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  • 2011

  • Chan, Sarah; Harris, John (2011): Moral enhancement and pro-social behaviour. In: Journal of medical ethics 37 (3), S. 130-131. DOI: 10.1136/jme.2010.041434

    DOI: http://www.ncbi.nlm.nih.gov/pubmed/21325675 

    Abstract: Moral enhancement is a topic that has sparked much current interest in the world of bioethics. The possibility of making people ‘better,’ not just in the conventional enhancement sense of improving health and other desirable (and desired) qualities and capacities, but by making them somehow more moral, more decent, altogether better people, has attracted attention from both advocates1 2 and sceptics3 alike. The concept of moral enhancement, however, is fraught with difficult questions, theoretical and practical. What does it actually mean to be ‘more moral’? How would moral enhancement be defined and would it necessarily, as some have claimed, make the world a better or safer place? How would or could such enhancement be achieved safely and without undue constraint on personal liberty and autonomy? On this subject, a recent paper by Crockett et al4 investigating the effects of the neurotransmitter serotonin on moral decisionmaking provides an intriguing scientific basis for examining what might or might not constitute moral enhancement. The study involved treatment with citalopram, a drug that increases the action of serotonin in the brain, and subsequent analysis of participants' decisionmaking behaviour in two different situations involving moral dilemmas: the well known ‘Trolley Problem’5 and the ‘Ultimatum Game’.6 The researchers found that citalopram promoted what they call ‘prosocial behaviour’, increasing the participants' aversion to causing direct harm to others: in the first scenario, they were less likely to select the option that required killing one in order to save five, and in the secod, less likely to reject unfair offers at the expense of others.

    Keywords: Bioethics,, chemisch / neurologisch / medikamentös / durch Substanzen, Disziplin, entscheiden, Humans, Moral, moral enhancement, moralische Dimension, Moralphilosophie, Morals, Philosophie, pro-social behaviour, Prosocial Behaviour, Serotonin, Serotonin/physiology, Social Behavior, Spieltheorie, Status / biologische Marker

  • 2010

  • Novella, Enric J. (2010): Mental health care and the politics of inclusion. A social systems account of psychiatric deinstitutionalization. In: Theoretical medicine and bioethics 31 (6), S. 411-427. DOI: 10.1007/s11017-010-9155-8

    DOI: http://www.ncbi.nlm.nih.gov/pubmed/20711755 

    Abstract: This paper provides an interpretation, based on the social systems theory of German sociologist Niklas Luhmann, of the recent paradigmatic shift of mental health care from an asylum-based model to a community-oriented network of services. The observed shift is described as the development of psychiatry as a function system of modern society and whose operative goal has moved from the medical and social management of a lower and marginalized group to the specialized medical and psychological care of the whole population. From this theoretical viewpoint, the wider deployment of the modern social order as a functionally differentiated system may be considered to be a consistent driving force for this process; it has made asylum psychiatry overly incompatible with prevailing social values (particularly with the normative and regulative principle of inclusion of all individuals in the different functional spheres of society and with the common patterns of participation in modern function systems) and has, in turn, required the availability of psychiatric care for a growing number of individuals. After presenting this account, some major challenges for the future of mental health care provision, such as the overburdening of services or the overt exclusion of a significant group of potential users, are identified and briefly discussed.

    Keywords: Bioethics,, Community Mental Health Services/organization & administration, Deinstitutionalization, Diskriminierung, Ethik, Fehlverhalten, Gesellschaftsprofit, Health Services Accessibility, Hospitals, Psychiatric, Humans, Medizin, Mental Disorders, Mental Health, Pathologie, Patient Care Team, Pflege, Politics, Psychiatry/trends, social systems, ethics, Social Values, Soziale Ordnung, Spain, systems theory, Werte
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