论健康伦理学及其基本理论架构——“九大理论”视野中的健康伦理

当代医学道德发展的走向理应是健康道德,后医学伦理学时代理应是健康伦理学。建设健康伦理学需要搭成一个基本理论架构。其组成至少应该有“九大理论”,即生命神圣论、生命质量论、生命价值论,医学人本论、医学功利论、医学公正论,医者美德论、医者义务(患者权利)论、医患和谐论。其间,按顺序由每三论构成一个“统一论”,将第一个“统一论”作为立论前提,将第二个“统一论”作为直接依据,将第三个“统一论”作为应用指南,如此,才能由三个“统一论”共同地更好地阐释全部健康伦理学问题。     

论当代西方宪政理论的基本架构

随着西方社会全面进入福利国家时代,宪政理论在人权的扩张和权力制衡的理念方面获得了新的表述。当代西方宪政理论主张通过保障平等的自由来实现利益的公正分配,通过公正的程序机制实现形式法治和实质法治的统一,通过司法审查实现宪政的平衡价值,通过人权法律的全球化实现人权的一体化和全球化保护。     

论伦理学的性质——兼论理论伦理学与应用伦理学的关系

本文针对现行伦理学把伦理学理解为关于道德的学问的片面性和忽视应用伦理学研究的缺陷 ,正面阐述作者对伦理学的性质以及理论伦理学与应用伦理学的关系的看法。作者认为作为哲学分支之一的伦理学既是人生哲学 ,也是价值哲学 ,又是幸福哲学。伦理学的意义在于 ,它能促进个人反思和规划人生并为之指示路向和提供原则 ,从理论上为社会确立终极价值目标和构建价值体系 ,为各门自然科学、社会科学、人文科学提供理论观念、一般原则和活动规范。伦理学的研究方法是反思、批判、构建有机统一的思辨方法。作者主张把运用理论伦理学的观念和原则解决当代人类生活和实践中出现的实际问题的应用伦理学研究划分为领域伦理学研究、职业伦理学研究、人群伦理学研究 ,认为它们构成应用伦理学研究的三个基本领域。     

编医学伦理知识宝典传医学人文科学精神--读《医学伦理学辞典》

我认为这部辞典有这样两方面的特点,值得医学人文学术界大力宣传与学习.     

中国公共健康伦理学的理论自觉与范式转换

理论自觉不仅直接关乎中国特色公共健康伦理学的理论构建,也直接关乎中国公共健康伦理学的持续发展和现实功能的发挥。中国公共健康伦理学的理论自觉包括对学科关系、中西关系、古今关系以及理论与实践关系的自觉等四个基本维度;其问题域或基本理论结构包括本体论层面的基本问题、对象问题和范畴问题,认识论层面的视角和向度问题以及价值论层面的发展取向、价值追求和学者的价值选择问题。范式意识的自觉是中国公共健康伦理学理论自觉的方法论标志。当前,中国公共健康伦理学研究范式应该实现从西方范式向马克思主义范式、从个体论或整体论向个体论与整体论相结合的范式、从职业伦理或实践伦理向职业伦理与实践伦理相结合的范式转换。     

论传播伦理学的理论建设

传播的基本属性决定了传播的道德属性 ,传播在其过程中深受社会道德的制约 ,因而 ,从理论上探讨传播伦理的性质特点及其与社会道德的关系 ,论述了传播伦理学的内涵、研究对象和任务及学科属性 ,在当今尤显重要。     

理论脱贫:当代中国医学伦理学跨入新境界的大门

我国当代医学伦理学建设一直存在的一个重大缺憾--医学伦理学基本理论的贫困化,对整个学科的发展形成了严重的制约.理论贫困化的主要"症状"是科学理论匮乏、实用理论混乱、理论取向混沌等.因此,理论脱贫是当代中国医学伦理学取得突破性进展的关键.这种"脱贫致富"需要从简单的传承和移植转向创造,任何投机取巧和工于炒作都是无济于事的;目前亟需的是构建一个能够胜任科学解读、系统建构整个医学伦理学学科体系的基本理论框架,然后不断完善.     

应用伦理学的理论形态

应用伦理学是一个正在兴起并广受瞩目的学科及专业领域,它不仅拥有伦理委员会、伦理诊所等实践形态,也具备典型的理论形态。作为一种程序伦理,应用伦理学渗透着强烈的价值理念或价值意涵,贯穿着一种融贯主义的方法论,反映并同时深化和强化了现代伦理学运作的两个基本特点,即现代社会一方面更重视个体的地位,另一方面也更重视整体的力量。应用伦理学的基本特征就是直面冲突、诉诸商谈、达成共识、形成规则、为立法提供理据。应用伦理学既有对基本原则的恪守,又有判断力和实践明智的运用。它是伦理学的一种新的发展,与规范伦理学、描述伦理学、元伦理学四足鼎立。     

经济伦理与伦理经济--兼论经济伦理学的方法问题

经济伦理研究和伦理经济研究有共同的论域,即经济学与伦理学相交的范围;这种研究必须面对现实的经济生活和社会道德状况,并从中引申出经济与伦理交互作用的规律性;作为经济学与伦理学的交叉学科,经济伦理学既是一门实证科学,又是一门价值学科;经济伦理学的研究必须遵循实事求是的原则、历史与逻辑相统一的原则和价值学的原则.     

关于医学伦理学的基本原则

医学伦理学与生命伦理学既有相同之处也有诸多差异,它的基本原则和生命伦理学应有所不同。将病人利益置于首位、自主、不伤害、公正、友善五原则可视为医学伦理学的基本原则。病人利益主要是指病人生命和健康利益,是由医生根据医学科学允许度、医生的经验和病人实情决定的;将病人利益置于首位原则的落实,首先需要医生和医院对此有真切的认识,同时也需要有制度的保障和国家的财政支持;将目前实际上已经被倒置的医患利益关系纠正过来,是既艰难又十分迫切的,需要做多方面的工作。假以时日,这一目标是应当而且能够实现的。

     

The simplicity of theories: Its degree and form

Almost all commentators acknowledge that among the grounds on which scientists perform theory-choices are criteria of simplicity. In general, simplicity is regarded either as only a logico-empirical quality of a theory, diagnostic of the theory's future predictive success, or as a purely aesthetic or otherwise extra-empirical property of it. This paper attempts to demonstrate that the simplicity-criteria applied in scientific practice include both a logicoempirical and a quasi-aesthetic criterion: to conflate these in an account of scientists' theory-choice is to court confusion.     

The Health Professional Ethics Rubric: Practical Assessment in Ethics Education for Health Professional Schools

A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The DIT contains certain philosophical assumptions (??Kohlbergian?? or ??neo-Kohlbergian??) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric??which the authors have named the Health Professional Ethics Rubric??for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This rubric is also practical to use. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus-wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision.     

机构伦理委员会档案建设及其监管

伦理委员会档案是其在建设和运作中自然产生的最真实可靠的原始记录.通过对档案的产生和意义,分类、文件归档范围以及目前管理问题的分析,建议对其质量内涵审评,建立规范化的管理系统,进行有利于信息数据的统计评估和指导性政策的修订,以促进机构伦理委员会职能发挥,改善医疗、科研环境.     

Ethics of caring and the institutional ethics committee

Institutional ethics committees (lECs) in health care facilities now create moral policy, provide moral education, and consult with physicians and other health care workers. After sketching reasons for the development of IECs, this paper first examines the predominant moral standards it is often assumed lECs are now using, these standards being neo-Kantian principles of justice and utilitarian principles of the greatest good. Then, it is argued that a feminine ethics of care, as posited by Carol Gilligan and Nel Noddings, is an unacknowledged basis for /EC discussions and decisions. Further, it is suggested that feminine ethics of care can and should provide underlying theoretical tools and standards for lECs.     

The ethics of selectively marketing the Health Maintenance Organization

Health Maintenance Organization (HMO) administrators have been accused of engaging in ‘selective marketing’. That is, through such strategies as tailoring the benefits package of the program or advertising in styles or in media that do not appeal to certain ‘undesirable’ audiences, the administrator can minimize the percentage of persons in the HMO who are heavy users of health care services. By means of analyzing what ‘insurance’ is (philosophically) and what it means for something to be a free market commodity, the author argues that, as long as American society chooses to regard health insurance as a commodity or service of the free market, the use of such strategies is within the moral rights of health administrators. The author concludes by noting some morally undesirable results of treating health insurance as a market commodity.