[Responsibility of the physician]

The more difficult it is to reach consensus as to the ethical framework for action, the greater the challenge to individuals to take the responsibility for the consequences of their actions and to be accountable to others and themselves. First and foremost, both responsibility and accountability imply providing answers to those who question the reasons for an action. Thus, responsibility presupposes that agents must know that their actions will have consequences, that these consequences must be intended, and furthermore, they must be justified as consequences which are known and intended. With reference to a case study, this paper discusses these points on four levels: 1) the medical standards, 2) the integration of the patient's intention and sense of well-being, 3) the institutional framework for action, and 4) the assessment of the action in its relation to the universal question whether it is good for all human beings.