数字疗法研究现状及伦理问题分析

随着大数据体系、智慧医疗和云建设等方面快速发展,数字疗法为人类健康管理带来了全新解决方案,发展前景广阔,同时也面临不小的伦理挑战和问题。如果开发和使用不当,这些产品可能会给患者带来风险。通过梳理数字疗法在疾病管理和治疗方面的研究现状,显示其在糖尿病、高血压、神经康复等领域均有应用。在此背景下,数字疗法的健康发展尤为重要,应用过程中将面临隐私保护、公平公正、产品安全等伦理问题,进一步将可能出现的伦理问题进行分析并提出相应策略。确保数字疗法充分发挥其作用潜力,获得持续性发展,能够更好、更安全地造福广大患者。

     

Procedural fairness predicts cooperative behaviour for high-self-esteem individuals but not for low-self-esteem individuals

Cooperation is vital for modern society. Previous studies showed that procedural fairness promotes cooperation; however, they mainly focused on cooperation intention, which may fail to reveal actual cooperative behaviour. Moreover, little is known regarding the personality boundary of the effect of procedural fairness on cooperation. Guided by previous findings that self-esteem increases sensitivity to procedural unfairness, we attempted to explore the moderating effect of self-esteem on the association between procedural fairness and cooperative behaviour. In Experiment 1, 160 participants' self-esteem was measured using the Rosenberg Self-Esteem Scale; procedural fairness was manipulated in two conditions, depending on whether money was allocated in an economic game by rolling the dice twice or an allocator's arbitrary choice. Cooperative behaviour was assessed using the chicken game paradigm. Experiment 2 (148 participants) aimed to replicate and extend the results of Experiment 1 using a more rigorous experimental design, in which the possible effect of outcome favourability was excluded. The results of both experiments consistently showed that procedural fairness positively predicted cooperative behaviour, and this association was significant in high-self-esteem individuals, but not in low-self-esteem individuals. These findings shed light on the vital role of self-esteem in understanding the relationship between procedural fairness and cooperative behaviour.     

社会互动视角下人际公平形成的脑机制

最后通牒博弈任务被广泛用以探究公平行为, 以往研究大多集中于对博弈中某一方决策行为和神经机制的探讨, 但是人际公平可能是互动双方重复博弈的结果。因此只考察单个大脑活动, 并不足以揭示由互动双方共同完成的社会认知活动的脑机制。因此, 本研究结合修改版的最后通牒博弈任务和基于fNIRS的超扫描技术, 从群体脑水平上考察人际公平形成的脑机制。行为结果显示, 相比无惩罚条件, 惩罚下提议者的分配金额更高, 且惩罚力度越强, 分配越趋近公平分配。fNIRS的结果显示, 惩罚下右侧背外侧前额叶皮层、顶下小叶和颞-顶联合区的脑间活动同步性显著强于无惩罚条件, 而且两条件的分配金额差异越大, 右侧顶下小叶的脑间活动同步性差异也越大。综上, 脑间活动同步性可以作为惩罚下人际公平形成的客观脑指标, 研究为探讨人际公平的内在机制提供了新的视角。     

Rawls and Research on Cognitively Impaired Patients: A Reply to Maio

In his paper, “The Relevance of Rawls’ Principle of Justice for Research on Cognitively Impaired Patients” (Theoretical Medicine and Bioethics 23 (2002):45–53), Giovanni Maio has developed athought-provoking argument for the permissibility of non-therapeutic research on cognitively impaired patients. Maio argues that his conclusion follows from the acceptance of John Rawls’s principles of justice, specifically, Rawls’s “liberty principle” Maio has misinterpreted Rawls’s “libertyprinciple” – correctly interpreted it does notsupport non-therapeutic research on cognitivelyimpaired patients. Three other ‘Rawlsian’ arguments are suggested by Maio’s discussion –two “self-respect” arguments and a “presumed consent” argument – but none of them are convincing. However, an alternative argument developed from Rawls’s discussion of “justice in health care” in his most recent book, Justice as Fairness: A Restatement, may justify certain kinds of non-therapeutic research on some cognitively impaired patients in special circumstances. We should not expect anything more permissive from a liberal theory of justice. This revised version was published online in June 2006 with corrections to the Cover Date.     

“追名弃利”：权力动机与社会存在对亲社会行为的影响

目前关于权力动机的研究主要关注权力动机的阴暗面,但是对权力动机的积极面尚不清楚。本研究从公平与合作行为的角度出发,分别采用最后通牒博弈和公共物品博弈任务,探讨不同权力动机水平个体在内隐(眼睛线索)或外显(他人在场)社会存在下的亲社会行为是否不同。结果发现,在眼睛线索或他人在场条件下,相对于低权力动机者,高权力动机者表现出更高的公平与合作水平。然而当没有社会存在线索时,高低权力动机者的亲社会行为没有显著差异。结果提示高权力动机者出于名誉和地位的策略考虑,也会表现出积极的亲社会行为。     

公平偏好的电生理测量：来自脑电、皮肤电和心电的证据

研究发现,人们普遍具有追求公平的偏好,即人们在追求个人收益时也会关注收益分配的公平性。随着电生理技术的发展,越来越多的研究者采用电生理技术对公平偏好进行深入探讨。本研究从脑电、皮肤电、心电等方面梳理公平偏好的电生理机制。脑电的研究发现,公平偏好相关的脑电主要涉及反馈相关负波和P300;皮肤电的研究发现,相比于公平分配,个体在不公平分配情况下其皮肤电的激活水平更高;心率的研究发现,相比于公平分配,个体遭遇不公平分配时其心率降低。研究公平偏好电生理机制有助于更深入地揭示公平偏好的产生根源与形成过程。未来可从公平偏好电生理的整合研究、公平偏好的脑成像与电生理的整合性探索,以及拓展公平偏好电生理的外部效度和研究范式等方面展开进一步探究。     

信息呈现顺序对公平判断形成的影响

在公平启发理论的基础上,以130名大学生为被试采用实验室实验探讨了信息呈现顺序对公平判断形成的影响。结果表明：（1）信息呈现顺序能够影响人们的公平判断——当结果适宜性信息更早获得时,结果公平对公平判断的影响要大于结果适宜性信息较晚呈现时的影响;（2）公平形式偏好对公平判断的信息效应具有调节作用,即当高偏好信息先于低偏好信息出现时,公平判断的顺序效应会得到加强;而在低偏好信息先于高偏好信息出现的情况下,公平判断的顺序效应会被减弱。     

The Influence of Diversity Context on White Men's and Racial Minorities' Reactions to Disproportionate Group Harm

Abstract

The author examined the influence of organizational diversity management on White men's and racial minorities' perceptions of fairness when members of their identity group were disproportionately harmed in a layoff. Using a scenario design, the author studied the reactions of 284 White male and racial minority layoff survivors under 2 different diversity contexts. White men saw the layoff as less fair to their group when other White men were laid off disproportionately in an active-diversity context versus an inactive-diversity context. Racial minorities' perceptions of fairness when other minorities were laid off disproportionately were not influenced by the diversity context, but they perceived the layoff as more fair to their group in an active-diversity context when White men were laid off disproportionately. The findings suggest that during layoffs or other significant organizational changes where job insecurity is heightened, different identity groups might perceive diversity management differently.     

公平加工的情境依赖性:来自行为的证据

采用最后通牒博弈范式,考察利益水平及社会距离对个体公平加工的影响,探讨公平加工的情境依赖性。实验结果表明:(1)对分配提议的加工受到利益水平的调节,不利不公平条件下被试更加注重公平。(2)提议的不同水平影响被试的拒绝行为,提议越不公平,拒绝率越高。(3)虽然社会距离的主效应不显著,但在实际情境中,较近的社会距离下人们对公平的要求更严格,证实公平加工具有情境依赖性。