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981.
Daniel P. Sulmasy 《Theoretical medicine and bioethics》2018,39(3):233-263
A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: (1) double-effect sedation, (2) parsimonious direct sedation, and (3) sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical importance of intention, and the rule of double effect, these three practices are defined clearly and evaluated ethically. It is concluded that, if one is opposed to euthanasia and assisted suicide, double-effect sedation can frequently be ethically justified, that parsimonious direct sedation can be ethically justified only in extremely rare circumstances in which symptoms have already completely consumed the patient’s consciousness, and that sedation to unconsciousness and death is never justifiable. The special case of sedation for existential suffering is also considered and rejected. 相似文献
982.
Farr A. Curlin 《Theoretical medicine and bioethics》2018,39(3):197-209
Practitioners of palliative medicine frequently encounter patients suffering distress caused by uncontrolled pain or other symptoms. To relieve such distress, palliative medicine clinicians often use measures that result in sedation of the patient. Often such sedation is experienced as a loss by patients and their family members, but sometimes such sedation is sought as the desired outcome. Peace is wanted. Comfort is needed. Sedation appears to bring both. Yet to be sedated is to be cut off existentially from human experience, to be made incapable of engaging self-consciously in any human action. To that extent, it seems that to lose consciousness is to lose something of real value. In this paper, I describe how sedation and the question of intentionally bringing about sedation arise in the care of patients with advanced illness, and I propose heuristics to guide physicians, including Christian physicians, who seek to relieve suffering without contradicting their profession to heal. 相似文献
983.
Po-Sheng Huang Cheng-Hong Liu Hsueh-Chih Chen Scott Sommers 《Social Psychology of Education》2018,21(3):565-583
The main goals of the present study were to investigate the effects of outcome valence on attentional bias toward feedback and examine the internal mechanism of self-defense. We systematically manipulated the outcome valence by providing a bogus score in a rational thinking task and recorded the time positive feedback and negative feedback was viewed in experiment 1. We added the intervention of self-affirmation to examine the self-defense mechanism in experiment 2. The results suggest that (1) in good outcome situations, the participants viewed negative feedback longer than positive feedback. There was a tendency to slightly reduce the attention given to negative feedback in bad outcome situations. (2) Self-affirming participants in bad outcome situations increased their viewing time of negative feedback, which supported the activation of defensiveness. 相似文献
984.
We propose an original response to Derk Pereboom’s four-case manipulation argument. This response combines a hard-line and a soft-line. Like hard-liners, we insist that the manipulated agent is blameworthy for his wrongdoing. However, like soft-liners, we maintain that there is a difference in blameworthiness between the manipulated agent and the non-manipulated one. The former is less blameworthy than the latter. This difference is due to the fact that it is more difficult for the manipulated agent to do the right thing. We explain how we can make sense of this notion of difficulty in terms of Fischer and Ravizza’s notion of reasons-responsiveness. 相似文献
985.
It has been argued that some animals are moral subjects, that is, beings who are capable of behaving on the basis of moral motivations (Rowlands 2011, 2012, 2017). In this paper, we do not challenge this claim. Instead, we presuppose its plausibility in order to explore what ethical consequences follow from it. Using the capabilities approach (Nussbaum 2004, 2007), we argue that beings who are moral subjects are entitled to enjoy positive opportunities for the flourishing of their moral capabilities, and that the thwarting of these capabilities entails a harm that cannot be fully explained in terms of hedonistic welfare. We explore the implications of this idea for the assessment of current practices involving animals. 相似文献
986.
Seth Robertson 《Ethical Theory and Moral Practice》2018,21(2):341-358
Indirect situationist critiques of virtue ethics grant that virtue exists and is possible to acquire, but contend that given the low probability of success in acquiring it, a person genuinely interested in behaving as morally as possible would do better to rely on situationist strategies - or, in other words, strategies of environmental or ecological engineering or control (Doris, 2002, 1998; see also Levy 2012). In this paper, I develop a partial answer to this critique drawn from work in early Confucian ethics and in contemporary philosophy and psychology. From early Confucian ethics, I lean on the concept of li, or ritual. Ritual represents both a set of situational manipulations that are especially effective at directly producing moral behavior and at indirectly cultivating virtue over time, and also a virtue that consists of facility with and expertise in these situational manipulations (Mower 2013; Slingerland, 2011; Sarkissian, 2010; and Hutton, 2006). Appealing to the particular example of social power, I then argue that one is justified in attempting to acquire virtue if one (a) knows that one will frequently encounter circumstances in which purely situationist strategies lose effectiveness, (b) if these circumstances also carry moral urgency: the risk of great harm or opportunity for great benefit to others is high, and (c) if utilizing the potent combination of situationist strategies and virtue envisioned by the early Confucians as ritual is possible. 相似文献
987.
Samuel?ClarkEmail authorView authors OrcID profile 《Ethical Theory and Moral Practice》2018,21(2):371-385
Velleman, MacIntyre, and others have argued for the compositional view that lives can be other than equally good for the person who lives them even though they contain all and only the same moments, and that this is explained by their narrative structure. I argue instead for explanation by self-realization, partly by interpreting Siegfried Sassoon’s exemplary life-narrative. I decide between the two explanations by distinguishing the various features of the radial concept of narrative, and showing, for each, either that self-realization is just as good an account, or that we should prefer the self-realization account, of the composition it is supposed to explain. I conclude that, if the shape of a life matters, it matters because some shapes are self-realizations, not because they are narratives. 相似文献
988.
A dogma of contemporary normative theorizing holds that some reasons are distinctively moral while others are not. Call this view Reasons Pluralism. This essay looks at four approaches to vindicating the apparent distinction between moral and non-moral reasons. In the end, however, all are found wanting. Though not dispositive, the failure of these approaches supplies strong evidence that the dogma of Reasons Pluralism is ill-founded. 相似文献
989.
Matthew Coate 《Continental Philosophy Review》2018,51(4):565-591
On Dan Zahavi’s Husserlian account of the subject, the self-temporalization of subjectivity presupposes what he calls an “immediate impressional self-manifestation.” It follows from this view that self-awareness is an inherent power of the one who will be subject, rather than a product of sociality introduced into life from without. In this paper, I argue against Zahavi’s position by going over the development of Husserl’s account of time-consciousness, examining the positions Husserl takes and the reasons that he comes to these positions. Once we reach Husserl’s ultimate account, it becomes evident that Zahavi’s position is untenable. 相似文献
990.
Björn Petersson 《Ethical Theory and Moral Practice》2018,21(4):841-850
A popular strategy for meeting over-determination and pre-emption challenges to the comparative counterfactual conception of harm is Derek Parfit’s suggestion, more recently defended by Neil Feit, that a plurality of events harms A if and only if that plurality is the smallest plurality of events such that, if none of them had occurred, A would have been better off. This analysis of ‘harm’ rests on a simple but natural mistake about the relevant counterfactual comparison. Pluralities fulfilling these conditions make no difference to the worse for anyone in the over-determination cases that prompted the need for revising the comparative conception of harm to begin with. We may choose to call them harmful anyway, but then we must abandon the idea that making a difference to the worse for someone is essential to harming. I argue that we should hold on to the difference-making criterion and give up the plural harm principle. I offer an explanation of why Parfit’s and Feit’s plural harm approach seems attractive. Finally, I argue that the consequences of giving up the plural harm principle and holding on to the simple comparative counterfactual analysis of harm are less radical than we may think, in relation to questions about wrongness and responsibility. 相似文献