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Books by Weronika Chańska
Wydawnictwo Uniwersytetu Jagiellońskiego, 2022
This volume is a “philosophical ethnography,” whose subject is the genetic counselling that accom... more This volume is a “philosophical ethnography,” whose subject is the genetic counselling that accompanies prenatal diagnostics. It is “philosophical” in the sense that it poses questions of the meaning of notions, normative assumptions, and values that determine the adoption of particular norms of conduct. Rarely is anything assumed to be self-evident in the exploration of the principles and reasoning presented on its pages, which is conducted from a number of different angles. Irrespective of its purely scholarly values this book is also a story about women who have decided to undergo prenatal screening and have faced the decision on the course of action in the case of severe fetal abnormalities. It is also an expression of the admiration for their perseverance, courage, and, not infrequently, their moral heroism. The first, theoretical part of the book presents the normative approach to genetic counselling accompanying prenatal testing, and the changes that have occurred in this sphere over previous decades. The impact of discoveries in the field of clinical genetics and of social changes on counseling standards is shown. Much attention has been devoted to the analysis of the nondirectiveness principle, which is considered to be one of the main principles of genetic counseling, and one of particular importance in counseling on procreation decisions. It is analyzed how the understanding of this principle changed over time and how various normative postulates were derived from it. The book also describes contemporary methods and strategies in prenatal diagnosis. Much attention has been devoted to distinguishing the studies performed as part of population screening from the so-called targeted diagnostics – that is, diagnostics aimed at identifying particular genetic anomalies in the fetus, which are conducted in families with genetic diseases. The main goals and assumptions of screening tests are presented, basic methodological concepts are discussed, and the measures and indicators most frequently used in prenatal screening are described here. The book’s second part is entirely focused on the system of prenatal diagnostics in Poland and on the accompanying genetic counselling. It traces the history of prenatal diagnostics and describes its current state, presenting the standards and professional recommendations as well as the scheme of prenatal screening financed from public means. The shortcomings and deficiencies of this system are thoroughly discussed. All this is based in extensively cited and presented official reports, original analyses, and documents handed over by former civil servants. This part of the book also recounts three empirical studies conducted by the author in the years 2016–2019 – these are: a survey conducted among physicians specializing in genetics, observation of genetic counseling, and interviews with pregnant women undergoing invasive prenatal diagnostics. The recourse to the results of empirical research allows to confront the theoretical and normative postulates found in the literature on the standards of genetic counseling with the implementation of these standards in Polish clinical practice. The book ends with a critical analysis of the October 22, 2020 ruling of the Constitutional Tribunal, which stated that the provision allowing termination of pregnancy by a physician in cases where prenatal tests or other medical findings indicate a high risk that the fetus will be severely and irreversibly damaged or suffering from an incurable, life-threatening disease, is inconsistent with the Constitution of the Republic of Poland. Legal analyses pertaining to this judgment and the possible negative consequences it entails in the form of restricting or blocking access to prenatal tests for Polish women are presented in the final sections.
Seria: Monografie Fundacji na Rzecz Nauki Polskiej
Summary in English: HAPLESS GIFT OF LIFE. PHILOSOPHY AND ETHICS OF QUALITY OF LIFE IN MODERN MEDI... more Summary in English: HAPLESS GIFT OF LIFE. PHILOSOPHY AND ETHICS OF QUALITY OF LIFE IN MODERN MEDICINE The book aims at investigating how the notion of"quality of life" functions in modern medic ine. The author tries to show how this category has emerged in the bioethical thought; in what circumstances it has become an element in its canon of notions and what philosophical values and premises form its basis. She researches the position and function of the notion in modern medicine, where the diagnosis of low quality of a patient's life sometimes becomes the moral grounds underlying the decision-making process. The author aims at detem1ining the circumstances when such decisions are morally justified. The book consists of four parts. Part I entitled "Sanctity of Life" is devoted to the reconstrnction of the concept and presenting the context in which, and in the opposition to which, the ethics of quality of life is defined. The author proves that sanctity of life is not a specifically Catholic notion, mentioning the authors descending from non-Catholic traditions for whom the notion of sanctity of life plays a paramount role. The author aims at presenting possible - and frequently much diversified - meanings of the notion and proves that the conviction of sanctity of human life may be derived from very different sources without the need to refer to Supreme Being. Part 2 entitled "Life as the Subject of Moral Appraisal" presents various views seeking an answer to the question of what attributes life with quality. It discusses the manner in which the quality in question may be assessed, whose prerogative it should be and the criteria for such assessment. Part 3 entitled "Quality of Life in Selected Clinical Situations" presents cases of practical application of the standpoints and decisions discussed in the previous chapter. The author discusses clinical practice and considers the situations when medical treatment may be discontinued, what criteria should be taken into account when such decisions are made and whose opinion should be decisive in such cases. The author tries to answer the question whether quality of life may become a universal criterion for such decisions. Part 3 is also devoted to the impact which progress made by the 20111 century medicine has had on ethics and everyday reality of the medical profession. The author shows how new and increasingly more reliable methods of medical treatment have extended the range of medical intervention, which resulted in the emergence of previously unknown moral dilemmas and controversies.
Papers by Weronika Chańska
Journal of Bioethical Inquiry, Sep 1, 2022
Nondirectiveness is widely regarded as an important principle of genetic counseling. However, num... more Nondirectiveness is widely regarded as an important principle of genetic counseling. However, numerous studies have indicated that the use of this principle and its content itself are subject to controversies. The present study aimed to verify how the nondirectiveness principle is defined by Polish geneticists, the extent to which it is considered the main principle in clinical practice, and the situations in which geneticists see the positive value of the directive action. Using quantitative and qualitative methods, the study compared the abstract declarations of the directiveness validity and the scope of this principle with the declaration of action in situations close to reality (case scenarios). The results showed that the high rank assigned to the nondirectiveness principle does not translate into the conviction about the absolute obligation to use it in clinical practice. Polish geneticists are inclined to restrict the scope of patients' choices when these are outside of their definition of medical standard. Strong medical paternalism manifests itself particularly in invasive prenatal diagnostics, where geneticists play the role of gatekeepers. In this study, we offer hypotheses about the sources of these attitudes by analyzing the current cultural and legal context of Poland.
Warszawa : Lex a Wolters Kluwer business, 2013
Monografia Weroniki Chańskiej to książka „bioetycznie zaangażowana” – chce nie tylko opisywać, al... more Monografia Weroniki Chańskiej to książka „bioetycznie zaangażowana” – chce nie tylko opisywać, ale także zmieniać rzeczywistość. Autorka analizuje polski system badań prenatalnych. Stawia pytania o jego założenia i niewypowiadane wprost racje stojące za przyjęciem pewnych rozwiązań. Odsłania wartości, na jakich wspiera się diagnostyka prenatalna i towarzyszące jej poradnictwo genetyczne. Pozwala je lepiej zrozumieć i bardziej świadomie z nich korzystać. Niezależnie od swoich walorów naukowych książka jest również przejmującą opowieścią o kobietach, które zdecydowały się na wykonanie badań prenatalnych i zmierzyły z decyzją, co zrobić w przypadku ciężkiej wady płodu. Wyrazem podziwu dla ich determinacji, odwagi, często moralnego heroizmu. „Rzadko się zdarza, żeby praca naukowa dotycząca kwestii bardzo specjalistycznej i bardzo wąskiej idealnie trafiała w swój czas. [… ] Nie czytałem wcześniej na ten temat żadnej pracy, ani w literaturze światowej, ani tym bardziej w polskiej, która z...
Medicine, Health Care and Philosophy
Przegląd Prawa Medycznego, Aug 23, 2021
Wydawnictwo Uniwersytetu Jagiellońskiego, 2022
This volume is a “philosophical ethnography,” whose subject is the genetic counselling that accom... more This volume is a “philosophical ethnography,” whose subject is the genetic counselling that accompanies prenatal diagnostics. It is “philosophical” in the sense that it poses questions of the meaning of notions, normative assumptions, and values that determine the adoption of particular norms of conduct. Rarely is anything assumed to be self-evident in the exploration of the principles and reasoning presented on its pages, which is conducted from a number of different angles. Irrespective of its purely scholarly values this book is also a story about women who have decided to undergo prenatal screening and have faced the decision on the course of action in the case of severe fetal abnormalities. It is also an expression of the admiration for their perseverance, courage, and, not infrequently, their moral heroism. The first, theoretical part of the book presents the normative approach to genetic counselling accompanying prenatal testing, and the changes that have occurred in this sphere over previous decades. The impact of discoveries in the field of clinical genetics and of social changes on counseling standards is shown. Much attention has been devoted to the analysis of the nondirectiveness principle, which is considered to be one of the main principles of genetic counseling, and one of particular importance in counseling on procreation decisions. It is analyzed how the understanding of this principle changed over time and how various normative postulates were derived from it. The book also describes contemporary methods and strategies in prenatal diagnosis. Much attention has been devoted to distinguishing the studies performed as part of population screening from the so-called targeted diagnostics – that is, diagnostics aimed at identifying particular genetic anomalies in the fetus, which are conducted in families with genetic diseases. The main goals and assumptions of screening tests are presented, basic methodological concepts are discussed, and the measures and indicators most frequently used in prenatal screening are described here. The book’s second part is entirely focused on the system of prenatal diagnostics in Poland and on the accompanying genetic counselling. It traces the history of prenatal diagnostics and describes its current state, presenting the standards and professional recommendations as well as the scheme of prenatal screening financed from public means. The shortcomings and deficiencies of this system are thoroughly discussed. All this is based in extensively cited and presented official reports, original analyses, and documents handed over by former civil servants. This part of the book also recounts three empirical studies conducted by the author in the years 2016–2019 – these are: a survey conducted among physicians specializing in genetics, observation of genetic counseling, and interviews with pregnant women undergoing invasive prenatal diagnostics. The recourse to the results of empirical research allows to confront the theoretical and normative postulates found in the literature on the standards of genetic counseling with the implementation of these standards in Polish clinical practice. The book ends with a critical analysis of the October 22, 2020 ruling of the Constitutional Tribunal, which stated that the provision allowing termination of pregnancy by a physician in cases where prenatal tests or other medical findings indicate a high risk that the fetus will be severely and irreversibly damaged or suffering from an incurable, life-threatening disease, is inconsistent with the Constitution of the Republic of Poland. Legal analyses pertaining to this judgment and the possible negative consequences it entails in the form of restricting or blocking access to prenatal tests for Polish women are presented in the final sections.
Seria: Monografie Fundacji na Rzecz Nauki Polskiej
Summary in English: HAPLESS GIFT OF LIFE. PHILOSOPHY AND ETHICS OF QUALITY OF LIFE IN MODERN MEDI... more Summary in English: HAPLESS GIFT OF LIFE. PHILOSOPHY AND ETHICS OF QUALITY OF LIFE IN MODERN MEDICINE The book aims at investigating how the notion of"quality of life" functions in modern medic ine. The author tries to show how this category has emerged in the bioethical thought; in what circumstances it has become an element in its canon of notions and what philosophical values and premises form its basis. She researches the position and function of the notion in modern medicine, where the diagnosis of low quality of a patient's life sometimes becomes the moral grounds underlying the decision-making process. The author aims at detem1ining the circumstances when such decisions are morally justified. The book consists of four parts. Part I entitled "Sanctity of Life" is devoted to the reconstrnction of the concept and presenting the context in which, and in the opposition to which, the ethics of quality of life is defined. The author proves that sanctity of life is not a specifically Catholic notion, mentioning the authors descending from non-Catholic traditions for whom the notion of sanctity of life plays a paramount role. The author aims at presenting possible - and frequently much diversified - meanings of the notion and proves that the conviction of sanctity of human life may be derived from very different sources without the need to refer to Supreme Being. Part 2 entitled "Life as the Subject of Moral Appraisal" presents various views seeking an answer to the question of what attributes life with quality. It discusses the manner in which the quality in question may be assessed, whose prerogative it should be and the criteria for such assessment. Part 3 entitled "Quality of Life in Selected Clinical Situations" presents cases of practical application of the standpoints and decisions discussed in the previous chapter. The author discusses clinical practice and considers the situations when medical treatment may be discontinued, what criteria should be taken into account when such decisions are made and whose opinion should be decisive in such cases. The author tries to answer the question whether quality of life may become a universal criterion for such decisions. Part 3 is also devoted to the impact which progress made by the 20111 century medicine has had on ethics and everyday reality of the medical profession. The author shows how new and increasingly more reliable methods of medical treatment have extended the range of medical intervention, which resulted in the emergence of previously unknown moral dilemmas and controversies.
Journal of Bioethical Inquiry, Sep 1, 2022
Nondirectiveness is widely regarded as an important principle of genetic counseling. However, num... more Nondirectiveness is widely regarded as an important principle of genetic counseling. However, numerous studies have indicated that the use of this principle and its content itself are subject to controversies. The present study aimed to verify how the nondirectiveness principle is defined by Polish geneticists, the extent to which it is considered the main principle in clinical practice, and the situations in which geneticists see the positive value of the directive action. Using quantitative and qualitative methods, the study compared the abstract declarations of the directiveness validity and the scope of this principle with the declaration of action in situations close to reality (case scenarios). The results showed that the high rank assigned to the nondirectiveness principle does not translate into the conviction about the absolute obligation to use it in clinical practice. Polish geneticists are inclined to restrict the scope of patients' choices when these are outside of their definition of medical standard. Strong medical paternalism manifests itself particularly in invasive prenatal diagnostics, where geneticists play the role of gatekeepers. In this study, we offer hypotheses about the sources of these attitudes by analyzing the current cultural and legal context of Poland.
Warszawa : Lex a Wolters Kluwer business, 2013
Monografia Weroniki Chańskiej to książka „bioetycznie zaangażowana” – chce nie tylko opisywać, al... more Monografia Weroniki Chańskiej to książka „bioetycznie zaangażowana” – chce nie tylko opisywać, ale także zmieniać rzeczywistość. Autorka analizuje polski system badań prenatalnych. Stawia pytania o jego założenia i niewypowiadane wprost racje stojące za przyjęciem pewnych rozwiązań. Odsłania wartości, na jakich wspiera się diagnostyka prenatalna i towarzyszące jej poradnictwo genetyczne. Pozwala je lepiej zrozumieć i bardziej świadomie z nich korzystać. Niezależnie od swoich walorów naukowych książka jest również przejmującą opowieścią o kobietach, które zdecydowały się na wykonanie badań prenatalnych i zmierzyły z decyzją, co zrobić w przypadku ciężkiej wady płodu. Wyrazem podziwu dla ich determinacji, odwagi, często moralnego heroizmu. „Rzadko się zdarza, żeby praca naukowa dotycząca kwestii bardzo specjalistycznej i bardzo wąskiej idealnie trafiała w swój czas. [… ] Nie czytałem wcześniej na ten temat żadnej pracy, ani w literaturze światowej, ani tym bardziej w polskiej, która z...
Medicine, Health Care and Philosophy
Przegląd Prawa Medycznego, Aug 23, 2021
ADMINISTRACJA PUBLICZNA, 2009
Page 179. anETTa bRECzko1* RECEnzja WERonIka ChańSka: nIESzCzęSny daR żyCIa. fIlozofIa I ETyka ja... more Page 179. anETTa bRECzko1* RECEnzja WERonIka ChańSka: nIESzCzęSny daR żyCIa. fIlozofIa I ETyka jakoŚCI żyCIa W mEdyCynIE WSPółCzESnEj Monografie Fundacji na rzecz Nauki Polskiej, Seria humanistyczna, Wydawnictwo Uniwersytetu Wrocławskiego Sp. ...
