公民逝世后器官捐献的伦理审查与监督

在器官移植的供体来源为尸体器官时,无器官移植资质的医院常没有针对公民逝世后器官捐献做伦理审查。基于此现状,结合国内《执业医师法》《侵权责任法》《人体器官移植条例》《医疗机构管理条例》等有关法律法规,探讨在医疗机构环境下,公民逝世前后的器官捐献伦理审查和监督制度,以进一步尊重公民的尊严和意愿,保护隐私,避免医生职务利益冲突,规范和完善公民死亡判定与器官捐献工作流程,切实维护公民权益,增进社会公众对器官捐献伦理的认识和支持。     

我国《人体器官移植条例》评析

我国《人体器官移植条例》对有推定同意权的“亲属”的限定范围过窄,阻却了第二、第三顺序亲属实施推定同意的权利;临床应用与伦理委员会的人员组成未排除实施器官移植的专家的参与,可能影响论证结果的客观性,且伦理审查时限不明;在违反《条例》的法律责任中,排除了公民生前未表示不同意捐献器官且其家属也未表示同意捐献尸体器官,而对其实施器官摘除的情形。缺失了医疗机构及其医务人员在明知器官来源不合法或实为买卖器官却加以利用并实施器官移植的法律责任。建议尽快根据《条例》制定具体的实施细则,以确保《条例》的正确实施。     

心脏死亡器官捐献的困境及对策

心脏死亡供体作为增加器官来源的重要途径;已受到世界移植界的广泛关注.在我国特殊的移植环境中;心脏死亡器官捐献的开展有其优势;但也面临着伦理、技术及社会方面的困境.除了要加大宣传力度;树立新观念外;还应培训器官捐献协调员;建立合理的补偿机制;树立医院良好形象;促进器官捐献不断发展.     

医务人员对辅助生殖技术伦理认知的调查

为了解医务人员对辅助生殖技术伦理知识的认知情况及对待争议问题的观点,对已开展多年辅助生殖技术的上海市第一妇婴保健院的所有医务人员进行有关辅助生殖技术伦理认知的问卷调查.问卷包括配子和胚胎的处理、捐献问题、子代问题及有关新技术的问题.结果显示,医务人员对其中一些争议问题态度相对宽松,但对这些问题的认知情况仍然不足,在伦理知识方面需要更多培训普及.     

逝世后自愿器官捐献微信伦理审查模式及创新价值研究

针对公民逝世后自愿器官捐献(donation after cardiac death,DCD)时间紧、距离远的特点,昆明市第一人民医院伦理委员会在多年的伦理审查实践中利用互联网技术及微信平台,将"互联网+"思路融入到DCD紧急伦理审查工作中,在国内率先探索并构建DCD微信快速伦理审查模式。主要研究该模式的内涵及操作规程,探索其首创价值与提高紧急伦理审查效率、确保供体捐献器官的较好质量等方面的重要意义,总结微信伦理审查模式的实效,具有缩短审查时间、方便伦理委员参会和有效地解决了DCD紧急伦理审查存在的困难等。     

器官捐献推定同意原则在我国的境遇研究

器官捐献推定同意原则为一些国家立法承认,但在实施中尚存在伦理、法律等争议。该原则在我国的实施既存在逻辑原点方面的认识误区,也存在难以保障有效的知情同意、缺乏良好的信任环境和器官捐献公众平台建设滞后等困难。实行器官捐献推定同意应以维护人的自由平等为前提,以尊重人的自主自愿为基础,以保障愿意捐献器官的人能够实现合理合法捐献愿望为目的。同时,还需要具备存在同意的极大可能性等法律要件和充分的知情同意宣传教育,广泛的公众参与,良好的社会信用体系,方便易行的退出机制以及公正的器官分配体系等伦理条件。     

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.     

医务人员对辅助生殖技术伦理认知的调查

为了解医务人员对辅助生殖技术伦理知识的认知情况及对待争议问题的观点,对已开展多年辅助生殖技术的上海市第一妇婴保健院的所有医务人员进行有关辅助生殖技术伦理认知的问卷调查。问卷包括配子和胚胎的处理、捐献问题、子代问题及有关新技术的问题。结果显示,医务人员对其中一些争议问题态度相对宽松,但对这些问题的认知情况仍然不足,在伦理知识方面需要更多培训普及。     

"人体器官捐献补偿系统"的构想及相关伦理思考

器官移植技术日趋成熟,应用日益广泛,供体器官来源不足成为推广应用这项新技术的瓶颈,适当合理的器官移植补偿是缓解这一问题的方法之一.建立一套符合医学伦理学原则且行之有效的人体器官捐献补偿系统有助于保护器官移植供受双方的利益,缓解移植器官供体来源不足的问题.提出了"人体器官捐献补偿系统"的构想,并阐述了其伦理依据.     

影响器官捐献的社会观念解析

据专家统计,我国目前有150万尿毒症患者,每年却仅能做5 000例左右肾脏移植手术;我国有400万白血病患者在等待骨髓移植,而全国骨髓库的资料才3万份[1].阻碍器官捐献的原因相当复杂,有社会捐献渠道通畅、社会公益性组织机构和保障机制缺乏等"硬"问题,更有社会观念和意识障碍等"软"问题的制约.有人调查发现,91.5%的医务人员认为影响器官捐献的原因主要是人们的观念障碍[2].     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

The Possibility of Meaning in Human Evolution

Science undermines the certitude of non-naturalistic answers to the question of whether human life has meaning. I explore whether evolution can provide a naturalistic basis for existential meaning. Using the work of philosopher Daniel Dennett and scientist Ursula Goodenough, I argue that evolution is the locus of the possibility of meaning because it has produced intentionality, the matrix of consciousness. I conclude that the question of the meaning of human life is an existentialist one: existential meaning is a product of the individual and collective tasks human beings undertake.     

Phenotypic plasticity and archetype: a response to common objections to the biological theory of archetype and instinct

Since Jung’s death in 1961, scholars have attempted to integrate growing biological science data into Jungian concepts such as the collective unconscious, instincts and the archetypes. This enterprise has been challenging due to persistent false dichotomies of gene and environment occasionally arising. Recent works by Roesler (2022a, 2022b) for example, have raised objections to the biological theory of archetypes, but the objections are plagued by such dichotomies. The concept of phenotypic plasticity, however, helps to both avoid this problem as well as bridge the gap between competing theories into a more integrated model with solid biological foundations.     

When is it time to stop? When good enough becomes bad enough

This article draws on Winnicott’s concept of the good enough mother to discuss how to know whether a therapeutic situation is good enough to continue or bad enough to end. This dilemma is explored in terms of clinical syndromes, such as anorexia and pathological gambling, but focuses mainly on analyst-initiated endings, which are termed the ‘Casablanca dilemma’, based on an amplification of the ending of the film Casablanca. The author goes on to discuss such one-sided endings, drawing on interviews with 40 analysts and therapists about their clinical experience. A typology of bad enough endings is presented. The psychological differences between a good enough analysis as opposed to a bad enough one are explored through the ideas of Winnicott and Neumann.     

Kann Es Ein Argument Für Den Skeptizismus Geben? Das Epistemische Problem Der Irrtumsmöglichkeit

Summary  Is there any argument for scepticism? The epistemic problem of the possibility of error. Arguments for scepticism rest on the assumption that knowledge claims are fallible. For this reason the concept of knowledge appears to be questionable. Since it is necessary to distinguish doubts from possible doubts, the arguments for scepticism appear to be unconvincing. If we take it into account that we know something that is immune to doubt, we should draw the conclusion that, contrary to scepticism, knowledge claims have to be compatible with being fallible. Thus any knowledge claim is capable of being doubted.     

The transcendent function in Spitteler’s Prometheus and Epimetheus

In August 2020, John Beebe and Steve Myers met via Zoom to discuss their differing interpretations of psychological typology and the different sources within Jung’s writings that influenced their books: Integrity in Depth: Energies and Patterns in Psychological Type (Beebe), and Myers-Briggs Typology vs Jungian Individuation (Myers). The discussion centred on Spitteler’s epic poem Prometheus und Epimetheus, which forms the basis of chapter V of Psychological Types. This is both the largest chapter and one of two chapters that Jung highlighted in the Argentine foreword as containing the essence of the book. Jung’s book is primarily about the transformation of personality rather than the categorization of people. Although it contains a critical psychology that deconstructs the nature of consciousness, that is only one half of the book and a stepping-stone to the other half, which is the reconciliation of opposites with particular emphasis on the relation of consciousness and the unconscious. Jung assumed that readers were already familiar with Prometheus und Epimetheus, an understanding of which sheds light on the nature of the transformation that Jung described – the development of a new attitude towards attitude itself.     

Chapter 6: Biblical Foundations for a Practical Theology of Aging

SUMMARY

This article reviews Biblical sources pertaining to the elderly, particularly the frail elderly. Founded on these sources, implications for elderly with Alzheimer's Disease and other forms of dementia are addressed through a personal perspective informed by writings of Christian mystics.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.