多器官衰竭认识过程中的启示

作为危重病、创伤、手术以及严重感染等所致的高死亡率原因———多器官衰竭 (ＭＯＦ) ,已被广大医务工作者所接受 ,并从宏观的机体状况以及相对微观的器官功能进行评价 ,努力寻找防止ＭＯＦ发生的有效途径。但从病理过程来看 ,ＭＯＦ仅是严重创伤、感染等所致的结果 ,而其间的病理机制显然是阻碍这一领域取得突破性进展的根本原因。全身炎症反应综合征 (ＳＩＲＳ)与器官功能不全综合征 (ＭＯＤＳ)的提出为我们对ＭＯＦ的认识及临床思维起到积极的作用。1　对ＭＯＦ的认识沿革1 1　最初认识阶段 :二次大战中 ,由于创伤、出血所引出的创伤性…     

"堵"与"导"--多器官衰竭防治的困惑

相传远古时期鸿水滔天 ,鲧奉命治水 ,采用“堵”的方法 ,筑坝堵水 ,9年而洪水不息。大禹继续治水 ,改用“导”的方法 ,开山凿川 ,九川入海 ,13年而水息。目前 ,多器官衰竭 (ＭＯＦ)的防治就面临着“堵”与“导”的困惑。1　问题的提出ＭＯＦ是指在重大手术、休克、创伤、感染期间或其后的疾病稳定期同时或连续出现的两个或两个以上的器官或系统功能衰竭[1] 。自 1975年提出ＭＯＦ这个概念以来 ,ＭＯＦ一直是外科的常见危重症和死亡原因。ＭＯＦ的发病机制 ,主要有如下几种学说[1] :(1)肠道学说 :大量研究证实 ,肠道血供极为脆弱 ,各种ＭＯＦ…     

拓宽尸体器官来源的法律思考

世界各国获取尸体器官的法律规定各不相同:自愿捐献、推定同意、有偿捐献、需要决定原则、胎儿供体问题.中国有着任何国家无法比拟的人体器官资源,由于没有可实施的器官移植法律,大量的良好器官被白白浪费掉.中国应该借鉴国外行之有效的法律条文,制定正确的拓宽尸体器官来源的法律,为繁荣器官移植事业做出贡献.     

器官移植供体公平分配问题的初步研究

随着器官移植技术的飞速发展,供体器官严重缺乏的问题日益突出,在供需矛盾严重失衡的情况下,如何保障供体器官的公平分配成为社会焦点.通过分析研究了目前国内外器官分配的基本情况,建议进一步完善器官移植立法和医保模式,借签国外经验建立全国性器官移植协调中心,进而实现我国供体器官的公平分配.     

高血压联合用药与靶器官保护

高血压是造成心血管疾病最重要的可逆性危险因素之一,但大多数患者仍未采取合适治疗,或未达到合适的血压控制目标.循证医学证实,联合使用降压药物不仅是控制血压达标的主要手段,而且是保护靶器官的重要措施,可明显减少心、脑、肾等重要靶器官损害,降低心血管疾病的发病率、病死率和致残率.高血压的联合用药应得到高度重视.     

Why We Must Leave Our Organs to Others

Organ procurement presents several ethical concerns (from what constitutes acceptable criteria for death to issues involved in specifically designating to whom an organ can be given), but none is more central than the concern for what are appropriate means for acquiring organs. The following discussion attempts a different perspective on the issue of organ procurement by arguing that, rather than appealing to our charitable consciences or our pocketbooks, relinquishing our organs after death in this day and age is, in fact, obligatory for most people. Each of us is pressed by the growing demand for our organs should we die “rightly,” and that desperate need has risen to such a level that not to release our organs for transplantation would constitute a serious moral wrong.     

Why We Should Not Pay for Human Organs

The right to buy and sell human organs is challenged by the authors within the framework of a broad Christian perspective. Opposition to organ sales is argued in the light of the developing underclass of poor organ donors throughout the world who sell their organs to the rich. Very often neither the donors nor the recipients are fully informed about the medical risks involved in the procedure of organ transplantation.     

高血压联合用药与靶器官保护

高血压是造成心血管疾病最重要的可逆性危险因素之一,但大多数患者仍未采取合适治疗,或未达到合适的血压控制目标。循证医学证实,联合使用降压药物不仅是控制血压达标的主要手段,而且是保护靶器官的重要措施,可明显减少心、脑、肾等重要靶器官损害,降低心血管疾病的发病率、病死率和致残率。高血压的联合用药应得到高度重视。     

人体器官买卖的立法干预探析

人体器官买卖不利于保证受体生命健康,严重违背生命伦理,是一种新型犯罪,并会引发其他犯罪,因而,我国应对人体器官买卖进行立法干预。当前,还有相当一部分学者支持人体器官买卖,但此观点存在严重缺陷或错误,应予以摈弃。我国应制定人体器官捐献与移植法,确立禁止买卖人体器官的原则、设立完善的人体器官来源审查制度、制订和补充旨在严厉打击人体器官买卖行为的刑法规则,以干预和规制人体器官买卖行为。     

人体器官买卖的立法干预探析

人体器官买卖不利于保证受体生命健康,严重违背生命伦理,是一种新型犯罪,并会引发其他犯罪,因而,我国应对人体器官买卖进行立法干预.当前,还有相当一部分学者支持人体器官买卖,但此观点存在严重缺陷或错误,应予以摈弃.我国应制定人体器官捐献与移植法,确立禁止买卖人体器官的原则、设立完善的人体器官来源审查制度、制订和补充旨在严厉打击人体器官买卖行为的刑法规则,以干预和规制人体器官买卖行为.     

人体器官商业化之争:误区和对策

当前,关于人体器官可否商业化之争中存在两个误区：器官商业化的概念误区和反对非法器官交易的措施误区。要想在禁止器官商业化的前提下切实有效地增加器官来源,应在法学上和伦理学上明确人体器官的性质;明确界定器官商业化的概念和范围;制定相关法律和配套措施,倡导自愿无偿捐献,允许有偿捐献,严厉打击器官移植犯罪。     

人体器官买卖成因和对策的法学思考

器官供需严重不平衡导致了人体器官买卖的产生,器官买卖对供体和受体均存在潜在风险,对社会危险性也不容忽视.分析了器官买卖链条中供体、受体和中介各自的角色和地位,并提出了立法推动尸体器官捐献、加强医院和医务人员承担的法律责任、打击买卖中介和加强网络监管等建议.     

Bonus Allocation Points for Those Willing to Donate Organs

The U.S. federal regulations require investigators conducting nonbeneficial research to obtain the assent of children who are capable of providing it. Unfortunately, there has been no analysis of which children are capable of assent or even what abilities ground the capacity to give assent. Why should investigators be required to obtain the positive agreement of some children, but not others, before enrolling them in research that does not offer a compensating potential for direct benefit? We argue that the scope of children's research decision making should be based on the principles of respect for autonomy and nonmaleficence. These principles imply that the threshold for assent should be fixed at 14 years of age, and a dissent requirement should be adopted for all children in the context of nonbeneficial research.     

Conceptual Cognitive Organs: Toward an Historical-Materialist Theory of Scientific Knowledge

Scientific concepts and conceptual systems (theories) are particular forms of higher mental activity. They are cognitive organs that provide the ability of systematic cognition of phenomena, which are not available to the grasp of ordinary sense organs. They are tools of scientific “groping” of phenomena. Scientific concepts free perceptual and cognitive activity from determination of ordinary sense organs by providing a high degree of cognitive abstraction and generalization. Scientific cognition, like perceptual activity, is actualized by consciousness but outside the consciousness.     

Intrinsic-Extrinsic Religiosity and University Students' Willingness to Donate Organs Posthumously

This research focuses on the links between intrinsic and extrinsic religious orientations as they relate to willingness to donate organs posthumously. Participants responded to a factual test of their knowledge about organ donation, indicated their degree of willingness to donate organs, and filled out personality inventories measuring their intrinsic and extrinsic orientations. The data indicated a high level of factual knowledge about organ donation. Also, contrary to Allport's (1966) arguments, people with an intrinsic religious orientation were not more likely to donate their organs, nor were people with an extrinsic religious orientation less likely to do so. Instead, it was found that intrinsic religiosity was unrelated to willingness to donate organs and that extrinsics with strong social orientations were more willing to donate their organs. Discussion centers on the need to develop more psy-chometrically sound measures of mature religiosity as a means of conducting a fairer test of Allport's original theorizing about intrinsic religiosity.     

公众对活体大器官移植的认知态度与对策

对河南地区公众关于活体大器官移植态度进行的抽样调查结果显示：（1）公众赞成开展活体大器官移植;（2）多数公众反对器官买卖,但赞成器官买卖的也有相当大的比例;（3）亲情是亲属活体器官捐献者愿意捐献的主要原因。针对调查结果,我们在比较分析的基础上,提出了相关对策,促使活体大器官移植技术更好地造福于人类。     

公众对活体大器官移植的认知态度与对策

对河南地区公众关于活体大器官移植态度进行的抽样调查结果显示:(1)公众赞成开展活体大器官移植;(2)多数公众反对器官买卖,但赞成器官买卖的也有相当大的比例;(3)亲情是亲属活体器官捐献者愿意捐献的主要原因.针对调查结果,我们在比较分析的基础上,提出了相关对策,促使活体大器官移植技术更好地造福于人类.     

脱离人体的组织和器官社会伦理问题研究

近年来,因医疗活动所产生的“脱离人体的组织和器官”引发了医疗废弃物处置、器官移植、胚胎干细胞研究、病理研究标本等社会伦理问题。“脱离人体的组织和器官”尽管具有“物”的法律属性,但它们同时也是人的情感载体,因而具有伦理属性,从而应先从“人”这个角度来考虑。应该根据其有无传染性或病菌对“脱离人体的组织和器官”进行系统的归类划分。“脱离人体的组织和器官”在组织胚胎、生物化学、生殖免疫学等领域彰显重要价值,需要根据其社会危害性进行分类处置。