术前谈话与患者的知情同意权

告知说明义务是医师的法定义务,知情同意权是患者的法定权利,术前谈话是外科医师履行告知说明义务和手术患者实现知情同意权的共同方式.外科医师应深入理解患者的知情同意权,合理履行告知说明义务,临床实践中做到告知说明内容充分,变更手术重新告知说明,避免使用穷尽式列举,确定签字人身份合法且具有完全民事行为能力.     

医护人员对癌症告知态度的调查研究

为了了解医护人员对癌症告知的态度,对634名医护人员进行问卷调查.结果显示,医护人员不十分赞同将真情完全告知患者,其告知意愿在一定程度上取决于患者的知情愿望,他们比较认同家属拥有决策权,且普遍认为患者不是充分知晓病情.因此,医护人员应该增强告知认识,尊重患者告知意愿,引导家属告知观念,努力提高患者知情程度.     

《侵权责任法》视域中患者知情不同意的法律思考

患者知情同意原则本质地内涵着患者知情不同意的权利,医方对患者知情不同意更应谨慎处理.针对患者知情不同意的不同类型,在实践中适用《侵权责任法》时应当注意替代同意的效力问题,明确医方告知的信息范围和告知方式,并在患者拒绝治疗后谨慎处理医生干涉权和患者自主权之间的关系.     

术前谈话与患者的知情同意权

告知说明义务是医师的法定义务,知情同意权是患者的法定权利,术前谈话是外科医师履行告知说明义务和手术患者实现知情同意权的共同方式。外科医师应深入理解患者的知情同意权,合理履行告知说明义务,临床实践中做到告知说明内容充分,变更手术重新告知说明,避免使用穷尽式列举,确定签字人身份合法且具有完全民事行为能力。     

精准医学对传统知情同意原则的挑战

知情同意包括信息的告知、对信息的理解以及同意的自主性等几个重要环节。知情同意原则的这几个环节在精准医学情境中面临新的挑战。在精准医学中,由于风险和收益存在未知数,风险告知成为难题,告知范围具有不确定性,无法做到信息的充分告知;由于患者或受试者对信息的理解难度增加并影响传统知情同意模式的有效实施;同时,个人自主与群体自主之间面临冲突。在精准医学时代,应当对传统的知情同意原则进行补充,构建出新的知情同意原则的实践模式,以使其更好地发挥作用。     

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.     

中美医疗告知义务比较研究

《侵权责任法》第五十五条界定了医疗告知义务的内容和形式,以此保护患者知情同意权。然而,告知义务不仅限于该规定的内容,还包括转诊告知、治愈率告知等义务。在美国,医师与患者利益冲突也是告知义务的内容。对比中国大陆、台湾地区和美国的法律、案例,发现美国的医疗告知义务更侧重对患者知情同意权的保护,而中国大陆和台湾地区则侧重告知义务的履行形式。对告知义务的违反意味着对患者知情同意权的侵犯。在美国对侵犯知情同意权的责任形态区分故意和过失,而在中国大陆,通常不作区分,一般只认定为有过错。     

浅谈肺癌手术的知情同意

手术在肺癌治疗中占有重要地位。胸外科医生充分告知手术利弊、患者和／或代理人充分理解告知内容是顺利完成知情同意的重要步骤。本文就肺癌手术知情同意的意义、临床工作中存在的问题及解决办法进行了初步的探讨。     

医疗机构口头告知不宜扩大

口头告知界定的不明确给医疗机构及其医务人员带来了困扰.知情同意和告知义务虽被越来越多的医疗机构和公众关注,但对于告知方式并没有过多的注意,医疗机构因为口头告知导致损害赔偿的案件也不鲜见.本文探讨了医疗告知含义、医疗告知的多种方式,通过口头告知的利与弊来提出口头告知不宜过于扩大化.     

手术同意书的相关法律问题

医患双方都非常重视手术同意书,从法理角度分析,手术同意书是患者知情同意权利和医方告知义务的体现;符合民事法律要件的合法有效的手术同意书,证明了医患之间告知与知情同意权的实现.对手术同意书的法律性质及法律效力进行探究,有助于维护医患双方的合法权利.     

儿童Graves'病研究进展

Grave's病(GD)是导致儿童甲亢最常见的病因,其易感性80%决定于基因因素.ATD治疗是最常推荐的初始治疗手段,但长期缓解率仅为30%.ATD诱导儿童GD缓解的合适用药时间尚不明确.最佳治疗方式(ATD、RAI或手术)的选择还存在重大争议.药物治疗复发的预测非常重要,最近建立了一种复发风险评分,通过种族、年龄、诊断时FT4、TRAb水平、ATD预期治疗持续时间将GD儿童分成低中高三类风险人群,对其复发风险作出评估,对于确定GD儿童在初始治疗时选择何种方案更为适合意义重大.     

Certification in Testing in Canada

This article presents a brief outline of a program developed by the Canada Employment and Immigration Commission (CEIC) for certifying employment counselors to use tests in Canada Employment Centres (CECs).     

自伤青少年的冲动性

以自我报告、行为学和脑电为指标, 检验自伤青少年的冲动性。研究1, 对820名普通中学生和72名工读生进行问卷调查, 探讨自伤行为与情绪调节困难、冲动性的关系。结果表明, 冲动性能够预测自伤行为, 且预测效应量大于情绪调节困难。研究2, 采用Go/Nogo范式的ERPs实验, 检验自伤组与对照组冲动控制的行为学与脑电差异。结果表明, 自伤组Nogo正确反应的N2波幅显著高于对照组, N2潜伏期在部分电极点处高于对照组。脑电地形图显示两者的脑电差异主要体现在前额叶区。结论：自伤青少年的冲动性高于同龄普通青少年。     

Occupational Stress in Workers and Managers in Steelworks in China

Occupational stressors and strains of 121 Chinese steelwork employees and 122 managers were measured using the Chinese version of the Occupational Stress Indicator (OSI). It was found that factors intrinsic to the job, Type A behavior, logic, and organizational structure and climate were the main predictors of mental ill-health and physical ill-health in managers. Organizational structure and climate and relationships with other people were important predictors for workers. Management processes and organizational forces were the strongest predicting factors of job satisfaction in both samples. On certain OSI scales and subscales, managers scored statistically higher than workers. It is proposed that these results reflect the enormous economic and social changes currently taking place in China, together with certain features inherent in Chinese organizational and managerial processes.     

Sex differences in relational aggression in preschool children in Iran

The purpose of this study was to compare scores on a Relational Aggression Questionnaire for preschool boys and girls in Iran. The questionnaire was developed here, and its reliability and validity were assessed. Teachers' reports of relational aggression in 258 children ages 3 to 7 years was studied. Sex differences in relational aggression were not observed and was not significantly different across age groups.     

Evidence for sex differences in brain organization in recovery in aphasia

Ninety-one adult aphasics of both sexes were studied before and after a 3-month period of language therapy. Although no initial sex difference was found in severity of language disorders, females within the global aphasic group showed significantly greater improvement in three tests of language comprehension. It is suggested that more bilateral representation of language functions in the female brain may account for this greater improvement.     

Ethical Issues in Counselling in Education

It is suggested that there are two quite distinct Systems of ethics and practice in use by counsellors in education: the integrated model, which emphasises viewing the counsellor-institution relationship as theprimary ethical perspective; and the differentiated model, which emphasises the counsellor-client relationship as the starting point for an ethical understanding of the counsellor's role. The implications of these two perspectives for ethical issues relating to sources of referrai, issues of confidentiality, accountability for resources, the implications of role diffusion, and the outcomes of counselling, are examined. The ethical consequences of viewing the two Systems as reconcilable or incompatible are explored.