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.     

优化卫生资源配置的基本对策

卫生改革的深化与卫生事业的发展,迫切要求优化卫生资源的配置,做为利用市场机制的基础。从而,既能提高效率与效益,又能贯彻公平原则,保证基本卫生服务,实现人人享有健康的社会目的。为此,在思维方式上,要增强通过宏观调控,优化增量,盘活存量,提高整体效益的观...     

2001年～2010年新疆13个地州市卫生资源配置公平性分析

基于洛伦兹曲线和基尼系数视角,对2001年～2010年新疆13个地州市卫生资源配置公平性进行分析,发现新疆13个地州市卫生技术人员和医生的配置大多数年份处于不公平状态,而病床的配置大多数年份处于比较公平状态,建议从卫生投入、政策倾斜及卫生人员培训等角度协调新疆卫生资源的配置.     

重庆市直辖以来卫生资源配置公平性研究

采用基尼系数方法从人口和地理分布两个方面定量分析重庆市卫生资源配置的公平性。重庆市主要卫生资源中,护士的基尼系数最高;重庆市的三个经济区域中,都市发达经济圈的基尼系数最高;资源按地理配置的公平性要差于按人口配置。重庆市护理人员严重不足且分布不公平,资源地理配置的公平性有待改善。     

重庆市直辖以来卫生资源配置公平性研究

采用基尼系数方法从人口和地理分布两个方面定量分析重庆市卫生资源配置的公平性.重庆市主要卫生资源中,护士的基尼系数最高;重庆市的三个经济区域中,都市发达经济圈的基尼系数最高;资源按地理配置的公平性要差于按人口配置.重庆市护理人员严重不足且分布不公平,资源地理配置的公平性有待改善.     

广东省医学高等教育的现状调查与分析

调查分析了广东省卫生人力及医学高等教育的现状和存在的问题,并以此为依据,用以指导医学高等院校适度调整医学高等教育的培养规划,旨在探索如何更好地促进医学高等教育及卫生人力资源的优化配置的健康发展,科学规划医学招生规模,确保高等医学院校人才培养与就业岗位有机结合。     

广东省医学高等教育的现状调查与分析

调查分析了广东省卫生人力及医学高等教育的现状和存在的问题,并以此为依据,用以指导医学高等院校适度调整医学高等教育的培养规划,旨在探索如何更好地促进医学高等教育及卫生人力资源的优化配置的健康发展,科学规划医学招生规模,确保高等医学院校人才培养与就业岗位有机结合.     

卫生资源市场配置的伦理思考

卫生资源市场配置的伦理思考四川省营山县人民医院（６３８１５０）张常明随着市场经济体制的建立,无疑将要求卫生资源的配置与之相适应;卫生资源的配置方式是否也和物质生产部门一样,市场的配置明显优于计划配置呢？市场配置卫生资源将导致什么样的结果？本文仅从伦理...     

卫生事业发展与公平的伦理

发展卫生事业的伦理原则是什么 ,是公平抑或效率 ?“效率优先 ,兼顾公平”是经济领域的基本原则 ,但是否也同样适用于卫生领域 ?卫生公平与卫生效率孰轻孰重 ?凡此种种问题常常聚讼不已 ,莫衷一是。在计划经济时代 ,我们曾以单纯的公平为原则 ,追求平均主义的绝对均等 ,但结果造成了卫生效率下降 ,卫生资源匮乏 ,人们的基本卫生需求得不到满足。改革开放以后 ,我们以市场为导向 ,把效率置于优先地位 ,却又拉大了人们的卫生保健差距。在我国进入全面建设小康社会的历史新时期 ,控制乃至缩小不同人群间的卫生保健差距 ,实现卫生公平 ,无疑是卫…     

我国卫生资源配置公平性的研究概况

优化卫生资源配置、提高其配置公平性,满足人们的健康需要是我国深化医药卫生体制改革的首要问题之一。利用文献计量法和内容分析法对已有科研文献的分布情况和研究现状及进展情况进行统计分析。研究发现,文献主要采用Lorenz曲线、Gini系数和Theil指数等经济学方法研究我国省级范围的卫生人力和物力资源的数量配置公平性;我国省际间、区域间和省辖市间的卫生资源配置公平性总体向合理趋势发展,配置公平性人口优于地理,卫生物力优于卫生人力。卫生资源配置公平性的研究深度和广度还需扩展,配置公平性的研究和指导有待加强。     

增加卫生改革的伦理含金量——兼论卫生改革中的效率与公平

卫生改革需要有包括卫生改革伦理学理念在内的全方位改革理念的联手支撑。伦理含金量缺失或者不足,卫生改革实践就难以取得圆满成功。因此,目前展开的新一轮卫生改革,必须以“效率与公平合理兼顾”为核心准则,在完善政策、规划目标、组织实施等全过程中切实保证卫生改革伦理学理念准确到位和正常运作。     

卫生保健政策与医学伦理学

卫生保健政策是卫生资源、价值目标和伦理原则三者的结合。医学伦理学是卫生政策的重要基础。当代卫生事业的特点,卫生保健服务面临的挑战以及医学伦理主体与客体的变化,决定了医学伦理学在当代卫生保健政策中的特殊意义。在医学面临全民保健的阶段,一个科学的符合人民健康利益的卫生保健政策是不言而喻的。摆脱当前卫生政策面临的困难,要求必须在医学伦理学方面作出正确的选择。     

中国医疗事业发展的思考

中国医疗事业有了很发展,医疗资源显著增加,城乡居民医疗服务水平明显提高。面临的主要问题是医疗资源的城乡及地区判别仍很大;干部,职工及农民的医疗服务水平存在明显差距。医疗机构的服务效率及效益逐年下降,医疗资源不足与浪费现象同时存在。中国医疗改革的策略应是：改革现行医疗保健制度提高城市居民的医疗保健水平;改革现行医疗机构的经济补偿机制,以控制医药费上升速度;加强政府对医疗事业的宏观管理,调整医疗资源的     

The Extended Mind Rehabilitates The Metaphysical Hegel

The nonmetaphysical interpretation of Hegel's philosophy asserts that the metaphysical reading is not credible and so his philosophy must be rationally reconstructed so as to elide its metaphysical aspects. This article shows that the thesis of the extended mind approaches the metaphysical reading, thereby undermining denials of its credibility and providing the resources to articulate and defend the metaphysical reading of Hegel's philosophy. This fully rehabilitates the metaphysical Hegel. The article does not argue for the truth of the metaphysical Hegel's claims. Rather, it defends the correctness of reading his philosophy as metaphysical.     

Succeeding in Rural Mental Health Practice: Being Sensitive to Culture by Fitting in and Collaborating

Sustainable solutions to the access to mental health care problems are complex and must address both the availability of mental health care resources and the acceptability of those resources to consumers. The purpose of this study was to determine how to address the acceptability problem by learning from medical and mental health care providers what mental health therapists need to know to be successful in providing care in rural communities. Using a qualitative design, focus groups were conducted in three rural communities (<2,500) with medical and mental health care providers practicing in these communities. Data were analyzed using inductive qualitative methods. Results indicate that in addition to sound clinical skill, mental health therapists should (A) be sensitive to the culture of the rural community in which they are working and (B) practice in a way that accommodates to the care culture of the community. The latter includes spending time with patients commensurate with what is expected by other providers, engaging in generalist practice, and collaborating with local providers in patient care. An important implication of these results is that mental health care must be acceptable to both the residents of the community and the gatekeepers to health care.     

神经营养因子发现的启示

本文对神经营养因子的发现,生理作用及意义进行了回顾研究,综合自然辨证法的基本原理得出在科学研究中的两点启示：一在科学研究中要牢记事物是普遍联系的;二是科学研究中要勇于接受新观点。     

Exploring the Stability of Belief: Resiliency and Temptation

Abstract

Belief allows us to coordinate our thought with our action. As Ramsey famously puts it, belief is a map by which we steer. For belief to play its role, on the one hand it must be stable under certain kinds of informational change; on the other hand it must be sensitive to changing evidence. Keeping belief stability in mind, we can ask about the norms that govern belief change in circumstances where there is epistemic pressure on us to change our belief. One such circumstance involves interpersonal conflict—in cases of disagreement with others. Another such circumstance involves intrapersonal conflict—the case of epistemic temptation. In this paper, I focus on a particular epistemic temptation case to explore what is rationally permitted and what is rationally required for us to do in the name of stability of belief.     

耳科学的发展与展望

耳科学在人类与耳部疾病的斗争中兴起了１９世纪,在本世纪随科学技术的发展而获得迅速发展,特别是抗菌素和手术显微镜的出现,使耳显同外科技术不断提高,不仅能彻底地祛除耳部感染,而且可以有效地提高听力,耳科学家在聋病的治疗过程中,已能够有效地治疗传导性耳聋,但仍面临着治疗神经性耳聋的挑战,在现代科学技术革命的推动下,随着分析子生物学,细胞生物学等新技术的发展,在２１世纪,人类必定能够彻底治疗聋病。     

Natural resources for morality: commentary

Loewy makes an extraordinary and audacious claim. He does not only reject virtue ethics, casuistry, the "Kantian injunction of respect for persons based on their capacity for self-legislation," and the utilitarian greatest good as possible groundings for clinical ethics. He even offers another grounding that he qualifies explicitly as "universally acceptable." Of course we have to analyze what it is that he offers. But prior to that, we must analyze what he means by "grounding." Grounding suggests an evidence that can neither be rationally grounded again nor rationally questioned but that other concepts can be rationally grounded upon. And it is at least doubtful whether the alternatives he quotes are groundings in that strict sense....     

A paradox for supertask decision makers

I consider two puzzles in which an agent undergoes a sequence of decision problems. In both cases it is possible to respond rationally to any given problem yet it is impossible to respond rationally to every problem in the sequence, even though the choices are independent. In particular, although it might be a requirement of rationality that one must respond in a certain way at each point in the sequence, it seems it cannot be a requirement to respond as such at every point for that would be to require the impossible.