Andreas Frewer

Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany

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Publications (16)3.97 Total impact

  • Leyla Fröhlich-Güzelsoy · Andreas Frewer ·
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    ABSTRACT: Breaking bad news – an interdisciplinary curricular teaching-concept
  • Leyla Fröhlich-Güzelsoy · Inken Emrich · Andreas Frewer ·

    Ethik in der Medizin aus Patientensicht. Perspektivwechsel im Gesundheitswesen, Band 5 edited by Inken Emrich, Leyla Fröhlich-Güzelsoy, Andreas Frewer, 01/2014: pages 13-18; Peter Lang Verlag., ISBN: 978-3-631-65418-7
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    ABSTRACT: In recent years, the rights of patients have assumed a more pivotal role in international discussion. Stricter laws on the protection of patients place greater priority on the perspective and the status of patients. The purpose of this study is to emphasize ethical aspects in communication, the role of patient advocates as contacts for the concerns and suggestions of patients, and how many problems of ethics disappear when communication is highlighted. We reviewed 680 documented cases of consultation in a 10-year period of patient advocates' activity at a big German university hospital with 1,300 beds. On the basis of this extensive material, the article will focus on the intersection of the advocate's work with the problems of patients in hospitals. Deficits in the level of communication between health care professionals and patients were frequently uncovered. Patients primarily complain about the lack of dialogue and empathy. Middle-aged patients consulted the patients' advocate disproportionately more often. Measured against this baseline, the group of 65 and older complained less frequently. Besides complaints the advocate was asked in more than one-third of all cases for information about medical matters, hospital regulations or administrative problems. Patients obviously see the advocate as a well-connected and ideally unbiased contact person for uncertainties concerning their malady or a potential stay in hospital. Those seeking help often set hope in the information given by the voluntary patient representative. It should be highly recommended for every German hospital to establish the position of a patient advocate. Furthermore, patients can profit from regular exchange between the advocate and the Ethics Committee, also, to help ensure that their rights are taken into account and implemented in an ethically desirable context.
    HEC Forum 12/2013; 26(2). DOI:10.1007/s10730-013-9225-1
  • Andreas Frewer ·

    Historia hospitalium 06/2012; 27:105-14.
  • Leyla Fröhlich-Güzelsoy · Andreas Frewer ·
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    ABSTRACT: 1. Einführung Ärztliche Aufklärung über schwierige Krankheiten und ernste Diagnosen, das Mitteilen schlechter Prognosen oder bereits das normale Gespräch mit dem Patienten im klinischen Alltag – überall sind Kompetenzen für das Einfühlen in den Kranken sowie empathische Betreuung des Arztes gefragt und gefordert. Zugleich belegen empirische Studien eine steigende Unzufriedenheit von Patienten mit den behandelnden Ärzten: Kranke bemängeln besonders fehlende Kommunikation und Empathiefähigkeit. Eine Studie der Professur für Ethik in der Medizin der Universität Erlangen-Nürnberg kommt zu einem ähnlichen Ergebnis: Der weit überwiegende Teil der an den Patientenfürsprecher eines Großklinikums herangetragenen Probleme beruht auf unzureichenden Gesprächen, unverständlicher Aufklärung bis hin zu nicht erfolgter Kommunikation und mangelnder Empathie. Fehlende kommunikative Fähigkeiten, schlecht verständliche oder wenig informative Gespräche belasten die Bewertung des Arzt-Patienten-Verhältnisses: „Medizinern“ wird damit einhergehend mangelndes Mitgefühl unterstellt, ist doch Empathie eng mit der Fähigkeit zur adäquaten Interaktion verbunden. Besonders auffällig wird dieses Problem, sobald Patienten eine schwierige Diagnose mitzuteilen ist („Breaking bad news“). Wenn sich der Aufenthalt in der Klinik als ein gravierender und bleibender Einschnitt im Leben herausstellt, ist die Art und Weise, wie dem Patienten einschneidende emotionale Ereignisse mitgeteilt werden, von grundlegender Bedeutung. Das Überbringen einer schlechten Nachricht im Rahmen ärztlicher Kommunikation stellt eine besondere Herausforderung für den Arzt dar. Auch von klinisch erfahrenen Ärzten wird diese Situation als schwierig und emotional belastend bezeichnet. Dies sind die schlechten Nachrichten – aber kann dagegen nicht etwas getan werden, etwa durch neue Formen und Methoden der Ausbildung und innovativen Unterricht? Sind Sprachgefühl und Kommunikationskompetenz mit Simulationspatienten oder in Rollenspielen verbesserbar? Ja, die Fähigkeit zur gelungenen Kommunikation ist trainierbar: International werden zunehmend Lehr- und Fortbildungsveranstaltungen zur Arzt-Patient- Kommunikation angeboten; dies erfordert emotionale Offenheit gegenüber sich selbst und anderen sowie geeignete Lerneinheiten – auch mit Simulationspatienten.
    Medizin, Moral und Gefühl. Emotionen im ethischen Diskurs: JEK5, JEK5 edited by Andreas Frewer, Florian Bruns, Wolfgang Rascher, 01/2012: pages 233-256; Königshausen&Neumann., ISBN: 978-3-8260-5088-6
  • Florian Bruns · Andreas Frewer ·
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    ABSTRACT: There is no doubt that emotions have an important effect on practices of moral reasoning such as clinical ethics consultation. Empathy is not only a basic human emotion but also an important and learnable skill for health care professionals. A basic amount of empathy is essential both in patient care and in clinical ethics consultation. This article debates the "adequate dose" of empathy in ethics consultations in clinical settings and tries to identify possible situations within the process of consultation in which this crucial feeling is at risk.
    HEC Forum 09/2011; 23(4):247-55. DOI:10.1007/s10730-011-9164-7
  • Bernd Friedrich · Florian Bruns · Kristina Raske · Andreas Frewer ·

    09/2011; 1(04):250-257. DOI:10.1055/s-0031-1286603
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    Andreas Frewer · Markus Rothhaar ·

    Medicine Health Care and Philosophy 08/2010; 13(3):247-9. DOI:10.1007/s11019-010-9244-5 · 0.91 Impact Factor
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    Andreas Frewer ·
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    ABSTRACT: The "Universal Declaration of Human Rights" and the "Geneva Declaration" by the World Medical Association, both in 1948, were preceded by the foundation of the United Nations in New York (1945), the World Medical Association in London (1946) and the World Health Organization in Geneva (1948). After the end of World War II the community of nations strove to achieve and sustain their primary goals of peace and security, as well as their basic premise, namely the health of human beings. All these associations were well aware of the crimes by medicine, in particular by the accused Nazi physicians at the Nuremberg Doctors Trial (1946/47, sentence: August 1947). During the first conference of the World Medical Association (September 1947) issues of medical ethics played a major role: and a new document was drafted concerning the values of the medical profession. After the catastrophe of the War and the criminal activities of scientists, the late 1940s saw increased scrutiny paid to fundamental questions of human rights and medical ethics, which are still highly relevant for today's medicine and morality. The article focuses on the development of medical ethics and human rights reflected in the statement of important persons, codes and institutions in the field.
    Medicine Health Care and Philosophy 05/2010; 13(3):259-68. DOI:10.1007/s11019-010-9247-2 · 0.91 Impact Factor
  • Daniel Schäfer · Andreas Frewer ·

    Das Gesundheitswesen 04/2010; 72(4):199-200. · 0.62 Impact Factor
  • Daniel Schaefer · Andreas Frewer ·

    Das Gesundheitswesen 04/2010; 72(4):199-200. · 0.62 Impact Factor
  • Holger Furtmayr · Andreas Frewer ·
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    ABSTRACT: The so-called Istanbul Protocol, a Manual on the Effective Investigation and Documentation of Torture and other Cruel, Inhumane or Degrading Treatment or Punishment was adopted by the United Nations soon after its completion in 1999 and since then has become an acknowledged standard for documenting cases of alleged torture and other forms of severe maltreatment. In 2009 the "Forum for medicine and human rights" at the Medical Faculty at the University Erlangen-Nuremburg has provided the first German edition of this manual. The article traces back the development of the protocol taking into account the general background as well as the factual occasion of its initiation. The main ethical and legal principles of the manual are introduced as well as the projects for implementing the rules provided in the protocol that have been carried out so far. From this the urgent need for implementation of the Istanbul Protocol guidelines also in Europe and in German-speaking countries and here not exclusively but especially within asylum procedures becomes clear.
    Medicine Health Care and Philosophy 04/2010; 13(3):279-86. DOI:10.1007/s11019-010-9248-1 · 0.91 Impact Factor
  • Christian Säfken · Andreas Frewer ·

    HEC Forum 01/2008; 19(4):313-26. DOI:10.1007/s10730-007-9051-4
  • Kurt W Schmidt · Andreas Frewer ·

    HEC Forum 01/2008; 19(4):273-6. DOI:10.1007/s10730-007-9052-3
  • Andreas Frewer · Uwe Fahr ·

    HEC Forum 01/2008; 19(4):277-91. DOI:10.1007/s10730-007-9056-z
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    Markus Rothhaar · Andreas Frewer ·