[ChatGPT: aid to medical ethics decision making?] / ChatGPT: Hilfe bei der medizinethischen Entscheidungsfindung?

BACKGROUND: Physicians have to make countless decisions every day. The medical, ethical and legal aspects are often intertwined and subject to change over time. Involving an ethics committee or arranging an ethical consultation are examples of potential aids to decision making. Whether and how artificial intelligence (AI) and the large language model (LLM) of the company OpenAI (San Francisco, CA, USA), known under the name ChatGPT, can also help and support ethical decision making is increasingly becoming a matter of controversial debate. MATERIAL AND METHODS: Based on a case example, in which a female physician is confronted with ethical and legal issues and presents these to ChatGPT to come up with answers, the first indications of the strengths and weaknesses are ascertained. CONCLUSION: Due to the rapid technical development and access to ever increasing quantities of data, the utilization should be closely observed and evaluated.

[ChatGPT: aid to medical ethics decision making?] / ChatGPT: Hilfe bei der medizinethischen Entscheidungsfindung?

BACKGROUND: Physicians have to make countless decisions every day. The medical, ethical and legal aspects are often intertwined and subject to change over time. Involving an ethics committee or arranging an ethical consultation are examples of potential aids to decision making. Whether and how artificial intelligence (AI) and the large language model (LLM) of the company OpenAI (San Francisco, CA, USA), known under the name ChatGPT, can also help and support ethical decision making is increasingly becoming a matter of controversial debate. MATERIAL AND METHODS: Based on a case example, in which a female physician is confronted with ethical and legal issues and presents these to ChatGPT to come up with answers, the first indications of the strengths and weaknesses are ascertained. CONCLUSION: Due to the rapid technical development and access to ever increasing quantities of data, the utilization should be closely observed and evaluated.

[Handling critical incidents as organizational-ethical challenges using the example of "medical errors"]. / Der Umgang mit belastenden Ereignissen als organisationsethische Herausforderung am Beispiel "Behandlungsfehler".

Definition of the problem: Employees in the healthcare sector are expected to deal professionally with patients and their families at all times. Accompanying them through existential crises, disease, dying, and death is highly demanding. A situation which employees can experience as particularly stressful is when a decision needs to be made and they find themselves in a moral conflict or dilemma. Arguments: Such situations range from extremely rare triage decisions to comparably "everyday" involvement in (alleged) medical error. Conclusion: In some cases the outcome for patients and their families, who had placed their trust in the institution, can be tragic, and this already burdensome situation for employees is further exacerbated when there is no credible concept established within the organization for dealing with such events in a structured manner, and when colleagues and their superiors have little to no knowledge about helpful support options.

[Christmas with Charles Dickens - The Man of Letters as Syndrome-Spotter and Good Moralist]. / Weihnachten mit Charles Dickens.

Charles Dickens, as a writer, was also a great master of patient observation. He described more than 40 syndromes, some of which were named after characters and titles of his literary works. Within these he often referred to the connection between illness, poverty and social misery. Some of his descriptions have withstood the litmus test of time and are still used in today's medicine: Amongst these are the characters Frederick, Little Dorrit's uncle, who suffers from Parkinson's disease, Fat Joe after whom the Pickwick-syndrome was named, Tiny Tim who is beaten with Pott's disease, Ebenezer Scrooge, a victim of posttraumatic embitterment disorder, and Mr. Krook who dies from spontaneous human combustion. Charles Dickens loved animals, and he was a member and supporter of The Royal Society for the Protection of Cruelty to Animals and actively engaged in public activities against vivisection. Furthermore he explicitly cared for children, and when his novel "Oliver Twist" appeared, the begging children received more alms, and the government improved the poor houses. Finally, there is probably no other author who has portrayed the power of Christmas so sensitively and impressively. Dickens hoped that in these days, just before the turn of the year, personal transformations would take place and redemption would be experienced as a result of new insights. For such transformations, he was convinced that man occasionally needs external stimuli.

[Assisted suicide in the movies - what is (not) shown?] / Sterbehilfe in (Spiel-)Filmen ­ Was wird (nicht) gezeigt?

Whereas changes to the existing legal situation regarding assisted suicide have been a topic of controversial debate in Germany for the last few years, this issue has long been of interest for international film-makers. Since the mid-1980s, the theme of assisted suicide has repeatedly been taken up by cinema, predominantly as central to a relationship drama. A sick person asks somebody close to them for help. Often this somebody is a physician or a nurse, ultimately an obvious way of solving the practical problem of how the assistant is to gain access to a lethal substance. At the same time, this constellation enables a physician or nurse to be forced into a dramatic conflict between professional ethics and a personal obligation towards a loved one.Alongside more classic clinical pictures such as terminal cancer, recent films about assisted suicide have featured neurodegenerative diseases and physical disabilities. Another new development is that elderly patients are no longer alone in requesting assistance; films also and increasingly portray young adults. Besides a fear of unbearable pain, more recent films have also increasingly addressed the worry that permanent nursing might be required, as well as the subjectively experienced loss of dignity. The possibilities offered by palliative care hardly play a role in feature films. However, we should not forget, that movies are fictional and orchestrated, or, in other words, they are neither educational nor documental. They neither need nor want to portray reality, although they do wish to draw upon real experiences. They exploit highly emotional and ethically controversial themes to create tensions and stir up emotions in the audience, but ultimately they seek to entertain. Movies about death and dying are always "die-tainment".

"... As we forgive those who trespass against us...": theological reflections on sin and guilt in the hospital environment.

In general parlance the term sin has lost its existential meaning. Originally a Jewish-Christian term within a purely religious context, referring to a wrongdoing with regard to God, sin has slowly become reduced to guilt in the course of the secularization process. Guilt refers to a wrongdoing, especially with regard to fellow human beings. It also refers to errors of judgement with what can be tragic consequences. These errors can occur whenever human beings are called upon to act, including the hospital environment. A Christian hospital has to address the issue of how to deal not only with guilt-ridden misdemeanors, but also with wrongdoing unto God, which overshadows every instance of guilt-ridden human behavior. Here, as in every parish, the Church Service is the place to acknowledge sin, confess sin, and forgive sin, beyond the boundaries of the parish itself.