医疗机器人的研究进展及伦理学思考

随着现代科技的日新月异,医疗机器人被广泛应用于医疗行业,大大推动了医学的发展,并成为机器人研究领域的热门方向之一。在简要介绍国内外医疗机器人研究进展及应用现状的基础上,本文指出该项技术存在的医疗责任追究机制不完善、缺少法律保障和规范、对医疗岗位冲击、无法体现对患者人文关怀等伦理问题;提出积极发展和推广医疗机器人技术的同时,推动人们对医疗机器人观念的更新,进一步制定和完善相关法律法规是解决该项技术伦理问题的关键。     

关于医疗、科研的一点认识

临床医疗是医院的根本使命,在权重上医疗自然重于科研.医疗实践是科研的出发点与归宿,决定了科研的基本走向.当前,科研工作受到前所未有的重视,科研作为医疗人员绩效考核的权重过大,偏离了医院的根本使命,会对科研、医疗、医护人员乃至整个社会造成伤害.SCI论文与临床关系不密切,不宜用来评价临床医师的水准.应该建立科学的考评机制,考核标准应细化、全面,对科研的奖励应适度.对于医护人员的考核应以医疗为主、科研为辅.     

临床医学整合：中心化整合关键在于观念转变

医学转型的实质是推进医学的整合,微观层面以临床医学的整合为核心部分,宏观上则以临床医学与预防医学的整合为核心。在诸多整合之中,以临床医学的整合最为迫切,它是整个医学整合过程中的基础和开端。当前进行的临床中心化整合似乎已成为一种主导的趋势,然而,如何进行中心化整合却仍然存在诸多问题需要探讨,某些医院对专科化的热衷和偏爱更令人担忧,医学资本的诱惑也是当今临床整合的一道障碍,因此,医学整合任重而道远,不仅需要医学形式上的重组,更需要有观念上的根本转变。     

The Concept of Yuko-Datotsu in Kendo: Interpreted from the Aesthetics of Zanshin

As kendo continues to gain in international popularity, there are hopes for its adoption in the Olympic Games as an international competitive event, even while moves to further this aim have not necessarily occurred in Japan or elsewhere. One reason for the efforts to achieve a form of globalization of kendo different from Judo is the attempt to adhere to and preserve the unique concepts kendo, the sport embodies by remaining true to the forms of traditional Japanese culture. This is epitomized by the importance given to zanshin (the combination of posture and fighting spirit after striking), one of the key concepts that constitute yuko-datotsu in kendo. Our purpose in this study is to discuss the intersubjective nature of the decisions regarding the conditions for point-scoring in competitive sports. In particular, we will focus on the aesthetics required for zanshin in kendo, focusing on the theory behind yuko-datotsu (point score), which will also considerably influence its international dissemination. Kendo is characterized from the perspective of western rationalism as an appreciation of form and rules of behavior referred to as formalism and, in this respect, it has unique characteristics differing from those of modern sports that are disseminated internationally. In martial arts, besides refinement and proficiency in the rules of behavior by rigidly adhering to form and rules of behavior and repetition, the aim is to transcend said form and the rules of behavior and embody the spiritual nature dwelling in the background. Kendo should remain traditional path and keep zanshin in the value of point (yuko-datotsu) for its virtue. Kendo has not yet developed into an international competitive sport, but it is in the process of traversing that Geido path as a Do for the purpose of character building through it. Throughout life, one should try to devote oneself to kendo with thought for the value of transcending form and the rules of behaviour, and embodying the spiritual nature of the sport that inheres in its background. That is why one may perceive an evident hesitation or indeed negativity regarding the possible internationalization or development as an Olympic event.     

The impact of empathy on burnout in medical students: new findings

Introduction: Research on medical students has shown they are at a higher risk for burnout and that this burnout may become more prevalent as they advance in medical school. The literature, thus far, has not explored the construct of ,emotional empathy and whether this can impact burnout in medical students. Objective: To understand the relationship between empathy (Empathic Concern [EC] and Personal Distress [PD]) and burnout in medical students. Method: Five successive classes of medical students enrolled at a new medical school were given the Maslach Burnout Inventory and Davis’ Interpersonal Reactivity Index over the course of three successive years (n = 353). Two dimensions of empathy were evaluated to determine if they have an impact on three dimensions of burnout (Emotional Exhaustion/EE, Depersonalization/DP, Personal Accomplishment/PA). Results: data was analyzed using a linear mixed model for each of the three components of burnout based on gender, age, year in medical school, and two types of empathy: EC, and PD. Conclusion: It was discovered that students with high levels of EC had statistically lower scores of burnout over time while students with high levels of PD empathy showed statistically higher scores of burnout over three years. Implications for these findings are discussed.     

Association between intimate partner violence during pregnancy and maternal pregnancy complications among recently delivered women in Bangladesh

Intimate partner violence (IPV), an actual or threatened physical, sexual, or psychological abuse by a current or former partner or spouse, is a common global public health issue. Understanding both the prevalence of IPV during pregnancy and its potential impact on the health of pregnant women is important for the development and implementation of interventions to prevent maternal morbidity and mortality. The purpose of this study was to explore the association between maternal experiences of IPV during pregnancy and pregnancy complications. A health‐facility‐based cross‐sectional study was conducted from July 2015 to April 2016 among 400 randomly selected women who were admitted to the postnatal wards of Rajshahi Medical College Hospital for delivery. Data were collected through face‐to‐face interviews using a structured questionnaire. Multivariable logistic regressions were performed to assess relationships between variables of interest after controlling for potential confounders. Results indicated that 39.0% of women reported physical IPV and 26.3% of women reported sexual IPV during pregnancy. Additionally, 69.5% of women experienced medical complications (MCs); of this group, 44.3% experienced obstetric complications (OCs) and 79.3% experienced any pregnancy complication (AC) during their last pregnancy. The experience of physical IPV during pregnancy was significantly associated with the experience of MCs (adjusted odds ratio (AOR): 2.05, 95% confidence interval (CI): 1.15–4.01), OCs (AOR: 4.23, 95% CI: 2.01–7.12) and AC (AOR: 5.26, 95% CI: 2.98–10.52). Women who experienced sexual IPV during pregnancy were also at increased risk of suffering from any MC, any OC, and AC. Maternal experience of IPV during pregnancy is positively associated with pregnancy complications. Preventing IPV directed at pregnant women might reduce maternal morbidity and mortality in Bangladesh.

     

MATRIX THINKING: AN ADAPTATION AT THE FOUNDATION OF HUMAN SCIENCE,RELIGION, AND ART

Intrigued by Robinson and Southgate's 2010 work on “entering a semiotic matrix,” we expand their model to include the juxtaposition of all signs, symbols, and mental categories, and to explore the underpinnings of creativity in science, religion, and art. We rely on an interdisciplinary review of human sentience in archaeology, evolutionary biology, the cognitive science of religion, and literature, and speculate on the development of sentience in response to strong selection pressure on the hominin evolutionary line, leaving us the “lone survivors” of complex, multiple lines of physical and cultural evolution. What we call Matrix Thinking—the creative driver of human sentience—has important cognitive and intellectual features, but also equally important characteristics traced to our intense sociability and use of emotionality in vetting rational models. Scientist, theologian, and artist create new cultural knowledge within a social context even if alone. They are rewarded by emotional validation from group members, and guided by the ever present question, “Does it feel right?”     

Comparative analysis of the risk-handling procedures for gene technology applications in medical and plant science

In this paper we analyse how the risks associated with research on transgenic plants are regulated in Sweden. The paper outlines the way in which pilot projects in the plant sciences are overseen in Sweden, and discusses the international and national background to the current regulatory system. The historical, and hitherto unexplored, reasons for the evolution of current administrative and legislative procedures in plant science are of particular interest. Specifically, we discuss similarities and differences in the regulation of medicine and plant science, and we examine the tendency towards dichotomizing risk — focusing on social/ethical risks in medicine and biological risks in plant science. The context of this article is the Synpraxia research project, an inter-disciplinary program combining expertise in sciences and the humanities.     

Scriptural Reasoning as a “Classic”: The Aesthetics of Interreligious Politics

Seeking to find a new way of meeting between Abrahamic traditions, Scriptural Reasoning has established a unique dynamic. This unique dynamic centres on meetings that are based on friendship rather than consensus, wisdom rather than propositional knowledge or binary thinking. Such virtues are not without problems. This article considers one problem: how the results of Scriptural Reasoning, and the insights gleaned from the meetings, can be passed on to the Abrahamic communities and the wider public. Addressing this problematic, the article focuses on the aesthetics of Scriptural Reasoning and its performance. Whereas one method of extending its influence is to widen the practice into the civic sphere and draw more people into the meetings, this article proposes another approach that suggests that the meetings of scholars or “representatives” around their texts constitute a “classic”, which, through vicarious performance can affect the wider public. Further than this, the article outlines a kind of aesthetic politics of religions. Building upon the idea of aesthetic representation proposed in the political sphere by Frank Ankersmit, it is argued that interfaith movements such as Scriptural Reasoning might be presented as a form of political representation.