给予老年人体面的照护:为什么尊严很重要——欧洲经验

在医学哲学领域以及相关领域中,"尊严"的概念越来越受到关注.最近,在生物伦理学的国际会议中很流行这个概念.同时,在欧洲的许多国家中,"尊严"的概念也被引入到有关卫生保健的国家立法和政策制定中.本文将从检验一个在关于尊严和老年人的欧洲计划中产生的尊严理论模型开始.然后根据参与这个计划的老年人和卫生及社会保健的专业人员那里得到的经验进行研究,有6个国家参加这项研究.结果证明尊严是一个非常重要的事情,尤其是对那些弱势群体来说.本文结论认为:对于虚弱的老年人,相对于那种强调自主的医学伦理,长期的保健需要注重一个范围更为广泛的伦理内容.     

死亡的尊严:儒家和西方观点的比较

死亡的尊严问题是当代生命伦理学中讨论的一个重要问题。在当代的医疗实践中,各种新的医疗技术在老年人临终阶段的应用,已经引发了各种维护死亡的尊严之激烈争论。本文试图重建儒家的人的尊严和死亡的尊严之基本含义,并从这些观念出发,对死亡的尊严与人的生物学生命之关系,死亡的尊严与人的痛苦之关系,以及死亡的尊严同人的自主性之关系进行分析,并与西方思想家在这些问题上的立场做比较。文章还表明了,儒家关于人的尊严的观点是对以上问题作出的更好回答,它有助于化解西方死亡伦理研究中出现的概念混乱和理论矛盾。     

论尊严观念的正确使用

本文探讨了尊严概念。作者首先以霍布斯的《利维坦》为例,探讨作为掌权者的禀赋的尊严概念。然后指出康德捍卫完全另一种观念:是思考能力将尊严赋予人类。作者在文中指出,对尊严的尊重建立在对自律性、完整性和脆弱性的尊重之上。这四项伦理准则相互接合,以构建一种统一的和连贯的实践理性,可以引导医学领域和公共空间中的人类行动。     

生命伦理委员会：作为伦理研讨和政策建议的平台

1生命伦理委员会的四种形式及其目标(1)决策委员会和/或咨询委员会(2)保健专业人员协会委员会(3)保健/医院伦理委员会(4)研究伦理委员会1.1生命伦理委员会的前提条件生命伦理委员会应该:(1)尊重人权;(2)承认公民的尊严;(3)支持生命伦理教育计划。1.2四种形式的生命伦理委员会及其目标(1)决策委员会和/或咨询委员会:为成员国公民制订健全的科学和保健政策(公共卫生、福利和权利)(2)保健专业人员协会委员会:建立良好的病人医疗专业实践(医生、护士、药剂师和相关的保健专业人员)(3)保健伦理委员会:改进以病人为中心的保健(医院、门诊、长期护…     

生命伦理学语境中康德尊严观的重新阐释

人的尊严是生命伦理学的核心概念。康德的人性公式在很大程度上塑造了当代生命伦理研究中的尊严观。由于对人性公式的片面理解,生命伦理学中的"康德主义"否定人类尊严的平等性,遮蔽了康德的尊严概念本应具有的重要理论功能。人性公式论述的是尊严的道德要求,而非尊严的基础。构建康德的尊严观,需要超越人性公式之外对康德的尊严理论进行阐释。通过分析人性、人格和道德自主等康德哲学中的重要概念,可以得出以下推论:人类个体的尊严并非来自于个体自主选择的能力,而是来自于个体对人类整体尊严的分享;人类整体的尊严来自人类道德自主的潜力,而非已表现出的能力。这样的尊严观恰恰认可并论证了尊严概念在当代生命伦理研究中所承担的不同于以往的功能,并有助于解决当代生物医学技术的应用所带来的伦理困境。     

人的尊严和生命的尊严释义

人们时下经常提及“人的尊严”、“生命的尊严”、“民族的尊严”、“国家的尊严”等,但“尊严”一词始终是一个极为抽象的模糊概念。在哲学价值论的层面阐明“人的尊严”和“生命的尊严”的内涵及其相互关系,探讨生命的尊严的基本特征,或许可以开拓出一个与其他文化共同体就重大问题进行相互对话、增进共识的思想平台。更重要的是,当我们的干部群众对人的尊严、生命的尊严都达到深刻的认识和理解,并趋向于认同它们在现代价值体系中的崇高地位的时候,各种漠视生命、侵犯尊严的现象(如矿难频发、食品安全问题、执法侵权、医疗事故等)才能在思…     

国内外城市社区老年人生活质量研究现状

老年人生活质量是国家经济发展水平、社会文明程度的重要标志。如何提高老年人的生活质量己成为老年保健研究的一个重要课题。查阅了近年来国内外有关社区老年人生活质量的文献资料,对生活质量的概念,生活质量国内外研究动态作一综述。     

医学目的与发展自我保健医学的意义

随着社会进步和医学的发展,应将医学的全域性发展与医学伦理模型和医学目的的全新转变有机地结合起来,即建立“公正、均衡的医学伦理模型”。其含义是强调生命质量价值;维护人人平等的健康权;实现各方面与医学和健康有关的权力与义务的统一。关键在于创建和发展自我保健医学。它是以现代科学理论为基础,研究人类生命活动、保健需求、自我保健行为及社会活动规律;并通过“自我保健医学”诊断和开具自我保健处方,实施健康促进工     

国内外城市社区老年人生活质量研究现状

老年人生活质量是国家经济发展水平、社会文明程度的重要标志.如何提高老年人的生活质量已成为老年保健研究的一个重要课题.查阅了近年来国内外有关社区老年人生活质量的文献资料,对生活质量的概念,生活质量国内外研究动态作一综述.     

人的尊严与生命伦理

“尊严”是频繁出现在生命伦理学中的一个概念,但关国学者麦克琳却在最近认为,尊严在生命伦理学中是个无用的概念,可以毫无损失地用其它概念,比如尊重人的自主性概念所代替。反驳了麦克琳的观点,定义了尊严的含义,认为生命伦理学的使命就是在当代生命科技高度发达的情况下如何尊重和保护人的尊严。     

健康公平--概念、影响因素与政策

长期以来健康不平等和不公平一直是卫生改革与发展所关注的重点,并已经成为了国际卫生政策的主要方向.在国家之间健康不平等和不公平也存在不同的理解.发达国家主要集中在产生疾病和导致死亡率差异的社会经济阶层的形成机制,将健康不平等作为疾病病原学的一个函数,关键措施是加强初级卫生保健;在中低收入国家,人们却趋向于通过提供基本的医疗保健服务来解决这一问题.     

European values in bioethics: why,what, and how to be used?

Are there distinctly European values in bioethics, and if there are, what are they? Some Continental philosophers have argued that the principles of dignity, precaution, and solidarity reflect the European ethos better than the liberal concepts of autonomy, harm, and justice. These principles, so the argument goes, elevate prudence over hedonism, communality over individualism, and moral sense over pragmatism. Contrary to what their proponents often believe, however, dignity, precaution, and solidarity can be interpreted in many ways, and it is not clear which reading would, or should, be favored by popular opinion. It is therefore dangerous to think that any one understanding of "European", or any other, values could be legitimately imposed on those who have different ideas about morality in health care and related fields. Bioethical principles should be employed to promote discussion, not to suppress it.     

生命伦理学:权力与不公正--在第六届国际生命伦理学大会的致辞

在现代生命伦理学的讨论中,主要关注的是改造医患关系中的权力关系。通过强调人权和对个人尊严的尊重,对脆弱人群授予权利已经达到。然而,在卫生保健中,权力的不平衡依然普遍存在。这在相当程度上与对社会不公正的关注不够有关。那种权力的不平衡加之新的权力形式的发展,例如,通过新的遗传生物技术,产生了对日益增长的社会不公的恐惧与忧虑。由此,扩展与公共卫生有关的伦理学讨论将受到关注。政治哲学研究也需要变为改造国际权力关系和改善人口健康。     

The Association Between Life Satisfaction and Self‐Reported Health Status in Europe

Previous research has shown that life satisfaction (LS) and self‐reported health status are strongly related to each other. However, it is not clear whether this association holds across different nations or whether certain country‐level indicators significantly affect this association. The study was based on nationally representative samples of 32 countries from the first six rounds of the European Social Survey (N = 291 686). Results from hierarchical multilevel modelling indicated that there was a positive association between LS and self‐reported health status across countries, but this association was slightly stronger in countries where governments spent less on the health care of their residents. Self‐reported health ratings were also more strongly tied to LS judgements in countries where variability in LS ratings was larger. These results suggest that, especially in less wealthy European countries, policies should target reducing overall social inequality and the negative impact of governments' underinvestment in health care on LS. Copyright © 2015 European Association of Personality Psychology     

Health care reform: Can a communitarian perspective be salvaged?

The United States is culturally oriented more toward individual rights and values than to communitarian values. That proclivity has made it hard to develop a common good, or solidarity-based, perspective on health care. Too many people believe they have no obligation to support the health care of others and resist a strong role for government, higher taxation, or reduced health benefits. I argue that we need to build a communitarian perspective on the concept of solidarity, which has been the concept underlying European health care systems, by focusing not on individual needs, but rather, on those of different age groups—that is, what people need at different stages of life.     

Masked ball: Ethics,laws and financial contradictions in hungarian health care

Corruption is a major problem in the societies of the post-communist Central European countries. Corruption in health care has some unique characteristics undermining the efficacy of and respect for Hungarian health care. One of the forms of corruption is tipping. This highly contested phenomenon is present in most of the patient/health professional’s interactions in a sophisticated manner, raising serious ethical and legal dilemmas. The present paper analyzes tipping and other corruption-related factors, such as financial conflict of interest between industry and health care and argues that since ethical and legal considerations are often ignored in the country, patient care and clinical research are affected by these controversial issues to a great extent.     

13 Perspective: Suicide in Europe

In many European countries, suicidal behavior constitutes a major public and mental health problem. In most countries, the number of suicides is significantly higher than the number of deaths due to traffic accidents. According to official figures, the suicide rates among European countries differ widely; for example, Hungary has the highest rates. Suicide attempt rates, based on data from the WHO/Euro Multicentre project on Parasuicide, equally show variation; for example, the highest average rate of suicide attempts is for Helsinki, Finland. This paper outlines the epidemiological findings and then presents some hypotheses (e.g., age, ethnic difference) to explain the differences.     

Dignity,Capability, and Profound Disability

Martha Nussbaum has sought to establish the significance of disability for liberal theories of justice. She proposes that human dignity can serve as the basis of an entitlement to a set of capabilities that all human beings either possess or have the potential to develop. This article considers whether the concept of human dignity will serve as the justification for basic human capabilities in accounting for the demands of justice for people with profound learning difficulties and disabilities. It examines the relationship between dignity and capabilities, suggesting that Nussbaum fails to distinguish between several conceptions of human dignity, whilst also identifying one of these conceptions as coming close to meeting several of her demands. It is difficult enough, however, to show how dignity is related to just one of our basic entitlements, and even that requires more than the resources available in Nussbaum's approach.     

Psychiatrische Versorgung im europäischen Strafvollzug

Objective and methods:

We analysed administrative national data regarding mental health care and psychiatric prevalence in the penitentiary systems of 24 European countries. Data was provided by national experts via questionnaire.

Results:

There is a mixed approach for prison mental health care in European countries that either rely on separated psychiatric prison services or collaborate with specialized forensic or general mental health care services. Care provision in general is assessed as deficient. At all decisive points of detention, adequate screening or diagnostic routines are lacking. As a consequence, nothing is known about the prevalence of mental disorders in European prisons. At the moment, only a very limited number of secondary indicators are available for describing the problem.

Conclusion:

There is an urgent need for improving the reporting routines on mental disorders in prison inmates as a first step for improving substantially the mental health care provision for prisoners in European countries.     

Bringing the European Union closer to its young citizens: Youth active citizenship in Europe and trust in EU institutions

Abstract

European Union countries are participatory and representative democracies. Therefore, active citizenship in the EU and trust in EU institutions are paramount for the continuation and the strengthening of the EU project. Young Europeans who hold the future in their hands need to be actively engaged not only in the social and political life within their national communities, but also in the wider European community. The papers in this special issue examine whether and how European youth identify with the EU, trust EU institutions and engage in EU issues, and which societal and proximal-level contexts and/or individual-level attributes promote or hinder young people’s active citizenship in European context. They are based on results from the Horizon 2020 CATCH-EyoU project, standing for Constructing AcTive CitizensHip with European Youth: Policies, Practices, Challenges and Solutions. Scientists represent different disciplines (Psychology, Political Science, Sociology, Media and Communications, Education) and from eight European countries (Sweden, Estonia, U.K., Germany, Czech Republic, Greece, Portugal, Italy). Together, the papers contribute to the development of a new, cutting-edge conceptualization of youth active citizenship in the EU, and to a better understanding of the factors promoting or inhibiting young EU citizens’ engagement, participation and active citizenship at the European level.