Jochen Vollmann

• Professor, M.D., Ph.D.
• Ruhr University Bochum

Health technologies such as apps for digital contract tracing [DCT] played a crucial role in containing and combating infections during the COVID-19 pandemic. Their primary function was to prevent the spread of SARS-CoV-2 by consistently generating and disseminating information related to various events such as encounters, vaccinations or infection...

Background Smartphone apps, including those for digital contact tracing (DCT), played a crucial role in containing infections during the COVID-19 pandemic. Their primary function is to generate and disseminate information to disrupt transmissions based on various events, such as encounters, vaccinations, locations, or infections. Although the funct...

Die Klausurwoche wurde gemeinsam mit Expert:innen aus Deutschland sowie der japanischen Kiyoto University und der Teikyo University durchgeführt. Aufgrund der Zeitverschiebung und der pandemischen Kontaktbeschränkung wurde ein voll-ständiges Onlineformat entwickelt. Dabei wurde eine zentrale Webplattform mit unterschiedlichen Kommunikationsangebote...

Bislang ist nur wenig zum Thema DSD/Intersexualität und Schwangerschaft bekannt, während die Behandlungsgeschichten von Menschen mit einer Variante der Geschlechtsentwicklung (Intersexualität/DSD) in Wissenschaft und Öffentlichkeit intensiv diskutiert werden. Ziel dieser Studie ist es, im Rahmen eines Systematic Reviews einen Überblick über den akt...

Bislang ist nur wenig zum Thema DSD/Intersexualität und Schwangerschaft bekannt, während die Behandlungsgeschichten von Menschen mit einer Variante der Geschlechtsentwicklung (Intersexualität/DSD) in Wissenschaft und Öffentlichkeit intensiv diskutiert werden. Ziel dieser Studie ist es, im Rahmen eines Systematic Reviews einen Überblick über den akt...

Bislang ist nur wenig zum Thema DSD/Intersexualität und Schwangerschaft bekannt, während die Behandlungsgeschichten von Menschen mit einer Variante der Geschlechtsentwicklung (Intersexualität/DSD) in Wissenschaft und Öffentlichkeit intensiv diskutiert werden. Ziel dieser Studie ist es, im Rahmen eines Systematic Reviews einen Überblick über den akt...

Krisen erschüttern die Routinen des gesellschaftlichen Zusammenlebens. Zugleich offenbaren sie, wie Gesellschaften funktionieren, zu welchen Anpassungsleistungen sie fähig sind und über welche Ressourcen sie verfügen. Die Coronakrise hat gezeigt, wie moderne Gesellschaften auf Gesundheitskrisen reagieren und zur Bewältigung mannigfaltige Technologi...

Background: Ethics consultation has been advocated as a valuable tool in ethically challenging clinical situations in healthcare. It is paramount for the development and implementation of clinical ethics support services (CESS) in psychiatry that interventions can address the moral needs of mental health professionals adequately and communicate the...

The COVID-19 pandemic poses significant challenges in psychiatric hospitals, particularly in the context of the treatment of people under involuntary commitment. The question arises at various points in the procedure for and process of involuntary commitment whether procedural modifications or further restrictive measures are necessary to minimise...

With increasing urgency, decisions about the digitalized future of healthcare and implementations of new assistive technologies are becoming focal points of societal and scientific debates and addresses large audiences. Decisions require a careful weighing of risks and benefits and contextualizing in-depth ethical analysis with robust empirical dat...

Background Clinical ethics support services (CESS) are increasingly advocated in psychiatry. One of their core elements is professional ethical expertise, that is, to be able to identify, analyze or contrib-ute to solutions of ethical issues more accurate than others. However, concepts of expertise are manifold and often vague. This study explores...

As most of you know, Clinicial ethics consultations services have been advocated in recent years as a valuable tool in difficult treatment situations and is now widely implemented. It is often suggested, however, that especially in psychiatry the situation and development might be somewhat different, due to differing settings and treatment practice...

Background: Treating legally committed patients on open, instead of locked wards is controversially discussed and the affected stakeholders (patients, mental health professionals) have ambiguous views on the benefits and disadvantages. The study aims to assess the opinions and values of relevant stakeholders with regard to the requirements for imp...

Background Recommending the optimal treatment for an individual patient requires a well-balanced consideration of various medical, social and ethical factors. The interplay of these factors, interpretation of the patient’s situation and understanding of the existing clinical guidelines can lead to divergent therapy recommendations, depending on the...

Background Personalized medicine (PM) and related concepts have dominated the scientific debates in oncology in recent years. This paper focuses on the relevance of PM-related challenges in research and clinical practice from an empirical ethical perspective. Objective The aim was an empirically informed ethical reflection on challenges related to...

Hintergrund: Ethische Fragen am Lebensende stehen im Mittelpunkt wissenschaftlicher und gesellschaftlicher Diskussionen. Bislang liegen wenige empirische Daten zur ärztlichen Handlungspraxis am Lebensende von Ärzten in Deutschland vor. Methoden: Querschnittsuntersuchung unter zufällig ausgewählten Ärzten in Deutschland unter Verwendung des Fragebog...

Definition of the problem In the current ethical debate on physician-assisted suicide in Germany new sanctions in criminal law are debated from different sides. Whereas in the beginning the debate focused only on the ban of organised forms of suicide assistance, the explicit licensing of assisted suicide is also now requested by physicians. Argumen...

Background Appropriate information and consent has been one of the most intensely discussed topics within the context of biobank research. In parallel to the normative debate, many socio-empirical studies have been conducted to gather experiences, preferences and views of patients, healthy research participants and further stakeholders. However, th...

Survey research indicates that decisions about the provision and limitation of treatment near the end of life in patients with cancer vary considerably. The study objectives were to review the evidence on variables associated with explicit decisions about limitation of treatment in patients with cancer and to critically appraise the factors from a...

Medizinethische Forschung wird häufig unter Verwendung sozialempirischer Methoden durchgeführt. Insbesondere die Anwendung von Methoden der qualitativen Sozialforschung hat eine breite Akzeptanz gefunden. Nach Kenntnis der Autoren fehlen allerdings bislang Untersuchungen, die den spezifischen Beitrag qualitativer Sozialforschung für medizinethische...

Background: Empirical-ethical research constitutes a relatively new field which integrates socio-empirical research and normative analysis. As direct inferences from descriptive data to normative conclusions are problematic, an ethical framework is needed to determine the relevance of the empirical data for normative argument. While issues of norm...

Even among advocates of legalising physician-assisted death, many argue that this should be done only once palliative care has become widely available. Meanwhile, according to them, physician-assisted death should be banned. Four arguments are often presented to support this claim, which we call the argument of lack of autonomy, the argument of exi...

“Personalised medicine” is currently attracting considerable attention and raising high hopes and expectations in modern medicine. The term “personalised medicine” denotes the use of genetic or other biomarker information it does not focus on a more personal patient-doctor relationship. Furthermore, personalised medicine is associated with...

In the current public debate on physician-assisted suicide it is argued that medical assistance in the suicide of a patient contravenes the tasks and aims of suicide prevention and therefore should be rejected. In an ethical analysis we first point out the normatively relevant differences between the cases of suicides of patients with severe mental...

In recent times, the phrase ̀personalised mediciné has become the symbol of medical progress and a label for better health care in the future. However, a controversial debate has developed around whether these promises of better, more personal and more cost–efficient medicine are realistic. This book brings together leading researchers from across...

Zusammenfassung In der aktuellen gesellschaftlichen Debatte um die ärztlich assistierte Selbsttötung wird das Argument vorgebracht, dass die ärztliche Unterstützung bei der Selbsttötung eines Patienten den Aufgaben und Zielen der Suizidprävention zuwiderlaufe und daher abzulehnen sei. In einer ethischen Analyse werden zunächst die normativ relevant...

Background: Ethical questions at the end of life are at the centre of scientific and public debates. Up to the present there is scarcity of empirical data regarding physicians' end-of-life practices in Germany. Methods: Cross-sectional study among a random sample of German physicians by means of the questionnaire of the EURELD Consortium with addit...

Across normative and empirical disciplines, considerable attention has been devoted to the prevalence and ethics of the non-medical use of prescription and illegal stimulants for neuroenhancement among students. A predominant assumption is that neuroenhancement is prevalent, in demand, and calls for appropriate policy action. In this paper, we pres...

Physician-assisted suicide (PAS), which is currently the subject of intense and controversial discussion in medical ethics, is barely discussed in psychiatry, albeit there are already dementia patients in Germany and other European countries who end their own lives with the assistance of physicians. Based on the finding that patients who ask for me...

The evolving vision for personalized medicine (PM) implies a systems approach to the re-organization of healthcare and how we define the boundary between care and research. Calls for scaling PM up to a systems level requires a broad definition of quality not restricted to how the different elements of the system perform (e.g., laboratory quality co...

Background: Decision making in oncology poses intricate ethical questions because treatment decisions should account not only for evidence-based standards but also for the patient's individual values and preferences. However, there is a scarcity of empirical knowledge about patient involvement in oncological decision making. Methods: Direct, non...

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 stakeholde...

The new compensation system for psychiatric and psychosomatic institutions (German acronym: PEPP) not only constitutes a change in billing practices, but also necessitates an ethical investigation and analysis of possible consequences of the new legislation for those affected in practice. Following the presentation of the new PEPP and its consequen...

The interdisciplinary Hannover Qualification Programme on ethics consultation has trained hospital staff to operate clinical ethics services in their respective hospitals since 2003. To evaluate Hannover Qualification Programme, all former participants were contacted using an online questionnaire including four domains: status quo before attending...

Die sogenannte „personalisierte Medizin“ hat in den vergangenen Jahren große Hoffnungen bei Forschungsinstitutionen, Patienten, Leistungserbringern und auch in der Politik geweckt. In der wissenschaftlichen und gesellschaftlichen Diskussion werden mit dem Begriff unterschiedliche Interventionen bezeichnet. Gemeinsam ist den verschiedenen Ansätzen,...

Die öffentliche Diskussion um die „personalisierte Medizin“ legt nahe, dass mit diesem medizinischen Ansatz hohe Erwartungen an einen Beitrag zur klinischen Versorgung verbunden werden. Über die Wahrnehmungen und Bewertungen klinisch tätiger Ärzte ist jedoch wenig bekannt. Die vorliegende qualitative Interviewstudie gibt einen Einblick bezüglich de...

Forschungs- und Therapieansätze einer „personalisierten Medizin“ erhalten gegenwärtig große Aufmerksamkeit und Förderung in Forschung, Wirtschaft und Politik und erwecken große Hoffnungen. Auf der Grundlage molekulargenetischer Biomarker soll ein zielgerichtetes, stratifiziertes Vorgehen im Bereich der Prävention, Diagnostik und Therapie erreicht w...

The new legal regulations of compulsory treatment in Germany require a change in clinical psychiatric practice as well as an ethical analysis of the consequences for those involved. The new legal regulations are reported and via ethical analysis new problematic fields, such as consequences of the new law are identified and discussed in the context...

For many years there has been a controversial international debate on physician-assisted suicide (PAS). While proponents of PAS regularly refer to the unbearable suffering and the right of self-determination of incurably ill patients, critics often warn about the diverse risks of abuse. In our article, we aim to present ethical arguments for and ag...

The work of clinical ethics committees and clinical ethics consultation begins with implementing these new ethics structures in hospitals and other health care institutions. Compared with the introduction of other innovations in the hospital setting, implementing clinical ethics consultation tends to be more difficult. The article is based on inter...

Background: Information about diagnosis, treatment options and prognosis has been emphasized as a key to empower cancer patients to make treatment decisions reflecting their values. However, surveys indicate that patients' preferences regarding information and treatment decision-making differ. In this qualitative interview study, we explored pancr...

Empirical studies on people's moral attitudes regarding ethically challenging topics contribute greatly to research in medical ethics. However, it is not always clear in which ways this research adds to medical ethics as a normative discipline. In this article, we aim to provide a systematic account of the different ways in which attitudinal resear...

Background: Surveys indicate considerable variation regarding the provision of cancer treatment at the end of life. The variation cannot be fully explained by differences concerning the clinical situation or patients' preferences. The aim of this qualitative study was to explore medical oncologists' experiences with advanced cancer, as well as the...

Zusammenfassung Diverging positions can be identified in applied ethics with regard to the justification, nature and application of ethical principles. In this article we will discuss the preconditions for establishing a relation between general principles and the particular situation which is to be evaluated in ethical judgment. The functioning of...

Die Aufklärung und Einwilligung von Patienten in der Psychiatrie gilt heute als allgemein akzeptierter rechtlicher und ethischer Standard. In der Praxis stößt das Konzept jedoch an Grenzen, wenn Patienten aufgrund ihrer psychischen Störung die Einwilligungsfähigkeit verlieren. Die Feststellung der Einwilligungsfähigkeit zur medizinischen Behandlung...

The methodology of medical ethics during the last few decades has shifted from a predominant use of normative-philosophical analyses to an increasing involvement of empirical methods. The articles which have been published in the course of this so-called 'empirical turn' can be divided into conceptual accounts of empirical-normative collaboration a...

Der Fall einer Sedierung und Begrenzung künstlicher Ernährung bei einem Patienten mit Hypopharynxkarzinom und schizoaffektiver Psychose birgt eine Vielzahl medizinischer und ethischer Herausforderungen. Dieser Kommentar fokussiert im ersten Teil auf die Selbstbestimmungsfähigkeit (rechtlich: Einwilligungsfähigkeit) des Patienten zu unterschiedliche...

Since 1 September 2009, advance directives are regulated by law in Germany. This article discusses ethical challenges of advance directives in patients with mental disorders. Besides concrete information on the preferred medical treatment in concrete clinical situations, the mental capacity of the patient at the time of issuing the directive is ess...

Research on the teaching experiences and knowledge of medical students on end-of-life decisions in medicine is important because it provides information on the competency of future doctors with respect to an important field of clinical practice and can support the development of a curriculum. A multiple-choice and free-text survey on the teaching e...

In 2009, the 6th edition of Principles of biomedical ethics was published.1 Undeniably, the book is one of the most prominent and important works in biomedical ethics. When Tom L Beauchamp and James F Childress published the first edition 30 years ago,2 the field was still in a nascent state, full of hot topics but poor in method. It was, as K Dann...

The objective of this study was to investigate the views of patients and experts in Germany on information provision and decision-making in assisted reproduction treatment (ART). Standard questionnaire techniques were used for interviewing Reproductive Physicians (n= 230), Psychosocial Counsellors (n = 66) and Patients (n = 1590). Descriptive data...

To investigate changes of different domains of breaking bad news (bbn) competences after a teaching module for medical students, and to collage the results generated by different approaches of evaluation. Rating of medical student-SP interactions by means of a global rating scale and a detailed checklist used by SPs and independent raters. Students...

Buiting and colleagues’ study suggests that medical oncologists’ treatment decisions in end stage cancer are based mostly on rational considerations regarding (side) effects.1 This contrasts with the findings of our qualitative interview study …

Einführung In Deutschland liegen vergleichsweise wenige Daten zu ethischen und klinischen Kennzeichen der ärztlichen Handlungspraxis am Lebensende vor. In diesem Beitrag werden ausgewählte Ergebnisse einer Umfrage unter ärztlichen Mitgliedern der Deutschen Gesellschaft für Palliativmedizin (DGP) zusammengefasst. Methodik Schriftliche Querschnittsun...

Background and research question: Discussions with seriously ill patients are part of physicians' tasks. These discussions are very demanding with respect to communication skills. In this paper we present the concept of an obligatory postgraduate course for physicians on breaking bad news and the results of the course evaluation. Research partici...

Co-payments to the extent of 50% of the costs of assisted reproductive techniques (ART) have applied to members of the German statutory health insurances since 2004. This regulation led to a significant decrease in demand for ART. Court decisions confirmed that this is in accordance with German constitutional law. However, there is an ongoing publi...

To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Cross-sectional postal survey. Data collection via the secretary of the German Society for Palliativ...

Background: Costs for medical care and strategies to handle limited resources in health care are discussed in many European countries. Few empirical studies explore the oncologists' perceptions and views regarding economical aspects in clinical practice. Research participants and methods: Semi-structured interviews with physicians working in onc...

Costs for medical care and strategies to handle limited resources in health care are discussed in many European countries. Few empirical studies explore the oncologists' perceptions and views regarding economical aspects in clinical practice. RESEARCH PARTICIPANTS AND METHODS: Semi-structured interviews with physicians working in oncology in German...

To elicit types and frequencies of end-of-life practices by physician members of the German Society for Palliative Medicine. To analyse associations between characteristics of physicians and patients and end-of-life practices with intended hastening of death. Cross-sectional postal survey. Types and frequencies of end-of-life practices with foresee...

The Hannover qualifying programme 'ethics consultation in hospitals', conducted by a four-institution cooperation partnership, is an interdisciplinary, scientifically based programme for healthcare professionals interested in ethics consultation services and is widely acknowledged by hospital managements and healthcare professionals. It is unique c...

Background and research question: Physicians' decisions regarding the indication of medical treatment are central to the application or limitation of medical measures in advanced cancer. This qualitative study explores criteria and procedural aspects of treatment decisions with patients with cancer near the end of life from the perspective of onco...

Clinical ethics committees and ethics consultation are new ways to institutionalize ethics in medicine and healthcare. Over the last decade ethics consultation has undergone a rapid development in many European countries. This article provides an overview of this development with a special focus on the field of psychiatry. Clinical ethics consultat...

Introduction: This paper reports from a multidisciplinary, ethnographic study exploring the views, values and practices (the ethical frameworks) drawn on by professional staff in assisted conception units and stem cell laboratories in relation to embryo donation for human embryonic stem cell (hESC) research in the UK. The continued widespread supp...

Financing ART is variously regulated in the different countries of Europe. In Germany, coverage of assisted reproduction by statutory health insurances was restricted to 50% in 2004. We conducted a national survey among patients, professionals (physicians and other academics in IVF centres, psychosocial counsellors, medical ethicists, social lawyer...

This volume brings together researchers from different European countries and disciplines who are involved in Clinical Ethics Consultation (CEC). The work provides an analysis of the theories and methods underlying CEC as well a discussion of practical issues regarding the implementation and evaluation of CEC. The first section deals with different...

Background The right of patients to decide autonomously about their treatment is gaining increasing importance in radiooncology. Associated with this is the discussion about advance directives, which are used infrequently in the clinical setting despite their general acceptance. This qualitative study intended to analyse the attitudes of patients,...

Definition of the problem The contribution of empirical research to medical ethics is part of the current interdisciplinary debate on methods in medical ethics. In contrast to the numerous empirical studies which have been published in medical ethics journals there is scarcity of literature which reflects on methodical challenges of empirical resea...

The four-principle approach to biomedical ethics is used worldwide by practitioners and researchers alike but it is rather unclear what exactly people do when they apply this approach. Ranking, specification, and balancing vary greatly among different people regarding a particular case. Thus, a sound and coherent applicability of principlism seems...

To elicit the perceptions and preferences of patients with rheumatoid arthritis regarding information and participation in treatment decision-making. To analyse the patients' narratives on the background of the ethical discourse on various approaches to treatment decision-making. In-depth interviews with themes identified using principles of ground...

This article provides a review on health care ethics committees and clinical ethics consultation in Germany. After a definition of these new institutions in the German health care system, detailed information on development, structures, implementation process and tasks of health care committees is provided. The three main tasks of health care ethic...

Der vorliegende Beitrag informiert über Klinische Ethikkomitees und klinische Ethikberatung als neue Einrichtungen im deutschen Gesundheitswesen. Nach einer Begriffsbestimmung und Abgrenzung von (Forschungs-)Ethikkommissionen werden Entwicklung, Strukturen, Implementierungsprozess und Aufgaben von Klinischen Ethikkomitees dargestellt. Die 3 Hauptau...