神经外科高新技术应用中的人文问题

文在分析医疗高新技术给神经外科带来发展的同时,阐述了其所带来的一系列人文问题.并对神经外科医务人员如何在临床中合理应用医疗高新技术,把握好医患关系,合理利用医疗资源,表现良好的医德医风提出了要求.     

现代神经外科高新技术与人文关怀

高新科技进入医学领域 ,直接导致了现代医学的突飞猛进 ,使许多过去难以想象的医学难题得以解决。神经外科作为医学中最年轻、最复杂的一门学科 ,纵观其成长的历程 ,无不充满了现代科技革命的烙印 ,特别是近 30年来 ,神经外科技术呈现出加速度发展 ,在医学领域中 ,可以说 ,它是惟一最充分享用现代高新技术成果的学科。但是 ,这些新技术在给人们带来惊喜的同时 ,亦对传统的伦理观念、思想和文化提出了根本性的挑战 ,并给当代神经医学理论和实践留下了非常尖锐、必须认真对待的社会学问题。作为高新技术的享用者和实践者 ,神经外科学者在其“…     

加入WTO对中国高新技术产业的影响及应对策略

本文剖析了我国高新技术产业发展的现状,探讨了加入世贸组织给我国高新技术产业带来的影响,并在此基础上结合我国高新技术产业发展进程中的诸多问题提出了相应的对策.     

临床医学中人性化医疗的非显性误区辨析

随着现代医疗技术的迅猛发展,人们在享受高新技术提供服务的同时,却对临床医学存在的非人性化趋势提出越来越多的质疑,因此,需要对医学目的和价值进行重新审视。本文阐述了人性化医疗中存在的某些非显性误区,这是医学人文削减的主要内在原因,面对技术与人文之间的矛盾关系,出路在于医疗技术的人性化方向,赋予非人性化手段以人性化关怀,在探索人性化的医疗手段中实现医疗的人性化复兴。     

前额叶皮质切除术的实践与教训

前额叶皮质切除术是一种神经外科手术,其方法是切除与前额叶皮质有联系的组织.它一度成为神经外科在20世纪四五十年代的主流程序.其后人们普遍认识到它频繁而严重的负效应以及由此带来的痛苦,从而严格禁止这一手术.这一惨痛的教训使得神经伦理学的兴起成为必要.     

新技术革命前沿的神经外科

近年来,由于新技术革命的发展和信息交流的加快神经外取得了突飞猛进的发展,主要表现在ＣＴ、ＭＲＩ、ＤＳＡ、ＰＥＴ、ＩＯＭ、术中导航系统和远程医疗的应用等方面,使神经外科的诊断和治疗水平有了长足的发展。     

社区卫生服务在医疗体制改革中的作用和地位—英国的经验与教训

社区卫生服务通过六位一体的服务可以合理疏导医疗服务需求,解决医疗服务的公平性和合理控制医疗费用增长过快,在医疗体制改革中扮演着制约医院服务的重要角色。没有社区卫生服务组织和全科医生的积极参与和强有力的制约,医疗市场很难形成有效的竞争,医疗体制改革的初衷就很难实现。英国在该方面的经验与教训,足以引起起我们的关注与警惕,结合中国国情来借鉴,渴望我国在该方面的发展更趋稳定和合理。     

医疗人工智能科技异化及其伦理风险探析

医疗人工智能广泛应用于现代医疗形式。医疗科技的日新月异,大大推动了人类医学的发展进程及诊疗模式。与此同时,医疗人工智能科技的发展出现了异化现象,并由此带来了人和社会的异化,诸如对人与类人机器的角色定位不清,人对技术的依赖性过度增强,医疗全生命周期中的责任伦理缺失,技术价值失衡等社会问题。以这些异化带来的伦理风险为进度,探析在医疗人工智能使用中的隐私安全与数据使用的边界问题,人在医疗过程中的主体地位问题,"医生-人工智能-患者"的共同决策体系构建问题,构建医疗人工智能科技向善理念及法律问题。     

当代我国医学职业精神的基本特征

医学职业精神是以医学科学和人文科学为基础产生和发展的,具有很强的社会时代性.当今,中国医疗服务市场化的出现和高新技术的广泛应用,产生了医疗公平等问题,医学职业精神也遭受了极大的冲击和挑战.从深刻认识医学职业精神实质的角度出发,联系当前医疗卫生的实际,分析阐述当代我国医学职业精神的基本特征.     

当代我国医学职业精神的基本特征

医学职业精神是以医学科学和人文科学为基础产生和发展的,具有很强的社会时代性。当今,中国医疗服务市场化的出现和高新技术的广泛应用,产生了医疗公平等问题,医学职业精神也遭受了极大的冲击和挑战。从深刻认识医学职业精神实质的角度出发,联系当前医疗卫生的实际,分析阐述当代我国医学职业精神的基本特征。     

Prediction of neurosurgical results by psychological evaluation.

There has been an increasing interest in the role of personality factors in the outcome of medical treatment. The present study examined the role of personality measures in predicting the outcome of neurosurgery for patients with a well-documented disruption of one or more discs. Each of 15 male and 16 female patients whose average age was 40.8 yr. received the Minnesota Multiphasic Personality Inventory before surgery and received a follow-up at least one year after surgery or until a final, stable level of recovery was attained. A multiple correlation of .64 between the personality measures and treatment outcome suggested that even in cases with a well-documented need for surgery, psychological factors can play a major influence in the eventual outcome. Possible psychological interventions before surgery which might increase the likelihood of a good outcome are briefly outlined.     

There is no moral authority in medicine: response to Cowdin and Tuohey.

Central to the Cowdin-Tuohey paper is the concept of a moral authority proper to medical practitioners. Much as I agree with the authors in refusing to degrade doctors to the status of mere technicians, I argue that one does not succeed in retrieving the moral dimension of medical practice by investing doctors with moral authority. I show that none of the cases brought forth by Cowdin-Tuohey really amounts to a case of moral authority. Then I try to explain why no such cases can be found. Developing an insight that is common to all the major moral thinkers in the philosophia perennis, I show that doctors are professionally competent with respect only to a part of the human good; morally wise persons are competent with respect to that which makes man good as man. I try to show why it follows that a) professional expertise has no natural tendency to pass over into moral understanding, and that b) doctor and non-doctor alike start from the same point in developing their understanding of medical morality. It follows that the authors fail in their attempt to de-center the moral magisterium of the Church by setting up centers of moral authority outside of the Church.     

Sterilization, Catholic health care, and the legitimate autonomy of culture.

Disagreement over the legitimacy of direct sterilization continues within Catholic moral debate, with painful and at times confusing ramifications for Catholic healthcare systems. This paper argues that the medical profession should be construed as a key moral authority in this debate, on two grounds. First, the recent revival of neo-Aristotelianism in moral philosophy as applied to medical ethics has brought out the inherently moral dimensions of the history and current practice of medicine. Second, this recognition can be linked to Catholic morality through Vatican II's affirmation of the legitimate autonomy of culture, including the sciences. A partial precedent for understanding the moral authority of medicine can be found in the recent history of Catholic medical morality, and we further argue that a full contemporary recognition of that authority would weigh against an absolute prohibition of direct sterilizations. Institutionally, we propose the allowance of direct sterilizations in cases where the clinically perceived biomedical good of the patient is at stake.     

Mistakes as a social construct: an historical approach.

The Institute of Medicine (IOM) published To Err is Human: Building a Safer Health System in November 1999. The report focused public attention on the errors that occur within the medical system that cause death and harm to patients. It outlined a series of changes for health care that are aimed at reducing these errors by 50 percent over the next five years.This paper examines the problem of medical mistakes historically. It documents how legal, scientific, and medical trends during the years 1890-1934 intersected to effect the reporting of mistakes in the subspecialty of neurosurgery. At the start of this timeframe, mistakes were reported openly in journal articles as an educational tool. By its end, however, mistakes had gone "underground" and were buried amid a more objective, scientific reporting system. Using this historical perspective as a baseline, the paper concludes by re-examining the IOM's suggestions for change and comments on what they mean for the culture of medicine.     

从医疗语言看医学特质

语言是人类的生存方式之一,医学也是人类的生存方式之一.语言与医学的相通和交融,形成了一门新的交叉性、应用性、边缘性学科--医疗语言学.在医疗环境里,透过人类最活跃、最直接、最形象性的语言,可以深切感受到医疗过程中的人文关怀和医学的人文本质.     

差异中的医学人类学与社会学意义——对《中国人群死亡及其危险因素流行水平、趋势和分布》数据的透视

从医学人类学的视角对《中国人群死亡及其危险因素流行、趋势和分布》一书进行了评述,认为本书以大量的数据重新论证了医学人类学和社会医学的基本命题,也给读者带来了一些关于"人类发展与疾病流行"关系的思考。     

微创神经外科发展的思考

神经外科的发展历史就是一个不断追求微创的过程。微创神经外科狭义的理解,更多侧重于微创技术手段的应用;而广义的理解,则是指微创理念。微创神经外科取得了很大的成就,但还有许多问题需要解决。在微创神经外科的实践和发展中,不仅应重视微创技术的应用,更要注意应用微创理念。     

浅析蕴含在神经外科技术发展过程中的辩证思维

自然辩证法揭示了自然界以及科学技术发展的一般规律,神经外科学也不例外。纵观现代神经外科学一百多年来的技术变革和发展历程,无不渗透着辩证思想的影响。作为科学的认识论和方法论,自然辩证法对神经外科技术发展和临床实践的指导意义值得我们重视,本文对矛盾规律、质量互变规律、否定之否定规律、内因与外因、偶然性与必然性等范畴或规律在神经外科技术变革过程中的体现和意义进行了探讨。     

病历书写中的质量缺陷

病历书写中的质量缺陷存在于主诉、病史、体格检查、病程记录、诊断等各个方面。提高医学生病历书写质量及临床思维能力,是完成高质量病历书写的关键。同时病历书写有关的法律、法规相继出台,对病历书写提出了新的挑战。