The art (and science) of seduction: Why,when, and for whom seductive details matter

In this commentary, the two critical attributes of seductive details are described through a historical lens: relevance and interest. For each of these attributes, various forms that have populated the seductive detail literature are distinguished, and the specific manner in which each is interpreted by contributors to the Special Issue is considered. The forms of relevance overviewed are personal, structural, instructional, and task relevance. For interest, distinctions between individual and situational interest are noted, and the concept of interestingness is delineated. With this historical backdrop, the studies in this Special Issue are analyzed, and four provocative questions are posed: When are “seductive details” not seductive? What contextual factors contribute to seduction? For whom is seduction a problem? When is the solution worse than the problem?     

器官移植手术中的医患利益冲突

我国的器官移植手术得到超常发展的重要原因是走了捷径,海归医学人士为我国器官移植手术的开展做出了贡献。但器官移植发展“喜忧参半”。手术背后有医患之间的利益冲突。科学利益和经济利益至上给器官移植的健康发展蒙上阴影。必须加强器官移植的法规建设和管理监督,使我国的器官移植更符合伦理的要求。     

论患者的不真正义务

患者的不真正义务是法律没有规定且医患双方亦没有约定患者必须履行的,医方通常不得请求履行,而其违反也不发生损害赔偿责任,仅使患者遭受权利减损或者丧失之不利益的义务.主要包括患者的披露的义务、遵照医嘱的义务与签字的义务.患者的不真正义务是不同于患者给付义务和附随义务的一种独立义务.患者的不真正义务不应保护医方使其免于承担治疗失当的责任.     

医学专业面临的危机：利益冲突——再论医学专业精神

医患间未能遵守利益限度和利益边界原则,使矛盾转化为冲突。当前我国面临的医患冲突与一些国家相比是全面而深刻的。体制与非体制原因相互交错,直接冲突与间接冲突相互影响,理性冲突向非理性冲突转化,群体性与个体性的不同表现,即发生与后发性的不同特点,是我国医患冲突演化的规律与特征。要正确对待第三方的介入。端正专业思想是理顺医患关系的治本之道。     

医学伦理学不可忽视的课题：利益伦理

当今是一个以利益为轴心的时代。利益伦理学是医学伦理学不可忽视的课题。将病人利益置于首位应当是现代医学伦理学的首要原则。欲望是无穷的,利益是有限的。任何利益都有自己的边界和限度。我们必须设置利益的道德界限,以回答当前医学伦理学面临的种种现实课题。     

The fit of Holland’s RIASEC model to US occupations

Holland’s [Holland, J. L. (1959). A theory of occupational choice. Journal of Counseling Psychology, 6, 35-45; Holland, J. L. (1997). Making vocational choices: A theory of vocational personalities and work environments (3rd ed.). Odessa, FL: Psychological Assessment Resources, Inc.] RIASEC types were initially developed using a restricted range of occupational titles. Holland’s type classification system has been extended to encompass the full range of occupations in the US, using both statistical and expert rating methods. However, the extent that Holland’s classification model is sufficient to represent the full range of occupational interests has not been examined. Multidimensional scaling (MDS) was used to analyze college students’ (266 men, 572 women) interests in occupations representing approximately 85% of the US labor market. A two-dimensional MDS solution of the full set of occupations did not fit Holland’s model, but limiting the analysis to occupations used in Holland-based measures produced the expected RIASEC structure. In comparison, a three-dimensional solution included Prediger’s [Prediger, D. J. (1982). Dimensions underlying Holland’s hexagon: Missing link between interests and occupations? Journal of Vocational Behavior, 21, 259-287] dimensions (Things/People and Data/Ideas) consistent with Holland’s model, but also included prestige and sex-type dimensions that were not orthogonal to Prediger’s dimensions. These results demonstrate that the RIASEC types are not sufficient to represent the full range of occupational interests and are confounded with prestige and sex-type.     

Nanotoxicology and Ethical Conditions for Informed Consent

While their strength, electrical, optical, or magnetic properties are expected to contribute a trillion dollars in global commerce before 2015, nanomaterials also appear to pose threats to human health and safety. Nanotoxicology is the study of these threats. Do nanomaterial benefits exceed their risks? Should all nanomaterials be regulated? Currently nanotoxicologists cannot help answer these questions because too little is known about nanomaterials, because their properties differ from those of bulk materials having the same chemical composition, and because they differ so widely in their applications. Instead, this paper answers a preliminary ethical question: What nanotech policies are likely to contribute to society’s ability to give or withhold free informed consent to the potential risks associated with production and use of nanomaterials? This paper argues that at least four current policies appear to jeopardize the risk-disclosure condition that is required for informed consent. These are the funding problem, the conflict-of-interest problem, the labeling problem, and the extrapolation problem. Apart from future decisions on how to ethically make, use, and regulate nanomaterials, this paper argues that, at a minimum, these four policies must be modified. Government must spend greater monies on nanotoxicology; ensure independent nanotoxicology research; label consumer products containing nanomaterials; and avoid assuming that nanotoxicological properties are based merely on mass and chemical composition. Otherwise free informed consent to these new technologies and materials may be jeopardized.     

The <Emphasis Type="Italic">Not Unreasonable</Emphasis> Standard for Assessment of Surrogates and Surrogate Decisions

Standard views on surrogate decision making present alternative ideal models of what ideal surrogates should consider in rendering a decision. They do not, however, explain the physician's responsibility to a patient who lacks decisional capacity or how a physician should regard surrogates and surrogate decisions. The authors argue that it is critical to recognize the moral difference between a patient's decisions and a surrogate's and the professional responsibilities implied by that distinction. In every case involving a patient who lacks decisional capacity, physicians and the treatment team have to make judgments about the appropriateness of both the surrogate and the surrogate's decision. They have to assess the surrogate's decisional capacity and attitude toward the patient as well as the reasons that support the surrogate's decision. This paper provides a model for acceptable surrogate decisions and a standard for blocking inappropriate surrogates. Only decisions based on widely shared reasons are allowable for surrogate refusal of highly beneficial treatment.     

Problems for biomedical research at the academia-industrial interface

Throughout much of the world, universities have driven towards industrial partnerships. This collaboration, which, in the biochemical field at least, has to continue if potential benefits for patients are to be realised, has brought with it a number of problems. These include the neglect of long-term research in favour of short-term projects, the curtailing of free dissemination of research information within university departments and the biasing of results of clinical trials by the financial interests of the investigators. It is very important that governments, universities, and industry itself address these problems. Universities should monitor the amount of basic, curiosity-driven research that is being carried on, compared with that which is more short-term goal orientated. PhD students and post-doctoral fellows should be exposed to the principles of bioethics early on in their careers. Further work is necessary on the terms of research contracts to protect, on the one hand, the rights of individual scientists and, on the other, industry from rogue scientists. Where problems arise, procedures should be in place for independent reviews to be conducted by bodies such as the Medical Research Council in the UK or the National Institutes of Health in the USA. The conflict-of-interest rules recently introduced for publication in medical journals should be extended to all branches of science.