Heiner Fangerau

The aim of regenerative medicine is to reconstruct tissue that has been lost or pathologically altered. Therapeutic cloning seems to offer a method of achieving this aim; however, the ethical debate surrounding human therapeutic cloning is highly controversial. Artificial parthenogenesis—obtaining embryos from unfertilised eggs—seems to offer a way to sidestep these ethical pitfalls. Jacques Loeb , the founding father of artificial parthogenesis, faced negative public opinion when he published his research in 1899. His research, the public’s response to his findings, and his ethical foundations serve as an historical argument both for the communication of science and compromise in biological research

Die Schweigepflicht, einer der Grundpfeiler medizinischer Ethik, spielt in der aktuellen Diskussion um die Verbesserung des Kinderschutzes eine zentrale Rolle. Unklare und mehrdeutige gesetzliche Regelungen und Handlungsanweisungen, wie mit Anhaltspunkten für eine Kindeswohlgefährdung umzugehen ist, wenn die Sorgeberechtigten eine weitergehende Hilfe ablehnen, werden als Hindernis für einen wirksamen Kinderschutz betrachtet. Aus der schwer durchschaubaren Rechtslage resultieren für Angehörige der Gesundheitsberufe regelmäßig Handlungsunsicherheiten, die im Einzelfall notwendige Hilfe verzögern oder gar verhindern könnten. Neue Gesetze auf Länderebene haben deshalb im Sinne eines verbesserten Kinderschutzes eine Erhöhung der Rechtssicherheit sowie eine Förderung der Vernetzung der beteiligten Akteure zum Ziel. Wenn auch einigen der Gesetze ein gewisses Klarstellungspotenzial zugebilligt werden kann, ist doch im Augenblick ihr Beitrag zu mehr Rechtssicherheit im Umgang mit Kinderschutzfällen noch als sehr eingeschränkt zu betrachten. Ein Bundesgesetz, welches die Intention hatte, die heterogenen Landesnormen durch eine bundeseinheitliche Regelung zu ersetzen, ist wenigstens in der letzten Legislaturperiode gescheitert

The German–American physiologist Jacques Loeb (1859–1924) and the Polish embryologist Emil Godlewski, jr. (1875–1944) contributed many valuable works to the body of developmental biology. Jacques Loeb was world famous at the beginning of the twentieth century for his development and demonstration of artificial parthenogenesis in 1899 and his experiments on regeneration. He served as a role model for the younger Polish experimenter Emil Godlewski, who began his career as a researcher like Loeb at the Zoological Station in Naples. Following Godlewski’s first visit to Naples in 1901 a close relationship between the two scientists developed. Until Loeb’s death in 1924 the two exchanged ideas via correspondence that was only interrupted during the First World War. The aim of the paper is to examine the transatlantic transfer of knowledge in the field of biological experimentation that was fostered by these two protagonists. Using a modification of Bruno Latour’s model of the ‘Circulatory System of Science’ as a heuristic tool, different mechanisms of scientific exchange are displayed. With the help of Loeb’s and Godlewski’s correspondence the role of scientific communities, methods, allies, the public and institutions in the process of knowledge transfer are analysed. Preconditions for success and failure in transferring science are examined.

In a critical review of late twentieth-century gene-culture co-evolutionary models labelled as ‘global phylogeny’, the authors present evidence for the long legacy of co-evolutionary theories in European-based thinking, highlighting that (1) ideas of social and cultural evolution preceded the idea of biological evolution, (2) linguistics played a dominant role in the formation of a unified theory of human co-evolution, and (3) that co-evolutionary thinking was only possible due to perpetuated and renewed transdisciplinary reticulations between scholars of different disciplines—especially within the integrative framework of the ‘humanid’ and the ‘hominid’ branches of anthropology.

The efforts of the European Commission to create a European Research Area in the field of biotechnology are accompanied by a growing demand for an ethical discourse. Cultural differences between the European Union's member states create a vital need to improve bioethical information structures in Europe so as to foster European bioethics discourses and to cope with ethical pluralism. Responding to the need for an increased European contribution to the international discussion on ethics in medicine and biotechnology, some of Europe's leading bioethics institutions have joined forces to establish the international network EURETHNET . 18 partners from nine European countries agreed to develop an information network and knowledge base in the field of ethics in medicine and biotechnology. This short communication displays the aims, scope and realisation of the network

Objectives: In this study the author aimed to provide information for researchers to help them with the selection of suitable databases for finding medical ethics literature. The quantity of medical ethical literature that is indexed in different existing electronic bibliographies was ascertained. Method: Using the international journal index Ulrich’s Periodicals Directory, journals on medical ethics were identified. The electronic bibliographies indexing these journals were analysed. In an additional analysis documentalists indexing bioethical literature were asked to name European journals on medical ethics. The bibliographies indexing these journals were examined. Results: Of 290 journals on medical ethics 173 were indexed in at least one bibliography. Current Contents showed the highest coverage with 66 (22.8%) journals indexed followed by MEDLINE (22.1%). By a combined search in the top ten bibliographies with the highest coverage, a maximum coverage of 45.2% of all journals could be reached. All the bibliographies showed a tendency to index more North American than European literature. This result was verified by the supplementary analysis of a sample of continental European journals. Here EMBASE covered the highest number of journals (20.6%) followed by the Russian Academy of Sciences Bibliographies (19.2%). Conclusion: A medical ethics literature search has to be carried out in several databases in order to reach an adequate collection of literature. The databases one wishes to combine should be carefully chosen. There seems to be a regional bias in the most popular databases, favouring North American periodicals compared with European literature on medical ethics.

ZusammenfassungDie Schweigepflicht, einer der Grundpfeiler medizinischer Ethik, spielt in der aktuellen Diskussion um die Verbesserung des Kinderschutzes eine zentrale Rolle. Unklare und mehrdeutige gesetzliche Regelungen und Handlungsanweisungen, wie mit Anhaltspunkten für eine Kindeswohlgefährdung umzugehen ist, wenn die Sorgeberechtigten eine weitergehende Hilfe ablehnen, werden als Hindernis für einen wirksamen Kinderschutz betrachtet. Aus der schwer durchschaubaren Rechtslage resultieren für Angehörige der Gesundheitsberufe regelmäßig Handlungsunsicherheiten, die im Einzelfall notwendige Hilfe verzögern oder gar verhindern könnten. Neue Gesetze auf Länderebene haben deshalb im Sinne eines verbesserten Kinderschutzes eine Erhöhung der Rechtssicherheit sowie eine Förderung der Vernetzung der beteiligten Akteure zum Ziel. Wenn auch einigen der Gesetze ein gewisses Klarstellungspotenzial zugebilligt werden kann, ist doch im Augenblick ihr Beitrag zu mehr Rechtssicherheit im Umgang mit Kinderschutzfällen noch als sehr eingeschränkt zu betrachten. Ein Bundesgesetz, welches die Intention hatte, die heterogenen Landesnormen durch eine bundeseinheitliche Regelung zu ersetzen, ist wenigstens in der letzten Legislaturperiode gescheitert.

Das Altern ist nicht nur eine biologische, sondern auch eine kulturelle Tatsache. Als Objekt der Verhandlungen zwischen Wissensdiskursen erscheint Alter als ein ebenso heterogenes wie problematisches Phanomen, das von Werturteilen und Weltanschauungen bestimmt wird. Des Weiteren sind Alter und Medizin in der offentlichen Meinung moderner Gesellschaften eng miteinander verbunden. Das interdisziplinare Forschungsprojekt "Kulturelle Variationen und Reprasentationen des Alters" geht von einem erweiterten, die geistes-, sozial- und medizinwissenschaftlichen Diskurse integrierenden Konzept von Alterskulturen und Potentialen des Alters aus. Dies bedeutet, Alter als Gegenstand des Wissens und als Konzept zu begreifen. Alterskonzepte, das heisst Vorstellungen, Wertungen und, Bilder des Alters, sind Deutungsmuster fur elementare Bedurfnisse an der Schnittstelle von individuellem und kollektivem Leben. Mit Beitragen von David Blane und Gopalakrishnan Netuveli, Johannes Siegrist und Morten Wahrendorf, Peter Rusterholz, Anouk Janssen, Hiltrud Westermann-Angerhausen, Stefanie Knoll, Jean-Claude Schmitt, Gerd Gockenjan, Giovanna Pinna, Hans-Georg Pott, Monika Gomille, Miriam Seidler, Pat Thane, Simone Moses, Heiner Fangerau und Jorg Vogele, Anja Schonlau, Thomas Kupper"

The value of life can be viewed from moral, biologic, and economic perspectives. In connection with the development of genetics, each of these perspectives has gained importance throughout history. Whereas agricultural genetics has always been directed towards having an economic impact, from the beginning genetics research in humans has focused on all dimensions of the value of life. Today, health insurance, employers, politicians, and public health scientists view genetics research as one of the key disciplines to predict costs and economic values of human beings. However, the reasoning cannot go without considering biologic health risks and moral values to the same extent. This paper examines the historical dimensions of current debates surrounding genetics and the value of life. Thus, the paper is conceptual and offers a heuristic model and analytical categories for answering the question, “what is so intriguing about genetics that it can be closely connected with different value concepts,” although the consideration of the moral, biologic, or economic value of life may lead to completely different ideas of man and society. A special emphasis will be placed on the use of genetics for the purposes of the eugenics movement. During the heyday of eugenics, the economic value of life changed the understanding of the moral value, as well as the biologic value of life by referring to genetic principles. It will be argued that an intended intertwinement of the different dimensions of the concept of “value” on the one hand increased the impact of genetics as a key discipline of the eugenics movement, and on the other hand had a lasting impact on debates about the economic usefulness of genetics as a predictive, prophylactic medical discipline

Im diachronen Vergleich kann über die Epochen hinweg eine Verschiebung der Gewichtung einzelner Aspekte von Optimierung, Selbstverbesserung oder der Idee eines ‚guten Lebens‘ identifiziert werden. Die analytischen Überlegungen zum Neuro- Enhancement machen deutlich, dass aufklärerische Ideale heute noch wirkmächtig bleiben. Vor allem zum Neuro-Enhancement analoge Leitmotive lassen sich - so die These des Beitrags - in den philanthropischen Theorien der Spätaufklärung finden. Und auch die dort angelegten Widersprüche und Ambivalenzen wirken in die heutigen Diskurse um das Neuro-Enhancement. Ziel dieses Beitrags ist es, den Versuch zu unternehmen, die historischen Ideale eines ‚perfekten Menschen‘ zur heutigen Enhancement-Situation anschlussfähig zu machen.

“Prizeworthy Research?” Wilhelm Roux and His Program of Developmental Mechanics. The Nobel Prize in physiology or medicine is awarded annually to a maximum of three laureates. Not surprisingly, the number of nominees is much larger. Drawing on Nobel Prize nominations in the Nobel archives in Sweden, the core of this paper deals with the nomination letters for the physiologist Wilhelm Roux to discuss competition and some controversies among German physiologists around 1900 in this particular context. The paper elucidates the arguments brought forward to portray Roux as a scientist who had conferred “the greatest benefit to mankind” in the field of physiology or medicine ; examines some other runners-up, and reconstructs why Roux as well as some of his peers were not awarded the Nobel Prize. On a more general level, we argue that an analysis of Nobel Prize nominations contributes to a broader history of excellence in science and medicine in the twentieth century.

In a critical review of late twentieth-century gene-culture co-evolutionary models labelled as ‘global phylogeny’, the authors present evidence for the long legacy of co-evolutionary theories in European-based thinking, highlighting that (1) ideas of social and cultural evolution preceded the idea of biological evolution, (2) linguistics played a dominant role in the formation of a unified theory of human co-evolution, and (3) that co-evolutionary thinking was only possible due to perpetuated and renewed transdisciplinary reticulations between scholars of different disciplines—especially within the integrative framework of the ‘humanid’ and the ‘hominid’ branches of anthropology.

The scope and mission of the history of science have been constant objects of reflection and debate within the profession. Recently, Lorraine Daston has called for a shift of focus: from the history of science to the history of knowledge. Such a move is an attempt at broadening the field and ridding it of the contradictions deriving from its modernist myth of origin and principle of demarcation. Taking the move from a pluralistic concept of medicine, the present paper explores the actual and possible contributions that a history of knowledge can offer to the history of medicine in particular. As we will argue, the history of medicine has always been a history of knowledge, but for good reasons has always stuck to the concept of medicine as its object and problem throughout the ages, including the modern, scientific one. We argue that, in the history of medicine, the demarcation between scientific and non‐scientific represents an accident, but is not foundational as in the case of natural science. Furthermore, the history of medicine programmatically played a role in at least two academic domains (history proper and medical education), adjusting historical narratives of medical knowledge to its audience. Accordingly, we underscore that the history of both science and medicine, as traditionally defined, already provides room for almost the whole spectrum of approaches to history. Moreover, their different myths of origin can, and indeed must, be included in the reflexivity of the historical gaze. We argue that the position towards a history of science, medicine, or knowledge is not a question of narrative or theory, rather, it is a question of relevance and awareness of extant contexts.

During the nineteenth century physiologists and clinicians developed several graphical recording systems for the mechanical registration of heart sounds. However, none of these replaced traditional methods of auscultation. The paper describes criticism of the aural sense as one of the driving forces behind the development of phonocardiography and analyses its variants from a technological and clinical perspective. Against the background of the physiological “method of curves,” the parameters that prevented the implementation of phonocardiography against overwhelming odds are highlighted. Contemporaries denied specific evidence beyond auscultation. Many clinicians also feared that the art of auscultation was being undermined by the new, reproducible mechanical methods. The paper argues that phonocardiography was on the one hand regarded as impractical in clinical settings; on the other hand—and even more important—implicit practices, tacit knowledge and cultural models fostered skepticism against the new method. The argument of “self-evidence”—often connected to medical images, curves, graphs or tables—was not valid for the visualization of cardiac sounds in the opinion of the promoters of acoustic heart sound registration and its individual interpretation. Rather, the acts of subjective hearing and objectively reporting what was heard seemed “self-evident” for pathophysiological characteristics and the development of a diagnosis. Therefore, auscultation and phonocardiography coexisted with different emphases. While auscultation remained the method of choice for a bedside diagnosis, phonocardiography played its role in differential diagnostics or research settings.

Shortly after bacteriologist Paul de Kruif had been dismissed from a research position at the Rockefeller Institute for Medical Research, he started contributing to a novel in collaboration with the future Nobel laureate Sinclair Lewis. The novel, Arrowsmith, would become one of the most famous satires on medicine and science. Using de Kruif’s correspondence with his idol Jacques Loeb, this paper describes the many ways in which medical science is depicted in Arrowsmith. This article compares the novel with de Kruif’s and Loeb’s biographies, and focuses on the struggles of the main character, Martin Arrowsmith, as an allegory of the institutionalisation of medical research in the US, shows that Sinclair’s purpose is to caricaturise scientific work in modern medical research institutions anywhere and shows that the novel depicts a reductionist philosophy of research that seems to contradict the “messiness” of medical practice