On the basis of experiences in pastoral hospital care, the relationship between disease, sin, and guilt in the life of patients is explored. Against the disregard of this subject in medicine, and even in most of pastoral care, it is argued that patients' interest requires that their hidden or manifest questions be addressed, rather than their being exposed to efforts at “helping” through mere attempts at “debt clearance.” Only by openly confronting sin and guilt can the patient be taken seriously (...) in his role as subject of his disease. Theological and anthropological background considerations revealing the essence of sin as a disruption or even destruction of the Divine gift of life in its realization through a lived relationship to God and other humans are offered as evidence for this claim. (shrink)

In einer kühnen Metapher haben einst Hieronymus, Erasmus und Luther die Heilige Schrift als ein Labyrinth bezeichnet, das die Leser bei fortgesetztem Lesen in eine sich sogar steigernde Verwirrung stürze. Beinah im selben Atemzug wird eben dieselbe Heilige Schrift von eben denselben Autoren als der einzige Faden gepriesen, der die Leser aus dem Labyrinth ihres Lebens herausführe. Eines und dasselbe als Labyrinth und als Faden: Diese Figur ist paradigmatisch. Im Labyrinth der Ethik geht es nicht anders zu. Nur wer sich (...) ihm überläßt, findet aus ihm heraus. 24 Beiträge von namhaften Theologen und Theologinnen zur Theologischen Ethik finden sich in den fünf Abschnitten des vorliegenden Buches, das nacheinander "Biblische Grundlagen", "Theologische Systematik", "Ethische Modelle", "Ethische Leitbegriffe" und "Ethik und die Religionen" behandelt: Hans-Dieter Bastian: Zwischen Glauben und Handeln: Bibel-Lesen - Werner H. Schmidt: Glaube und Handeln. Aspekte des Alten Testaments - Wolfgang Schrage: Der 1. Korintherbrief als Paradigma paulinischer Ethik - Michael Wolter: Der Kompromiß bei Paulus - Jörg Haustein: Beobachtungen zum Schriftverständnis ökumenischer Dokumente - Gerhard Sauter: "Schrifttreue" in ethischer Urteilsbildung Günter Bader: Handeln im Namen Gottes - Erich Gräßer: Die ersten und die letzten Dinge. Bemerkungen zur theologischen und ethischen Schöpfungswahrnehmung - Marcin Hintz: Glaube, Tradition, Vernunft: Auf den Spuren theologischer Urteilsbildung im polnischen Protestantismus - Rolf Schäfer: Christliche Glaubens- und Sittenlehre bei Schleiermacher - Karl-Wilhelm Dahm: Herausforderungen für Selbstverständnis und Rolle des protestantischen Pfarrers im Zuge des Modernisierungsprozesses Traugott Jähnichen: Sozialethik auf dem Weg der Ausbildung von Bereichsethiken - Historische Traditionen und perspektivische Herausforderungen - Ulrich Eibach: Christengemeinde und christliches Leben und Handeln in der pluralistischen Gesellschaft - Ludger Honnefelder: Gesundheit unser "höchstes Gut"? Wertentscheidungen im Rahmen der Ressourcenallokation im Gesundheitswesen - Jörg Hübner: Kollektives Handeln im Zeitalter der Globalisierung. Perspektiven für eine zukünftige politische Ethik - Gottfried Hütter: Menschenwürde und Menschenrechte für Tiere? - Tobias Schlingensiepen: Adam, wo bist du? Die Entkontextualisierung menschlichen Lebens als Problem u. Herausforderung evangelischer Ethik Edgar Thaidigsmann: "Ehrfurcht vor dem Leben". Das Problem der Begründung einer Ethik der Verantwortung für das Lebendige bei Albert Schweitzer und Hans Jonas - Konrad Stock: Laster - der "vielnamige Frevel". Eine theologische Erinnerung an ein vergessenes Problem - Ulrich H. J. Körtner: Bildung und Wertebewußtsein. Anmerkungen zum Wertbegriff in der aktuellen Bildungsdiskussion - Hans G. Ulrich: Güter oder Werte? Zur Aufgabe der Theoriebildung in der evangelischen Sozialethik - Hartmut Kreß: Toleranz als Verpflichtung protestantischer Ethik Hans Waldenfels: Unterwegs zu einer interreligiösen Theologie - Sung-Hee Lee-Linke: Interreligiöse Ethik. Ein Modell für die Zukunft? (shrink)

Surveys ofpatients show that in crisis situations decisions about their life are primarily left to physicians and relatives. Only few actually have drawn or wish to draw up a living will, and that the trust in physicians and relatives is rnuch more irnportant to thern than any autonomaus self-deterrnination about their life and the type of their treatrnent. So the author points out that a renaissance of an ethics of care is needed, which places the well-being of the ill and (...) dying at the centre of ethical considerations and which constantly attempts to clarify the proper and good goals at which medical treatment and medical care should aim. Such ethics of care is based on relations of trust between the physician and patient which is not possible to establish without confidence-building talks and acquisition and habitualisation of medical and care virtues such as sympathy, goodwill, recognition of limitations of their own abilities, honesty and others. Just plain specialised information about the diagnosis and prognosis, which leaves the »autonomous enlightened« patients alone with their decision is not a sufficient basis for an ethics of care. (shrink)

Definition of the problem: Advances in medical technology resulting in an explosion of therapies available, considered within the context of the current demographic development, raise the question as to whether these advances can be made available to all in an equitable manner. Arguments: The following suggestions are being made in the discussion of how the costs can be held in check: (1) the prevention of expensive procedures being introduced into medical practice, (2) a far-reaching shifting of financing the health care (...) services into the private sector, and (3) excluding certain groups of persons from receiving expensive therapies, namely those whose ”quality of life” is considered to be very low and whose care constitutes a burden to society (e.g. the aged, the chronically ill and the handicapped). Suggestions 2 and 3 violate the basic – Christian – ethical principles of human dignity, justice and solidarity with regard to the gift of life and corresponding good health. Conclusion: The standard for the distribution of generally offered medical services must also be – with respect to persons – available for the chronically ill and for handicapped persons dependent upon care. (shrink)

The German debate on bioethics and medical ethics turns on a change in the meaning of human dignity. Such dignity is increasingly rendered contingent upon a person's empirically assessable quality of life. In contrast to such dignity-endowed human life, a merely biological human life is taken to disqualify its bearer from such dignity, depriving his life of the protection “respect for human dignity” would otherwise guarantee. The idea of a “life not worth living” or “undignified life” evokes categories, which were (...) developed at the beginning of the 20th century, and later informed the crimes of National Socialist medicine in Germany. Against this secular development, this article analyses the theological and church-based discussion of basic bioethical questions in Germany, especially the controversy among Protestants: once Protestant ethicists abandon an explicitly theological basis for their arguments, their conclusions come to closely resemble those of the secular participants in the debate. As a result, such Protestants relativize fundamental ethical norms. They subordinate, along with their secular environment, the protection of life to respect for autonomy. They thus prepare the ground for a revival of the risky concepts of the past. (shrink)