医生医疗行为失范的成因与对策

社会转型带来的医德人格扭曲、医疗行政监管缺位和医疗行为中的诸多法律盲区等是医生医疗行为失范的主因.强化新伦理观教育实现医德建设的与时俱进、创新医疗行政管理制度、出台进一步规范医疗行为的法律法规是矫治医生医疗行为失范的对策.     

论医学生职业道德态度的“预防接种”

社会心理学视域中的医生职业道德,是医生对待自己的职业、对待患者及同事同行、对待社会的一种特定的态度与行为。经过"预防接种",增强医生职业道德态度的"免疫力",可使医生在职业活动中坚持道德自律。因社会及个人双重原因,当下医学生职业道德态度必须进行"预防接种",具体策略在于:第一步告知社会转型期医德失范不可避免;第二步以医疗行业典型负面道德事件为"疫苗"给予轻微攻击;第三步引导医学生进行主动反击。     

试论如何搞好医德案例教学

试论如何搞好医德案例教学广西右江民族医学院（５３３０００）农乐颁魏洁一、明确医德案例教学的目的医务人员在医疗实践中，每一个医疗行为都包括有以下两个方面：１诊断、治疗、护理和预防，这主要根据医疗技术和病人病理、生理与心理的变化作出技术处理，是属于医疗...     

行政道德的失范及其治理

一、行政道德失范的原因与类型行政道德失范,是指行政权力异化,讲的是一个过程,指本来是行政主体按照国家利益至上的原则行使行政权力,但是发展的结果,却变成了异己的力量,超出了政府的控制,行政权力变成行政主体损害国家及公众利益、谋取私利的工具。行政道德失范...     

"仁"——医德的元德

医德是医学道德的简称,具言之,它是指医务人员在医疗卫生服务的职业活动中应该具备的仁爱、救死扶伤等的品德,是道德德目在医务人员身上的内化,也是对医务人员必须具备的最起码的要求.我们评价一个医生,首先是直面他的医德,医德是医生形象的体现,没有医德的医生即使技艺再高超,也算不上一个完整意义上的医生,"无德不成医".事实上一个医德低下的医生,他的技艺也不会高超的.     

“医疗经济绩效”至上消解医院宗旨的启示

"医疗经济绩效"机制具有医家"逐利"性质,是"医家利益"型医疗消费的典型表现,在一定程度上对医院宗旨有消解作用。"医疗经济绩效"至上造成医学人道主义信仰缺失,玷污善良总原则,助长从医人员的随意行医行为,诋毁医德"红利"和医生美德,衰败"医师职业精神",向患者树敌,推崇VIP服务使医疗资源分配不合理、不公平。这些都是消解医院宗旨的危险因素,其将"医家利益"转嫁给医疗消费者,直接引发了医患之间的利益差别、利益矛盾和利益冲突。"医疗经济绩效"至上与消解医院宗旨的因果关系毋容置疑。     

刍议医德迷失与重塑

在我国的医疗行政界、医务界、医学教育界以及临床医者中出现了医德迷失现象.社会发展模式,道德激励游戏化,败德激励机制的精细化,个人生存压力,专业知识垄断等原因共同导致医德迷失.医德境界的提升应从教育做起,完善政策引导机制、社会监督评价机制,做好医务人员的岗前培训,提倡医者的自我修养.     

医疗行为的不安全因素分析

医疗行为的不安全因素分析山西铝厂职工医院（０４３３００）薛轴一、医务人员不循规蹈矩医疗行为必须遵循严格的规章制度。医务人员循规蹈矩观念的培养、形成与巩固,有赖于正规的医学伦理学教育、常抓不懈的医德医风建设和医疗规章制度的约束。医疗单位的领导和职能部门...     

必须守住医学伦理底线

1　医学伦理底线受到市场经济的冲击在医学界 ,医学伦理道德受到了来自市场经济的冲击。在经济利益的驱动下 ,医学道德在许多方面退守到了伦理底线 ,而伦理底线并未被有效守住。病人应当享受医疗权、知情权、不受伤害权、不被欺诈权和隐私权等。保护和实现病人的这些权利 ,是医学道德的伦理底线。这些医学伦理底线是不能被突破的 ,否则 ,医疗行为将完全被利益驱动 ,最终将远离医学目的 ,导致医疗行为与医学目的的背离。1 1　市场经济利益驱动使医学伦理底线受到冲击社会各方面在批评不良医德现象时 ,常常把矛头对准第一线的医生。其实 ,不…     

"医闹"产生的原因及防范对策

医德是医学道德的简称,具言之,它是指医务人员在医疗卫生服务的职业活动中应该具备的仁爱、救死扶伤等的品德,是道德德目在医务人员身上的内化,也是对医务人员必须具备的最起码的要求。我们评价一个医生,首先是直面他的医德,医德是医生形象的体现,没有医德的医生即使技艺再高超     

Are the Votes of Ethics Committees in Germany for the Protection of Clinical Study Trial Subjects “Sovereign Acts?”

A sudden paradigm shift has resulted in governmental measures that greatly impact the scope in which the ethics committees in Germany can perform their task of providing expert opinions for clinical research. The so-called “revaluation” of the Medical Device Law Deutsches Medizinproduktegesetz—MPG) is, in our opinion, not based on sound political and professional judgment. In accordance with the changed regulations, ethics committees are now seen as being sub-organs of the state medical associations or the medical faculties and are therefore official authorities. It follows that the votes of ethics committees are then “sovereign acts” or authoritative measures! However, equality and justice speak against this misleading conclusion and its resulting consequence that an ethics committee’s vote is a sovereign act. This has, in turn, resulted in the public ethics committees obtaining their long-sought goal of having a state-sanctioned monopoly. The private ethics committees are not recognized as being authoritative bodies, nor are they to be seen as such in the future (i.e. such a status has been denied the Freiburg Ethics Commission International (FEKI) in Baden-Württemberg). This political mistake must be corrected, otherwise, conducting clinical research will become increasingly difficult.     

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.     

中国古代医德教育对现代医学生医德教育的启示

医德医风已成为全社会普遍关注的焦点,特殊职业要求医务工作者应具有高尚的医德,而高尚医德的培养应从医学生教育阶段开始,努力提高医学生的医德素养。我国传统的医德教育方法,如医学生人品的选拔,老师言传身教,徒弟满师传统等等对于培养现代医学生关爱病人、救死扶伤的医德风范仍具有积极的借鉴意义。     

Some reflections on postgraduate medical ethics education

Three goals of teaching medical ethics to physicians are reviewed. Components of a basic course in medical ethics are described with special attention to the roles of case conferences, ethics rounds, and role modeling. Obstacles to teaching ethics are also addressed.     

国外军事医学伦理学的发展概论

走入战场的医生与正在进行与军事有关的医学研究的人员应具有的独特伦理准则,是军事医学伦理学研究的核心。但是军事医学伦理的准则始终受到战争的挑战。在新的反恐战争中,西方的军事医学伦理困惑聚增,使这一学科迅速发展并经历激烈争论。我们应关注西方的医学伦理在军事领域的延伸。     

Teaching Medical Law in Medical Education

Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics.     

Gouvernance et éthique cliniques : deux outils complémentaires pour une meilleure coordination des soins et des traitements

“Governance”, “ethics” and “clinical” three words for a same goal: protect the human health. “Corporate governance” must be associated with the new theory of the firm, for which the theory of asymmetric information provides the foundations. Indeed problems of information represent a fundamental change in the prevailing paradigm within economics; they are central to understanding political economy. “Clinical governance”, promoted by the UK government, constitutes an overarching mechanism designed to improve clinical quality in the National Health Service. To the medical establishment, it is a means to improve the quality of medical practice through clinical guidelines. To make a significant impact on the improvement of healthcare quality, the principles of clinical governance must produce synergy by involving professionals in the modernization of the organization. To obtain excellence in heath care, collective actions and shared decision making were essential. In this context, Clinical ethics consultations could provide a structured approach to decision making that could assist heath professional to resolve conflicts or ethical problems that arise in the care of particular patients.     

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.     

面向生活世界的伦理人类学

一、在规范伦理学与德性伦理学论争的背后规范伦理学与德性伦理学的论争是当代伦理学研究中的重要学术现象。规范伦理学以罗尔斯和哈贝马斯为代表,德性伦理学以麦金太尔为代表,形成了观点相互对立的两大伦理学阵营。规范伦理学以哲学思辨的方法研究伦理问题,其研究领域主要是伦理的价值或道德的应然,期望     

Medical ethics in Britain

This paper describes ‘the medical ethics scene’ in Britain. After giving a brief account of the structure of British medical ethics and of the roles of the different groups involved it mentions some of the important medico-moral events and issues of the fairly recent past, and describes in greater detail four important examples of professional, legal, governmental and media concerns with medical ethics, themselves illustrating the wide variety of interests wishing to influence the British medical profession's ethics. The examples offered are the development of research ethics committees, the Sidaway case concerning informed consent, the Warnock Committee's Report on in vitro fertilisation and associated issues, and the 1980 Reith Lectures on ‘Unmasking Medicine’. In the final section a fairly new methodological development in British medical ethics is described in which the medical profession is increasingly recognising the need to add to traditional medical ethics education, with its longstanding history of the inculation and enforcement of ethical norms, an element of philosophical or critical medical ethics, at the heart of which is justification of substantive medico-moral claims in the light of counterarguments.