卫生保健政策与医学伦理学

卫生保健政策是卫生资源、价值目标和伦理原则三者的结合。医学伦理学是卫生政策的重要基础。当代卫生事业的特点,卫生保健服务面临的挑战以及医学伦理主体与客体的变化,决定了医学伦理学在当代卫生保健政策中的特殊意义。在医学面临全民保健的阶段,一个科学的符合人民健康利益的卫生保健政策是不言而喻的。摆脱当前卫生政策面临的困难,要求必须在医学伦理学方面作出正确的选择。     

Cultural Similarity, Foreign Policy Actions, and Regime Perception: An Experimental Study of International Cues and Democratic Peace

This study examines previous explanations of democratic peace in light of sociocultural factors and foreign policy actions that influence public perceptions of another country. Two experiments assessed the effects of relevant sociocultural and foreign policy action cues on perception of the regime type of a target nation and on public approval of the use of force. The findings suggest that sociocultural cues affect regime perception. Moreover, perceived similarity of a target nation and foreign policy actions are significant determinants of the public approval of the use of force in addition to perceptions of regime type.     

Reframing the question of forbidden knowledge for modern science

In this paper I use the concept of forbidden knowledge to explore questions about putting limits on science. Science has generally been understood to seek and produce objective truth, and this understanding of science has grounded its claim to freedom of inquiry. What happens to decision making about science when this claim to objective, disinterested truth is rejected? There are two changes that must be made to update the idea of forbidden knowledge for modern science. The first is to shift from presuming that decisions to constrain or even forbid knowledge can be made from a position of omniscience (perfect knowledge) to recognizing that such decisions made by human beings are made from a position of limited or partial knowledge. The second is to reject the idea that knowledge is objective and disinterested and accept that knowledge (even scientific knowledge) is interested. In particular, choices about what knowledge gets created are normative, value choices. When these two changes are made to the idea of forbidden knowledge, questions about limiting or forbidding lines of inquiry are shown to distract attention from the more important matters of who makes and how decisions are made about what knowledge is produced. Much more attention should be focused on choosing directions in science, and as this is done, the matter of whether constraints should be placed on science will fall into place.     

Idealism or Pragmatism? An Operational Code Analysis of Yitzhak Rabin andShimon Peres

This study quantitatively measured the operational codes of Yitzhak Rabin and Shimon Peres according to the Verbs in Context System (VICS) devised by Walker, Schafer, and Young (1998). Rabin's and Peres's basic propensities regarding the nature and conduct of foreign policy were then compared through analyses of variance, both to each other and across time. Three main trends were found in the results. First, both leaders' conception of their political environment changed over time, from basically conflictual in the 1970s to essentially neutral in the 1990s. Second, the remainder of Rabin's operational code, including a surprisingly strong predisposition to approach politics in a cooperative manner, was generally constant across time. Third, unlike Rabin, several other components of Peres's operational code underwent acute fluctuations, seemingly in response to the perceived different situational context. On the basis of these results and the operational code construct in general, a typology was created that classifies leaders according to their predisposition to pursue either cooperative or conflictual strategies and their level of responsiveness to their political environment.     

Sustainable development, engineering and multinational corporations: Ethical and public policy implications

This paper explores the concept of sustainable development and its ethical and public policy implications for engineering and multinational corporations. Sustainable development involves achieving objectives in three realms: ecological (sustainable scale), economic (efficient allocation) and social (just distribution). While movement toward a sustainable society is dependent upon satisfying all three objectives, questions of just distribution and other questions of equity are often left off the table or downplayed when engineers and corporate leaders consider sustainable development issues. Indeed, almost all the effort of engineers and engineering organizations on the issue of sustainable development has been focused on striking a balance between economic development and environmental protection. Similarly, corporate approaches rely on technological fixes to the challenges posed by sustainable development. While there have been some efforts aimed at incorporating environmental and social equity concepts into engineering codes of ethics, social concerns have been secondary to environmental issues. The incongruity between the ideal of sustainable development and the way in which it is typically characterized by the engineering and business communities has significant implications for engineering and public policy, engineering ethics, and the potential roles of engineers and multinational corporations as facilitators of a transition to a sustainable society. Presented at the Engineering Foundation Conference on “Ethics for Science and Engineering Based International Industries”, Durham, NC, USA, September 1997. An earlier version was presented at and appeared in the proceedings of the “1997 International Symposium on Technology and Society”, IEEE Society on Social Implications of Technology, Glasgow, Scotland, UK, June 1997. The author, an Assistant Prolessor of Multidisciplinary Studies, teaches in the Science, Technology and Society Program and is Director of the Benjamin Franklin Scholars Program, a dual-degree program in engineering and humanities/social sciences.     

Infant food refusal and parental social support

The purpose of this study was to examine the relations between various aspects of social support and maternal and infant outcome variables in a group of families having infants showing food refusal compared to a control group. In the case of early food refusal, the results indicated that access to emotional support and satisfaction with support were related to maternal psychosomatic health. The relationships were interpreted as showing that social support has moderating effects on negative outcomes of food refusal.     

Effects of income on drug choice in humans.

The effects of income (money available to spend during the experimental session) on human choice were examined in a concurrent-schedule arrangement. Subjects were 7 nicotine-dependent smokers, and reinforcers were puffs on the subject's usual brand of cigarette ("own") and puffs on a less preferred brand of cigarette with equal nicotine content ("other"). Across sessions, income varied and the price of the two reinforcers was held constant, with the other puffs one fifth the price of the own puffs. As income increased, consumption of own puffs increased while consumption of the less expensive other puffs decreased. These effects of income on choice were highly consistent across subjects. For some subjects, however, income had little effect on total puff consumption. Finally, an additional condition examined whether price and income manipulations would have functionally equivalent effects on choice by repeating an income condition in which the price of the other brand was increased. Although the increased price of the other puffs decreased their consumption in 4 subjects, 2 subjects showed increased consumption of the other puffs at the higher price. The results, when defined in economic terms, indicate that the own puffs were a normal good (consumption and income are directly related), the other puffs were an inferior good (consumption and income are inversely related), and the direct relationship between consumption of the other puffs and their price is defined as a Giffengood effect. The latter result also suggests that for these 2 subjects, price and income manipulations had equivalent effects on choice. These results extend findings from previous studies that have examined the effects of income on choice responding to human subjects and drug reinforcers, and provide a framework for further experimental tests of the effects of income on human choice behavior. Methodological and theoretical implications for the study of choice and for behavioral pharmacology are discussed.     

Transdisciplinarity,neuro-techno-philosophy,and the future of philosophy

Philosophy and science have always striven to make sense of the world, continuously influencing each other in the process. Their interplay paved the way for neurophilosophy, which harnesses neuroscientific insights to address traditionally philosophical questions. Given the rapid neuroscientific and technological advances in recent years, this paper argues that philosophers who wish to tackle intractable philosophical problems and influence public discourse and policies should engage in neuro-techno-philosophy. This novel type of inquiry describes the transdisciplinary endeavor of philosophers, (neuro)scientists, and others to anticipate the societal implications of the impending transformations of subjects and theorizers. While human enhancement is likely to irreversibly change what it means to be human, disruptive technologies might lead to the emergence of artificial intelligent agents and human-machine hybrids. The paper predicts that neuro-techno-philosophy will be indispensable to understanding and engaging with these game-changing innovations and thus play a pivotal role in the future of philosophy.     

关于城镇职工医疗保险制度改革和发展趋势

我国城镇职工医疗保险制度改革是本届政府的五大改革之一。改革的基本思路是“低水平、广覆盖、双方负担、统筹结合”。同时,国家有关部委又区同制定出台了６个医疗保险制度改革配套文件。最后对我国医疗保险的发展趋势进行了分析！?     

Ethically Allocating COVID-19 Drugs Via Pre-approval Access and Emergency Use Authorization

Abstract

Allocating access to unapproved COVID-19 drugs available via Pre-Approval Access pathways or Emergency Use Authorization raises unique challenges at the intersection of clinical care and research. In conditions of scarcity, prioritization approaches should minimize harm, maximize benefit, and promote fairness. To promote continued data collection, patients seeking access to unproven COVID-19 drugs should receive lower priority for allocation when they decline to participate in clinical trials, either of the requested drug or other investigational products, offering a comparable balance of risks and benefits; special attention should be paid to concerns of voluntariness and distrust. In addition, institutional treatment protocols that can contribute more robust real world data should be preferred to single patient requests for access, with priority for inclusion based on traditional clinical allocation criteria relying on available evidence. Fairness demands distribution of these protocols across a diverse range of sites, particularly those serving marginalized populations, among other protections.