Ethics Remediation,Rehabilitation, and Recommitment to Medical Professionalism: A Programmatic Approach

This article recounts the development of the Professional/Problem-Based Ethics (ProBE) Program, the original physicians’ professional ethics remediation course. Since 1992, more than 1,200 healthcare professionals of many disciplines have been mandated to attend ProBE by licensing boards and other oversight entities. Using a small-group, interprofessional setting, the ProBE Program assists participants to discover and articulate ethical underpinnings violated by their misconduct; appreciate professional responsibilities that are societal, regulatory, and ethical; and recommit to professional ideals. The authors describe the rationale for developing ProBE, its curriculum, participant demographics, and infractions and reconsider medical professionalism in light of two decades of ProBE.     

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。

     

Ethics,Changing Populations,and the Dental Profession

This review emphasizes the worldwide and U.S. evolving population demographics and the need for the dental profession to exercise its professional and ethical duty to expand its traditional patient base to provide needed services.     

Professionalism,Ethics, and Value‐Based Conflicts in Counseling: An Introduction to the Special Section

This introduction to this special section of the Journal of Counseling & Development explores the importance of a code of ethics to the establishment and maintenance of a profession. Recognizing a code of ethics as a communication of a profession's collective values and expectations, the editors of this special section acknowledge the dilemmas that arise when a counselor's personal values do not align with the profession's collective values. The authors of each article address value‐based conflicts in counseling.     

Trainees with Competence Problems in the Professionalism Domain

Increasingly, professionalism has been recognized as a core competency for health service professionals and is the domain in which vexing competence problems are observed in trainees. We begin by describing manifestations of problems of professionalism in accord with the values that fall within the rubric of this multifaceted construct. We provide an approach for evaluating problems of professionalism and discuss intervention for trainees with mild, moderate, or severe problems in this domain. We propose implications for training focused on enhancing the culture of programs; bolstering the education, guidance, and mentoring provided related to professionalism; and encouraging best practices for addressing trainees with problems of professionalism. We conclude by sharing ideas about defining professionalism, identifying problems of professionalism, strengthening our approach to assessing professionalism and intervening when problems are evident, developing strategies for preventing professionalism problems, and ensuring that psychologists take seriously their responsibility to address professionalism concerns with colleagues.     

医学教育中医师职业精神评估方法初探

医师职业精神是每个医师所必须达到并表现出来的一个基本胜任力,相应也是医学职业教育的重要内容。对医师职业精神的细化和评估是促进医师职业精神建设的基础,各种评估方法也是促进职业精神教育的基本工具。国外目前主要的医师职业精神评估方法为伦理知识和道德推理检测,定性、定量的观察评价。观察评估主体包括自评和不同来源的他评。结合医学教育的不同阶段选用合理的职业精神评估方法,可为国内医师职业精神的建设和教育提供参考和借鉴。     

职业精神与弱势病人

医学职业研究所对美国医生的现实行为的调查说明:医生们是相信且赞同职业精神在对待弱势病人方面的关键信条的;增强美国医生的职业精神的努力,也应该包括努力转变医生照顾弱势病人的行为方面。但是,增强职业精神的努力不仅要通过书本上的或理论上的教育,也应该包括致力于制定使医生更容易履行这些义务的实践政策,提供体制上的支持可使医生更容易做他们已经知道其应该做的行为。     

职业精神与弱势病人

医学职业研究所对美国医生的现实行为的调查说明:医生们是相信且赞同职业精神在对待弱势病人方面的关键信条的;增强美国医生的职业精神的努力,也应该包括努力转变医生照顾弱势病人的行为方面。但是,增强职业精神的努力不仅要通过书本上的或理论上的教育,也应该包括致力于制定使医生更容易履行这些义务的实践政策,提供体制上的支持可使医生更容易做他们已经知道其应该做的行为。     

Neuromarketing Research Practices: Attitudes,Ethics, and Behavioral Intentions

As a new addition to the marketing research toolbox, neuromarketing science has given rise to a variety of questions relevant to consumer perceptions of this nascent area of investigation. Neuromarketing researchers are dependent on consumer involvement as research participants, and finding means to educate the public about neuromarketing is a priority for professionals working in the field. This article describes the results of two online questionnaire studies focused on the role of personal constructs presumed to underlie perceptions of neuromarketing research. The findings point to neuromarketing research knowledge, attitudes toward science, attitudes toward technology, and ethical ideology as important factors linked to neuromarketing research attitudes, perceptions of the ethicality of neuromarketing research, and willingness to participate in neuromarketing studies. We discuss the implications of our findings for educating the public about neuromarketing research and encouraging research participation, and we conclude by suggesting directions for future research.     

Research Ethics in Japanese Higher Education: Faculty Attitudes and Cultural Mediation

Principles of research ethics, derived largely from Western philosophical thought, are spreading across the world of higher education. Since 2006 the Japanese Ministry of Education has required universities in Japan to establish codes of ethical conduct and ensure that procedures are in place to punish research misconduct. Drawing on semi-structured interviews with 13 academics in a research-intensive university in Japan, this paper considers how research ethics is interpreted in relation to their own practice. Interviewees articulated a range of ethical issues connected with data gathering and interpretation, applying for and using research funds, relationships with peers and research subjects, and the dissemination of results. The paper also explores the effect of personal values and cultural norms on the Japanese interpretation of research ethics identifying the impact in terms of the treatment of graduate research students and decision-making processes.     

山东省医疗机构医学伦理委员会运行现状调查

为了解山东省医疗机构医学伦理委员会的运行现状、人员构成和任免情况、伦理审核状况和运行情况,课题组对山东省17地市58家医疗机构进行了问卷调查.结果显示,成立医学伦理委员会的有27家,占46.55％,其中12家成立了多种类别的伦理委员会,且大部分成立时间较短.医院伦理委员会成员的总人数平均为19.89人,本单位成员占94.77％,96.30％的主任委员由行政领导兼任.调查发现,目前仍存在成员结构需完善、培训交流较欠缺、相关政策支持力度不够、伦理审核能力有待加强等问题.     

A Meta-Analysis of Ethics Instruction Effectiveness in the Sciences

Scholars have proposed a number of courses and programs intended to improve the ethical behavior of scientists in an attempt to maintain the integrity of the scientific enterprise. In the present study, we conducted a quantitative meta-analysis based on 26 previous ethics program evaluation efforts, and the results showed that the overall effectiveness of ethics instruction was modest. The effects of ethics instruction, however, were related to a number of instructional program factors, such as course content and delivery methods, in addition to factors of the evaluation study itself, such as the field of investigator and criterion measure utilized. An examination of the characteristics contributing to the relative effectiveness of instructional programs revealed that more successful programs were conducted as seminars separate from the standard curricula rather than being embedded in existing courses. Furthermore, more successful programs were case based and interactive, and they allowed participants to learn and practice the application of real-world ethical decision-making skills. The implications of these findings for future course development and evaluation are discussed.     

医学专业精神的初步研究

由于历史和社会文化的差异,中西方对医学专业精神有着不同的理解。在中西不同语境下,分析了“Profession”和“Professionalism”这两个核心概念的涵义,并从中西对比的视角,对中西方医学专业精神所面临的几个共同问题进行了初步研究,包括医学专业核心道德价值观念、利益冲突、行业自治等。在此基础之上,还对我国医学专业精神的发展提出建议。     

医疗机构应守住初心,让伦理引领发展

医疗机构承载着救死扶伤、防病治病的重任,寄托着民众维护生命健康的希望。医疗机构伦理是实现医学目的,践行医院宗旨,实现医师专业精神的基础和保障。医疗机构伦理建设和医院的经营发展并不是非此即彼的矛盾对立关系。在趋利化导向严重损害了医疗机构的社会形象的情况下,医疗机构应始终坚持人道主义的行善宗旨和不以谋利为目的的伦理本色,秉承全心全意为民众健康服务的核心价值观,坚持公益性办院方向,用得道多助、开放共赢的思维模式推动医疗机构良性发展。     

Professionalism: A Competency Cluster Whose Time Has Come

Despite the burgeoning literature on professionalism in other health professions, psychology lags behind in the level of attention given to this core competency. In this article, we review definitions from other health professions and how they address professionalism. Next, we review how this competency evolved within health service psychology (HSP), and we propose a definition. We offer an approach for assessing professionalism within HSP. Consideration is given to strategies and methods for providing effective education and training in this multifaceted competency. Finally, recommendations are made for creating a culture of professionalism within HSP and honoring psychology’s social contract with multiple publics.     

医药企业的过度介入与医学专业精神

医药企业促进了现代医学的发展,但同时其过度介入会对医学专业精神和医疗职业宗旨带来冲击,不利于医学的发展,为了解决这一问题,必须从医师、企业自身和管理层三方面入手,使医药企业适度介入医疗活动,充分利用其对现代医学的积极促进作用,减消其消极作用,才能使现代医学沿着健康科学的方向发展。     

Ethics training: A genuine dilemma for engineering educators

This is an examination of three main strategies used by engineering educators to integrate ethics into the engineering curriculum. They are: (1) the standalone course, (2) the ethics imperative mandating ethics content for all engineering courses, and (3) outsourcing ethics instruction to an external expert. The expectations from each approach are discussed and their main limitations described. These limitations include the insular status of the stand-alone course, the diffuse and uneven integration with the ethics imperative, and the orphaned status of ethics using the outside expert. A fourth option is proposed — a special modular option. This strategy avoids the limitations of earlier approaches and harmonizes well with curricular objectives and professional values. While some help is provided by a professional ethicist, the headliner for the series of seminars is a high-profile engineer who shares an ethics dilemma encountered in professional practice. Students discuss the case and propose solutions. The goal is to make ethics applicable to real-life problems facing working engineers and to help change behaviors. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Christian Ethics,Religious Ethics,and Secular Ethics: A Contemporary Reappraisal

In this essay, I argue that Christian ethicists should not think of themselves as religious ethicists. I defend this claim by arguing that the concept of religious ethics, as it has come to be understood as a discipline that is distinct from secular ethics, is incoherent. In part one, I describe the fraught attempts by theologians in the 20th century to identify the distinctiveness of Christian ethics. In part two, I argue that certain accounts of natural law unwittingly reinforce a problematic conception of secular ethics. Part three examines some trends in religious studies and comparative religious ethics to highlight problematic conceptions of religion. Drawing together these strands of inquiry, I contend that that the secular-religious dichotomy in contemporary ethics should be rejected, but by the same token, I suggest that comparative ethics remains a worthwhile enterprise.     

医学伦理学不可忽视的课题:利益伦理

当今是一个以利益为轴心的时代。利益伦理学是医学伦理学不可忽视的课题。将病人利益置于首位应当是现代医学伦理学的首要原则。欲望是无穷的,利益是有限的。任何利益都有自己的边界和限度。我们必须设置利益的道德界限,以回答当前医学伦理学面临的种种现实课题。