Ethical issues in pediatric life-threatening illness: dilemmas of consent, assent, and communication

The treatment of life-threatening illnesses in childhood is replete with ethical issues and with clinical issues that have ethical implications. The central issues are those involved with a child's participation in the decision-making process and with communication of information about the illness and treatments to children. This article examines the questions of patient autonomy and of parental responsibility and prerogative in the context of pediatric oncology. Included in this examination of the ethical dimensions of pediatric life-threatening illness is a discussion of the many related aspects involved, including medical, cultural, psychosocial, legal, and developmental. A multidimensional approach that considers the ways in which these multiple aspects interact with one another, and which focuses on establishing a strong working alliance between the health care team and the pediatric patient's family, can help to avoid or resolve potential ethical and clinical conflicts.     

Util-izing animals

ABSTRACT Biomedical experimentation on animals is justified, researchers say, because of its enormous benefits to human beings. Sure, animals suffer and die, but that is morally insignificant since the benefits of research incalculably outweigh the evils. Although this utilitarian claim appears straightforward and relatively uncontroversial, it is neither straightforward nor uncontroversial. This defence of animal experimentation is likely to succeed only by rejecting three widely held moral presumptions. We identify these assumptions and explain their relevance to the justification of animal experimentation. We argue that, even if non-human animals have considerably less moral worth than humans, experimentation is justified only if the benefits are overwhelming. By building on and expanding on arguments offered in earlier papers, we show that researchers cannot substantiate their claims on behalf of animal research. We conclude that there is currently no acceptable utilitarian defence of animal experimentation. Moreover, it is unlikely that there could be one. Since most apologists of animal experimentation rely on utilitarian justifications of their practice, it appears that biomedical experimentation on animals is not morally justified .     

开放的中国──封闭的中国

禁地,亦即指由于地形原因而不可进入的地区,尤其是指出于政治、宗教或其他动机而作出的决策所禁止入内的区域（场所、城市、国家）。禁地往往蒙上了一种神秘的气氛．几乎必然会引起人们的好奇。到达拉萨曾是几代探险家的梦想。这一地区不仅对外人封闭,而且对“内部人”也封闭：任何人不得离开“外出”。德川幕府对日本实行的隔绝就是这样一种双向隔离。当然．地理条件也有助于这种隔离,因而使之轻易地付诸实行。有人指出（或许这种说法不够严肃）．举世闻名的中国长城不仅意味着防范匈奴入侵,更意味着防止中国人逃离。史料也表明中国过…     

信息高速公路对医学发展的影响

自１９９３年美国率先提出“信息高速公路”这一全新概念以来,在世界范围内迅速兴起了一股“信息高速公路”热,因为它的建立与发展必将在社会各个领域产生巨大而深刻的影响。作为一名医务工作者,尤其应该意识到,在未来的几十年里,信息高速公路将通过其对临床医疗与康复、预防医学、医学教育、医学科研等多方面的影响来彻底改变传统的生物医学模式。     

Formation of transitivity in conditional matching to sample by pigeons

Four homing pigeons were trained over 5 months in a zero-delay, “arbitrary” matching-to-sample procedure with sample and comparison stimuli presented on any of three response keys. Birds were also required to complete a fixed-ratio 10 requirement on both sample and comparison stimuli to terminate their presentation. The procedure resulted in the establishment of relations that were not specifically trained and that can be characterized by the property of transitivity in a stimulus equivalence context. This result was in contrast with the findings obtained from most previous research with nonhuman subjects.     

现实化的可能体与最简的量化模态逻辑

现实论(actualism)这项方案,旨在清除逻辑与模态形而上学中那些讨人嫌的本体论承诺。它从一切存在的都是现实的这个观点出发,试图重新解释语言,以避免承诺“可能体”(possibilia)的存在。所谓“可能体”,指那些可能的,但非现实的对象。量化模态逻辑(QML)似乎就要求这种对象存在。最简QML为古典量化理论与模态命题逻辑之合并,可是它使巴康(Barcan)公式(今日x由→ax令Q)有效。从而,由可能存在一头会说话的驴子这个事实,就推出了存在某物,它可能是一头会说话的驴子。这看起来在宣称一个可能实体的存在(假定每个现实的东西都不可能是会说话的驴子)。现实论者们大力主张克里普克(Kripke)所描述的语义学,以此来免除这项承诺,这种语义学采用了可变论域,因而使巴康公式归于无效。     

Longitudinal Development of the Automatic Postural Response in Infants

In this longitudinal study, the development of automatic postural responses elicited during stance following perturbation of the support surface was investigated. Infants (N = 9) unable to stand without support were tested initially: follow-up tests were performed until the infants were able to stand and walk independently. Surface electromyographic recordings of leg and trunk muscle activity following a postural perturbation induced by a forward or backward translation of the support surface were made for each infant. Muscle onset latencies following the perturbation and the proportion of trials in which muscle activity was recorded were determined. First, infants activated appropriate muscles either in isolation or in pairs and then combined these muscles into functional synergies. Although activation of all three postural muscles was recorded in infants before they were able to stand and walk independently, the three-muscle response was not consistent in the youngest children. The proportion of trials eliciting muscle activity continued to increase (p <.O5) after infants began to walk independently, with postural muscle activity recorded in virtually every trial by late independent walking. Thus. the automatic postural response elicited during stance was shown to begin with activity in single or paired muscles, followed by activation of the postural muscles in functional synergies. These data illustrate the progressive development of an effective sensory-motor organization.     

早期年龄儿童短时记忆的发展

有关短时记忆的发展问题,如果说在种系发展上已经完成了大量的研究工作,并且做了充分令人信服的、关于在进化中短时记忆不断改善的结论的话,那么,在个体发展上,人的早期短对记忆的发展问题的研究,还是个空白。有关记忆的实验心理学研究,是从儿童生后的第三、四年开始的。以往有关个体发育的早期阶段记忆的发展材料,主要来自《母亲日记》一类的资料,在这类资料中,有关记忆的记述,带有偶然性。在这个时期,记忆的某些形式,其中包括短时记忆,一般地说,还没有研究。