Spindler M
Graduiertenkolleg Bioethik, Internationales Zentrum für Ethik in den Wissenschaften, Universität Tübingen.
Gesundheitswesen. 2010 Mar;72(3):135-9. doi: 10.1055/s-0030-1247579. Epub 2010 Feb 25.
This paper explores the problem of dealing with normalisation in public health concepts, using the example of the relaunching of anti-aging-medicine in Germany. The analysis mainly draws upon qualitative analyses of publications of different anti-aging-medicine organisations. The German branch of anti-aging-medicine's new concepts of the nature, the morality and the self-design of aging are delineated. These are the concepts of aging as a medically controllable health risk (nature), the emphasis of the moral duty to responsible personal risk control (morality) and the self-design through individual risk profiles and prevention programmes. The analysis shows that the proposed bio-political programme cannot only be induced from biologically, societally or medically given facts, but that it is - as all public health concepts - a normative concept. It is argued that the normative aspects of public health concepts cannot be avoided but should be explicated and negotiated. This paper therefore concludes with an exploration of what there is to negotiate concerning the German anti-aging-physicians' surprisingly uncontroversial plea for a shift of emphasis from the collective right to health to a new individual duty for health maintenance in old age.
本文以德国抗衰老医学重新兴起为例,探讨了公共卫生概念中处理规范化的问题。分析主要基于对不同抗衰老医学组织出版物的定性分析。文中阐述了德国抗衰老医学分支关于衰老的本质、道德以及自我设计的新概念。这些概念包括:将衰老视为一种可通过医学控制的健康风险(本质);强调个人有责任控制风险的道德义务(道德);以及通过个人风险概况和预防计划进行自我设计。分析表明,所提出的生物政治计划并非仅仅源于生物学、社会或医学给定的事实,而是与所有公共卫生概念一样,是一个规范性概念。本文认为,公共卫生概念的规范性方面无法回避,而应予以阐明和协商。因此,本文最后探讨了德国抗衰老医生令人惊讶地毫无争议地呼吁将重点从集体健康权转向老年人新的个人健康维护义务这一问题上有哪些需要协商的内容。