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Medical Ethics and Time

Time plays a crucial role in medical care in various ways. For example, finding the right moment for medical decisions and discussions may prove challenging: at what moment should life-saving treatments be withdrawn if there is no hope left? What is the right moment to undertake certain medical tests in a patients’ life? When should problematic results, such as incidental medical findings, be communicated to patients? And what is the right moment to talk about advance care planning or the possibility of post-mortem organ donation? Is there in medical practice and decision-making something such as the greek concept of “kairos”, that is, a proper and opportune time, or does every situation have to be judged individually with the aim of determining the best possible moment?

Questions surrounding time and the lack thereof can be found in clinical settings such as emergency rooms, where life-saving decisions have to be taken in very short time, and in disciplines including, but not limited to, gerontology, neonatology, anti-aging medicine and gynaecology. Is it, for example, possible and ethically justifiable to draw a clear-cut line in time for an upper (or lower) age limit for fertility treatments? And should we further develop the domain of anti-aging medicine, or should we simply accept that some conditions are just normal companions of aging and life?

Time also plays an important role in the everyday life of physicians: their financial remuneration is often based on how much time they spend on a patient. Furthermore, many healthcare professionals nowadays experience shortage of time caused by an increasing workload due to the „economization“ of health care, which may be harmful for patients and stressful for the treating healthcare professionals.

A further topic concerns the phenomenology of time in medicine: do medical patients (for example persons with a severe or life-threatening disease or on medical waiting lists) experience time differently than healthy individuals? If yes, does it depend on the individual or on the medical situation as such?

While time is a thoroughly studied research topic in physics and metaphysics, it has received less attention in ethics and medical ethics, despite the crucial role it plays in various ways in these domains. Bioethica Forum will therefore publish a special issue on medical ethics and time in winter 2018 and invites all interested clinicians and scholars of various disciplines to submit contributions in English, French or German.

Authors can submit either an original article or a personal viewpoint (for details, see www.bioethica-forum.ch, Instructions).

Bioethica Forum is the official journal of the Swiss Society for Biomedical Ethics. It publishes scientific articles on bioethics topics four times per year.

Please submit original articles by June 1, 2018, and viewpoints and other contributions by September 1, 2018 to: angela.martin@unifr.ch