A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.     

医学生之医学伦理素养教育剖辨

对医学生加强医学伦理素养教育是当前国内外医学教育的共识,但在教育的内容、方式和方法上却是各具特色.相对而言,我国医学院校对医学生的医学伦理素养教育尚处于不成熟的阶段,其表现就是教育过程中存在着诸多的问题、教学效果不甚理想.从医学伦理素养教育的现状入手,尝试分析我国医学伦理素养教育中的重点和难点问题.     

A Code of Ethics for Health Care Ethics Consultants: Journey to the Present and Implications for the Field

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.     

战争伦理:一种世界观念

战争伦理主要论及战争如何受到道德强制,或者说,它涉及道德的进步如何影响到战争。同时,与人类其他活动相比,战争行为更具国际性,因此,战争伦理作为抑制战争的一种道义力量,也更易成为一种世界观念。可以将战争伦理分为军事伦理、军备伦理、军人伦理三个层面,分别代表基于人、武器以及人与武器相结合而采取的行动———作战之上的伦理规范,它们都是随着时代的发展而发展的。     

Development,Ethics, and the Ethics of Development

This article investigates three things: (1) what development might be, (2) how development and ethics might be related, and (3) what an ethics of development might look like. First, I show how if we move away from an essentialist metaphysics of being to a possibilist-functionalist metaphysics of becoming in our understanding of development, we can reconceptualize ethics as self-directed ontogeny. Thus, ethics turns out to be a part of development. Secondly, I sketch out the possibility of an ethics of development, showing how it should be based on three desiderata: (1) sustainability, promoting the long-term existence of the maximum human and non-human biodiversity, (2) democracy, promoting human-human relationships that are bidirectional and, to the extent possible, non-imposing, and (3) non-ethnocentrism, promoting true modernity; a modernity not predicated on a non-existent abstract universality but on concrete syncretism. The ultimate aim of this ethics of development is the optimization of individual and collective subjectivity and agency across time.     

Evaluating Ethics Education Programs: A Multilevel Approach

Although education in the responsible conduct of research is considered necessary, evidence bearing on the effectiveness of these programs in improving research ethics has indicated that, although some programs are successful, many fail. Accordingly, there is a need for systematic evaluation of ethics education programs. In the present effort, we examine procedures for evaluation of ethics education programs from a multilevel perspective: examining both within-program evaluation and cross-program evaluation. With regard to within-program evaluation, we note requisite designs and measures for conducting systematic program evaluation have been developed and multiple measures should be applied in program evaluation. With regard to cross-program evaluation, we argue that a meta-analytic framework should be employed where analyses are used to identify best practices in ethics education. The implications of this multilevel approach for improving responsible conduct of research educational programs are discussed.     

德性伦理与规范伦理在生命伦理中的契合

在生命伦理领域中,规范伦理与德性伦理都曾发挥重要作用,然而,德性伦理没有受到人们足够的重视,重新厘定传统德性伦理的现代价值显得尤为重要。初步探究在生命伦理迅速发展的情况下,德性伦理与规范伦理相结合的模式。     

传统伦理学的价值伦理学转向

传统伦理学的价值伦理学转向,一是基于研究重心由“应当”问题转换为“德行之所以然”的问题,二是基于研究范式上由目的论、德性论、义务论等转换为价值论。作为传统伦理学的集大成者,康德伦理学一方面因其浓烈的价值论色彩而成为舍勒和N．哈特曼价值伦理学的前奏,另一方面因其“实质”内容缺失而致的形式主义又为后者的拓展提供了空间。舍勒,尤其是N．哈特曼的实质价值伦理学正是在康德伦理学的理论平台上得以建立的。     

启新、拓新与创新——论生态伦理学对伦理学的贡献

构建和谐社会,必须弘扬生态伦理,繁荣生态伦理学。生态伦理学对伦理学的贡献功不可没,主要体现为：开辟了伦理学研究的新领域,确立了处理人与自然关系的新原则,培育了人对自然的新态度,对传统思想展开了新的系统批判,明确了人类在自然生活中扮演的新角色,对伦理学基本观念进行了新阐释,制定了人类行为新规范。     

作为一种规范学科的信息伦理学

在信息伦理学领域 ,存在着两种不同的研究取向 :有些学者将信息伦理学作为一门非规范的伦理学来研究 ,而另一些学者则偏重于信息伦理学的规范性质。信息伦理学作为一门规范学科 ,应当研究不同类型的信息活动中已经存在或可能发生的伦理问题 ,而不能成为计算机伦理学、媒体伦理学、生物信息伦理学、网络伦理学的集装箱。规范的信息伦理学可以参考义务论、美德论、效果论的分析框架 ,而且要综合运用多种学科的方法。各国的信息伦理学有本土化的问题 ,但在全球性的信息沟通中 ,应当实现不同的信息伦理学的整合。     

试论信息伦理的特点与本质

信息伦理学作为科技哲学与伦理学的边缘学科 ,不仅要关注现实生活中出现的各种各样的信息行为 ,而且要深入研究信息的“元伦理学”问题 ,同时还要对信息化与传统社会现象交融过程中出现的“交叉伦理”问题进行相关分析 ,准确把握。信息伦理本质上有三个层面。即从信息伦理的起源上看 ,信息伦理是人类交往活动的现实需要和规律反映 ;从信息伦理的应用上看 ,信息伦理调节着人们在信息交往活动中的功利实现 ;从信息伦理的目的上看 ,信息伦理追求人类社会在信息时代的和谐与进步。     

Four Roles of Ethical Theory in Clinical Ethics Consultation

When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of ethical theory in clinical ethics consultation are described and their significance highlighted, while an example case is used as an illustration throughout.     

The Emergence of Clinical Research Ethics Consultation: Insights From a National Collaborative

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards (IRBs), to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation (REC) services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research.     

走向深层发展伦理学——贝克风险社会理论的发展伦理学意蕴

对发展伦理学而言,贝克“风险社会理论”的根本方法论意义,在于启发我们思考这样一个问题:“应该用什么方法、在什么层面上建构发展伦理学”?贝克风险社会理论对明确发展伦理学的研究视域、学理层次、研究平台等具有重要方法论启示。     

人才伦理学刍议

人才伦理是使人才之所以成为人才的各种伦理要素的总和;人才伦理既是人力资源管理理论的重要内容,也是伦理学特别是人才伦理学的研究对象。人才伦理学的内容主要包括以下五个方面：德与才的关系、人才的道德素质、人才的道德标准、人才的道德环境、人才的道德作用。德与才的关系是人才伦理学所要处理的基本关系,“德才兼备”是人才伦理学的核心范畴。提高人才的道德素质,是人才伦理学所确立的最高目标。人才伦理研究要揭示各类人才在道德要求和道德素质上的共同性和特殊性,为新世纪新阶段我国人才培养工作确立新的人才伦理原则和道德标准。     

关于医学伦理学教育的几点思考

医学伦理学教育中长期存在的一些问题尚未很好解决.由于较多强调课程的道德教育功能,对其作为独立学科存在的性质和意义仍重视不够,医学伦理学是进行道德分析、准则与价值评判的理论体系,通过医学伦理学的学习和训练,应使学生能够对有关问题在广阔的背景中进行深层次思考并做出独立判断.我们应在进一步更新观念的基础上,改进哲学、伦理学基础教育,以促进医学伦理学教育的发展,而其意义已远超出医学伦理学之外.     

宗教伦理学研究的意义、现状与展望

在理论上,宗教伦理学研究有利于伦理学与宗教学的学科发展;在实践上,宗教伦理学研究有利于宗教对话与人类道德困境的解决,有利于我国的道德建设,并有利于宗教本身的健康发展。近些年来,在佛教伦理学、基督教伦理学、伊斯兰教伦理学以及基于宗教对话的世界伦理构想等几个领域都取得了丰硕的成果,但宗教伦理学的学科建设还未完全成型,其研究视野略显狭小,这些都有待拓展、完善。     

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。     

Recentering Christian Ethics as Comparative Religious Ethics

The filial relationship between Christian ethics and Comparative Religious Ethics (CRE) need not be perniciously distortive and can be salutary for comparative work. I suggest that the suspicions about CRE as a disguised form of a “Christian ethical enterprise” are overstated and that we can appreciate the value of the legacy of Christian ethics for comparative work in the focal themes of emancipatory criticism and common morality. Both of these themes, even if influenced by Christian ethics, reflect more universal social‐moral problems that can be discerned in cross‐cultural contexts.