从医学伦理学到生命伦理学--新西兰生命伦理学的历史与社会学研究之二

1从医学伦理学到生命伦理学:知情同意的重要性 卡特莱特调查代表着新西兰医学伦理学史上最具深远意义的转折点.它不仅暗示了一个传统医学伦理学时代(主要着力于医生个体从职业立场出发而应有的礼仪)走向尾声,还宣布着一个新的生命伦理学时代(有着更宽泛的并以患者为中心的观点)的到来.     

Applying Virtue to Ethics

Virtue ethics is sometimes taken to be incapable of providing guidance for an individual's actions, as some other ethical theories do. I show how virtue ethics does provide guidance for action, and also meet the objection that, while it may account for what we ought to do, it cannot account for the force of duty and obligation.     

From the Galleries to the Clinic: Applying Art Museum Lessons to Patient Care

Increasingly, medical educators integrate art-viewing into curricular interventions that teach clinical observation—often with local art museum educators. How can cross-disciplinary collaborators explicitly connect the skills learned in the art museum with those used at the bedside? One approach is for educators to align their pedagogical approach using similar teaching methods in the separate contexts of the galleries and the clinic. We describe two linked pedagogical exercises—Visual Thinking Strategies (VTS) in the museum galleries and observation at the bedside—from “Training the Eye: Improving the Art of Physical Diagnosis,” an elective museum-based course at Harvard Medical School. It is our opinion that while strategic interactions with the visual arts can improve skills, it is essential for students to apply them in a clinical context with faculty support—requiring educators across disciplines to learn from one another.     

Ethics Lessons From Seattle’s Early Experience With COVID-19

Abstract

Ethics consultants and critical care clinicians reflect on Seattle’s early experience as the United States’ first epicenter of COVID-19. We discuss ethically salient issues confronted at UW Medicine’s hospitals and provide lessons for other health care institutions that may soon face what we have faced.     

Applying Research Findings to Enhance Pre-Practicum Ethics Training

Professions have a social obligation to ensure that their members’ professional behavior is morally appropriate. The psychology profession in most jurisdictions delegates the responsibility of ensuring that psychologists entering the profession are ethically competent to pre-practicum training programs. Educators responsible for teaching the ethics courses in these programs often base them on Rest’s (1984, 1994) theory that does not take into account a vast amount of contemporary psychological and neuroscientific research data on moral decision making. My aim with this article is therefore to summarize the psychological and neuroscience research findings relevant to moral decision making and consider how educators who teach ethics courses can apply them in developing ethics courses grounded in research.     

From Bodo Ethics to Distributive Justice

Concern with material equality as the central form of distributive justice is a very modern idea. Distributive justice for Aristotle and many other writers for millennia after him was a matter of distributing what each ought to get from merit or desert in some sense. Many, such as Hume, thought material equality a pernicious idea. In the medieval village life of Bodo, villagers knew enough about each other to govern relations through norms, including, when necessary, a norm of charity. In more complex modern societies, economic destitution cannot so well be handled by individual charity, but now it can be handled by states. Hence, we begin to conceive of the idea of distributive justice as driven essentially by concern for material equality. The difference in state capacities is largely epistemological: states today can know much more about their citizens.     

中国古代医德教育对现代医学生医德教育的启示

医德医风已成为全社会普遍关注的焦点,特殊职业要求医务工作者应具有高尚的医德,而高尚医德的培养应从医学生教育阶段开始,努力提高医学生的医德素养。我国传统的医德教育方法,如医学生人品的选拔,老师言传身教,徒弟满师传统等等对于培养现代医学生关爱病人、救死扶伤的医德风范仍具有积极的借鉴意义。     

中国古代医德教育对现代医学生医德教育的启示

医德医风已成为全社会普遍关注的焦点,特殊职业要求医务工作者应具有高尚的医德,而高尚医德的培养应从医学生教育阶段开始,努力提高医学生的医德素养.我国传统的医德教育方法,如医学生人品的选拔,老师言传身教,徒弟满师传统等等对于培养现代医学生关爱病人、救死扶伤的医德风范仍具有积极的借鉴意义.     

加强医学伦理学教育指导医疗实践

通过对五所医院医务人员和两所医科大学的学生从医学伦理学教育和伦理培训等四方面进行现场调查和分析,提出目前在医科大学,医学伦理学已经逐步被认识和接受;医学伦理在临床实践和医疗科研中已有较大的影响;医学伦理委员会的工作需要进一步加强;医学伦理教育任重道远.     

医师专业精神与医学伦理学

医学伦理学与医师专业精神的历史发展轨迹都本源于医学,基础都是医学。二者不是同时出现的。在很长时期内,医学伦理学是以医师的个人品德的面貌面世的,医学的宗旨和使命,是通过医师的执业动机与态度表现的,两者的使命和主旨内涵是同一的。但医学伦理学不能等同于医师专业精神,作为谋生手段的职业性能和发展医学的历史使命同时也蕴藏于医师专业精神中。两者的差异处理不当可能造成医学伦理学与医师专业精神的矛盾和纠葛。医学伦理学旨在“言”,医师专业精神旨在“行”,医学伦理学有赖于忠于医学职业操守的医生的实践。“言”与“行”的统一,好医学目标的实现,是两者的理想归宿。

     

The Limits of Medical Practice

Theoretical Medicine and Bioethics - Should medicine be defined as the enterprise in charge of the health problems of society? If so, then any problem (individual, public, social or political) that...     

The Limits of Empirical Studies on Research Ethics

The results of empirical research in psychology and psychiatry are increasingly being used to formulate as well as understand problems at the interface of law and psychiatry. There has been a proliferation of studies, such as the determinants of individual competence or threat to self or others, the results of which are influencing policy and legislative decisions as well as buttressing holdings in court cases. In this article, I explore the issues of interpretation of epidemiological studies, particularly the role of ideological positions on the design and results of empirical findings, the importance of the way data are interpreted, and the role of ideologies in the way research findings are presented to provide support for policy positions. Two levels of analysis are involved in determining the validity of a study. The first addresses the questions of whether the study meets the statistical and epidemiological requirements for reliable results. These include considerations such as the appropriateness of the study design and methods for gathering and interpreting data. The second focuses on the underlying framework of the study. This involves factors such as the perspectives and values of those conducting the study, the explicit and implicit dominating ideologies where they operate, and the extent to which the study is constructed to reaffirm specific ideologies. This level of analysis is essential for disclosing the influences of ideologies on the results of studies and the way in which data are interpreted. In this article, I try to demonstrate through critiques of selected studies that the first stage of analysis is insufficient without an examination of underlying preconceived values to establish the meaningfulness of results.     

人文走进医学究竟路有多长?——医学伦理与医学关系视角的讨论

人文与医学的渐远和分离是生命科学与技术进步过程中的一种必然现象.医学的人文性是医学的本质规定性,人文走进医学本质上是一种相互完成回归的过程.医学道德与医学的关系是人文与医学关系的一个缩影.两者在特定历史阶段的分离,使它们从浑然一体分化为不同学科,如今的回归并非学科重归医学,而是医学道德回归家园.在社会与科学发展的大背景下,寻求回归之路成为可能,但受到多种条件限制,回归之路定很漫长.     

From Transcendence to Ethics: Shaping spirituality to schools

Although Education Acts require schools in England and Wales to make provision for the spiritual development of pupils, there is continued debate about the meaning of the word 'spirituality' and what it should mean for schools. This article explores these issues using interview material collected from ten people from a variety of faiths and worldviews. The interviews documented individuals' personal understandings of spirituality. Synopses of these different accounts are presented here. The interviews also documented individuals' perceptions of spirituality for school and it was observed that these involved much greater agreement than the accounts of personal spirituality. Agreement was reached by a common shift of emphasis away from transcendent phenomena toward ethical values. The shift toward ethics and consensus is discussed here in relation to National Curriculum Council and OFSTED definitions of spirituality. It is suggested that a drive toward consensus is detrimental to the spirit of spiritualities.     

西方进化伦理学的哲学收获和界限

尽管达尔文(Charles Darwin)的进化论(自然选择论)自诞生之日起就一直遭受各种激烈的批评乃至攻击,但却很少有人能够否认,它属于所有时代影响最为深远和最富有成果的自然科学理论.