公共卫生实践中诸主体的道德责任

公共卫生伦理的实质是维护公共健康的道德责任,明确其实践诸主体的具体道德责任,即政府应当尽力提供与公正分配公共卫生资源,公众应当追求公共善基础上的合法权利,卫生职业者应当献身职业,进而为维护和促进公共健康利益、减少和预防疾病、降低和最小化风险与伤害提供伦理支撑,也将为公共卫生实践主体提供正确的价值引导。     

公共健康伦理的公益性原则刍议

从厘清公共卫生和公共健康的关系出发,基于相关概念演变、理论研究现状、伦理价值"目的善"的角度论证凸显公共健康的核心地位。谈及公益性是公共健康伦理研究内在的价值追求,但公共健康实践中存在着公益性缺失特别是时下热点事件发生所暴露出的问题更是说明公共健康伦理强调公益性的伦理正当;同时强调公共健康的公益性对于体现人的尊严、缓和伦理冲突、维护社会正义又具有伦理应当性。为此,试从重视伦理冲突和解、责任共同体建立、关注国民健康素养提升等方面探索公共健康伦理公益性回归的突破口。     

伦理治理:医疗卫生机构的角色和责任

在推进"健康中国"战略的大环境下,医疗卫生机构承担着服务全民健康的重大职责。然而,当前医疗卫生实践面临着诸多伦理问题,其中一个关键原因在于医疗卫生机构尚缺乏相应的伦理规约。从"机构伦理"的视角出发,探讨医疗卫生机构的伦理治理。在从理论角度梳理医疗卫生机构面临的伦理问题和挑战的基础上,探讨医疗卫生机构同时作为"治理主体"和"治理对象"应当承担的道德责任,以期为探讨医疗卫生机构伦理提供一个可能的视角。     

国外公共健康伦理研究的新进展

近五年来国外公共健康伦理始终围绕公共健康、公民权利、政府责任及其相互关系这一主线展开探讨,而公共健康伦理原则的价值排序、公共健康伦理的分析方法与公共健康伦理的教育普及则是其中的理论热点。关于公共健康伦理原则的价值排序问题有特定原则、中层原则和主导原则等排序主张。公共健康伦理的基本分析方法有美德伦理方法、公共善方法和罗尔斯主义方法等。让公共健康专业人员理解公共健康伦理知识,提高道德能力和培养职业道德情操则是公共健康伦理教育的重要目标。     

全球公共健康伦理的可能性及其限度

全球公共健康伦理是随着全球性公共健康危机的不断暴发和公共健康国际合作的不断发展,在关于全球生命伦理的讨论中提出来的。作为在公共健康伦理学领域为维护和增进全人类共同健康利益而寻求的一种基本道德共识,全球公共健康伦理不仅有深刻的现实和历史依据,而且有内在的人性基础和文化依据,是维护人类健康的内在道德需要。全球公共健康伦理的建立是在承认和尊重差异性和多样性的基础上寻求普遍价值和道德共识的过程,其建立的方式是以人类健康的公共理性为基础的对话和交流,其推广和发挥作用的方式是倡导。     

角色伦理的理论维度和实践基础

从伦理学的视角考察社会角色,可以发现其中蕴含着伦理秩序、道德应当、角色责任等伦理意蕴.就角色理论和伦理学的逻辑延展而言,角色伦理是以社会学与伦理学的交叉为学理依据,以伦理学为视角,研究社会角色的权责关系、角色道德及其伦理行为模式的一种理论维度.就社会角色实践意义而言,它是与角色的身份地位相契合的权责伦理定位、道德规范和伦理行为模式.角色实践、社会主义市场经济的发展和构建社会主义和谐社会的吁求为角色伦理提供了实践基础,角色伦理为角色实践提供了价值导向和理论支撑,为完善社会主义市场经济和构建和谐社会提供了伦理基础.     

论记忆道德

记忆伦理涉及记忆主体与处于一定的伦理关系和伦理共同体之中的人和物的关系问题,其核心要义是要求记忆主体记住所有与之相关的人和事。记忆道德反映人类在主观上和实践上对记忆伦理的体现程度。具体地说,它反映记忆伦理通过人类的道德思维、道德敏感性、道德认知、道德情感、道德信念和道德行为得到体现的实际情况。记忆道德可以区分为个体记忆道德和集体记忆道德。无论记忆道德是以个体还是集体的形式存在,它要求人类的记忆行为遵循三个普遍有效的道德原则,即公正原则、以实践作为检验记忆价值唯一标准的原则以及记忆建构责任与记忆传承责任相统一的原则。     

伦理环境的原始发生及其归责问题

伦理环境乃是由人的道德认知和道德实践所形成的过程及其后果,包括主体形态的思与行、客体形态的规范体系。伦理环境原本是后果性的社会事实和精神事实,但它一经形成便又反身嵌入到人们的道德世界中,从而制约着人们的道德认知、情感、意志、选择、行动和评价。对伦理环境作事实和价值意义上的分析、论证和判断并不是一件困难的事情,困难的是谁为一个不良的伦理环境负责,伦理环境是追问道德责任的一个重要依据。在过往的和当下的伦理学研究中,人们着力研究的是每个人都应当对其行动担负道德责任,然而却从不追问谁为过往的和当下的伦理环境负责。如果不从不同人群在造成共同的伦理环境所起的作用入手,探讨归责问题,道德哲学和伦理学研究就不可能彻底,让所有的人共同承受不良的伦理环境并对不良的伦理环境担负同样的道德责任,乃是伦理学意义上的最大的不公平。     

重大公共卫生危机中社会排斥的伦理审视

社会排斥是重大公共卫生危机中常见的伦理困境。重大公共卫生危机中的社会排斥有着多张面孔,主要分为社会心理排斥、社会道德排斥和社会制度排斥。社会排斥将严重加深重大公共卫生危机,扰乱健康的伦理秩序,阻碍人们对于危机的控制与应对。社会排斥的产生有着复杂的原因,过度的自我认同、对于差异的狭隘观念、极端的个体本位意识都会导致社会排斥现象的出现。要有效规避社会排斥产生的伦理危害,就必须在重大公共卫生危机中深化人们的道德认知、培育公共精神、厚植人道关怀。     

从技术理性到行政伦理——大数据时代智慧治理的伦理反思

大数据推动了政府治理模式的变革,智慧治理是大数据时代政府治理的新模式,然而智慧治理面临人的主体性、隐私与自由、社会公正等诸多伦理挑战,这些挑战与技术理性的张扬密切相关。智慧治理的目的是实现公共善,而要实现公共善,就要对这种技术理性进行必要的行政伦理的审视,通过责任伦理实现价值理性与技术理性、目的善与手段善、公共善与公民权利之间的平衡,从而使智慧治理获得伦理确证与道德规约。     

Language,politics and dreams: the challenges of building resilience in refugees

This paper describes a case study of a 60-year-old Peruvian refugee in some detail, focusing on the importance of building emotional resilience in a patient in Spanish in order to create a space for learning the English language – the patient did not speak English after 20 years of living in Britain. The work was carried out with an interpreter and some of the literature on working with interpreters is referred to. The paper also briefly outlines the refugee journey in broad terms, which is a journey from the culturally known to the culturally unknown. The question of how well the literature on resilience, which sits firmly within a Western developmental perspective, can be applied to refugees, most of whom come from group and family-based cultures dominated by ideas of honour and shame, is discussed. The paper also touches on the importance of the receiving country enabling or not, as the case may be, a transitional space for refugees who have lost their home and are seeking to find a safe haven in a strange culture.     

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.     

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.     

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.     

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.     

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.     

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.     

Order,disorder, and the absolute: An experiment in dialogue

The first section of this dialogue is excerpted from an edited conversation between Sean Kelly and the late David Bohm, and focuses on the concepts of order, disorder, and the Absolute. The second section explores these concepts in greater depth, with Bohm maintaining the impossibility of absolute knowledge and the fundamental unintelligibility of the concept of disorder, preferring instead to speak of “orders of infinite degree” which emerge out of an “unknown ground.” Kelly responds by proposing the concept of “absolute knowing” as the cognitive process within which the concepts of order and disorder, the known and the Unknown are seen as dialectically related moments of the Absolute as complex whole. The third section is Edgar Morin's response to the preceding dialogue. He begins by outlining his views on the nature and limits of rationality, maintaining, with Bohm, the superiority of the “negative modality” of speaking about “being” or “reality.” In the second part, however, he proposes the notion of nature as “chaosmos,” which he understands as a creative “dialogic” of order, disorder, and organization.     

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.