医学职业潜规则主要表现及其认知的调查分析

综合运用问卷调查统计、对比方法了解不同群体对医学职业潜规则主要表现的认知情况.各群体对医学职业潜规则主要表现的认知基本一致,潜规则流行之势不容忽视.理性地分类和剖析了潜规则现象,发现医学职业潜规则流行与医改具体举措失误、医学职业生态的公益性缺失和医学知识权力的大量滥用密切相关.     

医学职业潜规则的颠覆与“伦理生态”的营造——论医学职业精神重构的第一要务

我国的医学职业精神重构是一项庞大的系统工程,目前的第一要务是营造良好的医学伦理生态,而要达到上述近远期目标,则必须从颠覆医学职业潜规则起步。颠覆是破,营造是立,二者相辅相成,而且都需要从认识的困惑与误区中走出来,都需要政府、卫生行政管理部门及其官员、医院院长和一线医务人员的同心协力。其中,政府、卫生行政管理部门及其官员合乎医学职业精神的积极作为是最为关键的首要环节。     

医学职业显规则何以不再“败走麦城”

近些年来,医学职业显规则接连受挫,医学职业生态呈现非常态甚至反常态。其根本原因在于,医学职业显规则与潜规则二者并存且此消彼长。职业规则是职业精神的核心。若要真正颠覆医学职业潜规则,让医学职业显规则回归医学职业生活,从而恢复或重构医学职业精神,就必须克服现存的医学职业显规则的致命性缺欠,进行自身优化,即强化自己的权威性、情境性与实用性。     

关于医学职业潜规则的系统调查研究

综合运用实证调研与思辨研究相结合的研究方法,初步厘清了医学职业潜规则的概念、本质、主要表现形式、流行成因链条等基本理论问题,概括了目前我国亟需建设的医学职业精神的基本理念,揭示了职业精神理念、职业行为及职业生态、职业实践四者之间关系的客观规律性,并提出了颠覆职业潜规则并养成职业精神的系统措施.     

医学职业潜规则的"去魅"

颠覆医学职业潜规则是一个值得深入讨论的重大课题.颠覆医学职业潜规则需要系统治理,而其前提条件便是对医学职业潜规则进行伦理学批判,尤其是对与其流行密切相关且收益不浅的群体在认识上进行"去魅",使人们真正认识到它的实质与危害即不合理性,如此才有可能谈颠覆问题.     

医学职业精神养成基本规律研究

围绕着职业精神理念、行为、生态、实践四大要素,具体阐释了医学职业实践决定职业精神理念、医学职业精神理念主导职业行为、职业精神理念与行为相互转化需要职业生态的必备条件等四要素相互关系基本原理,具体阐释了若在整体上养成职业精神则职业生态营造必须先行的规律性.     

医学职业潜规则的“去魅”

颠覆医学职业潜规则是一个值得深入讨论的重大课题。颠覆医学职业潜规则需要系统治理,而其前提条件便是对医学职业潜规则进行伦理学批判,尤其是对与其流行密切相关且收益不浅的群体在认识上进行"去魅",使人们真正认识到它的实质与危害即不合理性,如此才有可能谈颠覆问题。     

医学职业潜规则流行原因解析

调查显示,医学职业潜规则的产生和流行是由多重因素相互作用形成的合力导致的.主要因素有医改政策取向、“医药合一、以药养医”的体制及具体措施失误、医院管理过分追求经济效益、拜金主义影响导致医德水平下降等,其中起决定作用的因素是医改政策取向、体制缺陷及具体措施失误,由此诱发其它因素的相互作用和相互影响,最终导致潜规则 逐渐流行.     

当代我国医学职业精神的基本特征

医学职业精神是以医学科学和人文科学为基础产生和发展的,具有很强的社会时代性.当今,中国医疗服务市场化的出现和高新技术的广泛应用,产生了医疗公平等问题,医学职业精神也遭受了极大的冲击和挑战.从深刻认识医学职业精神实质的角度出发,联系当前医疗卫生的实际,分析阐述当代我国医学职业精神的基本特征.     

医乃仁术：中国医学职业伦理的基本原则

中国古代医学道德具有悠久的传统和独特的价值体系。中国医学史上著名的“医乃仁术”的命题,充分体现了医疗实践的伦理价值。它不仅反映了医学技术是“生生之具、活人之术”,而且也表达了中国古代医生的道德信念,即通过行医施药来实现仁爱爱人。济世救人的理想。中国传统医学十分重视医学的伦理价值,“医乃仁术”被普遍信奉为职业伦理原则。然而,尽管历代医家也提出过一些医学伦理准则和规范,但并未形成一个类似于西方医学史上“希波克拉底誓词”那样具有普遍约束力的、公认的誓言和准则。“医乃仁术”的普遍原则更多的是体现在强调医…     

Omnipotence in the transference and in the countertransference

The concept of omnipotence refers to a primitive fantasy, a mechanism of defense, and a pathological psychic structure. Omnipotence and its derivative defensive operation, omnipotent control, are highly prevalent in borderline personality organization. Three clinical vignettes illustrate these mechanisms in the treatment of patients with borderline, narcissistic, and obsessive personality disorders, respectively. These vignettes illustrate the transference developments when omnipotence and omnipotence control are dominant, and the therapeutic approach to these conditions.     

The patient in the family and the family in the patient

The notion that the family is “the unit of care” for family doctors has been enigmatic and controversial. Yet systems theory and the biopsychosocial model that results when it is imported into medicine make the family system an indispensable and important component of family medicine. The challenge, therefore, is to provide a coherent, plausible account of the role of the family in family practice. Through an extended case presentation and commentary, we elaborate two views of the family in family medicine — treating the patient in the family and treating the family in the patient — and defend both as appropriate foci for care by family doctors. The practical problem that arises when the family is introduced into health care is deciding when to concentrate on the family system. The moral problems that arise concern how extensively doctors may become involved in the personal lives of their patients and families. The patient-centered clinical method provides a strategy for handling both problems. Thus, making the family a focus of care in family medicine can be justified on theoretical, practical, and moral grounds.     

Information in the Universe and in the Organism

There is a branch of modern medicine that relies on information rather than on biochemical substances to maintain health and cure disease. Known as information medicine, it offers an important complement to the dominant biochemical approach of mainstream medicine. This note offers a few reflections on the potentials of information medicine in reference to what is currently known regarding the role of information in the universe, and in the living organism.     

Disequilibrium in the mind, disharmony in the body

Although it is generally acknowledged that experiences of frustration, confusion, and anxiety are embodied phenomena, very little is known about how these processes modulate presumably unconscious, but constantly present, subtle bodily movement. We addressed this problem by tracking the low-level dynamics of body movement, using 1/f noise, pink noise, or "fractal scaling", during naturalistic experiences of affect in two studies involving deep learning and effortful problem-solving. Our results indicate that body movement fluctuations of individuals experiencing cognitive equilibrium was characteristic of correlated pink noise, but there was a whitening of the signal when participants experienced states that are diagnostic of cognitive distress such as anxiety, confusion, and frustration. We orient our findings within theories that emphasise the embodied nature of cognition and affect and with perspectives that view affective and cognitive processes as emergent products of a self-organising dynamical system (the brain) that is inextricably coupled to the body.     

Disequilibrium in the mind,disharmony in the body

Although it is generally acknowledged that experiences of frustration, confusion, and anxiety are embodied phenomena, very little is known about how these processes modulate presumably unconscious, but constantly present, subtle bodily movement. We addressed this problem by tracking the low-level dynamics of body movement, using 1/f noise, pink noise, or “fractal scaling”, during naturalistic experiences of affect in two studies involving deep learning and effortful problem-solving. Our results indicate that body movement fluctuations of individuals experiencing cognitive equilibrium was characteristic of correlated pink noise, but there was a whitening of the signal when participants experienced states that are diagnostic of cognitive distress such as anxiety, confusion, and frustration. We orient our findings within theories that emphasise the embodied nature of cognition and affect and with perspectives that view affective and cognitive processes as emergent products of a self-organising dynamical system (the brain) that is inextricably coupled to the body.     

明代伏牛山佛教派系考

历史上对伏牛山地区的佛教记载较散,资料较详的是在明代。当时来山修行的僧人很多,但是到现在为止还没有人对伏牛山的佛教进行过研究,笔者根据掌握的禅宗史料提出这时伏牛山佛教已经有了明显的禅宗派系特征,在这里传教修行的僧人,主要是元代禅宗断桥伦一支的浙江天目山高峰原妙及其弟子中峰明本一系,其中受四川禅宗无际明悟禅师一派的影响很大,早期来山的僧人大多数都是无际明悟的弟子与后人,可以说成立了无际伏牛山禅派一系。     

孕育中的旅游伦理学--近年来西方国家旅游伦理研究述评

旅行和旅游是一项历史悠久的人类活动,旅游活动中的伦理问题的存在也和旅游发展的历史一样久远.二战以后,"大众旅游"经过半个多世纪的高速发展,对自然环境和社会文化的负面影响已经凸显出来,因此,旅游研究便开始关注旅游发展伦理问题;与此同时,应用伦理学研究也开始从不同的角度关注旅游发展这一新领域.