脑死亡立法的若干法律问题探讨

因为关系到基本人权,脑死亡立法应当由全国人民代表大会立法通过。制定科学的脑死亡标准和严谨的脑死亡判定程序是保障其接近正义的必需。在脑死亡判定方面应充分地保障患者生命权、自主选择权,尊重患者以及家属的知情同意权,保障患者的基本权利是脑死亡立法的核心所在。器官移植不是脑死亡立法的理由。     

关于"脑死亡"立法科学与伦理的纷争

我国对脑死亡的研究起步于 2 0世纪 80年代。1980年 ,学者李德祥提出脑死亡应是全脑死亡 ,从而克服了大脑死、脑干死等脑的部分死亡等同于脑死亡的缺陷[1] 。中国医学界开始讨论建立我国自己的脑死亡标准。 1997年在全国第七届卫生立法讲习班上 ,有 2 0多位国内的知名专家 ,联名提出关于脑死亡标准的立法问题。 1999年中华医学会组织了脑死亡标准 (草案 )专家研讨会 ,并提出了脑死亡诊断标准[2 ] 。同年 ,解放军总医院的人大代表李炎唐教授在全国人大会议上提交了关于脑死亡及器官移植的立法提案 ,促使我国脑死亡立法的步伐越来越快。2 0 0 …     

脑死亡判定的伦理学及实践中的几个问题

脑死亡是临床实践中的常见问题,随着当代医学科学的发展,经过临床严格的判定程序,患者脑死亡即生物学死亡已经成为科学标准,但由于我国在脑死亡立法、公众认知以及医生的各种心理考量,在我国开展脑死亡的判定还存在许多障碍。我们结合自己在判定患者脑死亡后的医患心理变化,以及存在的一些问题,期望引起更多的医学、法学和社会学家关注,使得临床医生对脑死亡的判定,顺应科学发展又能符合患者及其家属的最大利益。     

诊断脑死亡的伦理思考

随着医学的进步和社会的发展,死亡的定义、诊断标准和医生道德责任有了新的内容,脑死亡就是生命终结已为医学界普遍接受.诊断脑死亡是非常专业的技术性工作,有权进行脑死亡诊断的医疗单位和医生必须达到相应的资质要求.确诊和宣布脑死亡应遵循的伦理准则包含多方面的内容,如家属应有死亡标准选择权、脑死亡的诊断程序、脑死亡诊断结果的宣布和生效等方面的问题.     

脑死亡判定的伦理学及实践中的几个问题

脑死亡是临床实践中的常见问题.随着当代医学科学的发展,经过临床严格的判定程序,患者脑死亡即生物学死亡已经成为科学标准,但由于我国在脑死亡立法、公众认知以及医生的各种心理考量,在我国开展脑死亡的判定还存在许多障碍.我们结合自己在判定患者脑死亡后的医患心理变化,以及存在的一些问题,期望引起更多的医学、法学和社会学家关注,使得临床医生对脑死亡的判定,顺应科学发展又能符合患者及其家属的最大利益.     

“脑死亡法”与医学伦理

目前,世界上大多数国家都已经通过了“脑死亡法”,中国已初步具备实施“脑死亡法”的条件,时代呼吁“脑死亡法”不仅具有科学价值,而且具有深远的伦理意义。当今关键在于转变国人伦理观念,促使“脑死亡法”尽快实施。１时代呼吁“脑死亡法”１９６８年召开的世界第２...     

对我国脑死亡立法问题的反思

在对1999年以来我国脑死亡问题的研究成果进行初步梳理的基础上,针对我国学者主张脑死亡立法的主要论据,提出并分析了脑死亡问题的三个主要问题：（1）脑死亡是真正的死亡吗？（2）能否以经济效率的考量来定义生死？（3）器官移植和脑死亡到底有什么关系？还提出,脑死亡立法需要在我国现实的医疗卫生条件下进行讨论。     

韩国医师和公众对脑死亡的看法

韩国医师和公众对脑死亡的看法Ｈｙｅｏｎ－ＧｙｕｎＳｏｎ，Ｋｗａｎｇ－ＬｅｌＫｉｍ一、韩国医师对脑死亡的看法韩国医师对脑死亡的看法有５种：第一种看法：存在这种看法的医师被称为“利己主义的脑死亡赞成者”，他们从实用主义的角度出发积极赞成脑死亡，他们同意器...     

从拉图尔的转译理论看脑死亡问题

通常而言,公众对脑死亡问题的评判,不仅取决于伦理的标准,还受到对脑死亡认知程度的影响。因此,在讨论公众应不应当接受脑死亡标准的伦理学问题之前,首先需要解决的是公众对脑死亡的认识论问题。根据科学社会学中拉图尔的转译理论,依照公众的"兴趣"将科学断言转变为事实、切断科学家通常的道路、在迂回的道路上设立路标、重组兴趣和目标并最终变得不可或缺,有助于打开技术的黑箱,从而为脑死亡问题的解决清除认识论的屏障。     

从社会文化的角度看脑死亡

从社会文化的角度思考脑死亡，有多方面的重要性。它既影响到人们对脑死亡事实的认定，更影响到人们相应的价值选择。中国传统社会中蕴含着赞同脑死亡的文化因子，同时，儒家传统的孝文化以及死亡仪式化的深远影响也成为脑死亡社会化的重大障碍。要使脑死亡观念在社会上广为接受，除了要进行科学普及，更需要重塑相关的社会文化。     

Do Narrative Engagement and Recipients’ Thoughts Explain the Impact of an Entertainment-Education Narrative on Discouraging Binge Drinking?

Previous research suggests that narrative engagement (NE) in entertainment-education (E-E) narratives reduces counterarguing, thereby leading to E-E impact on behavior. It is, however, unclear how different NE processes (narrative understanding, attentional focus, emotional engagement, narrative presence) relate to different thought types (negative or positive; about the narrative form or about the target behavior) and to E-E impact. This study explores these relations in the context of alcohol binge drinking (BD). Participants (N = 172) watched an E-E narrative showing negative BD consequences, thereby aiming to discourage BD. The main findings were that the E-E narrative had a positive impact on discouraging BD on almost all assessed BD determinants such as beliefs and attitude. It was shown that attentional focus, emotional engagement, and narrative presence were associated with BD-discouraging impact, albeit on different BD-related determinants. No evidence was found that negative thoughts about BD mediated these associations. From this, we conclude that attentional focus, emotional engagement, and narrative presence were important for E-E impact but that negative thoughts about BD did not play a role therein. The study’s empirical and practical implications are discussed.     

Characterization of facial emotion recognition in bipolar disorder: Focus on emotion mislabelling and neutral expressions

Increasing evidence suggests that facial emotion recognition is impaired in bipolar disorder (BD). However, patient–control differences are small owing to ceiling effects on the tasks used to assess them. The extant literature is also limited by a relative absence of attention towards identifying patterns of emotion misattribution or understanding whether neutral faces are mislabelled in the same way as ones displaying emotion. We addressed these limitations by comparing facial emotion recognition performance in BD patients and healthy controls on a novel and challenging task. Thirty-four outpatients with BD I and 32 demographically matched healthy controls completed a facial emotion recognition task requiring the labelling of neutral and emotive faces displayed at low emotional intensities. Results indicated that BD patients were significantly less accurate at labelling faces than healthy controls, particularly if they displayed fear or neutral expressions. There were no between-group differences in response times or patterns of emotion mislabelling, with both groups confusing sad and neutral faces, although BD patients also mislabelled sad faces as angry. Task performance did not significantly correlate with mood symptom severity in the BD group. These findings suggest that facial emotion recognition impairments in BD extend to neutral face recognition. Emotion misattribution occurs in a similar, albeit exaggerated manner in patients with BD compared to healthy controls. Future behavioural and neuroimaging research should reconsider the use of neutral faces as baseline stimuli in their task designs.     

Body dissatisfaction levels and gender differences in attentional biases toward idealized bodies

Attentional bias toward idealized bodies (men: muscular; women: thin) may cause upward comparisons and increase body dissatisfaction (BD). We investigated attentional biases of 39 men and 41 women with high and low BD toward muscular male bodies and thin female bodies. An eye-tracker measured gaze durations and fixation frequencies while exposing participants to images of thin, normal, muscular, and fat bodies of the same gender. Results revealed longer and more frequent attention toward muscular bodies in high BD men, and toward thin bodies in high BD women. High BD men and women also rated muscular and thin bodies as more attractive than those with low BD. Although men attended to muscular and women attended to thin bodies, both showed an attentional bias toward body types they rated as more attractive. These findings could provide indirect evidence in explaining the relationship between BD and the social comparison theory with attentional bias.     

Memory in Early Onset Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder: Similarities and Differences

Differentiating between early-onset bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) can be difficult. Memory problems are commonly reported in BD, and forgetfulness is among the diagnostic criteria for ADHD. We compared children and adolescents with BD (n?=?23), ADHD combined type (ADHD-C; n?=?26), BD?+?ADHD-C (n?=?15), and 68 healthy controls on memory tests (Digit span, Children's Verbal Learning Test-II). Further analyses were performed on subgroups of BD (BD-I, BD-II/BD-NOS, with and without previous psychotic symptoms). All clinical groups demonstrated some problems with free recall, but the BD subgroup with a history of psychotic symptoms had a more pervasive problem that also included recognition and semantic clustering. The ADHD-C groups demonstrated the lowest performance on working memory. These data suggest that children and adolescents with BD and previously psychotic symptoms may have inefficient encoding of verbal material, whereas memory problems in ADHD-C appear more characterized by impaired free recall.     

Does body dissatisfaction have the same meaning for males and females? A measurement invariance study

ObjectivesThe aim of this study was to assess the psychometric equivalence of body dissatisfaction (BD) between males and females.MethodTwo scales, BD and Drive to Thinness (DT), from the Eating Disorder Inventory-3 were evaluated. The sample was comprised of 1616 adolescent males and 1429 adolescent females. Factorial invariance across gender of two scales was assessed in order to evaluate the equivalence of scores.ResultsThe results showed full invariance for the DT scale items, and partial invariance for BD scale items. The content analysis of the items confirmed that items related to the perception of thighs, stomach and hips showed differential functioning across gender.ConclusionsDifferent representation of the BD construct between males and females was concluded, and caution was recommended in assessing and interpreting BD in male samples with questionnaires designed for women.     

Effects of Exposure to Physique Slides on the Emotional Responses of Men and Women

The purpose of this study was to examine high and low body dissatisfied (BD) men's and women's in-task emotional responses to the acute exposure of sex-specific physique slides of the aesthetic ideal (i.e., ideal slides) and themselves (i.e., self-slides). Participants were 35 male and 30 female university students who reported their immediate in-task emotional responses (i.e., pleasure and arousal) to viewing the self- and ideal slides. It was found that the (a) high BD women reported the least amount of pleasure while viewing the self- and ideal slides; (b) women reported less pleasure while viewing the self-slides than did the men; (c) The high BD group reported less pleasure while viewing the self- vs. the ideal slides than did the low BD group, and (d) the high BD men reported the most arousal of any of the groups while viewing the self- and ideal slides. The differing emotional responses of the men and women and the high and low BD groups to viewing the self- vs. ideal slides are discussed, and future research directions are suggested.     

Temporal discounting of rewards in patients with bipolar disorder and schizophrenia

Patients with bipolar disorder (BD) and schizophrenia (SZ) often show decision-making deficits in everyday circumstances. A failure to appropriately weigh immediate versus future consequences of choices may contribute to these deficits. We used the delay discounting task in individuals with BD or SZ to investigate their temporal decision making. Twenty-two individuals with BD, 21 individuals with SZ, and 30 healthy individuals completed the delay discounting task along with neuropsychological measures of working memory and cognitive function. Both BD and SZ groups discounted delayed rewards more steeply than did the healthy group even after controlling for current substance use, age, gender, and employment. Hierarchical multiple regression analyses showed that discounting rate was associated with both diagnostic group and working memory or intelligence scores. In each group, working memory or intelligence scores negatively correlated with discounting rate. The results suggest that (a) both BD and SZ groups value smaller, immediate rewards more than larger, delayed rewards compared with the healthy group and (b) working memory or intelligence is related to temporal decision making in individuals with BD or SZ as well as in healthy individuals.     

Interference control in adolescents with Mild-to-Borderline Intellectual Disabilities and/or behavior disorders

The aim of this study was to investigate interference control in adolescents with Mild to Borderline Intellectual Disability (MBID) by addressing two key questions. First, as MBID is often associated with comorbid behavior disorders (BD), we investigated whether MBID and BD both affect interference control. Second, we studied whether interference control deficits are associated to problems in everyday executive functioning. Four groups of adolescents with and without MBID and/or BD performed the Eriksen flanker task, requiring participants to respond to a central target while ignoring interfering flanking stimuli. Their teachers rated behavior on the Behavior Rating Inventory Executive Function (BRIEF). We found pronounced effects of MBID but not BD on flanker interference control. In contrast, we observed pronounced effects of BD, but not MBID, on the BRIEF. In addition, flanker interference scores and BRIEF scores did not correlate. These results are taken to suggest that adolescents with MBID are characterized by deficits in interference control that do not become manifest in ratings of everyday executive functioning. In contrast, adolescents with BD are not characterized by deficits in interference control but do show elevated ratings of deficits in everyday executive function.     

Body image variability: the influence of body-composition information and neuroticism on young women's body dissatisfaction

The current studies consider the effect of body size, body composition feedback, and the moderating influence of neuroticism (N) on three measures of body dissatisfaction (BD) in young women. In Study One, normal-sized subjects who were given false feedback indicating that they were either fatter or leaner than average showed heightened BD compared to groups who received either accurate or no feedback about body size. There was no evidence of a moderating effect of N. In Study Two, thinner-than-average subjects who received accurate body-size feedback showed greater satisfaction than a control group receiving no information. For heavier than average subjects, feedback only increased BD for those low on N. Although these results show mixed support for N as a moderator, they are the first to show an effect of body composition information on BD.