论临床代理决策中的“患者最佳利益原则”

对于无行为能力患者的代理决策,传统的预先指令与替代决策模式已暴露其局限性,如误读患者利益或者掺杂代理人的利益.基于最佳利益原则的决策模式能最大限度维护他们的利益,医学最佳利益与拓展的最佳利益是其两种模式.前者将生命质量作为核心要素;后者还包括患者个体的价值观与宗教信仰等个体利益.在我国社会语境中,应当实施医学最佳利益标准.在临床实践中,判断最佳利益依然遭遇不少障碍,包括理性人视角、代理人情感投射等.因此,需要合理的医疗判断、明确其构成要素、设置必要的程序以及完善的法律制度.     

话题兴趣与文本阅读眼动特征的研究

以大学生为被试,用ASL504型眼动仪,探讨话题兴趣对文本阅读过程眼动特征和文本阅读理解的影响。结果表明：(1)话题兴趣促进深层理解,而不能促进表层理解。(2)话题兴趣主要与阅读时间和注视点数相关联,而与阅读效率无关。(3)文本阅读过程中,阅读时间、注视点数两项眼动指标存在显著的性别差异。     

Parental refusals of medical treatment: the harm principle as threshold for state intervention

Minors are generally considered incompetent to provide legally binding decisions regarding their health care, and parents or guardians are empowered to make those decisions on their behalf. Parental authority is not absolute, however, and when a parent acts contrary to the best interests of a child, the state may intervene. The best interests standard is the threshold most frequently employed in challenging a parent's refusal to provide consent for a child's medical care. In this paper, I will argue that the best interest standard provides insufficient guidance for decision-making regarding children and does not reflect the actual standard used by medical providers and courts. Rather, I will suggest that the Harm Principle provides a more appropriate threshold for state intervention than the Best Interest standard. Finally, I will suggest a series of criteria that can be used in deciding whether the state should intervene in a parent's decision to refuse medical care on behalf of a child.     

Conflict of interest in Croatia: doctors with dual obligations

There is an emerging awareness of the possibility of conflicts of interest in the practice of medicine in Croatia. The paper examines areas within the medical profession where conflicts of interest can and have occurred, probably not only in Croatia. Particularly addressed are situations when a doctor may have dual obligations and how independent ethics committees can help in decreasing the influence of a conflict of interest. The paper also presents extracts from the Croatian Code of Ethics for the medical profession that address problems of conflict of interest. An earlier version of this paper entitled was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

The resurrection of vocational interests in human resources research and practice: Evidence,challenges, and a working model

A large number of studies conducted over the past two decades reconsidered and supported the validity of vocational interests for predicting a range of important work outcomes. Yet to date, interests remain relatively underused in professional settings, in part because discussions of why, how, and where to use interest assessment tools in an evidence-based manner are lacking and often incomplete. In this article, we briefly review and summarize the available evidence to then further discuss ways in which interest assessment can support various stages of the human resources (HR) cycle, including recruiting, selecting, retaining, and developing employees. From this overview, a number of challenges and apparent paradoxes are derived when working with interests, which may hinder the effective application of these assessments. Therefore, we propose a new working model that treats interest assessments both as “select-out” and “select-in” tools, to identify personal attributes that can either be “must-haves” for an organization in the short term, but at the same time can represent “unique potential” for that organization in the long term. Throughout the text, we also discuss where additional research is needed to further substantiate the use of interests in the HR cycle.     

Moral Hazard in Pediatrics

“Moral hazard” is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general concern for the patient's seemingly excessive burden. This article brings the language and logic of moral hazard to pediatrics. The concept reminds us that decision makers in this context are often not the primary party affected by their decisions. It appraises the full scope of risk at issue when decision makers decide on behalf of others and leads us to separate, respect, and prioritize the interests of affected parties.     

Intensity seeking and novelty seeking: Their relationship to adolescent risk behavior and occupational interests

The aim of this study was to test the hypothesis that individual differences in sensation seeking account for adolescents’ risk behavior and vocational interests. We relied on Arnett’s (1994) conceptualization of sensation seeking as involving a need for intensity and a need for novelty, neither of which includes the willingness to take risks. Self-report scales measuring intensity seeking, novelty seeking, impulsiveness, risk behavior and vocational interest were administered to 636 adolescents. New scales measuring intensity seeking (IS) and novelty seeking (NS) were used. Regression analyses showed that IS and to a lesser extent NS accounted for a small part of variance of risk behavior, independent of impulsiveness. IS and NS accounted for vocational interests. The discussion emphasizes the importance of disentangling sensation seeking as a trait from willingness to take risks when one intends to analyse the effect of the former on risk behavior.     

Estimating true short-term consistency in vocational interests: A longitudinal SEM approach

This study aimed at estimating the correlation between true scores (true consistency) of vocational interest over a short time span in a sample of 1089 adults. Participants were administered 54 items assessing vocational, family, and leisure interests twice over a 1-month period. Responses were analyzed with a multitrait (MT) model, which supposes no temporal change, and a latent change (LC) model with temporally stable method effects. The LC model fitted the data well in 75% of cases whereas the MT never held. Error measurement is not sufficient in explaining the imperfect test-retest manifest correlations. True consistency estimates were very high with an average of .87, suggesting that although true temporal change occurs even within short periods its magnitude is rather limited.     

Talking Politics? Educational Category Salience Reinforces Differences in People’s Willingness to Participate in Deliberative Initiatives

Against the background of an ever-growing body of literature that documents educational differentials in different forms of political participation, scholars have started to study whether education itself becomes the object of intergroup behavior. Informed by social identity theory and self-categorization theory, we examine whether making educational categories and the associated status differences salient affects people’s prospective political participation. Two large survey experiments carried out in samples from Flanders (Belgium; N = 1,097) and the United States (N = 629) were used to assess categorization effects of education on people’s willingness to participate in deliberative political-participation initiatives. In general, our results indicated that rendering educational categories salient increased educational differentials in prospective political participation in a way that is disadvantageous to the less educated. We elaborate on the implications of our findings.