verlag Wien Softcover reprint ofthe hardcover 1st edition 1999 Product Liability: lbe publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 1be use of registered name.~, trademarks, etc. in this publication does not imply, even in the absence of specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free forg eneral use. Typesetting: Asco Trade Typesetting Ltd., Hong Kong Graphic design: Ecke Bonk Printed on acid-free and chlorine free bleached paper SPIN: 10130592 With I Figure Library of Congress Cataloging-in-Publication Data Neurosurgery and medical ethics I edited by H. August van Alphen. p. crn. - (Acta neurochirurgica. Supplement, ISSN 0065-1419 ; 14) Includes bibliographical references and index. ISBN 978-3-7091-7310-7 ISBN 978-3-7091-6387-0 (eBook) DOI 10.1007/978-3-7091-6387-0 I. Nervous system-Surgery-Moral and ethical aspects Congresses. 2. Medical ethics Congresses. I. Alphen, H. A.M . van. II. Series. [DNLM: 1. Neurosurgery Congresses. 2. Ethics, Medical Congresses. WI AC8661 no. 14 I999J R0593.N418 1999 611.4'8-<1c21 ONLMlDLC for Library of Congress 99-33462 CIP ISSN 0065-1419 Preface This supplement of Acta Neurochirurgica contains the proceedings of the Ninth Convention of the Academia Eurasiana Neurochirurgica held in Chateau St. Gerlach, Houthem, The Netherlands, 29 July - 1 August 1998. During this convention a three-day symposium on Neurosurgery and Medical Ethics was held. In this time of tremendous technical advancement in medicine in general and neurosurgery in particular, we are liable to lose sight of the sick patient as a human being, and the odds are that he will be the object rather than the subject of our action in the near future. It is a purpose and a task of the Academia Eurasiana Neurochirurgica to recognize this thread and to pay attention to tradition, morality and ethics in neurological surgery. The theme of this convention and the subject of the symposium met this purpose as no other. In the scientific sessions during the first day, the moral backgrounds of medical ethics in the most important cultures and religions in east and west were elucidated by invited experts in this field. A mutual respectful understanding of each other's conception of and belief in ethical principles is a growing necessity in our multicultural societies in both continents. On the second day, the ethical aspects of different fields of neurological surgery were discussed by members of the Academia. In this context, also the internationally much-discussed and much-criticized regulations on euthanasia in The Netherlands were explained. During the last morning, there were some papers and ample discussions on: How to educate our pupils in moral attitude and ethical behaviour? The convention was a very successful and highly inspiring gathering. We wish to express our sincere thanks to all speakers and participants for their contribution. We felt, that these contributions would be well worth reading for all physicians and others, working in different fields of medicine. It was a great pleasure, indeed, to edit this book for this purpose. I also like to cordially thank Ms. Susanne Mayr of the Production Department of Springer, Wien New York for her generous dedication and great help in realizing this issue. Amsterdam, July 1999 H. August van Alphen, M.D., Ph.D. Past President A. E.A.N. , Editor Contents Opening Ceremony Ninth Convention of the Academia Eurasiana Neurochirurgica . . . . . . . . . . . . . 1 van Alphen, H A.: Presidential Welcome Address 3 Sano, K.: Opening Address to the 9th Convention 5 Hoytink, A.: The Twain have met! 7 Avezaat, C. 1. 1.: Welcome Address on Behalf of the Netherlands Society of Neurosurgeons 1 1 Symposium Neurosurgery and Medical Ethics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 van Alphen, H A.: Introduction .......................................................................... 15 van Bommel, A.: Medical Ethics from the Muslim Perspective 17 Raja, l. A., Chaudhry, M. R.: Islam and Medical Ethics 29 Pandya, S. K.: Medical Ethics in India: Then and Now 35 Evers, R.: Biblical Moral and Religious Principles in Medical Practice 47 Eijk, W. 1.: Carrying on the Healing Mission of Christ: Medical Ethics in the Christian Tradition 53 Handa, H: Traditional Ethical Ideas on Life and Organ Transplantation in Japan 59 Rappaport, Z. H, Rappaport, I. T.: Principles and Concepts of Brain Death and Organ Donation: The Jewish Perspective 61 Backlund, £.-0.: Brain Death in Practice - A Retrospective View 65 VIII Contents Nagai, M.: Criteria for Selection of 'Death with Dignity' - From Clinical Cases of Malignant Brain Tumours 69 Backlund, E.-D.: Death With Dignity - On the Withdrawal of Life-Sustaining Measures 71 Dillmann, R.: Euthanasia in the Netherlands: Transparency and Accountability 75 Trojanowski, T.: New Technologies and Methods in Neurosurgery - Ethical Dilemmas 83 Schroten, E.: Professional Integrity: On Moral Education in Medicine 89 Van den Bergh, R.: Ethical Requisites of Basic Knowledge, Diagnostic Procedures and Operative Techniques in Neurosurgical Training and Practice ....................................................... 93 Author Index ......................................................................... 97 Opening Ceremony Ninth Convention of the Academia Eurasiana N eurochirurgica Acta Neurochir (1999) [Supp1] 74: 3-4 © Springer-Verlag 1999 Presidential Welcome Address H. August van Alphen Department of Neurosurgery, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands Dear Academicians, Dear Guests, Ladies and hope, that this convention may further intensify this Gentlemen. solidarity and friendship. But the real reason and aim to gather with this It is my great pleasure and honour, indeed, to cor academy is to discuss and to philosophise on serious dially welcome you all to this 9th convention of the matters, and again according to the constitution, to Academia Eurasiana Neurochirurgica, After having strengthen the traditions and ethics of neurological had the meetings in SeouL Copenhagen and Sydney surgery. as from 1992, we are very proud to serve as the Aca The theme and subject of the present scientific demy's host in Europe this time, and to have you with meeting: Neurosurgery and Medical Ethics, per us in this wonderful ambiance of Chateau St Gerlach fectly fits this purpose of the Academia Eurasiana in this most beautiful part of the Netherlands, N eurochirurgica. The original designation of "Academia" referred to Medical practice, and specifically neurosurgical the grove in which Plato's school of philosophy in an practice, is becoming more and more complex. The cient Greece took place and hence to the philosophical technical developments during the last decades, both ambiance itself The academies, founded in Europe in diagnostic and in therapeutic respects, are immense from the fifteenth century onwards, were philosophical and facinating and have brought blessing and happi clubs or communities of like-minded men, devoting ness to many patients. But almost daily, we also ex themselves to the pursuit of learning in an atmosphere perience, that these growing technical opportunities of friendship, leisure, and ease, preferably in a country more and more touch moral boundaries and may house far from the towns. cause great ethical problems. So, it is obvious that through the years the venue of These moral boundaries, however, are not the same the academies always played a prominent role in their for everybody, not even in the same country or in the gatherings. That is, why we searched all over the same hospital, let alone in different countries or differ country to find an appropriate location for this meet ent continents. It is not our intention and it will be even ing of the Academia Eurasiana Neurochirurgica. And impossible to draw up a set of ethical rules for neuro I think, we succeeded in our aim quite well. logical surgery or to aim for a mondial consensus on An appropriate venue will also facilitate the second ethical standards in neurosurgery during this meeting. criterion of the concept of "Academia", which is: to But in this multicultural society, it at least is necessary meet as a congenial group of people, who want to have to be informed of the different views of medical ethics discussions in an atmosphere of friendship, leisure and in different cultures and religions for a good mutual ease, and in this way, as is written in the constitution of understanding and respect. our academy, to promote scientific, academic, social We thought that the Academia meeting would be and cultural exchanges and mutual understanding the ideal setting for exploration, discussion and reflec between neurosurgeons of Asia and Europe. All of tion on the different opinions in this field in Asia and you, who attended earlier conventions, know, that this Europe. During this symposium we will hear about the principle is very much alive in this Academia. I really moral backgrounds of medical ethics from the per- 4 H. August van Alphen: Presidential Welcome Address spective of the most important cultures and religions of of the culture, tradition and the culinary delights of these continents. We will discuss the ethical aspects of this area of The Netherlands. different fields of neurosurgical practice. And we will Dear friends, welcome to Houthem-St. Gerlach, try to find out how we can teach our pupils moral welcome to this Convention of the Academia Eura attitude and ethical behaviour in the best way. siana Neurochirurgica. I really hope, you will meet At the same time, our ladies will have the opportu wisdom and friendship and will enjoy your stay with us nity to explore and reflect on the beauty and the trea during these days. sure of this wonderful estate, the Limburg landscape and city of Maastricht. And for real leisure, a special Correspondence: H. August van Alphen, M.D., Ph.D., Hoger programme has been designed, which will let you taste lustlaan 57, 1191 CL Ouderkerk aId Amstel, The Netherlands.
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