全社会共同努力,在发展中实现卫生公正

"公正"是科学发展观的重要内容,是卫生系统的主要价值取向,实现公正是医药卫生界的神圣职责.目前,在发展中实现卫生公正已经刻不容缓.我们必须以政府为主导,坚持以人为本和卫生公正,树立扶贫济困的社会风气,共同努力,采用多种措施实现卫生公正.     

社区卫生服务——体现效率与公正特征的改革之路

社区卫生服务比较全面地体现了公正与效率的原则，是卫生改革的一项重大举措。它公正有效地突破了固有的卫生体制；公正有效地实现了“人人享有初级卫生保健”的目的；公正有效地推进了医学模式的转移；公正有效地抓住了纠风的症结；公正有效地解决了医疗费居高不下的顽症。     

社区卫生服务

社区卫生服务比较全面地体现了公正与效率的原则,是卫生改革的一项重大举措。它公正有效地突破了固有的卫生体制;公正有效地实现了“人人享有初级卫生保健”的目的;公正有效地推进了医学模式的转移;公正有效地抓住了纠风的症结;公正有效地解决了医疗费居高不下的顽症。     

论医学公正

通过对公正的理论考量,揭示公正作为卫生经济伦理学的核心理念,在医学实践中具有重要的价值评判作用.同时指出中国的卫生经济发展的指导性方针应该是:公平优先,兼顾效率.     

论影响卫生资源分配公平性的因素

公平分配卫生资源是促进社会公正的重要方面.观念、体制与政策是影响卫生资源公平分配的重要因素.重医疗、轻预防的观念使宏观卫生资源分配失去公平,而城市尤其是大中城市优先的制度安排、按医疗项目付费方式的弊端、医疗保障体制的不公平等体制与政策因素则使微观卫生资源分配失去公平.从观念因素、体制与政策因素两个方面入手,改进卫生资源分配的公平性,是我国提高全民健康水平、促进社会公正的必由之路.     

"灯塔经济"与医改的"穷人经济学"

我国卫生改革一开始就缺乏伦理基准,医疗服务过度市场化倾向、政府责任不到位和伦理缺席已将卫生改革引向功利主义的死胡同,使得卫生改革背离了公正目标.在今后的深化改革中,必须强调医学目的,贯彻以人为本的指导思想,加大政府的投入,围绕公正目标,建立覆盖全民的医疗保障体制.     

卫生政策走向与公共健康及其伦理思考

政府通过决策决定卫生政策,卫生政策对于公共健康具有导向和引领作用。卫生政策走向直接影响公共健康,决定公共健康的发展方向。卫生政策与公共健康的关系是因果关系,前者决定后者。卫生政策需要有伦理学基础和伦理学专家的伦理论证,坚持公正、公平、公益的原则。     

我国医疗卫生改革中的伦理缺席

“中国的医疗卫生体制改革从总体上说是不成功的”结论的发表在社会上引发了对卫生改革的种种议论,从卫生改革的设计、实施和评估三方面论述了由于政府的缺位和伦理学的缺席,将卫生改革引向功利主义的死胡同,使得卫生改革背离了公正的目标而导致失败。但退回计划经济体制下的办医模式同样没有出路,在今后的深化改革中,必须强调医学目的,贯彻以人为本的指导思想,加大政府的投入,围绕公正目标,建立覆盖全民的医疗保障体制。     

我国医疗卫生改革中的伦理缺席

"中国的医疗卫生体制改革从总体上说是不成功的"结论的发表在社会上引发了对卫生改革的种种议论,从卫生改革的设计、实施和评估三方面论述了由于政府的缺位和伦理学的缺席,将卫生改革引向功利主义的死胡同,使得卫生改革背离了公正的目标而导致失败.但退回计划经济体制下的办医模式同样没有出路,在今后的深化改革中,必须强调医学目的,贯彻以人为本的指导思想,加大政府的投入,围绕公正目标,建立覆盖全民的医疗保障体制.     

河南省医疗改革的公平性分析

河南省医疗改革突出的难题在于如何实现保健资源的公平公正.影响河南医疗改革公平的因素是产权改制的方向偏差,道德异乡人的利益博弈,资本和技术对医学的剥蚀,医学、医疗自身发展的失衡.实现医疗改革公平的对策建议是显化政府责任伦理,重建医患利益共同体,整合优化卫生资源的配置,推行医学整体化的发展模式.     

Merleau-Ponty on human development and the retrospective realization of potential

In this essay, I propose that human development is the emergence of something significantly new out of a past situation that does not hold that novel achievement as a determinate potential except retrospectively. Development, in other words, might best be understood as a “realization” in the sense of a making-real of some new form of being that had no prior place in reality, that was not programmed in advance, but that once realized can have its roots traced back to determinate conditions and potentials in its own past. This amounts to a rethinking of the nature of developmental potential as retrospectively determined. But it also involves a reconception of the locus of such potential: I argue that developmental potential must be understood as located in the human-organism-in-its-situation, rather than simply in the human organism. I take my bearings from phenomenologist Maurice Merleau-Ponty, and I make my case by elucidating three different forms of human development described by Merleau-Ponty: intellectual realizations of insight; the realization of a new perceptual-motor skill; and a child’s realization of a new lived way of making sense of the interpersonal world.     

The implication of Rawls�� approach to public reason

Rawls’ appealing to free agreement in the original position cannot be understood as the source of real commitment to principles of social justice. According to the contextualistic interpretation, to establish and clarify the reasonableness of one context, one needs to appeal to the reasonableness of some higher-order contexts. Because the two meta-contexts of global basic structure and domestic basic structure can be seen as higher-order or lower-order context relative to each, depending on concrete cases, by excluding the consideration of global situation that must have effects on the realization of domestic justice, “justice as fairness” is blind both to the global context of domestic justice and to the domestic context of global justice.     

The concept of formal justice

Conclusion In Greek mythology, Themis, the goddess of justice, is blindfolded so that she may not see those who stand before her, and consequently, so that she can administer justice consistently and impartially. The imagery provides an apt illustration of the formal dimension of justice. Yet it serves only to blind us to the actual workings and character of the practice of doing justice. I have argued here that we must take seriously the full implications of material principles of jusitce. And when we do, there is no longer any conceptual space left in our reflections on justice for the virtue of formal justice. Of course, the just treatment of relevantly similar subjects does result in the equal treatment of these subjects; this, after all, is a logical consequence of acting upon a material principle of justice in similar cases. But this, let me emphasize, is only a consequence of doing justice and as such it reveals only a contingent feature of doing justice. The proponents of the formal dimension of justice have, so to speak, failed to see the trees through the forest. Impressed by the consequence of equality of treatment between cases, they have generalized their observations into specific claims about what it means to do justice to certain subjects. These generalizations, in turn, have led to the unfortunate and misleading reification of the concept of formal justice.Moreover, by exposing the myth of formal justice, the image of justice as an austere, rationalistic, and abstract virtue is also called into question. Justice is not blind to particular subjects. Quite the contrary, it looks to those who stand before her and demands from us the response which is appropriate for them. The practice of doing justice, this is to say, signals the need to respect the rights and deserts of particular subjects. Or rather, we comprehend and express this need by means of the practice of doing justice.     

Integrating the criminal justice system into mental health service delivery: the worcester diversion experience

The substantial number of persons with mental illness encountered in many sectors of the criminal justice system has spurred actors from various agencies within that system to take actions aimed at reducing the growth of this population. These actions have included the development of specialty police units, jail diversion programs, and other mechanisms for channeling persons with mental illness out of the criminal justice system and into mental health treatment. The courts, too, have become involved in this effort with the recent development of the "mental health court," the latest of the "specialty" or "problem solving courts." These courts have not been without their critics, however, nor are they the only feasible approach to court-based diversion. This paper identifies and explores a range of options for structuring the relationship between criminal courts and local mental health systems. Beginning with a discussion of the rationale motivating the development of mental health courts, two alternatives to this specialty court model are discussed. One involves judges dealing with defendants having mental illness and substance abuse on a case-by-case basis. The other takes advantages of linkages that may already exist between most courts and the mental health providers who conduct their forensic assessments, expanding the role of these providers to serve as boundary spanners between courts and the components of local mental health systems. Regardless of the model adopted, however, appropriate linkages must exist between the courts and relevant providers. A case study is provided that demonstrates how the status of a locale's linkages can be evaluated and how the information derived from such evaluation can be used to improve the linkages between police, courts, and health and human services agencies.     

GLOBAL JUSTICE AND THE LIMITS OF HUMAN RIGHTS

To a great extent, recent discussion of global obligations has been couched in the language of human rights. I argue that this is a mistake. If, as many theorists have supposed, a normative theory applicable to obligations of global justice must also respect the needs of justice internal to recipient nations, any such theory cannot take human rights as an important moral notion. Human rights are inapplicable for the domestic justice of poor nations, and thus cannot form a plausible basis for international justice. Instead, I propose an alternative basis, a form of welfarist maximizing consequentialism. My alternative is superior to rights-based theories in dealing with the special problems of justice found in poor nations.     

Justice and Game Advantage in Sporting Games

This paper is a case study of what Jon Elster calls "local justice"; particular schemes of justice which, on a relatively autonomous basis, are designed and implemented by institutions and practices to meet particular preferences and goals. The paper suggests an interpretation of the role of justice in sporting games. First, a framework for examinations of schemes of local justice is suggested. Second, norms are suggested that express the requirements that have to be met in order to consider a sporting game as just. The discussion shows that sports are characterized by a particular blend of meritocratic justice in which goods and burdens are distributed according to performance, and a non-meritocratic distribution through which goods and burdens arise as matters of chance. The essay concludes by arguing that the optimal blend of meritocratic justice and chance results in the realization of not merely fair sporting games, but of exciting and good games as well.     

推进代际公正 建设和谐社会

和谐社会是公平、正义的公正社会。代际公正理念强调对于每一代人（包括老年人）基本贡献的肯定和尊严的维护。在现阶段,公正对待老年人的问题正逐渐凸现,这个问题的解决直接关系到整个社会的公平正义能否实现。为此,除了社会的保障体系的建立和不断完善外,还必须继续弘扬尊老、敬老的中华民族传统美德,在社会、社区乃至每一个家庭中形成尊老敬老的良好风气,以代际和谐、家庭和谐推动社会和谐。     

Collecting Informed Consent with Juvenile Justice Populations: Issues and Implications for Research

Researchers must provide participants with opportunities to make informed decisions about whether to participate in research studies. Investigators conducting research with youth in the juvenile justice system face unique ethical, legal, and practical challenges to obtaining informed consent. Juvenile justice researchers must navigate multiple legal and ethical standards for collecting informed consent, take into account youths’ dual vulnerabilities as children and prisoners, and overcome practical limitations to obtaining parental/guardian permission. Given the challenges and complexity of obtaining standard informed consent of youth in juvenile justice facilities, this paper provides suggestions for overcoming obstacles to recruiting these youth for research participation. It offers guidance for fostering the enrollment of juvenile justice youth in research studies using procedures that comply with ethical and legal standards for research with this dually vulnerable population. Copyright © 2013 John Wiley & Sons, Ltd.     

Adolescent cognition and procedural justice: Broadening the impact of research findings on policy and practice

Research on adolescent social cognition has had an enormous impact on how the justice system conceptualizes adolescent legal responsibility and deals with adolescents who commit crimes. Such research also has broader implications for adolescent legal socialization, which have been largely underdeveloped. A renewed effort to connect psychological research with legal policy must expand beyond these beginnings to focus on all adolescents and their engagement in broader social institutions. Specifically, a consideration of the unique capacities for growth and development during the adolescent years should be leveraged toward fostering positive outcomes like community identity, academic and social achievement, and the development of an orientation toward law based upon legitimacy and trust. Studies suggest that a key component of positive socialization is dealing with authorities one experiences as procedurally just. Researchers focused on issues of juvenile justice should also expand their focus to consider how the social climate in institutions such as schools can be designed to take advantage of the unique capacities adolescents have for exploring identity and connecting with peers in developing their orientation to the law and legal authorities.