增加卫生改革的伦理含金量——兼论卫生改革中的效率与公平

卫生改革需要有包括卫生改革伦理学理念在内的全方位改革理念的联手支撑。伦理含金量缺失或者不足,卫生改革实践就难以取得圆满成功。因此,目前展开的新一轮卫生改革,必须以“效率与公平合理兼顾”为核心准则,在完善政策、规划目标、组织实施等全过程中切实保证卫生改革伦理学理念准确到位和正常运作。     

论高新生命科学技术发展的伦理困境复杂性

当下高新生命科学技术在发展过程中面临着诸多伦理困境,而其复杂性超过了一般性的医学道德问题。高新生命科学技术伦理困境的复杂性源于三个因素:当下后现代道德多元化的复杂性所引发的生命伦理问题多元化;高新生命科学技术不仅干预身体机能,还引发超身体干预;中国当下生命伦理学应对的复杂性。中国话语体系下的生命伦理学探索是值得发展的路径,但如何整合传统文化、西方传入文化和当下中国现代文化,以解决中国本土的生命伦理问题,任重而道远。     

中国语境下现代生命科学技术的伦理规制探索

生命科学技术伦理致力于建立生命科学技术与伦理之间动态平衡的契合点,以应对现代高新生命科学技术发展和应用过程中带来的复杂社会伦理问题。中国的生命技术伦理研究取得了一定的成果,但仍面临着巨大的挑战。中国传统的技术伦理思想在疏解当代生命科学技术发展所引发的伦理困惑中有着积极的意义和价值。鉴于中西方科技文化背景迥异,中国的生命科学技术伦理学研究应在汲取西方优秀经验和理论的基础上更加注重贴近中国实际的本土化研究,促进中国特色的生命伦理学研究和伦理规制体系的形成和完善。     

儒家伦理对当代生命伦理学发展的价值及其局限

对于当代生命伦理学的发展而言,儒家伦理提供了一种理论资源和研究进路,有积极的价值和意义.但是,一方面,儒学是一个历史概念,儒家伦理有其历史局限性和文化相对性,另方面,生命伦理学有不同于传统伦理学的性质、任务和方法,因此,对当代生命伦理学的发展而言,儒家伦理的价值也是有限的.儒家伦理不能自发地成为当代生命伦理学的理论基础、分析工具和核心价值.只有在认真地清理传统儒家伦理的基础上,在不断地对儒学进行"现代诠释"或称之为"儒学创新"的基础上,所构建的儒家生命伦理学才能在后现代多元文化处境中占有一席之地,对当代生命伦理学的发展做出贡献.     

经济伦理与伦理经济--兼论经济伦理学的方法问题

经济伦理研究和伦理经济研究有共同的论域,即经济学与伦理学相交的范围;这种研究必须面对现实的经济生活和社会道德状况,并从中引申出经济与伦理交互作用的规律性;作为经济学与伦理学的交叉学科,经济伦理学既是一门实证科学,又是一门价值学科;经济伦理学的研究必须遵循实事求是的原则、历史与逻辑相统一的原则和价值学的原则.     

落实当代护理伦理职责存在的问题及对策

在临床护理实践中,要落实当代护理伦理职责尚存在不少问题,例如忽视多元文化护理、关爱与人性化服务不够以及不能充分认识和维护患者的权利。要解决这些问题,宜促进护理伦理学课程改革,努力提高护士自身素质;同时,营造理想的医疗护理伦理环境,加强管理,也是落实当代护理伦理职责的必由之路。     

生命伦理学的学科框架、原则及相关问题之我见

生命伦理学应把主要的研究内容转移到精神、灵性与社会生命的伦理解读,研究什么是生命的伦理价值,以及"医疗与保健政策的公正"方面;生命伦理学的学科体系可分为原理(原道)、原论(原法)与原用(原实)三部分,可划分为理论生命伦理学与应用生命伦理学两部分;生命伦理学的原则可分为母原则,基本原则与应用原则;生命伦理学要鼓励创建各种学派,不要搞一言堂;在生命科学进化的今天,有必要保持心境平和,而不是戏剧性的躁动.     

伦理人类学对当代中国卫生政策的指导价值

1　问题的提起 :伦理人类学种种伦理人类学[1] (Ｅｔｈｉｃａｌａｎｔｈｒｏｐｏｌｏｇｙ)作为哲学人类学的分支 ,曾有着浓厚的宗教人类学传统 ,并与文化人类学、社会人类学相交叉 ;当代 ,它与诸多的应用人类学 ,特别是医学人类学和生命伦理学的理论与实践发生密切关联。其对于医学 ,尤其是非西方国家和地区的民族医学的发展以及卫生资源分配的伦理政策的作用不可忽视。尽管我们尚来不及对这一新兴学科进行认真的学理性考释 ,但它客观上已经对各国的医疗政策发生深刻影响。因为我们从来没有对其理论核心和研究方法进行必要的研究性对话 ,以…     

食品安全伦理建构

该著旨在通过对食品安全现状的分析,在进行伦理反思的基础上,提出涉及食品安全伦理体系的四维架构,即经济领域中的企业伦理、政治领域中的行政伦理、生活领域中的消费伦理,以及文化领域中的传播伦理。该著研究的主要内容与关键问题包括:食品安全及其伦理的基本内涵、食品安全问题的成因及其伦理反思、构建食品安全伦理的主要路径。该著的创新点在于,充分解析食品安全问题背后的伦理成因,探讨维护食品安全的伦理途径和对策;从尊重生命、敬畏生命等生命伦理学意蕴,探求食品安全伦理的人权表达,对食品安全引发的现实问题进行伦理批判和反思,揭示在当代社会的公共伦理建构中存在的伦理需求与道德供给之间的深刻矛盾。     

论"伦理世界观"

伦理道德作为实践理性,当以“意识—意志”的复合为研究对象,因而现象学意义上的意识和法哲学意义上的意志,就是合理的伦理体系和伦理精神的两个理想要素,由此伦理学的研究必须实现现象学与法哲学的璧合。“伦理世界观”的基本问题是伦理与自然(包括客观自然与主观自然)的关系问题。伦理与自然、义务与现实在伦理精神中原初的对峙与对立——绝对义务意识对伦理与自然关系的抽象统一——透过伦理行为达致的伦理与自然的现实统一,是伦理世界观的辩证结构,及其生长的具体—抽象—具体的辩证过程。     

卫生保健政策与医学伦理学

卫生保健政策是卫生资源、价值目标和伦理原则三者的结合。医学伦理学是卫生政策的重要基础。当代卫生事业的特点,卫生保健服务面临的挑战以及医学伦理主体与客体的变化,决定了医学伦理学在当代卫生保健政策中的特殊意义。在医学面临全民保健的阶段,一个科学的符合人民健康利益的卫生保健政策是不言而喻的。摆脱当前卫生政策面临的困难,要求必须在医学伦理学方面作出正确的选择。     

政府与个人的责任——中国当代医疗改革的责任伦理学剖析

卫生改革的重点必须放在政府部门;公共卫生,预防与初级医疗保健是人类生存的需要,带有鲜明的公益性和福利性。应由政府投资为主筹集资源,以国家投资为主体负担费用,这个层次的卫生服务产品,属非商品经济部分,并不以赢利为目的,不能引进市场经济,个人对健康负有重要责任,包括：选择医疗保健,决定花费数额,生活方式和卫生习惯的养成,主动接受健康教育,抵抗压力,支持国家与地区的卫生保健政策;个人对自身健康负责是一种道德责任,健商（health quotient)这一重要概念,具有伦理价值和普遍的医学人类学意义;个人对健康负责是一种社会风尚。     

Clinical Audit and Reform of the UK Research Ethics Review System

There is an international consensus that medical research involving humans should only be undertaken in accordance with ethical principles. Paradoxically though, there is no consensus over the kinds of activities that constitute research and should be subject to review. In the UK and elsewhere, research requiring review is distinguished from clinical audit. Unfortunately the two activities are not always easy to differentiate from one another. Moreover, as the volume of audit increases and becomes more formal in response to the demand for evidence-based practice in medicine, the overlap between research and audit grows more acute. Arguably, similar ethical standards and systems for ensuring that those standards are met should be applied regardless of whether or not a project is classified as research or audit. At a time when the research ethics review system in the UK is undergoing significant reform it is important that the opportunity is not missed to address the longstanding research-audit problem. We discuss suggestions for further reform that addresses this issue.     

从黄禹锡事件看伦理学对科学的重要性

克隆干细胞研究是一个与生命伦理密切相关的领域。当被誉为“克隆大王”、“韩国最高科学家”的黄禹锡因“卵子风波”的伦理问题不得不向公众道歉,并辞去世界干细胞研究中心的主任职务时,从科学家、政府官员到普通大众,支持黄禹锡,认为伦理学阻遏了干细胞研究的人不在少数。直到黄禹锡学术造假事件被揭露,人们才意识到问题的严重性,“黄禹锡神话”才因此破灭。科学不允许作假,科学也不允许作恶。黄禹锡事件给我们最大的启示是:伦理学对科学发展来说是重要的,科学研究不仅要遵循求真的学术道德,而且要遵循求善的人本道德,求善才能更好地求真!     

ISLAMIC VERDICTS IN HEALTH POLICY DISCOURSE: PORCINE‐BASED VACCINES AS A CASE STUDY

In this article, I apply a policy‐oriented applied Islamic bioethics lens to two verdicts on the permissibility of using vaccines with porcine components. I begin by reviewing the decrees and then proceed to describe how they were used by health policy stakeholders. Subsequently, My analysis will highlight aspects of the verdict's ethico‐legal arguments in order to illustrate salient legal concepts that must be accounted for when using Islamic verdicts as the basis for health policy. I will conclude with several suggestions for facilitating a more judicious use of verdicts in policy‐relevant discourse. My analysis is meant to contribute to the dialogue between science and religion, and aims to further efforts at developing health policies that value health while accommodating religious values. In the encounter between the Islamic tradition and global public health, a multidisciplinary dialogue, where Islamic legists become aware of the health policy implications of their ethico‐legal pronouncements, and where health policy actors gain a literate understanding of Islamic ethico‐legal theory, will lead to verdicts that better meet the needs of patients, health workers, and religious leaders.     

Medical Ethics Research Between Theory and Practice

The main object of criticism of present-day medical ethics is the standard view of the relationship between theory and practice. Medical ethics is more than the application of moral theories and principles, and health care is more than the domain of application of moral theories. Moral theories and principles are necessarily abstract, and therefore fail to take account of the sometimes idiosyncratic reality of clinical work and the actual experiences of practitioners. Suggestions to remedy the illnesses of contemporary medical ethics focus on re-establishing the connection between the internal and external morality of medicine. This article discusses the question how to develop a theoretical perspective on medical ethical issues that connects philosophical reflection with the everyday realities of medical practice. Four steps in a comprehensive approach of medical ethics research are distinguished: (1) examine health care contexts in order to obtain a better understanding of the internal morality of these practices; this requires empirical research; (2) analyze and interpret the external morality governing health care practices; sociological study of prevalent values, norms, and attitudes concerning medical-ethical issues is required; (3) creation of new theoretical perspectives on health care practices; Jensen's theory of healthcare practices will be useful here; (4) develop a new conception of bioethics that illuminates and clarifies the complex interaction between the internal and external morality of health care practices. Hermeneutical ethics can be helpful for integrating the experiences disclosed in the empirical ethical studies, as well as utilizing the insights gained from describing the value-contexts of health care practices. For a critical and normative perspective, hermeneutical ethics has to examine and explain the moral experiences uncovered, in order to understand what they tell us.     

A Debate on the Ethics of Aging: Does the Concept of Autonomy Provide a Sufficient Framework for Aging Policy?

This article presents a debate on the issue of autonomy in aging policy held at the 1994 annual meeting of the American Society on Aging held in San Francisco, California. Harry R. Moody, director of the Institute for Human Values in Aging at Hunter College, supports a reconceptualized notion of personal autonomy which focuses on issues of power, theory, and practice, and finds conflicts between autonomy and justice in the lived world of the elderly and disabled. In aging policy, he promotes an emphasis on social movements such as Hospice rather than on autonomy of individuals. He suggests alternatives to extreme paternalism or complete autonomy, such as a communicative ethics approach. Larry Polivka, director of the Florida Policy Exchange Center on Aging at the University of South Florida, affirms that policy for the aging and disabled should be based ona commitment to autonomy. He describes an integrated model for long-term care that places autonomy first and includes features of communicative ethics and the negotiated consent and virtues models of ethics.     

论医学宽容——兼全球生命伦理是否可能

宽容是一种文化,一种文明,一种成熟的伦理风格,一种时代精神,是生命伦理学的重要内容;应提倡和关注宽容主义,宽容伦理学的建立对医学和社会发展有极重要的意义,生命伦理学尤其需要宽容技术,宽容使全球生命伦理的建立成为可能;我们应争取主动快乐的宽容,宽容不是放弃思想,而是选择自由。如果没有宽容,就没有全球生命伦理,就没有人能够很好地生存。     

论健康伦理学及其基本理论架构——“九大理论”视野中的健康伦理

当代医学道德发展的走向理应是健康道德,后医学伦理学时代理应是健康伦理学。建设健康伦理学需要搭成一个基本理论架构。其组成至少应该有“九大理论”,即生命神圣论、生命质量论、生命价值论,医学人本论、医学功利论、医学公正论,医者美德论、医者义务(患者权利)论、医患和谐论。其间,按顺序由每三论构成一个“统一论”,将第一个“统一论”作为立论前提,将第二个“统一论”作为直接依据,将第三个“统一论”作为应用指南,如此,才能由三个“统一论”共同地更好地阐释全部健康伦理学问题。