Herbert Viefhues – författare

As a result of the policy to alleviate work permit restrictions within the European Community, the quantitative and qualitative distribution of doctors in the E.C. is of growing importance in health politics. Particularly under discussion are questions concerning future training programs for doctors and the role doctors have to play in the health economy under very different types of health systems. This monograph is divided into two parts. The first descriptive section presents, analyzes and discusses the various statistical data and trends as well as the legal positions in the following countries: U.K., Belgium, Federal Republic of Germany, Greece, Denmark, Ireland and Italy. The second part then provides a comprehensive survey of models for solving problems and predicting developments and possible demands for the future.

Moderne und leistungsfähige Technik erfordert moderne und leistungsfähige Formen der ethischen Analyse und Bewertung von Technikentwicklung und -anwendung. Dieses Buch stellt Methoden der Güterabwägung in klinischer Forschung, Differentialdiagnostik, Ethik, Theologie, Philosophie und Rechtswissenschaften vor. Die differential-ethische Güterabwägung und die Methoden ethischer Kosten-Nutzen-Risikobewertung haben über Äie biomedizinische Forschung und humanmedizinische Versorgung hinaus große Bedeutung für ein moralisches Verantwortungsbewußtsein auf allen Gebieten der modernen Technologie. Das Buch wendet sich an Kliniker und Forscher, Philosophen und Theologen, Manager, Politiker und alle, die ethische Risiken in komplexen Entscheidungssituationen abzuwägen haben.

Moderne und leistungsfähige Technik erfordert moderne und leistungsfähige Formen der ethischen Analyse und Bewertung von Technikentwicklung und -anwendung. Dieses Buch stellt Methoden der Güterabwägung in klinischer Forschung, Differentialdiagnostik, Ethik, Theologie, Philosophie und Rechtswissenschaften vor. Die differential-ethische Güterabwägung und die Methoden ethischer Kosten-Nutzen-Risikobewertung haben über Äie biomedizinische Forschung und humanmedizinische Versorgung hinaus große Bedeutung für ein moralisches Verantwortungsbewußtsein auf allen Gebieten der modernen Technologie. Das Buch wendet sich an Kliniker und Forscher, Philosophen und Theologen, Manager, Politiker und alle, die ethische Risiken in komplexen Entscheidungssituationen abzuwägen haben.

A. Schneeweiss Although the syndrome of congestive heart failure has been recognized many years ago, the approach for its evaluation and treatment has until recently, been partial and ''fragmentary''. Various aspects of the disease have been treated according to the evaluation tools and therapeutic measures available at each period. This approach resulted in some of the greatest achievements in the management of heart failure but also left many aspects neglected and also resulted in several paradoxes. Examples of the achievements and limitations of the ''fragmentary'' ap­ proach are the use of diuretics and hemodynamic measurements. The devel­ opment of diuretics has provided us with an important tool for helping pa­ tients whose predominant problem was edema. The success of diuretics masked the fact that their use may often be hemodynamically unsound and that they may reduce cardiac output. Only many years after their introduction has the use of diuretics found its appropriate place. Hemodynamic monitoring has gone via the same path. The great contribu­ tion of continuous bedside hemodynamic measurements to understanding heart failure resulted in over-usage by many clinicians, who found themselves treating hemodynamic charts rather than patients. It took almost a decade to realize that hemodynamic improvement, even in the chronic setting, does not necessarily mean symptomatic improvement or an increase in exercise capac­ ity.

A. Schneeweiss Although the syndrome of congestive heart failure has been recognized many years ago, the approach for its evaluation and treatment has until recently, been partial and 'fragmentary'. Various aspects of the disease have been treated according to the evaluation tools and therapeutic measures available at each period. This approach resulted in some of the greatest achievements in the management of heart failure but also left many aspects neglected and also resulted in several paradoxes. Examples of the achievements and limitations of the 'fragmentary' ap­ proach are the use of diuretics and hemodynamic measurements. The devel­ opment of diuretics has provided us with an important tool for helping pa­ tients whose predominant problem was edema. The success of diuretics masked the fact that their use may often be hemodynamically unsound and that they may reduce cardiac output. Only many years after their introduction has the use of diuretics found its appropriate place. Hemodynamic monitoring has gone via the same path. The great contribu­ tion of continuous bedside hemodynamic measurements to understanding heart failure resulted in over-usage by many clinicians, who found themselves treating hemodynamic charts rather than patients. It took almost a decade to realize that hemodynamic improvement, even in the chronic setting, does not necessarily mean symptomatic improvement or an increase in exercise capac­ ity.