安宁疗护实践中伦理困境的探讨

在对临终患者的照护中,医务人员常会面对较多的伦理困惑。对安宁疗护实践的四个方面及其存在的伦理困境和对策进行了探讨,包括预立医疗照护计划、心肺复苏术的使用、营养支持治疗及尊严死。要减少伦理冲突的发生,除了政府需健全相关法律法规及推进预立医疗照护计划外,医务人员应具有伦理敏感性,能把安宁疗护实践中的伦理问题与患者和家属进行深入的讨论。医务人员应了解和尊重患者的需要、偏好和价值观,使患者和家属深入了解生命维持治疗的利弊,同时,鼓励家属多从对患者有益的角度做出医疗决策。

     

智能医学算法决策的伦理困境及风险规制

智能医学呈现出难追溯性、不公平性、过程难以理解性、结果不确定性和数据驱动性的技术特征。上述特征与诊疗场景特性的融合交叠可能诱发医生主体地位被削弱、医患信任危机、医疗资源分配不均加剧以及诊疗结果不确定性增加等风险。为有效防范智能算法的决策风险,在智能医学应用中必须遵循以强化医生主体地位为根本出发点,以降低医患信任危机为主导,以平衡资源分配为方向和以增加诊疗结果确定性为目标的伦理规制。

     

Are Thoughtful People More Utilitarian? CRT as a Unique Predictor of Moral Minimalism in the Dilemmatic Context

Recent theorizing about the cognitive underpinnings of dilemmatic moral judgment has equated slow, deliberative thinking with the utilitarian disposition and fast, automatic thinking with the deontological disposition. However, evidence for the reflective utilitarian hypothesis—the hypothesized link between utilitarian judgment and individual differences in the capacity for rational reflection (gauged here by the Cognitive Reflection Test [CRT; Frederick, 2005]) has been inconsistent and difficult to interpret in light of several design flaws. In two studies aimed at addressing some of the flaws, we found robust evidence for a reflective minimalist hypothesis—high CRT performers’ tendency to regard utility‐optimizing acts as largely a matter of personal prerogative, permissible both to perform and to leave undone. This relationship between CRT and the “minimalist” orientation remained intact after controlling for age, sex, trait affect, social desirability, and educational attainment. No significant association was found between CRT and the strict utilitarian response pattern or CRT and the strict deontological response pattern, nor did we find any significant association between CRT and willingness to act in the utility‐optimizing manner. However, we found an inverse association between empathic concern and a willingness to act in the utility‐optimizing manner, but there was no comparable association between empathic concern and the deontological judgment pattern. Theoretical, methodological, and normative implications of the findings are discussed.     

社会价值取向与反馈对动态社会两难决策的影响：以水资源两难决策为例

以水资源两难情景为实验任务,探讨了社会价值取向与反馈在社会两难决策中的作用.结果表明: (1)社会价值取向在决策者的两难决策行为中起着非常重要的作用.合作型个体比非合作型个体显著地表现出更多的合作行为.个体的社会价值取向可以作为预测两难决策行为的一个重要因素: (2)不同的反馈类型对具有不同社会价值取向的决策者的决策行为影响不同.非合作型个体受反馈信息影响比较明显,而合作型个体则不易受他人的决策信息影响.     

公共物品困境中的突显身份效应及合作动机对合作行为影响

从合作动机的激发与破坏的角度探讨公共物品困境中突显身份对合作行为的影响,同时考察社会价值取向与突显身份之间的关系。结果表明：突显合作者与突显不合作者两种方式都会提高被试的合作水平;两种突显方式的作用机制不同。突显合作者条件下,被试的合作行为受内在动机和外在动机的共同影响。而突显不合作者则会破坏被试合作的内在动机,外在动机对提高合作行为起主要作用;突显合作者条件下,合作取向的被试更多受内在动机的影响,而非合作取向的被试则更多受外在动机的影响。在突显不合作者的条件下,合作取向和非合作取向被试的合作行为都受外在动机的影响较大。     

Explanations of interindividual – intergroup discontinuity: A review of the evidence

The authors review and evaluate various explanations for the tendency of intergroup relations to be more competitive, or less cooperative, than interindividual relations (the discontinuity effect). They distinguish between two general perspectives, each comprising a set of explanations for the discontinuity effect. The fear and greed perspective assumes that intergroup relations are characterised by greater fear and greed than are interindividual relations. The group decision-making perspective assumes a crucial role for group discussion in facilitating rational comprehension of mixed-motive situations. In general, explanations from the fear and greed perspective were found to be more consistent with the empirical record than explanations from the group decision-making perspective. The authors propose that a complete understanding of the discontinuity effect is yet to be achieved.