Příspěvek se zabývá institutem tzv. dříve vyslovených přání, přičemž zahrnuje jak některé právní, tak i některé etické problémy. Zejména se soustředí na otázky, které ještě v české odborné literatuře nebyly řešeny. V první části je shrnuta užívaná terminologie a historie institutu. Kromě toho jsou zmíněny tři modely dříve vyslovených přání, tzv. living will, substitute decision-making (rozhodování zvoleným zástupcem) a konečně tzv. values history (historie hodnot pacienta). Ve druhé části je shrnuta úprava v České republice. Ve třetí se pak článek zabývá konkrétními právními a etickými problémy., This article deals with advance directive and some legal and ethical issues associated with them. Its main purpose is to show some problems which haven´t been solved in Czech professional literature. The first part of this article summarizes terminology and history of this medical institute. Three models of advance directives are mentioned as well - living will, substitute decision-making and values history. The second part summarizes Czech legislation and its development. The last part speaks about some crucial ethical and legal issues associated with advance directives., and Adam Doležal.
The paper begins with the question of the participation of human subjects in biomedical research, pointing a way from the first principle of the Belmont Report towards the concept of autonomy as expressed by informed consent. From the use of informed consent in experimental medicine, the paper then moves to the application of informed consent in clinical practice. Further, the paper outlines the cultural and philosophical context of the transformation of medicine into biomedicine from the perspective of human subject research, discussing the concept which has played the key role in the ethical framework of both experimental and clinical medicine in the Czech Republic. Finally the paper provides some critical notes on the concept of informed consent and its practice in Czech healthcare., Josef Kuře., and Obsahuje poznámky a bibliografii
In the conception of modern bioethics, the concept of autonomy plays a dominant role. Contemporary bioethical discourse in many cases glorifies an approach founded on this principle, and it seems that its role in moral conduct in applied bioethics is considered to be the key to salvation. This article attempts, to a certain extent, to relativise the dominant principle of autonomy, especially in medical ethics, even if it does not deny its indispensability. It points, however, to particular practical aspects which respect for the principle of autonomy, especially in the doctor-patient relation, can influence in a negative way, or can quite negate. As the basic antithesis to theories which found their priority on the axiom of respect to autonomy, the author then presents paternalistic and neo-paternalistic concepts in bioethics which find support, above all, in the principle of beneficence. The argument in this article necessarily demands an outline of the basic properties of paternalism and autonomy. For this reason the article especially focuses on models of the relationships between doctor and patient, that is on medical ethics in the narrow sense., Adam Doležal., and Obsahuje poznámky a bibliografii