临床医学教育中的医学哲学

医学哲学是现代医学教育中的重要组成部分,医学科学必须与医学哲学相结合才是未来医学教育的发展方向。在以岗位胜任能力为导向的医学教育转型中,培养医学生的哲学思维无疑是其重要环节之一。为适应全球卫生事业的迅猛发展,医学教育务必在临床思维上进行整合。本文从培养合格医学毕业生的角度出发,阐述了医学与哲学的关系、医学教育中的哲学地位及哲学在临床医学教育中的具体应用。旨在提高医学生的哲学理念,促进现代医学教育的转型发展。     

Philosophy of medicine — From a medical perspective

In this commentary on the article by Arthur L. Caplan [1] the philosophy of medicine is viewed from a medical perspective. Philosophical studies have a long tradition in medicine, especially during periods of paradigmatic unrest, and they serve the same goal as other medical activities: the prevention and treatment of disease. The medical profession needs the help of professional philosophers in much the same way as it needs the cooperation of basic scientists. Philosophy of medicine may not deserve the status of a philosophical subspecialty or field, but it so closely linked to the main trends of contemporary medical thinking that it must be regarded as an emerging (or reemerging) medical subdiscipline.     

循证卫生管理的探讨

培养博学而人道的医学工作者是医学教育所追求的目标。作为一门交叉学科,医学哲学在医学生的人文素质培养中占有重要地位。对医学哲学的教学内容、理念与方法分别进行探讨,期望医学哲学教育能够提高医学生对与现代医学有关的知识、活动和态度进行批判性反思的意识和能力。     

对话：医学人人文中的普世关怀与公共理性

对话主张,我们不妨暂时放弃最高限度的理想化方式（终极关怀）,转而寻求宽容、宽泛前提下的公共理性,医学不仅是科学的,更是人文的。而要推动技术教育至上背景下生长的一代青年学子完成这样一次沉重的转向,有两门学科不可绕过,一门是科学史,另一门是科学哲学。     

History,philosophy and science teaching what can be done in an undergraduate course?

This paper describes an attempt to introduce philosophy and history of science to pre-service science teachers. I argue briefly for the view that science in the schools cannot be taught without implicitly assuming a particular philosophy of science. Therefore, both philosophy and history of science are necessary components of undergraduate science education courses.     

临床决策:医学哲学研究的一个重要领域

临床决策研究已成为临床医学中的一个重要领域.当下的临床决策问题涉及到医学信息学、循证医学、费用-效益评估、卫生技术评估、医学伦理与法律等学科领域.因此在临床决策中单一的经验-描述的研究纲领已不适应当代医学发展的需要,需要引入综合的决策方法.临床决策问题也为医学哲学研究提供了一个极佳的思想实验场所.临床决策的多维度研究,对于打通学科之间的壁垒,架构科学与人文之间的桥梁,更深刻地理解和把握医疗保健的整体性,使临床医疗达到最佳疗效具有重要意义.     

论医学哲学范畴

医学哲学范畴是医学哲学理论体系中最基本和最深刻的概念,是人们把握生命和健康问题的认识纲领,是对医学问题进行逻辑归类的思维形式。医学哲学范畴是哲学与医学之间多重学术关系的统一,是抽象性与具体性、普遍性与特殊性、稳定性与变易性的结合,体现了学术价值、实践价值和文化价值的等多重价值。医学哲学范畴研究以创新研究为灵魂,以基础研究为根本,以应用研究为标的。     

A TALE OF TWO CONTROVERSIES: DISSONANCE IN THE THEORY AND PRACTICE OF RATIONALITY

Abstract. The relation between rationality in science and rationality in moral discourse is of interest to philosophers and sociologists of science, to educators and moral philosophers. Apparently conflicting conceptions of rationality can be detected at the core of two current socio-educational controversies: the creationievolution controversy and that concerning "moral education." This paper takes as its starting point the recorded views of participants in these controversies; exhibits the contradictions and their effect on the public; relates these contradictions to developments in the philosophy and history of science; and suggests, in a preliminary way, one approach for dealing with the problem.     

要重视慢性乙型肝炎的抗病毒治疗

慢性乙型肝炎是我国常见的慢性传染病之一,严重危害人民健康.围绕着乙型肝炎的防治,带来巨大的经济负担,已成为不可忽视的社会问题.在慢性乙型肝炎-肝硬化-HCC的发生发展过程中,HBV病毒载量起着重要的作用,抗病毒治疗是目前治疗慢性乙型肝炎的有效手段.因此,要重视和规范抗病毒治疗.     

Does the philosophy of medicine exist? A commentary on Caplan

Caplan has argued that the philosophy of medicine does not exist. Although I will not deny the points he makes, I will argue that the philosophy of medicine has characteristics of a developing field with the potential to meet all of Caplan's criteria. The argument is based on Dewey's established views on logical development for a field of inquiry, as well as pointing out how other criteria Caplan imposes can be fulfilled.The U.S. Government right to retain a non-exclusive, royalty free licence in and to any copyright is acknowledged.     

医学人文运动与知识考古--中国人文医学的战略与策略

后现代理论影响和刺激了医学人文学,医学人文学学科意义与价值更加显明,医学需要人文学,人文学需要医学,医务人员迫切需要人文医学教育。经济发展、高新生命科学技术入驻世俗生活、医学模式转变、医疗改革与价值论哲学影响,这五大因素构成中国医学人文运动的背景;中国医学人文运动正在兴起。研究医学人文学的知识背景对制订人文医学战略与策略有重要意义。     

建立鼻腔结构与功能自适应生物力学模型在鼻科疾病中的作用

鼻腔结构在与鼻腔物理力学环境发生交互关系时,能够根据周围环境调整自身结构和形状,即所谓鼻腔结构与功能自适应性.鼻腔结构与功能自适应生物力学模型模拟鼻腔结构异常产生功能障碍所继发的上呼吸道疾病发生发展过程,为鼻科某些常见病的发生发展过程进行量化分析,为鼻内窥镜手术在恢复重建鼻腔结构功能方面临床决策提供依据.     

“精选、精讲、精练”教学法在临床教学中的应用

临床医学是集多学科知识为一体的专业学科,具有基础知识与临床实践紧密结合的显著特性。为适应新世纪医学教育的系统性转型,配合器官系统为中心课程模式的有效运行,我院采用“精选、精讲、精练”的教学方法,通过系统性整合各专业学科课程,加强学科间的知识联系,实现基础向临床的转化、从而开辟专业课程综合化发展的道路,给学生提供最优化的教学内容,在掌握专业技术的同时,拓宽临床思维,履践医学人文精神,为培养医学生未来临床岗位胜任能力奠定坚实基础。     

Does the philosophy of medicine exist?

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field.     

不良事件报告制度与患者安全

由于医院本身具有复杂性,不确定性和高风险性等专业特性,再加上越来越多新技术及新疗法的介入等错综复杂的因素,使得医疗风险无处不在。世界各国均存在不同程度的患者安全问题,这在发展中国家尤为严重,并由此产生了巨大的经济负担。患者安全问题已成为一个全球性的、亟待解决的问题,因此很有必要建立一个医疗安全监管系统。欧美多个国家已建立起医疗不良事件报告系统,我国虽然也有患者安全（不良事件）自愿报告系统,但发展还很不成熟。我们还应做出更多努力以推进该系统的发展,全面保障患者安全。     

WTO与医学生人文素质的培养

加入WTO对医学生培养带来全方位的挑战,其主要的方面则表现在人文素质的差距上,必须努力建设具有中国特色的医学教育文化,构建医学生人文素质教育课程体系,加强组织保障和评估,以赢得竞争。     

循证医学与医学教育改革

循证医学这一新的医疗模式反映了世界医学的发展趋势,代表了现代医学的前进方向。医学教育必须应这一趋势,按照循证医学的基本精神促进观念更新,推进医疗模式、教学内容、教学方法和继续教育等方面的改革,全面提高医学教育质量。     

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.     

Philosophy of Science in the Twenty‐First Century

Philosophy of science in the past half century can be seen as a reaction against logical empiricism's focus on modern logic as the format in which debates should be expressed and on physics as the canonical science. These reactions have resulted in a fragmentation of the field. Although this provides ways forward for disparate philosophies of various sciences, it threatens the very possibility of general philosophy of science. The debate that most obviously continues to be conducted at the general level—the debate about scientific realism—only does so because of a dangerous naïveté. Nevertheless, this article suggests that there is a place for general work not by starting at the highest level of abstraction but instead by abstracting general lessons from actual science.     

经导管射频消融术发展史及对医学教育的启示

自20世纪未,经导管射频消融术成功用于治疗快速心律失常,取得了瞩目的成就,本文回顾这一技术的发展史,认为它是理工科和医学高度结合的产物,提出医学教育与科研应该有理工医结合的环境。