艾滋病与责任伦理建构

人类自从20世纪80年代,美国首次发现并报道艾滋病以来,艾滋病已经成为了历史上最恐怖的传染病之一.据中国卫生部副部长朱庆生透露,目前中国已有84万艾滋病病毒感染者,其中艾滋病病人8万名.中国正处于艾滋病出现泛滥之前的关键时期.如果在这一关键阶段不采取有力的防治措施,"中国将成为世界上艾滋病感染人数最多的国家之一,艾滋病的流行将成为国家性灾难."[1]然而,迄今为止,人们还有意或无意地把艾滋病归结为个人的道德危机,而忽视了对造成艾滋病蔓延的社会、文化、经济等因素的关注.把艾滋病当作他者的事情,很难使公众确立艾滋病的危险意识和责任意识,认识到这是人类的共同危机.     

艾滋病防控中获取患者信息的伦理问题刍议

当前艾滋病获取患者信息中,存在公私观念上的摩擦、相关规定与环节存在疏漏、对信息弱势群体关照不足的伦理难题。问题背后包含着患者为了公共健康的伦理目的却又失去伦理关系的风险,“失德”名声带来的耻感与歧视,遵守政策规范却缺少应有的尊重与保护等矛盾。问题的解决需要在文化背景和利益关系下思量个人身心秩序与社会整体秩序间如何权衡,结合历史、理论与现实维度提出路径。“信”的建立是关键所在,包括公共卫生部门公信力的树立和相应制度措施建设,同时在信息活动中需要给“私”以合理地位,并注重艾滋病治疗相关医学信息的宣传。     

艾滋病研究中的常见伦理问题及其对策

为遏制艾滋病病毒 (HIV )和艾滋病 (AIDS)的迅速蔓延 ,在世界范围内广泛开展了预防控制HIV /AIDS的研究工作 ,研究包括流行病学研究、社会科学研究、教育学研究以及社会干预研究等[1] ,科研引发的伦理问题存在于研究对象选择、研究方法设计和研究实施等环节 ,常见的伦理问题表现为侵犯研究对象的自治权、导致对某些社会群体的歧视、损害研究对象的利益等 ,如何在艾滋病研究伦理审查委员会 (IRB)的监督和指导下 ,在公平、受益和尊重个人的科研伦理学基本原则[2 ] 的基础上 ,采取有效措施消除艾滋病科研中存在的伦理问题已成为预防控制…     

监管场所艾滋病检测结果告知和监管方式分析

通过现场调查和文献归纳,总结了我国监管场所艾滋病病毒检测阳性结果告知的形式和对感染该病毒的被监管人员的监管方式,分析了各形式的利弊.并提出建议:对艾滋病检测阳性结果采取相对及时的有条件的所内告知,对感染者尽可能实行集中监管的方式,并完善监管场所内预防艾滋病的措施等.     

艾滋病高危行为的伦理分析与公共伦理政策选择

艾滋病迅速蔓延与高危行为有着密切的直接关联。艾滋病高危行为的产生与行为者的伦理态度、社会伦理态度又有着深刻的关联。从伦理学角度分析艾滋病高危行为,可以从源头上了解高危行为产生的内在动因。由此,从公共伦理政策构建的层面上对艾滋病高危行为提出干预,是有效预防艾滋病的重要途径和措施。     

艾滋病科研设计的伦理思考

艾滋病严重地影响着人类的健康及生活质量,艾滋病相关因素的研究迫在眉睫,其科研中包含着一系列的伦理问题,如艾滋病患者的依从性问题,艾滋病患者进行试验研究的双盲、随机、对照等原则问题及艾滋病患者科研相关质量问题.要深刻地理解和认识这些伦理问题,在艾滋病科研设计中注意理解和尊重受试者,制定出有效而合乎伦理的科研政策,加强交流,从而得到艾滋病患者和家属以及社会的认同,以有利于在不同范围内进行科研合作.     

医学研究中的机构伦理问题探究

机构作为医学研究活动的主体,在构建国家科研伦理治理体系和倡导负责任的医学研究方面发挥着个体科研人员不可替代的作用,也引发了一系列独特而又时常被忽视的伦理问题和挑战。为此,引入一个全新的观点“机构伦理”,并辨析其与管理伦理、制度伦理、组织伦理之间的区别和联系,进而厘清机构伦理的概念和主要内容。重点剖析了医学科研机构中的两大伦理议题:机构伦理责任和机构利益冲突。医学科研机构的责任担当和有效规避利益冲突,在促进公众对医学研究的信任及营造良好的科研伦理环境方面具有重要意义。     

企业社会责任伦理探析

企业社会责任的影响日益增大,需要探讨其本质、进程、影响因素并推动其发展.企业社会责任本质上是伦理道德责任.企业社会责任由理念到运动,经历了由小到大、由弱到强的变化.企业社会责任受社会文化条件、经济条件和技术条件的影响而在不同时期凸显出不同的伦理内涵和实践要求.     

生死学视域中的“坏消息”告知

患者被隐瞒坏消息的主要理由是保护其免受恶性病情信息的打击。而主张告知患者坏消息则有四个重要理由。告知坏消息必要但不绝对,最终是否告知应当取决于患者的知情意愿,而且如果告知还需征得家属同意。强调应该由医生告知坏消息,而不是护士、社工、志愿者等。在坏消息告知方式上,强调以医护团队为主体的生死学场域的提前构建,生死学场域的构成则包括医护人员的叙事素养、生死学科普活动以及医院生死文化三个要素,其中生死学科普活动最为重要。

     

商业活动中的环境伦理问题探析

商业或贸易是互通有无的行为,通常被认为是对交易双方都有利的事情,但是这种交换却有可能对不参与交易的人或自然界造成危害.传统商业伦理研究交易双方之间的关系,环境伦理视野下的商业伦理则侧重研究交易双方与自然界之间的关系.现代商业活动中的基本伦理关系是卖方、买方及自然界三者之间的双向互动关系.商业活动之所以造成许多环境问题,就是因为交易双方出于利己之目的而不惜牺牲生态环境的结果.     

艾滋病防治中几个问题

HIV感染/艾滋病是一类新发的传染病,呈现全球大流行趋势,我国艾滋病流行经历了3个阶段,目前正处于HIV感染高速发展期,在地域范围、人群特点、传播途径等方面有了新变化,亟需从全社会各个层面上积极协作,有效地遏制疫情的蔓延。     

Counseling to End an Epidemic: Revisiting the Ethics of HIV/AIDS

In the decades since HIV/AIDS was first identified, medical discoveries have advanced prevention and treatment, and shifting demographics have changed the face of the illness. Despite these changes, the counseling literature on HIV/AIDS and its ethical implications for counselors have remained limited and stagnant. Whereas past discussions have focused primarily on issues of confidentiality, this article addresses multiple ethical implications of HIV/AIDS to reflect current knowledge about the illness and its effects on clients.     

Ethical aspects of HIV/AIDS prevention strategies and control in Malawi

HIV/AIDS prevention campaigns have been overshadowed by conflicting, competing, and contradictory views between those who support condom use as a last resort and those who are against it for fear of promoting sexual immorality. We argue that abstinence and faithfulness to one partner are the best available moral solutions to the HIV/AIDS pandemic. Of course, deontologists may argue that condom use might appear useful and effective in controlling HIV/AIDS; however, not everything that is useful is always good. In principle, all schools of thought and faith seem to agree on the question of faithfulness for married couples and abstinence for those who are not married. But they differ on condom use. On the ground, the situation is far more complex. We simply lack a single, entirely reliable way to resolve all disagreements regarding HIV/AIDS prevention strategies.

Perceived responsibility for disease onset affects HIV/AIDS Education

Abstract

Ninety-nine participants were assigned to one of three experimental conditions in which they viewed an AIDS education videotape that systematically manipulated whether or not the educator would be perceived as responsible for HIV infection. Participants were administered pre and post-video affect measures, and an HlV/AIDS knowledge test after watching the video. Participants who viewed the speaker who acquired HIV through a blood transfusion (perceived not responsible) and those who viewed the speaker who did not reveal mode of acquisition (control) performed significantly better on the knowledge test compared to those who viewed the speaker who acquired HIV through unprotected sexual inttrcourse (perceived responsible). In addition. male participants in the perceived responsible condition reported a significant increase in sensation-sceking after viewing the video. Finally, females experienced a significantly greater increase in anxiety as a result of seeing the video than did males. Implications of these tindings for the design and implmentation of AIDS education programs were discussed.     

山西省艾滋病防治政策分析

阐述了艾滋病在山西省流行的现状,探讨了艾滋病引发的社会问题,分析了艾滋病防治条例、四免一关怀政策以及艾滋病自愿咨询与检测制度的执行情况以及在执行过程中所存在的主要问题,研究了山西省艾滋病防治工作相关基金的来源和使用情况,针对山西省在艾滋病防治工作中存在的问题,提出了艾滋病防治工作与社区工作相结合的建议。     

The New Biology and its Impact in Biomedical Strategies Against HIV/AIDS

Abstract. The sequencing of the human genome and the initiation of the structural genomics projects have ushered in a new age of biology that involves multi‐lab, high‐cost projects with broad task‐oriented goals rather than the more conventional hypothesis‐driven approach of the past. The new biology has led to the development of new sets of tools for the scientist to use in the quest to solve mysteries of human disease, biomolecular structure‐function relationships, and other burning biological questions. Nevertheless, the impact of the new biology on the field of AIDS investigation has been minimal, predominantly because many of the tools in the HIV field of study were developed before the full advance of the new biology was felt in the biomedical community. Many of the high‐cost megaprojects that involve large technological advances and are marketed as projects of promise to the biomedical community are not likely to significantly impact the field of HIV/AIDS research and cannot serve as a substitute for direct funding to the HIV/AIDS scientists working for vaccine development, an understanding of mechanisms of disease causation, and new tools for therapeutic intervention.     

Culture at the Heart of Coping with HIV/AIDS

This study explored the manner in which a South African informal community coped with living with HIV/AIDS by relying on existing assets and local resources. A case study research design applying participatory reflection and action principles was used. Focus group/workshop sessions were conducted with ten selected female educators from the community. In addition, individual interviews with stakeholders and other members of the community (n=31, males=6, females=25) were also carried out. Supplemental data collection methods included observation, visual techniques, field notes and a reflective journal. The study found that community members coped with HIV/AIDS by relying on culture and family, faith in God, religiosity and prayer. Inner strength, hope, optimism and expectancy appeared to be key resources for informal settlement residents.     

Other- versus self-focus and risky health behavior: the case of HIV/AIDS

We examined the relationships of other-focus and self-focus with risky health behaviors among HIV+ individuals. Participants who were recruited by an AIDS advocacy organization completed anonymous questionnaires that included measures of other-focus (i.e. empathic concern and perspective-taking) and self-focus (i.e. personal distress and exaggerated internal control); direct measures of concern about the consequences of HIV/AIDS for the self, close others, and society; and a measure of willingness to engage in HIV/AIDS risk behaviors. As predicted, other-focus measures were generally associated with less, and self-focus measures with greater, willingness to engage in risky behavior. However, concern about the consequences of HIV/AIDS for close others was similar to self-focus and was associated with greater willingness to engage in risky behavior. These results are consistent with the notion that prevention efforts focusing on the consequences of HIV/AIDS – and perhaps other communicable diseases – might be more effective if they highlighted the consequences of the disease for society.     

Ethical issues in research on preventing HIV infection among injecting drug users

The ethical issues in conducting research on preventing HIV infection are among the most complex of any area of human subjects research. This article is an update of a 1987 article that addressed potential conflicts between research design and ethics with respect to AIDS prevention among injecting drug users. The present article reviews current ethical issues that arise in the design and conduct of HIV/AIDS prevention research focused on injecting drug users. Disclaimer: The content of this publication is solely the responsibility of the authors and does not necessarily represent the views of the Beth Israel Medical Center or Johns Hopkins University.