Rivista per le Medical Humanities

Franco Zambelloni
rMH 31, 2015, 11-16

The meaning of a gift

The practice of giving gifts is probably as old as the first human communities and is universally present in all cultures and throughout the ages. Numerous anthropological and ethnographic studies have shown how a gift constituted a form of exchange aimed at establishing important social relationships. However, this also involves some sort of obligation, since instinctual mechanisms imply that a gift should then be reciprocated. This is where the ambiguity of the gesture of giving arises that, in many circumstances, may be appreciated, but at the same time, disturbing. The evolution of culture and of moral codes have, however, also developed altruistic and entirely disinterested forms of giving gifts: donating organs is the most significant example.

Lucia Galvagni
Lucia Pilati
rMH 31, 2015, 17-35

The practice of transplanting organs and the criteria for their distribution: comparing Switzerland and Italy

This article sets out to give an account of a seminar regarding “The practice of transplanting and the criteria for distributing organs”, which was held in May 2014 in Trento, at the Fondazione Bruno Kessler, from which the Centro per le Scienze Religiose (Center for Religious Studies) was organized, in collaboration with the Commissione di Etica Clinica (Commission of Clinical Ethics) of the Ente Ospedaliero Can - tonale and the Fondazione Lanza in Pauda. This contribution offers an explanation of what emerged during the seminar work, along with some other considerations that allow to reallocate the theme and the scenario of reference within the history of debates regarding bioethics and medical ethics. The meeting was attended by clinicians, ethicists, and lawyers from both Italy and Switzerland.

Alan Vismara
rMH 31, 2015, 36-42

The architecture of choices in the system of organ donation in Switzerland

In Switzerland, where the excellence achieved by medicine does not have a high rate of organ donations, there is always a constant search for solutions that will increase the percentage of people who choose to donate organs. A very current topic, discussed also at a parliamentary level, is the ability to switch from the informed consent model to the model of presumed consent. Asking oneself how the economy can contribute to the debate, the author presents the perspective of behavioral economics, the principles of which are offere - das valuable interpretations in understanding the difficulties, resistance, and contradictions aroused by the relevant models.

Melania Borgo
Mario Picozzi
rMH 31, 2015, 43-47

Transplanting organs: between exchange and gift

This is a review of the book, La transplantation d’organes. Un commerce nouveau entre les êtres humains by the French sociologist, Philippe Steiner, who examines key issues, such as: transplant from cadavers, medical and social issues related to transplants from a living individual, and extreme forms of procuring organs, namely, the sale and “trafficking” of the same. One of the possible conclusions that can be drawn from this study is that, not having already done all that could be to encourage transplants from cadavers and, given the risks that could be encountered by further encouraging transplants from living individuals, it is still worth experimenting with transplants from cadavers before starting to take an al most one-way street towards transplants from living individuals.

Loris Puleo
rMH 31, 2015, 48-51

I also come by foot

This paper presents the autobiographical account of the turning point (brought to existence by the author) of the possibility – that became a reality – of receiving a kidney transplant: the waiting period, being added to the urgent list, the call, the decision, and finally waking up. The story of a new life, free from dialysis machines, gained back thanks to an organ donation.

Alberto Bondolfi
rMH 31, 2015, 73-78

Clarifying the historical and legal aspects of assisted suicide in Switzerland

For years, people worldwide have argued on the morally more acceptable way of dying. The ethical, legal, and political debate on the terminal stages of human life, especially when accompanied by increasingly sophisticated medical techniques, tends to not only intensify and differentiate itself, but also becomes more complicated. Switzerland is not spared this and these issues are discussed with their own emphases, which are not always understood and appropriately valued elsewhere. This paper aims at highlighting the specific aspects of Swiss regulations regarding assisted suicide, as compared to other European legislation, and to historically contextualize the genesis of the law that has reached the pres - ent day, in order to provide the critical tools needed to face future choices.

Franco Cavalli
rMH 31, 2015, 79-82

The Swiss situation: some contradictions that must be resolved

Beginning with the presentation of three cases in which he was directly involved, the author takes a position with respect to Swiss legislation regarding assisted suicides, high - lighting some weaknesses and structural contradictions. Firstly, those generated by Swiss law that, in Sections 114 and 115 of the Penal Code, combines an extremely liberal position with a conservative one, which does not distinguish be - tween medical staff and any other person, nor between the sick and healthy, but that distinguishes in a clear-cut manner between assisted suicide and directly active euthanasia, leaving a gray area with regard to indirect active euthanasia, creating the risk of abuses. The author hopes that the fed - eral law on the matter will be actualized.

Claudia Gamondi
rMH 31, 2015, 83-85

Focus on families

The issue of assisted suicides is very biased, and often the debate on this topic is not based very much on scientific evidence. Assisted suicides are the result of a complex decision- making process where many individuals are involved. In literature, very little has been researched regarding the effect on family members who take part in this, both during the decision-making stages, as well as during the mourning period, following the death of the individual. The existing data are rather controversial: studies conducted in the Netherlands and in the United States do not demonstrate an increased in - cidence of complicated grief expressed by family members who participated in assisted suicides. Instead, the data collec - ted from quantitative and qualitative studies in Switzerland show that family members who participated in assisted suicides meet ethical dilemmas during the decision-making process and are found to be rather isolated from the health care system during and after. Furthermore, both during and after the decision-making process, they address the topic with confidentially. In general, the experience of family members has been, so far, underestimated both clinically and in re - search. It is difficult to understand what the impact is on the family with reference to the various moments that distin - guish assisted suicides (decision-making, assisting at the moment of death, mourning).

Aldo Lafranchi
rMH 31, 2015, 86-95

Hans Küng's brave option

This paper presents a review of the book by Hans Küng, Glücklich sterben? (Piper, Munich, 2014), recently translated into Italian (Morire felici? Lasciare la vita senza paura, Rizzoli, Milan, 2015 – Dying happily? Leaving life without fear) where the almost 90-year-old theologian suffering from Parkinson’s deals with positions that are difficult, yet, also well debated: the question of the right of individuals who suffer from a serious and incurable illness to responsibly plan their own death. The paper provides a summary of the main contents of the book, identifying the personal decision-making experiences that led Küng to selecting a humanly dignified death and covers the issues that led him to sustain that selfdetermined death does not come into conflict with Christian doctrine.