PHILOSOPHI A Special Issue/2013 STUDIA UNIVERSITATIS BABEŞ-BOLYAI PHILOSOPHIA Special Issue March 2013 EDITORIAL BOARD: Jeffrey Andrew BARASH (Université Amiens) Monique CASTILLO (Université Paris XII Val-de-Marne) Chan Fai CHEUNG (Chinese University of Hong Kong) Virgil CIOMOŞ (Babeş-Bolyai University Cluj-Napoca) Aurel CODOBAN (Babeş-Bolyai University Cluj-Napoca) Peter EGYED (Babeş-Bolyai University Cluj-Napoca) Eliane ESCUBAS (Université Paris XII Val-de-Marne) Mircea FLONTA (University of Bucharest) Vasile FRĂTEANU (Babeş-Bolyai University Cluj-Napoca) Gyorgy GEREBY (CEU Budapest) Jad HATEM (USJ Beyrouth) Lester EMBREE (Florida Atlantic University) Domenico JERVOLINO (Università Federico II Napoli) Vasile MUSCĂ (Babeş-Bolyai University Cluj-Napoca) Marta PETREU-VARTIC (Babeş-Bolyai University Cluj-Napoca) Eveline PINTO (Université Paris I) Anca VASILIU (CNRS Paris) Károly VERESS (Babeş-Bolyai University Cluj-Napoca) Gérard WORMSER (ENS Lyon) Alexander BAUMGARTEN (Babeş-Bolyai University Cluj-Napoca) Marcel BODEA (Babeş-Bolyai University Cluj-Napoca) Gabriel CHINDEA (Babeş-Bolyai University Cluj-Napoca) László GÁL (Babeş-Bolyai University Cluj-Napoca) Dan-Eugen RAŢIU (Babeş-Bolyai University Cluj-Napoca) Lasse SCHERFFIG (Academy of Media Arts, Cologne) Emilian CIOC (Babeş-Bolyai University Cluj-Napoca) CHIEF EDITOR: Ion COPOERU (Babeş-Bolyai University Cluj-Napoca) EDITORIAL COMMITTEE: Tomas KACERAUSKAS (Technical University Vilnius) Dietmar KOCH (Eberhard-Karls Universität Tübingen) Alina NOVEANU (Babeş-Bolyai University Cluj-Napoca / Eberhard-Karls Universität Tübingen) Attila SZIGETI (Babeş-Bolyai University Cluj-Napoca) Tincuta HEINZEL (Academy of Media Arts, Cologne) SUB-EDITOR: Dan RADU (Babeş-Bolyai University Cluj-Napoca) YEAR Volume 58 (LVIII) 2013 MONTH MARCH ISSUE Special Issue S T U D I A UNIVERSITATIS BABEŞ–BOLYAI PHILOSOPHIA Special Issue ETHICAL ISSUES IN CLINICAL AND CULTURAL CONTEXT Special Issue. Guest Editors: Daniela-Tatiana AGHEORGHIESEI and Andrada PÂRVU Desktop Editing Office: 51ST B.P. Hasdeu, Cluj-Napoca, Romania, Phone + 40 264-40.53.52 CUPRINS – CONTENT – SOMMAIRE – INHALT DANIELA-TATIANA AGHEORGHIESEI, ANDRADA PÂRVU, Editorial ......................... 5 ANCA BOJAN, Observance of Patient Rights in Romania. Results of a Pilot Study........ 7 MARIANA ENACHE, SILVIA DUMITRAŞ, RODICA GRAMMA, ANDRADA PÂRVU, GABRIEL ROMAN, ŞTEFANA MARIA MOISA, LUCIAN MIRON, VLAD POROCH, BEATRICE IOAN, Ethics of Palliative Care in Romania from Principles to Practice ... 15 ANDRADA PÂRVU, SILVIA DUMITRAŞ, RODICA GRAMMA, ANGELA ENACHE, GABRIEL ROMAN, ŞTEFANA MOISA, RADU CHIRIŢĂ, BEATRICE IOAN, Disease in Rroma Communities – an Argument for Promoting Medical Team Cultural Competence .................................................................................................... 23 ANCA-DANIELA FARCAŞ, LAURA-ELENA NĂSTASĂ, Update in the Management of Patients with Heart Failure.......................................................................... 37 DANIELA-TATIANA AGHEORGHIESEI (CORODEANU), ION COPOERU, Managementul eticii – un prerequisite în instituţiile spitaliceşti. Strategii şi programe de etică * The Management of Ethics - a Prerequisite in Hospitals. Strategies and Ethics Programmes ................................................................................... 43 CRISTINA TÎRHAŞ, The Healthist Ideology: Towards a New Form of Health Awareness in the Contemporary Life-Style?...................................................................... 55 ION COPOERU, SEBASTIAN MOLDOVAN, The Virtues and Limits of the Biomedical Model for Interpreting Behaviours Related to Substance Misuse and Addiction.... 71 SEBASTIAN MOLDOVAN, ION COPOERU, DANIELA CORODEANU AGHEORGHIESEI, The Role of Case Management in the Assistance for Substance Use Disorders in Romania....................................................................................................... 79 DANIELA-TATIANA AGHEORGHIESEI (CORODEANU), ION COPOERU, Comunităţile virtuale de studenţi – parteneri în managementul post-tratamentelor pentru persoanele cu adicţie la substanţe * Virtual Communities of Students - Partners in the Management of Post-Treatment of People with Addiction to Substances .. 103 GEORGE FLORIAN MACARIE, ANDREEA IORDACHE, CRISTINEL ŞTEFĂNESCU, GABRIELA ELENA CHELE, VOICHIŢA ANA TEBEANU, Adolescents Internet Use – a Reason of Concern or a Relief? ......................................................... 119 Issuee Coordinators: Daniela-Tatiana AGHEORGHIESEI and Andrada PÂRVU Publishing Date: March, 2013 STUDIA UBB. PHILOSOPHIA, Vol. 58 (2013), Sp. Issue, pp. 5 - 6 (RECOMMENDED CITATION) EDITORIAL: ETHICAL ISSUES IN CLINICAL AND CULTURAL CONTEXT DANIELA-TATIANA AGHEORGHIESEI1, ANDRADA PÂRVU2 In the 21st Century, health care professionals all over the world are faced with situations that rise serious ethical challenges; some of them could be solved involving the knowledge and collaboration of legal professionals, psychologists, social services or clergy. Contemporary medicine is centred on patient’s autonomy and rights, as well as on health care models provided by multidisciplinary teams, adapted to the patient’s needs and specificities. All these issues are challenging the Romanian health care deciders to draft better policies and medical staff to improve their services. This supplement of Studia UBB. Philosophia aims to gather a broad spectrum of empirical and theoretical research focused on the role of moral values and on ethical issues in the realm of health care and public health policies in Romania. The papers are focused on complex, multi-dimensional and interdisciplinary models of care, some of them related to cultural patterns. Also, the management issues of care system and ethics programs implemented in hospital institutions are approached. Important challenges for medical staff in nowadays Romania are represented by ethical issues in clinical and cultural context, like communicating the severe diagnosis, the patient’s access to medical information, respecting the patient’s autonomy, patient’s access to medical services, and substance misuse and addiction. In order to offer high standard health care to chronic patients, the medical personnel must address the patient’s psychological needs and enhance its cultural competence for a better understanding of the ethnic minorities. 1 Center for Ethics and Health Policies, University of Medicine and Pharmacy “Gr T. Popa” Iaşi; Faculty of Economics and Business Administration, “Alexandru Ioan Cuza” University of Iaşi, [email protected] 2 PostPhD Researcher, Center for Ethics and Health Policies, University of Medicine and Pharmacy “Gr T. Popa” Iaşi; Asistant Professor, Hematology Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, [email protected] EDITORIAL In this context, end-of-life care and making decision is one of the most important bioethical problems. Dying patient are a vulnerable population and their rights must be protected. In Romania, palliative care services are insufficient and legislation regarding end-of–life issues is deficient. Another problem rises at the very threshold of clinical and cultural context: the healthist ideology, a socio-cultural phenomenon which has consequences like the presence of medicine in everyday life, self-medication, new types of health practitioners, or the growing social anxiety in connection with health, illness and medicine. Another important issue, both for practitioners in health and social services and for the political deciders, is substance abuse and addiction. The widespread biomedical model has positive and negative aspects. Medicalisation (pathologization) is not always the best solution for helping these people. The approach of the addictive behaviour must be therefore multidisciplinary, culture-adapted, and opened to alternative solutions. In the Romanian integrated service system for consumers of psychoactive substances, case management is considered a key procedure. However, reports shows that the degree of integration is low and case management is barely functional. In conclusion, in order to a better management of the substance abuse, there is a need to develop a social level kind of case management in order to increase the social responsiveness to the issues of substance abuse. For all that, the problem of addiction cannot be studied without making strong sense of reality of the Internet, which can be “enemy and ally” while solving the problem. Two relevant researches bring into focus the power of the internet in this way, the impact on young people. This force, if properly understood, could be avoided or used in a positive way. First at all, the impact of Internet use has been investigated by a qualitative research, aiming at analyzing the current experience as Internet users of 20 Romanian adolescents of 15-16 years old. The results could contribute to a better understanding of the development of the excessive Internet use or addictive behaviours of adolescents. Moreover, the role of virtual communities of students, as important tools in supporting the post-treatment of persons with substance addiction is the subject of an extended comparative research. We hope that the papers included in this issue will help extended medical care teams, which include not only physicians and nurses, but also psychologists, social workers, spiritual counsellors and so forth, to better understand their patient’s needs and rights and to provide high quality efficient services. 6 STUDIA UBB. PHILOSOPHIA,