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Health, Culture and the Human Body
Exploring the Role of Narrative Therapy in Obesity:
Overcoming Body Image Disturbances
Somayeh Sadat McKian1
“My body is like a swamp. Whatever I pour into my body, it begins
to sink. I have been sunk into myself too. Every day, I sink more than
before. My body is the only thing that I really want to throw away. But
it seems as if I myself cannot do it. How come I got captured into my
body? Who would believe that I took several actions so as to step away
from my body but every time I became more frustrated than before.
Wherever I take my body, it is still the same shape. It seems that the
universe does not intend to look at me in another shape. That is why the
world has become monotonous and unchanging to me.”
This note seems to be like a short story, perhaps similar to the des-
tiny of a man. It could be written by a famous author, or it could be a
narration of an obese woman about herself and her status. The latter
is correct, of course. I suggest it is better for a nutritionist to wait a bit
after hearing the above-mentioned sentence before saying immediately
“weigh yourself with a pair of scales”!
The way you cut your meat reflects the way you live
Confucius, Chinese philosopher
Introduction
Obesity has been widely regarded as a public health concern because
1 MA in General Psychology, Faculty of Psychology and educational Sciences,
Allameh Tabataba`i University, Young Researchers and Elite Club, Tehran, Iran.
E-mail: Somayeh.mckian@yahoo.com
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Health, Culture and the Human Body
of its adverse impact on individuals’ health. Obesity and overweight have
became epidemic throughout the world. Epidemiologists more than 30
years ago recognized a continuous trend towards a growing spread of
obesity in Europe, the US, Asia and the Middle East (Field et al. 2002, 3).
From the point of view of general health, the growth of effective inter-
ventions for curing obesity is an important subject. It is widely accepted
that obesity is strongly correlated with a variety of medical conditions
such as cardiovascular diseases, type 2 diabetes and some types of can-
cer. (Xu et al. 2011, 268). Also, obesity and overweight are a problem
that is mainly related to lifestyle habits (Kelishadi et al. 2013, 211).
The World Health Organization (1998) defines overweight as a body
mass index (BMI) between 25 and 29.9 and obesity as body mass index
above30 (Schwartz and Brownell 2004, 44). Classically, the treatment
of obesity has been based on altering behaviours, diet, and the amount
of physical exercise (Doak et al. 2006, 112). This type of treatment is
questioned today, following the observation that, though it often proved
positive in the short term, it turned out to be not very efficient in main-
taining the weight in the longer term (Lachal et al. 2012, 1099). Body
image research, which began in the 1980s, has dramatically increased in
line with the growing awareness of this problem. A negative body image
is one of the key factors contributing to eating disorders (Chisuwa and
O’Dea. 2010, 9). Greater body dissatisfaction, which is more commonly
observed among adolescent girls, contributes significantly to lower self
image. Body dissatisfaction is also a risk factor for clinical eating disor-
ders, which are common among girls (Tiggemann and Miller 2012, 79).
Preventing obesity and overweight has become a top priority in efforts
to improve public mental health. Although much research is needed to
address this problem, it is important to approach obesity with an un-
derstanding of body image disturbances that obese youths face, which
is pervasive and can have serious consequences for mental and physical
health.
Diet therapy will always apply methods to improve the female body
and its physical attractiveness by decreasing the Body Mass Index. But
when body image dissatisfaction exists, success in body weight reduc-
tion may decrease. Actually obesity is a progressive chronic condition
associated with failed attempts at change and repeated relapses. Also
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Health, Culture and the Human Body
self-esteem and body image are influenced by obesity (Christiansen et
al. 2012, 2). There are new approaches that seem to be helpful in manag-
ing weight and body image. We suggest that narrative Therapy, as a new
approach, along with diet therapy, can prevent theses relapses. The ways
in which individuals evaluate their body mass index and body image
might be a determinant of differences in life narratives of obese women
as dietary and physical activity patterns. Narrative therapy intervention
has been developed for clinical disorders. The centrality of narrative to
some forms of therapeutic practices dates back at least to the end of the
nineteenth century in the writings of Sigmund Freud. A primary as-
sumption of Freud’s psychoanalytic theory is that “the symptom carries
a meaning and is connected with the experience of the patient” (Mat-
tingly and Garro 2000, 6). Thus, it is hypothesized that obesity is one
of our narratives that may impact the effectiveness of diet therapy by
affecting body image quality. In addition, the body mass index of obese
and overweight women could also be affected by life narratives. Thus,
the present chapter aims to introduce the effect of narrative therapy on
the body image of Iranian women with overweight and obesity. One of
the authors, McKian, used this method in her master thesis in psychol-
ogy. The purpose of the thesis was to determine if the addition of narra-
tive therapy targeting obesity and overweight to a diet therapy program
would improve body image and decrease body mass index in obese and
overweight women.
Literature review
Body image
One of the most common psychological problems of obese women
is the perception of a fault in their body image. The physical appearance
is an important part of body image, given that physical appearance is
the first information source that people use for inducing other people to
socialize with them. Previous studies have found a positive relationship
between body mass index (BMI) and body image dissatisfaction (BID)
among obese individuals compared to the non-obese. Yet, BID has been
found to increase as the severity of obesity increased (Gavin et al. 2010,
574).
Body image is an internal reflection of the outside appearance of peo-
ple, and this reflection includes physical aspects, perception and men-
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Health, Culture and the Human Body
tality shown towards them (Pruzinsky 1990, 102). The main dimensions
of these mentalities include factors of evaluation (dissatisfaction with
the body), investment (imaginatively designing oneself and the impor-
tance of the ideal appearance which has been created inside the person
by him- or herself) and affects (Bohne et al. 2002, 102). In addition to
our own perception of our body, including evaluation of our size, there
is an emotional or attitudinal aspect to our image – the evaluation of
our body, i.e. the way we feel about our body. This is the aspect on which
we usually focus when we talk about negative body image in people
with eating disorders, using the term body dissatisfaction or disparage-
ment. More recent psychologists have added a third component –our
behaviour (Bell and Rushford. 2008, 1). While treatments exist for im-
proving body image in overweight individuals, the key question is how
such programs can be integrated with dietary patterns. Strong gender
disparities exist in the prevalence of excess weight in developing coun-
tries, particularly in the Middle East and North Africa (MENA), where
the prevalence of overweight and obesity is much higher in women than
in men (Kelishadi et al. 2013, 211). Body image disturbance is higher
in western white or Caucasian women (Altabe 1998, 155), but due to
globalization, individuals in non-Western cultures are increasingly ex-
posed to Western ideals. Concern about physical appearance has been
found to be twice as common among women as among men. (Harris
and Caar 2001, 226). Diet therapy will always seek methods to improve
the female body and physical attractiveness with decreasing Body Mass
Index. On the other hand, Body image concerns are associated with
more unhealthy weight control behaviours and lower well-being (Ver-
stuyf et al. 2012, 1). It is widely assumed that people who are obese must
feel bad about their bodies, and their everyday talk is rich with stories
and metaphors about body and weight. These narratives can capture the
essential nature of an experience. Remember the story at the beginning
of the chapter: “My body is like a swamp. Whatever I pour into my body,
it begins to sink”. The sense of repetitive, painful and self-defeating na-
ture of the body experience is instantly apparent. Those metaphors show
the narrator’s lived experience about her body.
Analyses of narratives relating to BMI reveal how obese women feel
and think about their body. Traditionally, such narrative processes have
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Health, Culture and the Human Body
been tackled by diet therapy. Furthermore, there are few studies on
the understanding of everyday life narratives of obese and overweight
women. A review of the literature exposes the gap in our knowledge
about the effects of treatment on body image perception with narrative
therapy in overweight and obese women.
Once upon a time, obesity: surveying the role of narrative therapy
“I have to wait and see how the other responds to what I say or do
before I say or do the next thing .The next thing I say or do must be
influenced by the others’ response to what I just said. The actions are
not shaped by any theories or hypotheses, but by a dialogical process”
(Andersen 1997, 130). People live in a world that their language defines
for them. The actual use of language, verbal or written (pictorial) com-
munication can be analysed from a psychological point of view as well;
content analysis as a procedure has been used in psychology for a long
time (László 2008, 131).
While later traditions elaborated a great deal on the concept of obesity,
this does not allow us to recognize the meaning of obesity in individuals
easily. Most people in the world in one period of their life face up to the
narrative of the obesity, dysfunctions in body image and increasing Body
Mass Index. As a whole, we want to add to the knowledge about charac-
teristics of their narratives and body image disturbances related to their
Body Mass Index. A focus on stories is a way of thinking – more specifi-
cally, narrative thinking (Clandinin and Connelly 2000, 16). Psychother-
apists are concerned with people’s stories: they work with case histories
and use narrative explanations to understand why the people they work
with behave the way they do (Wells 2011, 9). McAdams has used narrative
concepts as discussed in his 1993 volume to pursue a broad range of ques-
tions regarding the relationship between narrative and personality theory
(McAdams et al. 1996, 340), the relationship between narrative identity
and personality traits and motives (McAdams et al. 2004, 763) and the
relationship between narrative themes and psychiatric conditions (Adler
et al. 2006, 49). Narrative therapists base their ideas on poststructuralist
philosophy. Poststructuralism is a response to “structuralism,” which is
one label for a worldview that is still dominant in a range of fields, in-
cluding counselling and psychology (Combs and Freedman 2012, 1035).
As a matter of fact, psychological science in recent decades has seen the
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emergence of patterns and an increasing number of approaches to cure
which have made changes to individual and family therapies and have put
it on a new and innovative path. Some of these approaches are a reflection
of the phenomenon which is called the post-modern point of view. The
intellectuals following this perspective believe that knowledge and recog-
nition are relative subjects dependent on their context. In their view, our
belief system is solely reflecting structures of social mentality, i.e. different
perspectives, rather than the absolute reality that we have created about
our world (Lyotard 2003, 209).
Narrative practitioners assume that people’s experiences of prob-
lems are shaped by stories, which are constructions. But these are not
individual constructions. In any social group, small or large, we are all
participants in each other’s stories. We each shape, and are shaped by
the beliefs, intentions, and actions of others. Collectively, we all partic-
ipate in discourses. Rachel Hare-Mustin (1994) defines discourse as “a
system of statements, practices, and institutional structures that share
common values.” She goes on to say that “discourses bring certain phe-
nomena into sight and obscure other phenomena. […](pp. 19-20) […]
Post structuralism includes the assumption that since we are all part of
culture we can all be caught up by discourses, and therapists can un-
doubtedly reproduce these discourses in the therapy room without even
recognizing it (Hare-Mustin 1994; Combs and Friedman 2012: 1036)
It is clear that the difference between primary assumptions in mod-
ern and postmodern approaches can raise dilemmas in psychological
treatments. Narrative therapy is one of the examples that have been pre-
sented about eating disorders, and it seems that it can be effective in
improving the psychological condition of the affected individuals. Some
findings indicate that the difficulties associated with appearance have
less to do with beauty per se, but are more likely associated with nar-
ratives of loss, aging, decline and death. A narrative analytic approach
looks at the story being told by the teller and fully acknowledges that in-
dividuals construct the “self”, both past and present, through narrative.
This often involves a description of an event or action and an analysis
of its meaning which provides insight into the narrator’s sense of self
(Silver and Reavey 2010, 1642).
Narrative approaches also stress that it is essential for us to try and
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Health, Culture and the Human Body
formulate coherent stories, which enable us to connect both negative
and positive happenings, to consider alternative possibilities and to allow
reflection on and integration of the events in our lives (Johanstone and
Dallos 2009, 187). The identity of the self and also the possibility of iden-
tification with others and that of noticing and change are all borne within
narrative. In the Ricoeurian concept, the mode of action of psychotherapy
is no more than a dialogic construction of a life story by the joint inter-
pretative work of the therapist and patient. This interpretation will restore
the damaged coherence of the patient’s autobiography (László 2008, 47).
All people have stories to tell about their lives and who they are in
the world. There are many events that live outside the problem-saturat-
ed dominant stories but have been overshadowed, taken for granted or
not noticed as being significant. Through inquiry these events could be
further verbalized into existence and brought into alternate story lines.
This process is referred to as “re-storying”. It is a collaborative practice,
where the person consulting the therapist remains the primary author,
while the therapist asks questions that help the person move from the
known and familiar accounts of his or her life toward what is possible to
know and do and toward what fits more closely with that person’s pref-
erences for life (Malinen et al.2012, xvii). Through narratives of people
we can identify and reach their emotions, excitement and their perspec-
tives. By the narratives that they have expressed, humans start to take
action, and this process will lead them to feel that they are capable of
anticipating and controlling their own lives. In fact, narratives are in-
tended for constructing the individual’s experiences (Brown 2007, 29).
A primary way individuals make sense of experience is by casting it in a
narrative form (Riessman 1993, 4).
The “narrative turn” has entered history, anthropology and folklore,
psychology, sociolinguistics and communication studies, cultural stud-
ies, and sociology. THe professions, too, have embraced the concept,
along with investigators who study particular professions: law, medi-
cine, nursing, education, and occupational therapy. The narrative turn is
part of a larger “turn to language” in the human sciences, evidence of a
blurring of genres between the humanities and sciences […]. Although
narrative may have some roots in phenomenology […], applications
now extend beyond lived experience and worlds “behind” the author. A
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Health, Culture and the Human Body
central area of narrative study is human interaction in relationships—
the daily stuff of social work, counselling, and psychotherapy (Riessman
and Speedy 2007, 427).
Narrative analysis is useful when the interest is in how and why a
story is constructed as it is, what it accomplishes and how the audience
affects what may be told (Wells 2011, 7).
In her thesis, McKian chose narrative therapy in order to gain insight
into how obese women experience everyday life narrative. Narrative
protocol is well suited to provide insight into themes from the inter-
viewee’s life story from the subjects’ own perspectives. To gain insight
into such processes, a narrative approach was adopted. This method
helps to “elucidate the complicated narratives of body image in wom-
en’s lives”. Because weight-related stigma has a more significant impact
on body image for women than men (Antin and Hunt 2013, 17), it is
hypothesized that obesity is one of our narrative that may impact the
effectiveness of diet therapy by affecting body image quality. In addi-
tion, the body mass index of obese and overweight women could also
be impacted by life narratives. Thus, the study aimed to introduce the
comparison between efficacy of narrative therapy and diet therapy on
Body Image and Body Mass Index in Iranian women with overweight
and obesity. Obesity may not be the same for all women; As a result, we
have to explore how women’s life narratives influence their body image
and Body Mass Index consequently.
Narratives come soon in your spoon: the role of society
In the history of humanity there have been many more taboos on
food than sexual taboos (Rivière 1995, 189), and the social and cultural
dangers are much greater. Eating has never been a minor issue. Food is
a rich topic for research. Dietetics is probably one of the oldest forms
of human knowledge (Kaufmann 2010, 12). There is not just one story
about food or obesity. Everyone in the world has got a special narra-
tive about them. The strong cultural value placed on slimness, especially
for women, unfortunately may take precedence over health. To address
the impact of women’s body image dissatisfaction effectively requires
an understanding of the multiple contexts of women’s lives (Paquette
and Raine 2004, 1047). Modern Western culture emphasizes slimness,
denigrates excess weight, and stigmatizes obese individuals, making it
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Health, Culture and the Human Body
likely that obese people internalize these messages and feel badly about
the physical presence that brands them. It is also important to keep in
mind that it is not always obvious what exactly our body is and how we
perceive it. All branches in the humanities try to explain the cultural
construction of the human body. Especially the post-modern discussion
about the body has influenced disciplines like sociology, cultural and
gender studies as well as the history of biology and medicine.
Participants and methodology
This was an interventional Quasi-experimental study. Participants
were selected among overweight or obese women who referred to the
nutrition and diet therapy clinic of Shahid Beheshti University of Med-
ical Sciences, Tehran, Iran, for reducing their weight. 30 overweight or
obese (BMI≥ 25) women who were 18 to 36 years old were randomly
selected. Since narrative therapy is a kind of clinical intervention treat-
ment, the number of samples was determined according to previous
studies in this field (Carless and Douglas 2008, 581). After explanation
of the purpose of the study, participants were randomly divided into 3
equal groups (two intervention groups and one control group). One of
interventional groups (n=10) received low calorie diet by a nutrition
specialist for 5 weeks according to their age, height, and weight (group
1) and the other one (n=10) received 10 sessions of narrative therapy
addition to low calorie diet (Group 2). Both groups were asked to adjust
their physical activity according to the opinion of the nutritionist and
not to change their routines. 10 persons in the control group received no
intervention (group 3) and were asked to maintain their daily routine of
physical activity. These individuals were selected from the waiting list
of referrals to the clinic for starting weight reduction programs. Demo-
graphic data of all participants, consisting of marital status, number of
children, education, and occupation status were collected using a ques-
tionnaire. Exclusion criteria included pregnancy, taking antipsychotic
drugs, having cardiovascular and chronic kidney disease or thyroid
disease, any kind of eating disorders, suffering severe distress (such as
divorce or separation from partner). Women were also excluded if they
were currently enrolled in another weight loss program. The local ethics
committee of Allameh Tabataba`i University approved this study. Writ-
ten informed consent was obtained from all subjects.
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Health, Culture and the Human Body
Conclusion
The meaning of the communications and dialogue depends on their
utility in social relationships and conversation analysis, which means
that the protocol that is designed for Iranian women depends on social,
cultural, economical, political and psychological features of obesity in
woman from different cities in Iran, and these narratives can be differ-
ent from those of other women from various countries. I believe this
is the biggest dilemma. Everyday language of morbidly obese women
is full of metaphors about body image and body appearance, as I men-
tioned in the story at the beginning. These metaphors and their context
are valuable aids in therapy. Overcoming body image disturbances is
an active process that is at the heart of my work in narrative therapy for
obese and overweight women.
The key theoretical concept that I am linking to descriptions of ther-
apeutic practice is considering the effect of narrative therapy on a devel-
oping body image. This method is more suitable than the other methods
with greater results in weight loss. I think the necessity of this interven-
tion together with diet on improving the problem of obesity is perceived
in many countries.
Controlling obesity is a subject that can be discussed critically. Since
obesity is a phenomenon which is complicated, consisting of multiple
factors which can intervene in antecedents and consequences of envi-
ronmental, psychological and social factors, controlling and curing it
is outside the reach of a single field only. Based on analyzing the body
image, a new approach for curing obesity was designed. This approach
is used for minimizing the weight increase following weight loss. It has
been designed in order to overcome the psychological impediment of
long-term learning of effective behaviour for controlling weight, and it
helps the patients to learn the required and needed skills for controlling
their weight successfully and revising the narratives related to their
body, learning the body metaphors and then applying them. On the one
hand, no research has studied the effect of narrative therapy on body
image and Body Mass Index of women with obesity till now, and on
the other hand studying the obese individuals’ narrative is effective in
addressing their body image and has effective consequences in decreas-
ing the Body Mass Index. Therefore this study aimed at comparing the
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Health, Culture and the Human Body
effect of narrative therapy and diet on the index of body image of obese
women. It is hypothesized that obesity is one of our narratives that may
impact the effectiveness of diet therapy by affecting body image quality.
As a result, narrative therapy may help nutrition specialists in their abil-
ity to talk with the patients in order to construct more open narratives
about their body and fatness and retain their focus on the importance of
relationship and dialogue between nutrients and obese women.
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14. Health, Culture and
the Human Body
Epidemiology, Ethics and History of Medicine,
Perspectives from Turkey and Central Europe
İlhan İlkılıç, Hakan Ertin, Rainer Brömer, Hajo Zeeb (Eds.)
BETİM CENTER PRESS
Health, Culture and
the Human Body
Epidemiology, Ethics and History of Medicine,
Perspectives from Turkey and Central Europe
1
İlkılıç,Ertin,Brömer,Zeeb(Eds.)
BETİM CENTER PRESS
Migration and Health, Infectious Diseases, Beginning
of Life/Reproductive Medicine, End of Life, Human
Body, and Interculturality and Ethics – these six main
themes have been studied from historical, ethical,
and epidemiological perspectives, keeping the sister
disciplines in a transdisciplinary view.
The contributions reflect the themes of two meetings
in Mainz/Germany and Istanbul/Turkey. The book is
attempting at a synthesis of the different perspectives
and methodological approaches with a focus on Central
EuropeandTurkey.Theauthorsandeditorshaverevisited
the field and bring together a more comprehensive
approach to Health, Culture and the Human Body.
Health, Culture and
the Human Body
Epidemiology, Ethics and History of Medicine,
Perspectives from Turkey and Central Europe
9 7 8 6 0 5 8 6 9 5 7 1 9
15. Health, Culture and
the Human Body
Epidemiology, Ethics and History of Medicine,
Perspectives from Turkey and Central Europe
Editors
İlhan İlkılıç
Hakan Ertin
Rainer Brömer
Hajo Zeeb
Betim Center Press
17. Preface
MIGRATION AND HEALTH
History
Medical selection in the recruitment of migrant workers (“Gastarbeiter”)
Sascha Topp
The Historical Development of Health-Conditions Among Female
Immigrants from Turkey in the Federal Republic of Germany
Asli Topal-Cevahir
The Political Making of Care Worker Migration: The Austrian Example
Lukas Kaelin
Epidemiology
The Role of Illness Perceptions in The Health Care Provision of Turkish
Migrants
Patrick Brzoska, Yüce Yılmaz-Aslan, Oliver Razum
Storytelling for and Along with Turkish Caregivers in Germany: the saba
Study
Susanne Glodny, Yüce Yılmaz-Aslan, Oliver Razum
Contested Medical Identities, Migration of Health Care Providers and
Middle Eastern Students at Western Universities
Frank Kressing
Health Policies and Cultural Sensitivity in the Care for Elder Turkish
Migrants in Austria and Germany and the Role of Turkish Migrants
Nevin Altıntop
Medically Unexplained Physical Symptoms Among Turkish Migrant
Merlijn van Schayk, Karen Hosper
08
19
39
63
79
99
113
127
137
TABLE OF CONTENTS
18. Ethics
Medical Care for Migrants Without Health Insurance in Germany and
the Role of Civil Society
Fiene Wolf, Christa Blum, Jakov Gather, Hannah Windeln,
Eva-Maria Schwienhorst
INFECTIOUS DISEASES
History
European Physicians/Specialists During the 1893–95 Cholera Epidemic
in Istanbul
Nuran Yıldırım, Hakan Ertin
“Ethnology and Dermatology”. Lorenz Rigler and Alfred Marchionini in
Turkey (1842-56 and 1938-48 respectively)
Werner Friedrich Kümmel
Syphilis Control in the Age of Abdülhamid II
Nil Sarı
“Afflicted by God.” Ernst v. Düring and Endemic Syphilis in Anatolia
Around the Year 1900
Werner Friedrich Kümmel
Düring Pasha’s Services for the Ottoman Empire
Nuran Yıldırım
The Impact of Syphilis on the Military Capacity of the Ottoman Army
During the First World War
Murat Yolun
A Sanitary Journal for Common People: Yaşamak Yolu
Ceren Gülser İlikan Rasimoğlu
Epidemiology
Awareness of Sexually Transmitted Diseases Among Adolescents with
and Without Migrant Backgrounds in Bremen, Germany
Florence Samkange-Zeeb, Saskia Pöttgen, Beate Schütte, Hajo Zeeb
Current viral hepatitis B status and policy in Turkey and the relevance to
major immigration countries
Mehlika Toy
167
189
217
231
257
269
291
299
313
327
19. Doctors’ and Parents’ Perspectives on Communication Regarding HPV
Vaccination in Bulgaria
Elitsa Dimitrova, Yulia Panayotova, Irina Todorova,
Anna Alexandrova-Karamanova
Ethics
Integration of People With HIV/AIDS to Social Life: AIDS in Turkey and
Socio-ethical Reflections
M. Kemal Temel, Hakan Ertin
BEGINNING OF LIFE/REPRODUCTIVE MEDICINE
History
The Stone Tekija as a Cultic Place for the Cure of Infertility and the
Prevention of Various Diseases: Exploring Macedonian Folk Medicine
Dragica Popovska
Epidemiology
Advances in Perinatal and Neonatal Care for High-Risk Newborns:
Ethical Implications - a German Perspective
Herwig Stopfkuchen
Ethics
The Dignity of the beginnings of Human Life
Hans-Martin Sass
End-of-life decisions at the beginning of life
İlhan İlkılıç
Contemporary Cultural and Clinical Conflicts at the End-of-Life in
Neonatology Ethics
Ayesha Ahmad
The prohibition of egg donation as an issue of medical ethics
Clemens Heyder
Abortion According to the Turkish Law
Hakan Hakeri
341
365
379
393
403
433
447
463
483
20. END OF LIFE
History
Concepts About Death Throughout Turkish History. A Historical
Perspective of Religious Ethics in Connection with a Dying Patient
Nil Sarı
Epidemiology
Psychological, Religious, Legal and Folkloric Dimensions of Death
Tuğba Gencer, İbrahim Başağaoğlu
Ethics
End-of-Life-Decisions in Germany: Crucial Aspects of the Medico-
Ethical Debate and Clinical Practice
Monika Bobbert
Ethical Evaluation of the Pharmacy Services for Geriatric Patients
Sözen Şahne, Sevgi Şar
Be Healthy to Live – Live to be Healthy? Bioethics, Biopolics in Aging
Society
Petra Kutscheid
Advisory Ethics Committees for Artificial Nutrition and Hydration in
Patients
Hanzade Doğan
Ethics of (Palliative) Care and the Question of Euthanasia
Dejan Donev, Željko Kaluđerović
Demise and Death from the Perspective of Philosophy of Law; Especially
Violations of Dignity
Altan Heper
Legal Situation of Organ and Tissue Transplantation in Turkey
Yener Ünver
497
525
547
567
577
589
603
617
631
21. HUMAN BODY
History
Representations of the Female Body in Feminist Zines
Melanie Boeckmann
Epidemiology
Exploring the Role of Narrative Therapy in Obesity: Overcoming Body
Image Disturbances
Somayeh Sadat McKian
INTERCULTURALITY AND ETHICS
Epidemiology
The Need for Cultural Competence in Health Care: The Case of Roma
Population in Poland
Agata Strządała
Ethics
Interculturality and Ethics in Health Care
İlhan İlkılıç
Cross-Cultural Ethical Conflicts in Health Care. Developing Cultural
Competence in Health Care Personnel and Ethics Consultants
Tatjana Grützmann
659
667
683
697
711
