人体器官“有偿”获取机制的伦理依据与法律观照

人体器官、组织无偿捐献是当今获取器官的主流模式, 有偿模式 (含经济补偿、捐赠激励) 被排斥在体制之外。创建符合国情的器官捐献和移植体系, 既遵循我国社会的普遍伦理法则, 又符合国际通行的器官移植伦理标准, 提倡无偿、允许有偿 (补偿、激励) 获取人体器官模式和机制可能成为一种切合实际的选择。这既是对多年来关于人体器官“无偿”还是“有偿”获取讨论的回应, 也是对器官捐献机制的一个重大改进。为使这一机制真正发挥效力, 需要法律与伦理的融通和观照。     

再论经络——兼与严健民、章晓东同志商榷

<医学与哲学>2004年第10期上,中医研究评估栏目中所刊登的,严健民同志"关于利用‘循经感传'探讨经络实体的思考"和章晓东同志"经络实质的思辨"两篇文章,似乎有些踢开红旗闹革命的味道,他们的目的是要否定经络的客观存在,乃至否定整个中医的理论体系,反复研读,思绪万千,为了现代中医经络的前途和命运,有义务站出来与两位同志再谈经络.     

人体美与健康美

自1988年6月天津科学技术出版社出版邱琳枝、彭庆星主编的<医学美学>以来,特别是1990年成立中华医学会医学美学与美容学分会以来,我国学者对"医学美学"(medical aesthetics)概念的研究逐渐深入,围绕着医学美学与美容医学的定义、对象、任务、体系结构及其对现代医学模式转变和未来医学发展的影响等问题为轴心,展开了基础理论和学科建设等方面的一系列研究.     

Physical Activity,Suicide Risk Factors,and Suicidal Ideation in a Veteran Sample

The association between current level of suicidal ideation and physical activity was tested in a broad sample of veterans seeking care from the Veterans Health Administration. It was hypothesized that the two variables would be significantly inversely related. It was further hypothesized that the relationship would be mediated by depressive symptoms, disturbed sleep, and a measure of heart rate variability based on existing research regarding physical activity and sleep. Due to the first hypothesis not being supported, the second could not be tested. Post hoc correlation analyses did find associations between physical activity and depressive symptoms, in expected directions, and are discussed. Possible explanations for the negative findings along with recommendations for future research to continue exploring links between suicide risk and physical activity are presented. We conclude by suggesting that physical activity may have promise as a risk reduction intervention and that prospective data are more likely to yield significant results than the cross‐sectional methodology employed in the current study.     

Trajectories of Suicidal Ideation from Sixth through Tenth Grades in Predicting Suicide Attempts in Young Adulthood in an Urban African American Cohort

The trajectory of suicidal ideation across early adolescence may inform the timing of suicide prevention program implementation. This study aimed to identify developmental trajectories of suicidal ideation among an urban cohort of community‐residing African Americans (AA) longitudinally followed from middle school through early adulthood (ages 11–19 years). Subtypes based on the developmental course of suicidal ideation from late childhood through mid‐adolescence were identified using longitudinal latent class analysis (LLCA) with 581 AA adolescents (52.7% male; 71.1% free or reduced school meals). The developmental trajectories of suicidal ideation were then used to predict suicide attempts in young adulthood. Our LLCA indicated two subtypes (i.e., ideators and nonideators), with 8% of the sample in the ideator class. This trajectory class shows a peak of suicidal ideation in seventh grade and a steady decline in ideation in subsequent grades. Additionally, suicidal ideation trajectories significantly predicted suicide attempt. Results of these analyses suggest the need for suicide prevention approaches prior to high school for AA youth.     

The Interactive Effects of Impulsivity and Negative Emotions on Adolescent Nonsuicidal Self‐injury: A Latent Growth Curve Analysis

This study employed latent growth curve analysis to evaluate the interactive effects of two specific facets of impulsivity (i.e., negative urgency [NU] and premeditation [PRE]) and negative emotions (NE) on the developmental trajectory of nonsuicidal self‐injury (NSSI) among 3,453 (57% females) Chinese community adolescents. Participants completed questionnaires assessing NSSI, NU, PRE, and NE (i.e., depression, anxiety, and stress) at three waves of time. The initial levels of NE and NU significantly predicted the initial level of NSSI. Changes in NE and NU significantly predicted change in NSSI. Moreover, the initial levels of NU and PRE significantly moderated the relationship between the initial levels of NE and NSSI, such that among individuals with higher NU or less PRE, the three NE were associated with a higher level of NSSI. Additionally, among individuals with a faster increase in NU, depression and anxiety were associated with a faster increase in NSSI. These findings suggest that adolescents with trait impulsivity, especially in the form of NU, are more vulnerable to the engagement in NSSI.     

Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: Evaluation of Caller Risk Profiles and Interventions Implemented

Crisis lines are settings where identifying individuals at imminent risk of suicidal behavior and intervening to keep them safe are critical activities. We examined clinical characteristics of crisis callers assessed by telephone crisis helpers as being at imminent risk of suicide, and the interventions implemented with these callers. Data were derived from 491 call reports completed by 132 helpers at eight crisis centers in the National Suicide Prevention Lifeline network. Helpers actively engaged the callers in collaborating to keep themselves safe on 76.4% of calls and sent emergency services without the callers' collaboration on 24.6% of calls. Four different profiles of imminent risk calls emerged. Caller profiles and some helper characteristics were associated with intervention type. Our findings provide a first step toward an empirical formulation of imminent risk warning signs and recommended interventions.     

Factors that Influence Chaplains’ Suicide Intervention Behavior in the Army

We surveyed 868 Army chaplains and 410 chaplain assistants (CAs) about their role in identifying, caring for, and referring soldiers at risk of suicide to behavioral health care. We applied structural equation modeling to identify how behaviors and attitudes related to intervention behavior. In both samples, reluctance and stigma were related to intervention behaviors; efficacy was correlated with intervention behaviors only among chaplains. Training was associated with increased efficacy and lower levels of stigma among chaplains. Improved training may be warranted, but research needs to identify why chaplains and CAs are reluctant to refer soldiers in distress to behavioral health care.     

Factors Associated with Achieving Complete Mental Health among Individuals with Lifetime Suicidal Ideation

The objective of this study was to identify factors associated with complete mental health among Canadians who had ever seriously considered suicide. Data for this study were obtained from Statistics Canada's 2012 Canadian Community Health Survey–Mental Health (N = 2,844). The outcome variable examined in this study was complete mental health and was analyzed using binary logistic regression. Of the 2,844 respondents with lifetime suicidal ideation, 1,088 (38.2%) had complete mental health (i.e., had flourishing mental health, no mental illness, and no suicidal ideation in the past 12 months). Those who had a confidant were seven times more likely to have complete mental health. Other factors associated with achieving complete mental health among formerly suicidal respondents include being older, being a woman, having higher income, use of religious coping, and never previously having a mental illness. Considering the importance of these protective factors in formulating public health policies will allow for a more wide‐reaching approach to suicide prevention.     

The Incremental Utility of Emotion Regulation But Not Emotion Reactivity in Nonsuicidal Self‐Injury

This study assessed the incremental utility of emotion reactivity and emotion regulation in relation to nonsuicidal self‐injury (NSSI). Participants included 379 college students aged 18–22 who completed self‐report measures of emotion regulation, emotion reactivity, and NSSI. Emotion regulation was significantly related to NSSI both ignoring and controlling for reactivity, but the reverse was not true. Participants' use of NSSI for affect regulation appeared to moderate this relation. Findings support emotion regulation deficits as a target for intervention over and above heightened emotion reactivity, especially in those who use NSSI to regulate negative affect.