论健康伦理学及其基本理论架构--"九大理论"视野中的健康伦理

当代医学道德发展的走向理应是健康道德,后医学伦理学时代理应是健康伦理学.建设健康伦理学需要搭成一个基本理论架构.其组成至少应该有"九大理论",即生命神圣论、生命质量论、生命价值论,医学人本论、医学功利论、医学公正论,医者美德论、医者义务(患者权利)论、医患和谐论.其间,按顺序由每三论构成一个"统一论",将第一个"统一论"作为立论前提,将第二个"统一论"作为直接依据,将第三个"统一论"作为应用指南,如此,才能由三个"统一论"共同地更好地阐释全部健康伦理学问题.     

"敬畏生命"伦理思想在临床教学中的渗透和强化

学习、了解生命伦理学的基本知识,掌握生命伦理的基本问题,树立生命重于一切的意识,对于医学院校的大学生今后从事医学事业尤为重要.因此,对学生进行阿尔贝托·史韦兹"敬畏生命"伦理学教育具有积极的现实意义.     

2012北京国际生命伦理学高级研讨会会议综述

在中华医学基金会(China Medical Board,CMB)资助下,2012年12月15日～17日在北京协和医学院举行了"2012北京国际生命伦理学高级研讨会",与会的国内外著名生命伦理学专家就干细胞研究及其临床转化、移植器官的捐赠和获取、生物材料数据库与表观基因组研究、知情同意等生命伦理学问题的最新进展,以及我国在生物医学研究伦理实践中和监管制度的改革面临的挑战等若干问题进行了研讨.会议共有来自全国各地的中国医学科学院/北京协和医学院系统的伦理委员会委员、科研人员、生命伦理学或医学伦理学高校教师和医疗管理者等50余人参会.CMB项目负责人翟晓梅教授主持了这次会议.     

循证医学的生命伦理学观

循证医学包涵的一些生命伦理学问题往往被忽视;如病人的自主权、知情同意和信息披露的伦理依据;医疗不确定性下如何解释和处理医患关系的人文基础;知识更新和运用证据的道德意识等.循证医学符合生命伦理学的基本原则;必须融入现代医学教育并用于临床医疗决策.     

模棱两可的"准生命"--一把并不好使的剃刀

刘虹先生和孙慕义老师合著的<论准生命--寻找剖析生命疑难问题的"奥卡姆剃刀">[医学与哲学,2003(24)10:24]一文(以下称<论准生命>),在生命的健康、亚健康、疾病这三种状态之外,提出作为第四种状态的所谓"准生命"这一新概念,并试图以此来消解诸如脑死亡、"植物状态"和重残儿的处置、生育控制、干细胞研究、安乐死的实施和克隆人等长期困挠着伦理学界的问题.这种在伦理学基本理论上的大胆创新,是现代国内伦理学研究并不多见的,因而难能可贵,值得大力提倡.同时我们也注意到<论准生命>一文中还存在一些有待进一步商榷的问题,本文想就此方面提出管见,就教于二位先生及其他学界同仁.     

以"医改生命伦理职业精神"为主题,弘扬医师职业精神——中华医学会医学伦理学分会第十七届学术年会胜利召开

由中华医学会医学伦理学分会主办、西藏军区总医院承办的中华医学会医学伦理学分会第十七届学术年会于2013年7月26日～28日在拉萨召开.从事医学伦理学教学与研究、医疗机构管理、医学科研等领域的130多位代表参加了会议,与会者以"医改生命伦理职业精神"为主题,开展了深入的学术交流.     

超越义务论的伦理观——生命伦理学的几种范式

作为研究生命科学和医学道德行为的新兴学科,生命伦理学通过一个确定的形而上学的原则或者伦理规范来指导现实。生命伦理学的原则规范体系源自于人类道德哲学的思潮,义务论是对生命伦理学有着重大影响的思想来源,至今在医疗实践中承担着道德规范的作用。当代医学科学技术的巨大发展所引发的生命、生殖、医患关系等难题,对传统的伦理观提出了挑战。在理性多元化的今天,生命伦理学不可能依赖一种普适的道德规范来指导人们的实践,而只能在探索过程中寻找适应不同文化背景和指导生命科学发展进路的伦理范式。     

解读现代版希波克拉底誓言

随着医学的飞速发展,医学伦理学、医学哲学被赋予了新的科学内涵.这一内涵在现代版"希波克拉底誓言"中得以具体体现.从行善原则、生命价值原则、尊重自主原则、公平公益原则、有利与不伤害原则、医疗最优化原则、医疗保密原则等方面对该誓言进行了全面阐述,其中蕴涵着丰富的社会哲学、价值哲学、道德哲学等哲学思想.     

通古今中西促百家争鸣——第七届建构中国生命伦理学研讨会会议纪要

2013年6月28日～30日,由香港浸会大学应用伦理学研究中心和医学与哲学杂志社联合主办的"第七届建构中国生命伦理学研讨会"在大连召开."建构中国生命伦理学研讨会"于2007年始建,前六次皆是在香港举办,本次是第一次移至内地.香港城市大学范瑞平教授,香港浸会大学应用伦理学研究中心主任罗秉祥、副主任陈强立、张颖教授,大连医科大学党委书记周万春、副书记宫福清、党委常委佟春光教授,以及《医学与哲学》杂志主编杜治政、常务副主编赵明杰教授和海内外近百位专家学者参会.会议集中探讨了家庭在当代中国生命伦理实践和医疗保健中的作用,并分别从家庭伦理、医疗保健制度改革和传统伦理三个专题就医疗决策中的家庭主义与个人主义、自由主义,医疗保健制度改革中的儒家正义观与公正等问题展开了深入而热烈地探讨.     

群体健康与关系"正义"

生命伦理学具有广泛性和综合性,着眼于群体健康是当前生命伦理学发展的趋势.在群体水平的生命伦理学的研究中,有关"正义"的概念是核心的问题.涛慕思·W·博格提出了正义的"关系概念",借以考察范围广泛的社会制度与健康结果的产生具有什么样的因果关系,进而强调社会制度的制定者和支持者对其产生的健康结果负有责任.通过对此"关系概念"进行分析,以期对中国国内健康领域问题的解决有所启示.     

"Psychotherapy" versus "treatment"

Presents a comment on "Psychological treatments" by D. H. Barlow. Barlow proposed that we distinguish between the terms "treatment" and "psychotherapy." The author believes that not only is the distinction unnecessary, but that its implications could have negative consequences for the field of clinical psychology. It is the proposed distinguishing feature that treatments are "specifically tailored to the pathological process that is causing the impairment and distress" that is most problematic. Clinical psychology does not need a distinction that further exacerbates the split between researchers and practitioners.     

"Enmeshment" and "Fusion"

The paper examines two related concepts utilized by two different schools of family therapy. Any family seen to be "enmeshed" is also seen as "fused," and vice versa. The difference in the level of focus, on the "system containing the individuals" (structural) or the "individual in the system" (fusion), determines the difference in therapeutic approach of these two schools.     

"本体论"与"伦理学"--形而上学的两个向度

形而上学有两个密切相关的内在向度,就是本体论向度与伦理学向度.在哲学史上,哲学家们之所以在"追求形而上学"的同时,又总是"反形而上学",并非是人们的形上本性出了问题,而是因为人们总是将形而上学视为单纯的"一维性",总是用一个向度来取代或遮蔽另一个向度.而所谓的"后形而上学思想",也并不是消解了形而上学,而是指形而上学从"本体论向度"转向了"伦理学向度".     

“对的”与“好的”

什么是“对的”,和对它的证立,是道德哲学中具有争议性的核心问题,也是效用主义和道义论间的主要差异之所在。统合效用主义对于“好的就是对的”这个陈述有一套完整周延的说法。而道义论对这个问题的证立不够周延或没有足够的说服力。     

"Us" and "Them":

Abstract: In the Aristotelian tradition, politics is a matter of public deliberation over questions of justice and injustice. The Bush administration's response to the terrorist attacks of September 11, 2001, has been uniformly hostile to this notion, and it has instead promoted a jingoistic politics of self‐assertion by an America largely identified with the executive branch of its government. This is doubly disturbing, as the executive branch has sought to free itself from international law, multinational commitments, and domestic judicial regulation, even as it has sought to validate itself by demonizing its enemies. This essay draws out the disturbing echoes here of Carl Schmitt's work of the 1920s, in particular of Schmitt's conception of the sovereign as the ungrounded ground of the law and the political as the site of mortal conflict between friend and enemy. The essay argues that Schmitt's position in the twenties, for all of its evident problems, is superior to that of Bush, Wolfowitz, and Ashcroft in at least two senses: Schmitt condemns the idea of waging war for profit and recognizes that such wars will often be disguised as moral crusades waged against the “inhuman”; and he acknowledges that claiming to fight a war for humanity denies one's enemies their humanity, leaving them open to torture and even extermination.     

"石狮"、"风水"与"吉祥"

谁都知道,在古老的中国,不管是衙门、宫殿、庙宇的门前,还是豪宅、大户人家的门口,人们都能看到摆着一对石狮。据说,这对石狮子在许多中国人的心目中,它不但是一种气派的象征,而且还是一种被人认为是好的“吉祥物”。如今,旧时的衙门没有了,但遗留下来的宫殿、庙宇的门前,其中有些石狮仍有保存。然而,想像不到的是,这号称“吉祥物”的石狮今天却开始“走”进某些党政机关的大门口,它们(石狮)在那里时时都在保护着这些政府要员“平平安安”、“吉祥如意”。这不仅使我联想起一些极端的报道,有些政府官员为升迁,请算命先生定位,用风水术为政府…     

PREFERRING "HOUSEWIVES" TO "FEMINISTS"

Four studies are described outlining the favorability of attitudes toward women. In Study 1, participants indicated their attitudes toward women and men and their construal of the term "women". The results revealed that women were evaluated more favorably than men, but that male right-wing authoritarians (RWAs) who construed women as referring primarily to feminists were least favorable in their attitudes. In Study 2, participants indicated their attitudes toward both "housewives" and "feminists". The results revealed that feminists were evaluated less favorably than housewives, and that the most negative attitudes toward feminists were expressed by authoritarian men. Study 3 revealed that high-RWA males held more negative symbolic beliefs concerning feminists (i.e., beliefs that feminists failed to promote participants'values) and that these beliefs accounted for variation in attitudes among high RWAs and much of the RWA-attitude relation. Finally, Study 4 revealed that high RWAs perceived greater value dissimilarity between them-selves and feminists. The implications of the findings for future research are discussed.     

从"管制"到"平衡"--政府与公众理想关系模式的构建及其制度化

论文从行政民主的角度探讨政府与公众之间的理想关系模式及其制度化构建过程 ,将我国在改革之前的政府与公众模式概括为管制模式。论文指出 ,在制度变迁的过程中 ,这一模式日益受到挑战。而在新的制度环境下 ,我国政府与公众的关系模式应该是平衡模式。这一模式的制度化措施包括培育自主的市民社会 ,赋予公众以独立的活动空间 ;促进行政公开 ,建立一个开放负责的政府 ;推进行政法建设 ,抑制行政恣意     

The "Natural" and the "Formal"

The paper presents an argument against a metaphysical conception of logic according to which logic spells out a specific kind of mathematical structure that is somehow inherently related to our factual reasoning. In contrast, it is argued that it is always an empirical question as to whether a given mathematical structure really does captures a principle of reasoning. (More generally, it is argued that it is not meaningful to replace an empirical investigation of a thing by an investigation of its a priori analyzable structure without paying due attention to the question of whether it really is the structure of the thing in question.) It is proposed to elucidate the situation by distinguishing two essentially different realms with which our reason must deal: the realm of the natural, constituted by the things of our empirical world, and the realm of the formal, constituted by the structures that we use as prisms to view, to make sense of, and to reconstruct the world. It is suggested that this vantage point may throw light on many foundational problems of logic.