加强ART实施过程中知情同意及其方式探讨

通过分析新疆医科大学第一附属医院生殖助孕中心400余对接受辅助生殖技术治疗不育夫妇知情同意过程,观察不育夫妇知情同意满意度,发现采取的8种方式可以提高不育夫妇的知情同意满意度,分阶段、反复的信息告知同时结合个体化的咨询、答疑是知情同意的基础,也是辅助生殖技术实施过程中知情同意实施的较好的方式.     

从辅助生殖技术的个案析要论知情同意的完善

结合在人类辅助生殖技术服务过程中发生的案例进行分析,就如何完善知情同意提出了一些见解.认为,医疗技术服务中,知情同意的完善必须注重两个环节,知情同意过程和签署知情同意书.这两个环节必须根据具体情况来进行实施,绝不能敷衍走过场.因此,相关医生对知情同意的认识和伦理监督就显得尤为重要.     

从辅助生殖技术的个案析要论知情同意的完善

结合在人类辅助生殖技术服务过程中发生的案例进行分析,就如何完善知情同意提出了一些见解。认为,医疗技术服务中,知情同意的完善必须注重两个环节,知情同意过程和签署知情同意书。这两个环节必须根据具体情况来进行实施,绝不能敷衍走过场。因此,相关医生对知情同意的认识和伦理监督就显得尤为重要。     

对知情同意书和知情同意过程的探讨

在《医疗事故处理条例》实施中,存在着一种现象:重视一张由患者签字的知情同意书,轻待知情同意过程。签字的知情同意书不等于知情同意,知情同意书不等于“生死契约”。知情同意的本义:对患者权利、尊严、人格和自由的尊重,只有在知情同意过程中获得。因此知情同意过程应该重要于知情同意书。医生严格履行好法定的告知和说明义务,尊重患者的知情同意权,就是尊重法律,也是医生保护自己的最好方式。     

对知情同意书和知情同意过程的探讨

在<医疗事故处理条例>实施中,存在着一种现象:重视一张由患者签字的知情同意书,轻待知情同意过程.签字的知情同意书不等于知情同意,知情同意书不等于"生死契约".知情同意的本义:对患者权利、尊严、人格和自由的尊重,只有在知情同意过程中获得.因此知情同意过程应该重要于知情同意书.医生严格履行好法定的告知和说明义务,尊重患者的知情同意权,就是尊重法律,也是医生保护自己的最好方式.     

知情同意在中医药临床诊疗中的应用思考

知情同意在中医药临床诊疗中的应用,医生要掌握知情同意的要素和方法,将中医药的不良反应及中医药特殊性告知病人,让病人的充分知情、自愿选择、实施同意。医疗机构也要承担推进知情同意应用的责任,开展不良反应监测、建立实施规范,教育和评估知情同意落实情况。     

浅论生殖医学伦理委员会的功能

辅助生殖技术的开展为医学伦理带来了新的内容和挑战。我国卫生部于2001年2月20日发布的《人类辅助生殖技术管理办法》中规定,人类辅助生殖技术的应符合有利于患者的原则、知情同意的原则、保护后代的原则、社会公益原则、保密原则、严防商业化的原则和伦理监督的原则。开展辅助生殖技术的条件之一是医疗机构建立生殖医学伦理委员会。伦理委员会是教育性、咨询性、义务性及独立组织。生殖医学伦理委员会应依据上述原则对人类辅助生殖技术的全过程和有关研究进行监督,开展生殖医学伦理宣传教育,并对实施中遇到的伦理问题进行审查、咨询、论证和建议。     

知情同意对危重病患者心理影响的现状研究

探讨知情同意对危重病患者的心理影响。根据知情同意实施现状,将患者分为患者知情组、家属知情组,采用问卷调查和访谈相结合的方法对两组知情同意前、后的心理状况进行评估和比较。采取自愿方式及适宜的告知方法由患者本人知情同意,患者的心理状况与选择家属知情同意的患者无明显区别。     

接受辅助生殖技术女性病人权利的伦理思考

接受辅助生殖技术的女性从治疗开始已经承受生理、心理、社会关系、经济等方面的各种压力,这足以对其以后的生活产生不良影响。因此,在实施此项技术过程中应尽量避免对受术女性产生不必要的伤害,尊重其平等就医权和知情同意权,保护身心健康,尊重人格及尊严,提高其生命质量。     

接受辅助生殖技术女性病人权利的伦理思考

接受辅助生殖技术的女性从治疗开始已经承受生理、心理、社会关系、经济等方面的各种压力,这足以对其以后的生活产生不良影响.因此,在实施此项技术过程中应尽量避免对受术女性产生不必要的伤害,尊重其平等就医权和知情同意权,保护身心健康,尊重人格及尊严,提高其生命质量.     

女性选择辅助生殖技术的文化动力

在现代医学的语境中,女性的身体究竟是什么?是被当作肉体还是视作活生生的身体?这在很大程度上影响着女性的地位和命运。辅助生殖技术迎合了社会的主流需要,使女性的身体客观化为肉体,女性作为活生生的身体已被淡漠和遗忘。辅助生殖技术只有成为女性的自主选择才是合理的。     

Third party assisted conception: an African perspective

The central importance of reproduction in all human cultures has given rise to many methods and techniques of assisting reproduction or overcoming infertility. Such methods and techniques have achieved spectacular successes in the Western world, where processes like in vitro fertilization (IVF) constitute a remarkable breakthrough. In this paper, the author attempts to reflect critically on assisted reproduction technologies (ART) from the background and perspective of African culture, a culture within which human reproduction is given the highest priority but which also exhibits a highly ambivalent attitude to modern technology-assisted methods of reproduction. The author considers the ethical crux of reproductive technologies to be linked to the issue of the moral status of the human embryo and argues that a morally significant line of demarcation cannot be drawn between embryos and other categories of humans.     

The Purchase of Fruitfulness: Assisted Conception and Reproductive Disability in a Seventeenth-Century Comedy

The relationships between socioeconomic and biogenetic reproduction are always socially constructed but not always acknowledged. These relationships are examined as they apply to an instance of infertility and assisted reproduction presented in a seventeenth-century English play, Thomas Middleton's 1613 comedy, A Chaste Maid in Cheapside. Middleton's satirization of the effects of secrecy on the category of reproductive disability is analyzed and its applicability to our own time considered. The discussion is in four parts, focusing on: the attribution of disabled status to one member of the couple, the wife; the use of this attribution to protect the husband's reputation for sexual and reproductive health; the concealment of the nature of assisted reproduction; and the interests of the child conceived with such assistance.     

La fécondation artificielle post-mortem dans le Code civil Hellénique

Medically assisted reproduction offers a technique that allows to have children of a recently deceased person. This is provided for in the Hellenic Civil Code. This article analyzes and criticizes the conditions of post-mortem assisted reproduction according to the Hellenic Civil Code.     

The Convention on Human Rights and Biomedicine of the Council of Europe

The Convention on Human Rights and Biomedicine developed by the Council of Europe, now undergoing ratification, is the first international treaty focused on bioethics. This article describes the background of the Convention's development and its general provisions and provides a comparison of its requirements with those of federal regulations governing research with human subjects. Although most provisions are comparable, there are significant differences in scope and applicability, for example, in the areas of compensation for injury, research participation by persons with limited capacity to consent, assisted reproduction, organ transplantation, and research in emergency situations. The Convention represents a milestone in international bioethics and protection of human rights that will probably be referred to with increasing frequency.     

Biotechnologies that empower transgender persons to self-actualize as individuals,partners, spouses,and parents are defining new ways to conceive a child: psychological considerations and ethical issues

Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary seminars that gathered child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology (ART) and gender dysphoria, philosophers interested in bioethics, biologists interested in ART, and endocrinologists interested in pubertal suppression, we explore how new biotechnical advances, whether in gender transition or procreation, could create new ways to conceive a child possible. After reviewing the various medical/surgical techniques for physical gender transition and the current ART options, we discuss how these new ways for persons to self-actualize and to experience parenthood can not only improve the condition of transgender persons (and the human condition as a whole through greater equity) but also introduce some elements of change in the habitual patterns of thinking especially in France. Finally, we discuss the ethical issues that accompany the arrival of these children and provide creative solutions to help society handle, accept, and support the advances made in this area.     

Ethical and Religious Aspects of Gamete and Embryo Donation and Legislation in Iran

During recent decades, new assisted reproductive technologies (ARTs) have improved significantly, but their ethical, social, psychological, religious and legal aspects are blurred and need further research. New techniques using donor sperm or egg allow for third party involvement in the procreation process, which has created new hope for infertile couples. The corresponding clinical applications also raise new religious questions, which require appropriate interpretation in order to make their use possible, particularly in religious communities. In this paper, we discuss the most important ethical issues and the Islamic view of third party reproduction. Likewise, the current method of third party reproduction in Iran will be described, and the advantages and disadvantages of the Act of Embryo Donation to Infertile Spouses will be stated. Consideration of this outlook could generate inspiration in many Islamic countries.     

右侧背外侧前额叶皮质在时间知觉中的作用:基于经颅磁刺激的研究

将10 Hz的重复经颅磁刺激(r TMS)施加于右背外侧前额叶皮质(r DLPFC),探讨该区域在时间加工模型中的作用。实验一采用时间复制任务,通过比较基线和后测条件下时间估计行为的差异,探究高频r TMS离线施加于r DLPFC之后对时间知觉的影响。实验二采用毫秒和秒两种范围的时距,探究r DLPFC在不同范围的时间知觉中的作用。结果发现r TMS施加于r DLPFC导致对1.5 s高估,对600 ms的估计无显著影响,提示r DLPFC在涉及工作记忆加工过程的秒范围的时间知觉中有重要作用。     

The Temporal and Dynamic Nature of Self-Regulatory Processes During Independent and Externally Assisted Hypermedia Learning

This study examined the temporal and dynamic nature of students’ self-regulatory processes while learning about the circulatory system with hypermedia. A total of 74 undergraduate students were randomly assigned to 1 of 2 conditions: independent learning or externally assisted learning. Participants in the independent learning condition used a hypermedia environment to learn about the circulatory system on their own, while participants in the externally assisted condition used the same hypermedia environment, but were given prompts and feedback from a human tutor during the session to facilitate their self-regulatory behavior. Previously published pretest–posttest shifts toward more mature understanding of the circulatory system indicate that the externally assisted condition leads to greater learning. The present article uses think-aloud data during learning to explore process issues in light of models of self-regulated learning and conditions of engagement that may affect those processes. Results indicate that access to a human tutor influences the deployment of regulatory processes, intervals of use, and temporal dependencies. For example, there is significantly more planning during the final time interval of the learning session in the externally assisted condition; students in both conditions deploy more learning strategies in the first and second time intervals, compared to the last two time intervals. Additionally, in the externally assisted condition participants were more likely to shift from planning to monitoring and less likely to shift from learning strategies to planning. We discuss theoretical, conceptual, and methodological issues pertaining to these results, as well as implications for future research and the design of adaptive hypermedia systems.     

罗杰斯与老子的人性观比较研究

西方人本主义理论的代表人物罗杰斯与道家的创始人老子的理论对人性的观点有很多相似之处,这种相似的人性观主要表现在他们对人的基本动机的理解之上,这两个基本动机分别为实现倾向性和复归倾向性。该文通过比较这两种基本动机,探讨罗杰斯与老子的人性观的相似点与不同点。