Freedom in responsibility: a response.

This paper is a critical response to Elisabeth Gr?b-Schmidt's article "Freedom in responsibility: On the relevance of 'sin' as hermeneutic guiding principle in bioethical decision making." Gr?b-Schmidt's chief contention is that ethics begins with anthropology, and that moral responsibility is thereby grounded within a set of given limits. Freedom is distorted into sin when these limits are transgressed. My principal complaint is that her account of the relationship between freedom and sin is grounded in a tragic ontology. Alternatively, I contend that anthropology is grounded in Christology in which freedom is a gift of the Spirit. Consequently, sin is not so much tragic as it marks a refusal of humans to accept their divine election. The issues of human cloning and embryonic stem-cell research are used to exemplify what difference these respective differences might make in a process of moral deliberation.     

The Fine Art of Sitting on Two Stools: Multicultural Education Between Postmodernism and Critical Theory

The paper examines two philosophical origins of multicultural education -- postmodern philosophy and critical theory. Critical theory is closely connected to grand narrative of liberation, while postmodern tradition rejects such narrative. The ambivalence of fundamental assumptions makes multicultural theory vulnerable to criticism. However, author maintains, this ambivalence can be a strength rather than a weakness of the multicultural theory. Using Mikhail Bakhtin's notion of polyphony, author attempts to show that incompatible theoretical perspectives may productively coexist within framework of dialogical engagement. The result of such dialogical relations is reciprocal change and not an eventual merge.(With Support of NAE/Spencer Foundation)     

现代医学存在自身缺陷的依据、原因、现象及其后果

目的 探讨现代医学理论体系存在的自身缺陷、根本原因和现象以及由此而产生的后果。方法 明确指出现代医学的理论主体就是实验医学,指出现代医学理论体系所存在的自身缺陷是由于过于依赖实验医学的研究方法而造成的,通过对世界医学发展史上医学与哲学之间关系上的变化进行深入分析,全面阐述了现代医学在对人体研究上的片面性和不完整性,指出现代医学理论之所以存在自身缺陷的根本原因就是没有科学地认识实验医学和经验医学各自的优点并加以合理地利用,列举了现代医学理论存在自身缺陷在基础与临床方面的具体现象及其后果。结论 现代医学理论体系存在着难以自我完善的自身缺陷,并使其发展举步维艰。     

Professional responsibility: The role of the engineer in society

We argue that the practice of engineering does not exist outside the domain of societal interests. That is, the practice of engineering has an inherent (and unavoidable) impact on society. Engineering is based upon that relationship with society (inter alia). An engineer’s conduct (as captured in professional codes of conduct) toward other engineers, toward employers, toward clients, and toward the public is an essential part of the life of a professional engineer, yet the education process and professional societies pay inadequate attention to the area. If one adopts Skooglund’s definition of professional ethics^I (how we agree to relate to one another), then the codes of professional conduct lay out a road map for professional relationships. As professionals, engineers need to internalize their codes and to realize that they have a personal stake in the application of codes as well as the process of developing the codes. Yet, most engineers view professional codes as static statements developed by “others” with little (or no) input from the individual engineer. Complicating the problem, questions of professionalism (such as ethics) are frequently viewed as topics outside the normal realm of engineering analysis and design. In reality, professional responsibility is an integral part of the engineering process.     

The Role of Science in Medicine

Theoretical Medicine and Bioethics - A suitable demarcation between pure science and applied research can be drawn in terms of their goals. This distinction of goals has methodological and cultural...     

我们需要一场医疗观念的革命——关于文化医学与物种医学的思考

现代文明的本质特征是用文化秩序取代自然秩序,用文化选择取代自然选择。现代文明的生活方式同人的生命原理的冲突,是现代许多疾病产生的文化根源。因而我们需要一种对现代疾病的“文化治疗”。传统医学只是关注个体生命的“个体医学”。由于个体健康同物种健康之间的内在冲突,我们需要一种防止物种衰退的“物种医学”。     

Healing Without Waging War: Beyond Military Metaphors in Medicine and HIV Cure Research

Military metaphors are pervasive in biomedicine, including HIV research. Rooted in the mind set that regards pathogens as enemies to be defeated, terms such as “shock and kill” have become widely accepted idioms within HIV cure research. Such language and symbolism must be critically examined as they may be especially problematic when used to express scientific ideas within emerging health-related fields. In this article, philosophical analysis and an interdisciplinary literature review utilizing key texts from sociology, anthropology, history, and Chinese and African studies were conducted to investigate the current proliferation of military metaphors. We found the use of these metaphors to be ironic, unfortunate, and unnecessary. To overcome military metaphors we propose to (1) give them less aggressive meanings, and/or (2) replace them with more peaceful metaphors. Building on previous authors' work, we argue for the increased use of “journey” (and related) metaphors as meaningful, cross-culturally appropriate alternatives to military metaphors.     

论医学哲学是什么和不是什么

弄清医学哲学是什么和不是什么,是医学哲学学科建设的基本问题。医学哲学理论构架的逻辑起点是生命健康,基本结构是医学哲学的本体论、认识论、方法论、价值论和发展观以及一系列医学范畴。“哲学理论 医学实例”不是医学哲学。医学哲学具备超验的思维方式、反思的学术精神、创新的学术风格、开放的学术视野,而临床经验总结、紧跟时局的宣传、时髦热闹的效果,从者众多的场面不是医学哲学。     

差异中的医学人类学与社会学意义——对《中国人群死亡及其危险因素流行水平、趋势和分布》数据的透视

从医学人类学的视角对《中国人群死亡及其危险因素流行、趋势和分布》一书进行了评述,认为本书以大量的数据重新论证了医学人类学和社会医学的基本命题,也给读者带来了一些关于"人类发展与疾病流行"关系的思考。     

Causal Responsibility and Rationing in Medicine

The article addresses the issue of rationing health care services, a topic currently being hotly debated in many countries. The author argues that the aspect of causal responsibility ought to play a decisive role in the allocation of limited medical resources. Starting out from Ronald Dworkin's distinction between option luck and brute luck, the appropriate and meaningful uses of the term causal responsibility are clarified first. A discussion of the conditions which might justify giving lower priority to patients whose illnesses are the result of unhealthy behavior, like e.g. alcohol abuse, follows. Causal responsibility is then viewed in the context of private health insurance and the club model of organ donation. It is argued that individuals themselves are basically responsible for their decisions regarding insurance coverage and membership in organ donors' clubs. Causal responsibility is shown to be a more suitable criterion for rationing scarce medical resources than other criteria which might alternatively be considered, such as patients' age.     

Technology in Medicine: Ontology,Epistemology, Ethics and Social Philosophy at the Crossroads

In reference to the different approaches in philosophy(of medicine) of the nature of (medical) technology,this article introduces the topic of this specialissue of Theoretical Medicine and Bioethics, that is,the way the different forms of medical technologyfunction in everyday medical practice. The authorselaborate on the active role technology plays inshaping our views on disease, illness, and the body,whence in shaping our world.     

Normatively demanding creatures: Hobbes,the Fall and individual responsibility

This paper explores an internal relation between wrong-doing and the ability to think in moral terms, through Hobbes’ thought. I use his neglected retelling of our ‘original sin’ as a springboard, seeing how we then discover a need to vindicate our own projects in terms shared by others. We become normatively demanding creatures: greedy for normative vindication, eager to judge others amid the difficulties of our world. However there is, of course, no choice for us but to choose our own principles of judgment, or at least some authority to provide these. Unconvinced by Hobbes’ remedies, I conclude with one implication for moral philosophy@ a need to look rather differently at agency and responsibility. This revised version was published online in August 2006 with corrections to the Cover Date.     

责任意识及其培养:从心理健康的视角来看

文章从心理健康的视角出发,认为责任意识是个体心理健康的内在要求,是构成心理健康标准的重要维度;强调责任意识的培养是心理健康教育的一个基本主题,它具体包括责任行为、责任认知和责任情感的培养三个方面。     

Future ethics: risk,care and non-reciprocal responsibility

As the number of intrinsically unknowable technologically produced risks global society faces continues to grow, it is evident that the question of our responsibilities towards future people is of urgent importance. However, the concepts with which this question is generally approached are, it is argued, deficient in comprehending the nature of these risks. In particular, the individualistic language of rights presents severe difficulties. An alternative understanding of responsibility is required, which, it is argued, can be developed from phenomenological and feminist concepts of care. Such concepts privilege an understanding of human beings that is primarily relational rather than individualistic, and show that responsibility is, in the first place, about connection rather than respecting separation. Care, by opening up for us an understanding of the diversity of values that are constitutive of a worthwhile life, also connects us to the future as the future of care. As such, it provides us with ethical resources that can guide us in the face of uncertainty, including general principles of action and the desire for institutions that can articulate them.     

现代医学模式形成与疾病治疗

现代生物心理社会医学模式已经成为卫生界领导及广大医务人员的共识 ,并以此指导临床医疗实践。临床诊断正在增添新的内容 ,疾病治疗这个概念也拓宽了她的外延 ,人文科学在医学中越来越显示出她独特的不可替代的地位和作用 ,生物治疗、心理治疗、哲学治疗是未来的三大块治疗模式     

Health of Organisms and Health of Persons: An Embedded Instrumentalist Approach

In a time when we as a society are in the process of deciding what our basic rights to health care are, it is critically important for us to have a full and complete understanding of what constitutes health. We argue for an analysis of health according to which certain states are healthy not in themselves but because they allow an individual to reach actual goals. Recognizing that the goals of an individual considered from the point of view of biology and the goals of the same individual considered as an agent in the world might be different, we introduce a distinction between the health of an individual qua organism and the health of an individual qua person. We then argue that this distinction characterizes the evaluations made by patients and healthcare providers better than the widely discussed distinction between disease and illness.     

公共卫生教育的发展及其与临床医学重整的困境

近代以来人类健康的改善公共卫生的作用居功至伟。1916年约翰霍普金斯大学建立了世界上第一所公共卫生学院,是公共卫生和医学机构分离的开始。尽管公共卫生的研究成果很多,公共卫生和医学在教育和实践上的分裂,削弱了公共卫生在维护大众健康中的作用,在传染病再次成为社会的威胁和医疗费用不断上涨时,因此弥补这个分裂更为重要。如今已经为此做出许多努力,但收效不大。     

Prescriptions: Autonomy,Humanism and the Purpose of Health Technology

My purpose is to examine two of the foundations of medical ethics: the principle of autonomy and the concept of the human. I also investigate the extent to which health technology makes autonomy and humanness possible. I begin by underlining Illich's point that the same health technology designed to promote health and autonomy also is pathogenic. I proceed to analyse the Kantian concept of autonomy, a concept which is closely associated with health and which continues to determine current ethical thinking. In so doing, I uncover an unexpected ontological function of health technology, a function described in Heidegger's work on technology. Based on this discovery, I suggest that calls for Kantian autonomy may often be self-defeating or even sometimes harmful. I conclude by calling for continued ethical vigilance, but also for a questioning of the hitherto virtually unquestionable concepts of ethics and humanness which may themselves play a role in our era's greatest problems.     

精诚合一:医学哲学事业的永恒主题

医学哲学事业的价值在于发现并弘扬医学的基本精神。“精诚合一”是医学亘古不变的基本精神。当代医学哲学研究的任务是揭示医学的“精诚合一”特征及其深刻内涵,注重“精”与“诚”的有机结合,批判现实医疗活动和理论研究在“精”、“诚”问题上的片面,弘扬医学的基本精神。     

关于医学哲学逻辑起点的思考——兼与刘虹教授商榷

人的生命存在在医学哲学理论体系中具有最抽象、最简单、最根本的规定性。医学哲学的其它概念都是人的生命存在的逻辑展开和转化。同时,人的生命存在是人的健康的先决条件,而健康只是人的生命存在的一种样态。因之,医学哲学应以人的生命存在作为其逻辑起点。