中西方医学专业精神异同:概念的比较

医学专业精神的概念反映了关于医学专业精神的本质认识.对于医学专业精神的确切表述、医学专业精神的核心原则及本质要素、将其作为完整体系的解读以及对其实践性特征的把握,中西方学者有着相似或不同的观点,对这些观点进行比较研究有助于我们更为准确地理解医学专业精神.     

儒家的宗教性及其与西方基督教精神之比较

本文力图从一个中西学术界争论颇多的问题———“儒家是否是宗教”的问题中发掘出问题背后所隐含的中西宗教文化交流的时代契机。作者首先对儒家“宗教性”的概念进行定义 ,然后从哲学、道德和超越性三方面阐释了儒家宗教性的具体体现 ,并比较分析了传统向度意义上的儒家和西方基督教在宗教精神方面的不同 ,包括超越意识、终极性宗教存在、对“人”的认识以及对“心灵”的认识。最后探讨了儒家与基督教对话的可能性和必要性。     

中西宗教观演进的比较

本文通过对中西宗教观的比较,指出中国和西方在文化价值观念、神人观念、“来世”观念方面存在巨大差异,“宗教在中西社会中的地位和作用及王权和教权在中西社会中的地位和作用也完全不同,从而解答了为何没有一种宗教在中国取得统治地位的问题,说明了中国哲学和文化虽与西方哲学和文化不同,但同样具有超越性。本文认为,中国文化价值观是以家庭为本位,以“忠”“孝”为核心的人生追求和伦理标准,它主张“天人合一”,总是以儒家伦理道德体系改造外来宗教,使之为世俗王权服务;由此决定了几大宗教都不可能在中国占统治地位,而把中国的宗教观硬装入西方的理性模式也是不可能成功的。     

浅谈中西宗教建筑艺术之差异

宗教观念、传统文化和艺术趣味的不同,造成了中西宗教建筑艺术的差异。西方宗教建筑重在外现人心中的宗教激情和超人性的迷狂,中国宗教建筑追求精神的宁静与平安;西方宗教建筑重物质,重外观,带有“雕刻”的意味,中国宗教建筑重精神,重意境,具有“绘画”美。     

也谈医学专业精神

专业精神有着其固定的内涵和社会经济文化基础.在构建医学专业精神的基本框架已经坍塌的社会背景下,即使在西方,医学专业精神存在的价值也受到了极大的挑战.照搬西方的经典医学专业精神或是生搬硬套中国的传统医学都不利于中国现代医疗体制的发展及和谐医患关系的构建.     

也谈医学专业精神

专业精神有着其固定的内涵和社会经济文化基础。在构建医学专业精神的基本框架已经坍塌的社会背景下,即使在西方,医学专业精神存在的价值也受到了极大的挑战。照搬西方的经典医学专业精神或是生搬硬套中国的传统医学都不利于中国现代医疗体制的发展及和谐医患关系的构建。     

浅析中西方绘画的区别

中西方绘画由于受地域、文化、观念等的影响,使中西方两大绘画体系形成了不同的历史和风格,并由两大体系产生出美术创作的多元性。本文就以这两大体系中的代表画种“中国画”和“油画”为论点,从多个角度出发,对这两大体系的性质、特点分别加以比较分析,希望在分析比较中,能使我们对中西绘画有更深层次的认识,并在以后的实践中得到运用。     

“我们”的世界缺什么

“我们”的世界缺什么?这一问题的真义是:“我”成为“我们”的精神世界缺什么?缺“伦理”,缺“本性上是普遍的东西”的伦理!这一缺失历史地根源于对人类文明原初经验和童年记忆的误解和误读,因而必须进行中西方民族精神发展的宏大叙事.苏格拉底之死是古希腊文明的集体记忆,作为一次伦理事件,其深远精神意义使它成为西方文化乃至整个人类文明的历史记忆;“制礼作乐”的西周维新是中华民族的原初经验,礼崩乐坏是中华民族的童年记忆.带着“伦”的世界和“神”的世界的原初经验和童年记忆,中西方民族开启了各自的精神之旅.20世纪初,中西方哲人以不同的话语形态和问题指向诞生了同一个文明觉悟,这就是“最后觉悟之最后觉悟”、“学会伦理地思考”的“伦理觉悟”.行至当代,中西方民族、中西人的精神世界“同是天涯沦落人”,面临同一个难题:伦理缺失,伦理家园失落.由此,“我们如何在一起”的道德追问,便演化为“我们如何在一起”的伦理追寻,最后演变为一场关于人类文明前途的信念危机:“我们能否在一起?”     

“天人合一”与“天人相分”——中西哲学比较研究中的一个误区

1 在中西哲学比较研究领域,有的学者将中西哲学的基本精神分别概括为“天人合一”与“天人相分”,并以此来表征它们之间的根本差异。这种观点由来已久,在有些人看来,似乎已成定论,并且经常以之作为立论的依据。尤其是看到西方某些思想家针对科技社会的诸多异化现象而表现出对东方文明所谓“天人合一”境界的浓厚兴趣,并以之为人与自然和诣的典范,立即感到欢欣鼓舞,似乎不仅为这种中西哲学差异论找到了最好的旁证,而且证明东方文明实优于西方文明,甚至认为东方文明才是世界文明的唯一出路和归宿,这种由妄自菲薄一变而为妄自尊大的偏狭心态无疑与对中西哲学之差异的误解有关。因此,对于“天人合一”与“天人相分”说进行一番考查和清算,已成为比较研究的紧迫工作。     

论马一浮的中西文化观

作为“千年国粹 ,一代儒宗”的马一浮有着自己的中西文化观 ,年轻时喜西学、黜国学 ,思想成熟时则明显地走上黜西学而崇国学的道路 ,对西方的社会以及政治学说进行了批判 ,提出了以“六艺该摄一切学术”为核心的中国文化观。马一浮的中西文化观本质上属于“非典型的现代新儒家”的理论样态。     

外科医生面临的困惑和思考

外科医生面临越来越大的压力和严峻的挑战,由于外科技术的局限性和人体差异的复杂性以及社会诉求价值过高等因素决定了外科是一门高风险的职业。如何规避职业风险?我们可以从加强责任心、严格执行医疗常规、提高医疗技术入手;但这还不够,一个外科医生智慧与技能的发掘以及处理问题的能力与技巧,还需要良好的职业素养、崇高的职业精神、科学的思维方法、和睦的医患关系。     

Towards a Confucian Virtue Bioethics: Reframing Chinese Medical Ethics in a Market Economy

This essay addresses a moral and cultural challenge facing health care in the People’s Republic of China: the need to create an understanding of medical professionalism that recognizes the new economic realities of China and that can maintain the integrity of the medical profession. It examines the rich Confucian resources for bioethics and health care policy by focusing on the Confucian tradition’s account of how virtue and human flourishing are compatible with the pursuit of profit. It offers the Confucian account of the division of labor and the financial inequalities this produces with special attention to China’s socialist project of creating the profession of barefoot doctors as egalitarian peasant physicians and why this project failed. It then further develops the Confucian acknowledgement of the unequal value of different services and products and how this conflicts with the current system of payment to physicians which has led to the corruption of medical professionalism through illegal supplementary payments. It further gives an account the oblique intentionality of Confucian moral psychology that shows how virtuous persons can pursue benevolent actions while both foreseeing profit and avoiding defining their character by greed. This account of Confucian virtue offers the basis for a medical professionalism that can function morally within a robustly profit-oriented market economy. The paper concludes with a summary of the characteristics of Confucian medical professionalism and of how it places the profit motive within its account of virtue ethics.     

关于医学专业精神的几个问题

职业与专业有所不同。医学专业精神基于医学专业的特点而产生,起着维护医学专业的社会责任和规范医疗行为的作用。医学专业的核心理念是病人健康利益高于一切,且具有历史的继承性与时代性的特点。医疗自治权的获得是医学专业形成和医学专业精神从自发走向自觉的标志。医学专业精神首先依赖医生的自律,但同时也需要来自外界的社会调控。     

医患关系的本质:医生的专业视角及其伦理意蕴

力图从为西方医学领域已完善发展及广为接受的专业(Professional)视角对医患关系(Patient-professional Relationship,以下及正文中皆简称为PPR)的伦理意蕴做探讨.简要追溯了现代医护专业精神的起源,说明了道德责任之所以是专业这一概念的重要组成部分的原因,并且指出为病人最大利益着想是医护专业最根本的道德规范与责任,亦是医患关系不可缺少的伦理基石.     

Online professionalism: social media, social contracts, trust, and medicine

The AMA Council on Ethical and Judicial Affairs (CEJA) has initiated an important discussion on medical professionalism and the use of social media by issuing thoughtful and practical guidance for physicians and medical students. The implications of online activities for trust in the profession, as well as for trust between patient and doctor, however, will need further exploration as digital life expands and evolves.     

医学生对医师责任和伦理修养若干问题的认知

为了探索以患者为中心的医学生医师职业精神教育,本研究调查了四川大学医学生对医师职业精神中的“伦理修养”（“保密与尊重”和“知情同意”）和“医师责任”两方面的认知,并将其与患者认知进行比较。笔者分析了医学生和患者认知差异,并对医学生医师职业精神的影响因素进行探讨。结果显示,医学生对医师职业精神的认识停留在比较肤浅的层面,未能发自内心地把患者的利益放在首位,最重视的仍然是临床技能的提高。研究提示医学生医师职业精神教育需要增强感染力和实践性。     

Reflective Writing about Near-Peer Blogs: A Novel Method for Introducing the Medical Humanities in Premedical Education

Narrative analysis, creative writing, and interactive reflective writing have been identified as valuable for professional identity formation and resilience among medical and premedical students alike. This study proposes that medical student blogs are novel pedagogical tools for fostering peer-to-peer learning in academic medicine and are currently underutilized as a near-peer resource for premedical students to learn about the medical profession. To evaluate the pedagogical utility of medical student blogs for introducing core themes in the medical humanities, the authors conducted qualitative analysis of one hundred seventy-six reflective essays by baccalaureate premedical students written in response to medical student-authored narrative blog posts. Using an iterative thematic approach, the authors identified common patterns in the reflective essays, distilled major themes, coded the essays, and conducted narrative analysis through close reading. Qualitative analysis identified three core themes (empathic conflict, bias in healthcare, and the humanity of medicine) and one overarching theme (near-peer affinities). The premedical students’ essays demonstrated significant self-reflection in response to near-peer works, discussed their perceptions of medical professionalism, and expressed concerns about their future progress through the medical education system. The essays consistently attributed the impact of the medical student narratives to the authors’ status as near-peers. The authors conclude that reading and engaging in reflective writing about near-peer blog posts encourages premedical students to develop an understanding of core concepts in the medical humanities and promotes their reflection on the profession of medicine. Thus, incorporating online blogs written by medical trainees as narrative works in medical humanities classrooms is a novel pedagogical method for fostering peer-to-peer learning in academic medicine.

     

中西医结合发展前景的展望

中西医结合的一个很重要的内容是中西医的兼容问题,包括交叉兼容、中西互补、结合创新。目前,中西医结合面临着强大现代医学的挑战,及理论研究、中药现代化、人才培养等方面的困难。能否处理好中西医的兼容问题及面临的困难,将直接影响到２１世纪中西医结合的发展。     

The personal and the political: notes on teachers’ vocations and values

This paper examines teachers’ sense of vocation and their values at the outset and in the middle of their careers, through reference to three small research projects and to the continuing tradition of research into teachers’ narrative accounts and interpretations of their values in relation to their work. Each of the projects worked with teachers who had an interest in values and spirituality. By enquiring into their reasons for starting and remaining in the teaching profession, the projects explore teachers’ changing values in tension with some of the dominant values of the education system. It is suggested that some teachers deal with the tension by moving from relatively private vocation‐based values, to values that embrace more public concepts of professionalism, and that their narratives are highly valuable for the profession and for policy‐makers.     

医师职业素养评测体系构建的研究进展

随着我国社会经济的发展,医疗体制的改革,医师职业素养的培养成为当今医疗体制下医学在校教育、住院医生培养、医疗卫生管理中必须关注的内容。目前国外对医师职业素养的培养做了大量的工作,也取得了较好的效果,但是对于职业素养的培养不仅需要理论教学的改革,更需要相应评估机制的建立。本文对国外医师执业素养评估的最新进展进行介绍,分析各种方法的优劣,以期为国内医学教育建立统一的、具有广泛公认度的测评体系提供参考。