浅谈现代普通外科观念的变更

随着自然科学和社会科学的发展,特别是现代医学模式的转变,普通外科的观念与传统观念有了很大不同.人本主义观念是普通外科的所有医疗活动的指导原则,循证观念成为解决临床问题的有效手段,微创观念将引导现代普通外科的发展方向,置换观念是社会和自然科学发展的必然,整体观念体现着现代医学对立统一的思想,而新的健康观念更符合人类文明进步的要求,协作观念则是提高医疗质量的保障.     

对自然科学之医学的思考

对自然科学之医学的思考日本国立民族学博物馆吉田集而一、自然科学之医学发源于西方的现代医学作为自然科学，其发展及取得的成就的确是惊人的，人类的平均寿命随之也大大延长了。然而发展到今天，现代医学似乎又变得难以理解了。在一些疑难病症尚未完全解决的同时，新的...     

提倡"理性医疗"

"理性医疗"是对疾病进行科学、客观地综合分析,由此筛选出一个理性的处置方案的医疗过程."理性医疗"不但有利于社会,有利于医患双方,更符合自然科学的规律,同时,对传统的伦理学观念也是一种补充与完善."理性医疗"的实现需要医患双方的共同协作.     

提倡“理性医疗”

“理性医疗”是对疾病进行科学、客观地综合分析,由此筛选出一个理性的处置方案的医疗过程。“理性医疗”不但有利于社会,有利于医患双方,更符合自然科学的规律,同时,对传统的伦理学观念也是一种补充与完善。“理性医疗”的实现需要医患双方的共同协作。     

医药企业的过度介入与医学专业精神

医药企业促进了现代医学的发展,但同时其过度介入会对医学专业精神和医疗职业宗旨带来冲击,不利于医学的发展,为了解决这一问题,必须从医师、企业自身和管理层三方面入手,使医药企业适度介入医疗活动,充分利用其对现代医学的积极促进作用,减消其消极作用,才能使现代医学沿着健康科学的方向发展。     

医药企业的过度介入与医学专业精神

医药企业促进了现代医学的发展,但同时其过度介入会对医学专业精神和医疗职业宗旨带来冲击,不利于医学的发展,为了解决这一问题,必须从医师、企业自身和管理层三方面入手,使医药企业适度介入医疗活动,充分利用其对现代医学的积极促进作用,减消其消极作用,才能使现代医学沿着健康科学的方向发展.     

以患者为中心的现代医学模式与喉癌治疗

随着现代医学模式兴起,人们的健康观念有了新的内容,不再是单纯的躯体健康,还涉及好的心理状态和良好的社会适应。医疗服务也由单纯的技术服务转变为技术与心理和精神相结合。喉癌是头颈部常见的恶性肿瘤,喉癌治疗方式直接影响患者的生活质量,因此喉癌的治疗应与以患者为中心的现代医学模式相结合,以达到良好的治疗效果。     

现代医学与人文医学的区别联系及走向--二者的融通才是医学发展之未来

现代医学的基本要素是:现代医学实践过程(包括所有内容、技术、手段和途径),实践的主体对象人和掌握与运用现代技术的人.其主要具有以下特征:(1)关于人的现代医学特征;(2)现代医学的人文文化特征;(3)现代医学工作者职业理性特征;(4)现代医学的人文社会化特征等.现代医学和人文医学的融通才是医学发展之未来.提出加大人文医学和医学伦理学的宣传教育力度,建立人文医学学科机制和搭构行业平台,由政府出面制定现代医学领域行业道德规范,医学科学公约,医疗行业行医准则,医疗道德公约等,四是有计划有目的的实践实际内容和真正意义上的融通.     

以患者为中心的现代医学模式与喉癌治疗

随着现代医学模式兴起,人们的健康观念有了新的内容,不再是单纯的躯体健康,还涉及好的心理状态和良好的社会适应。医疗服务也由单纯的技术服务转变为技术与心理和精神相结合。喉癌是头颈部常见的恶性肿瘤,喉癌治疗方式直接影响患者的生活质量,因此喉癌的治疗应与以患者为中心的现代医学模式相结合,以达到良好的治疗效果。     

预立医疗照护计划在重症医学科中的应用研究进展

基于目前我国医疗压力较大,过度治疗现象突出等问题,站在现代医学观念和辩证思维角度来思考如何合理且有效地利用现有的医疗资源,减少不必要且增加患者痛苦的治疗,减轻患者家庭负担,让患者有尊严地离开。同时,借鉴国外经验结合我国文化背景对预立医疗照护计划的可行性和必要性进行阐述,对国内外预立医疗照护计划实施的现状进行对比,并分析国内外预立医疗照护计划实施差异的原因,提出针对性的措施,以期为我国重症医学科推行预立医疗照护计划提供建议,促进安宁疗护的进一步发展。     

论现代医学视野中的伦理与现代伦理视野中的医学

医学与伦理的关系从古代、近代到现代,经过了一个浑然一体、相互分离和重新融合的否定之否定过程。通过对这一过程的简要考察和分析,着重阐述了现代医学视野中的伦理与现代伦理视野中的医学应当所具有的本质形相。在现代医学视野中,现代医学伦理是来自人类伦理遗产和对现实生命道德问题的伦理认识结果两方面的理论交汇。现代伦理应当是多层次的理论与实践系统,其中包括道德哲学层次的思考;生命伦理中的道德原则和规范的构建;关于生命道德规范长入现代医学的机制问题的思考;现代医学伦理的发展与相关学科的相互借鉴的研究。在现代伦理的视野中,现代医学的本质在于,现代“大医学”的概念已经取代了对医学的传统认识;医学作为现代社会文化构成部分的特质逐渐地被揭示出来;现代医学已经成为特定社会职业群体以科学技术为主体的重要社会活动。站在现代医学和现代伦理各自的立场认识和了解对方,对全面把握二者之间的关系和推进二者之间的有机结合具有重要意义。     

腹腔镜手术治疗子宫内膜异位症的临床价值

子宫内膜异位症是妇科常见病、多发病之一,可引起痛经、慢性盆腔痛、性交痛和不孕等症状,严重影响育龄期妇女的身心健康和生活质量,日益受到人们的关注。以人为本,微创手术是当代医学的模式之一。本文从哲学的角度出发、以辩证的观点对腹腔镜手术治疗子宫内膜异位症的临床价值进行综述。     

防御性医疗动因及干预策略

本文重点阐述了防御性医疗的概念及特点,分析了防御性医疗之动因,最后提出防御性医疗的干预策略,包括加强医务人员职业道德教育,提高人文服务水平;加强社会宣传,提升医务人员形象;加强沟通,重建医患信任关系;强化内部管理,建立风险应对机制;完善医疗法律法规,积极构建法制环境下的现代医学模式。     

盆底结构MRI研究进展及思考

盆底结构精细复杂,传统的解剖学以尸检为依据,现代影像学则提供了活体观察功能形态的有效方法。盆底结构核磁共振成像研究的新进展,体现了医学技术创新的稳健性、后发性、综合性,其发展取决于现代科学技术的进步。因此影像医学工作者作为医学科技主体,只有具备综合型知识结构,才能更好地进行医学技术创新。     

Incurable suffering from the “hiatus theoreticus”? Some epistemological problems in modern medicine and the clinical relevance of philosophy of medicine

Up to now neither the question, whether all theoretical medical knowledge can at least be described as scientific, nor the one how exactly access to the existing scientific and theoretical medical knowledge during clinical problem-solving is made, has been sufficiently answered. Scientific theories play an important role in controlling clinical practice and improving the quality of clinical care in modern medicine on the one hand, and making it vindicable on the other. Therefore, the vagueness of unexplicit interrelations between medicine's stock of knowledge and medical practice appears as a gap in the theoretical concept of modern medicine which can be described as Hiatus theoreticus in the anatomy of medicine. A central intention of the paper is to analyze the role of philosophy of medicine for the clarification of the theoretical basis of medical practice. Clinical relevance and normativity in the sense of modern theory of science are suggested as criteria to establish a differentiation between philosophy of medicine as a primary medical discipline and the application of general philosophy in medicine.     

The Evolution of Psychology as a Basic Bio-behavioral Science in Healthcare Education

For over a century, researchers and educators have called for the integration of psychological science into medical school curricula, but such efforts have been impeded by barriers within medicine and psychology. In addressing these barriers, Psychology has re-examined its relationship to Medicine, incorporated psychological practices into health care, and redefined its parameters as a science. In response to interdisciplinary research into the mechanisms of bio-behavioral interaction, Psychology evolved from an ancillary social science to a bio-behavioral science that is fundamental to medicine and health care. However, in recent medical school curriculum innovations, psychological science is being reduced to a set of “clinical skills,” and once again viewed as an ancillary social science. These developments warrant concern and consideration of new approaches to integrating psychological science in medical education.     

医学方法的演进与循证医学

医学方法是医学理论发展的显著标志。随着医学方法由自然观察、科学实验到循证医学的依次演进,医学也由古代医学、近代实验医学日益提升为现代循证医学。客观、辩证地认识医学方法的演变过程,对于更好地掌握和应用先进的循证医学法,促进人类医学事业的发展具有重要的理论意义和实践意义。     

Medicine and the Cartesian image of man

The contemporary philosophy of medicine may be characterized as a continuous struggle with the Cartesian heritage, in order to reach a more satisfying image of man. This paper outlines the influence of Cartesian dualism on the foundations of medicine. The notion of a real distinction between the mental and physical, particularly the mechanistic conception of the human body, made possible the development of the natural sciences as well as scientific medicine, not hampered any longer by the risk of colliding with religion or Church. The Cartesian machine model of man immediately appealed to seventeenth century physicians: Dutch Cartesians (Regius, Craanen) and followers of the iatrophysical school (Santorio, Borelli). Dichotomizing between mind and body, subject and object, self and world, self and other, knower and knowledge is constitutive for modern medicine conceiving itself as a natural science.     

摆在现代外科医师面前的若干矛盾现象

随着自然和社会科学的进步,现代外科在得到了空前发展的同时,许多矛盾现象也摆在外科医师的面前,例如手术和非手术、手术扩大与缩小、手工操作和器械使用、手术实施和手术风险、经验主义和循证、临床治愈和健康之间的矛盾,如何正视和解决这些矛盾问题,关系到到现代外科学长远发展。     

The physician in the technological age

Translator's summary and notes: Karl Jaspers (1883–1969) argues that modern advances in the natural sciences and in technology have exerted transforming influence on the art of clinical medicine and on its ancient Hippocratic ideal, even though Plato's classical argument about slave physicians and free physicians retains essential relevance for the physician of today. Medicine should be rooted not only in science and technology, but in the humanity of the physician as well. Jaspers thus shows how, within the mind of every medical person, the researcher contests with the physician and the technician with the humanist. Jaspers therefore opposes all modern tendencies that regard men as abstractions. As a creative existentialist influenced by Kierkegaard, Nietzsche, and Husserl, he reasons that clinical medicine should always treat patients as irreducable individuals, and his thinking on psychotherapy argues for a realm of interiority, freedom, intelligibility, and existential communication that transcends the reach of the causal thinking of natural science. This essay, written in 1959, reflects Jaspers' lifelong preoccupation with the philosophical meaning of medicine (he received his MD degree in 1909) and the totality of the human person. It should significantly enhance our own comprehension of medical power, dangers, reasoning, and accomplishments. Key words have been added by the translator.