关于医学伦理学教育的几点思考

医学伦理学教育中长期存在的一些问题尚未很好解决.由于较多强调课程的道德教育功能,对其作为独立学科存在的性质和意义仍重视不够,医学伦理学是进行道德分析、准则与价值评判的理论体系,通过医学伦理学的学习和训练,应使学生能够对有关问题在广阔的背景中进行深层次思考并做出独立判断.我们应在进一步更新观念的基础上,改进哲学、伦理学基础教育,以促进医学伦理学教育的发展,而其意义已远超出医学伦理学之外.     

自我保护性医疗的伦理扫描--论患方知情同意与医方规避风险

自我保护性医疗是近年来医方为应对医患关系重构而采取的一种行为模式,其本身和影响具有全新特点,充满价值冲突;这种行为模式,客观上是对应医疗风险尤其是重大医疗风险的;主观上同医方免责期待的张扬以及对知情同意的解读直接相关;因而,正当的自我保护性医疗既取决于医方合理的免责期待,以及改变对知情同意的误读,更依赖于自身的医学伦理综合素质的打造和完善。     

知情同意的临床实践存在的问题及对策

临床医疗实践中贯彻实施知情同意原则旨在保护病人的权益不受侵犯,然而知情同意原则实施起来并不简单,它常常会受到主客体两方面种种因素的制约,陷入意想不到的困境。分析了知情同意原则在实施过程中可能出现的一些难以回避的问题,并针对这些问题探讨了若干对策。     

“亚当·斯密问题”的逻辑张力

“亚当·斯密问题”是指斯密的《国富论》与《道德情操论》之间存在着对立或不一致的问题,最初由十九世纪中叶的德国历史学派所提出。此后,随着现实与理论的发展,出现了不同的看法。学者们普遍认为,斯密的两大著作之间、经济学与伦理学之间存在着对立或者不存在对立,而是相互一致的。这些看法都具有各自的积极合理的内容,但缺乏辩证的观点,而没有看到“斯密问题”自身的逻辑张力,也就是说,“斯密问题”所指涉的是现实的经济与伦理之间及作为其理论表现的经济学与伦理学之间的关系。“斯密问题”所含的这些关系呈现出了一个动态的、由肯定到否定再到否定之否定的辩证过程。     

关于克隆人试验与伦理学的三原则

由于克隆人试验的对象是人的活细胞,不是人的胚胎;并且由于人只能有限地决定自己的未来,根本无法决定自己的出生;同时由于基因诊断和修复有助于新生儿的健康,因而克隆人试验既不会伤害任何人的生命体,也不会侵犯任何可能出现的克隆人的自主权和平等权,进而不会违反伦理学的三原则。     

明清商人伦理形成之内在冲突及其特征

明清商人在传统儒家伦理化和制度歧视的历史背景下,有着自己内在的心理冲突,正是这种内在冲突促使明清商人形成了其特有的伦理特点及其伦理的历史命运,这对当前中国转型期间的经济伦理建设亦有借鉴意义。     

“善良意志”与道德权限

“善良意志”是康德伦理学的核心概念,他将善良意志提升到道德领域的至善地位,从而确定了道德的纯粹性。他还借助善良意志划分了善与恶的界限,指明了责任作为检验善恶的标准,将传统德性论的品质和功用主义的幸福都排除在道德领域之外。由此,康德还将伦理与道德的界限做了区分,他强调伦理与道德各自明确自身的权责,从而充分发挥各自的作用。     

Towards a Sociological turn in Contextualist Moral Philosophy

Contextualist moral philosophers criticise hands-off liberal theories of justice for abstracting from the cultural context in which people make choices. Will Kymlicka and Joseph Carens, for example, demonstrate that these theories are disadvantageous to cultural minorities who want to pursue their own way of life. I argue that Pierre Bourdieu's critique of moral reason radicalises contextualist moral philosophy by giving it a sociological turn. In Bourdieu's view it is not enough to provide marginalised groups or subgroups with equal access to public institutions and specific cultural rights—in some cases this may in fact be detrimental. He contends that scientists, politicians and other intellectuals have a duty to take seriously the social presuppositions of free deliberate choice and public opinion and to support cultural minorities with instruments to liberate themselves from their often precarious situation.     

Identity and moral responsibility of healthcare organizations

In this paper the moral responsibility of a Healthcare Organization (HCO) is conceived as an inextricable aspect of the identity of the HCO. We attempt to show that by exploring this relation a more profound insight in moral responsibility can be gained. Referring to Charles Taylor we explore the meaning of the concept of identity. It consists of three interdependent dimensions: a moral, a dialogical, and a narrative one. In section two we develop some additional arguments to apply his concept of personal identity to organizations. The final section works out the relationship of three dimensions of identity to some actual issues in contemporary HCOs: the tension between care and justice, the importance of dialogues about the diversity of goods, and the relevance of becoming familiar with the life-story of the HCO. Identity of an HCO is established and developed in commitments to and identification with certain goods that are central for a HCO. However, many of these goods are interwoven with everyday practices and policies. Therefore, moral responsibility asks for articulation of goods that often stay implicit and should not be reduced to a merely procedural approach. However difficult this articulation may be, if it is not tried at all HCOs run the risk of drifting away from their very identity as healthcare institutions: to offer care to patients and to do this in accordance with demands of social justice.     

HOW SCIENCE CAN HELP RELIGION BENEFIT SOCIETY

Abstract. Modern science has given us a revolutionary new understanding of the close interrelationship and interdependence of humans not only with all other humans but with all other living species and with the nonliving elements of the geosphere and the rest of the universe. This new understanding can provide a basis for new understandings of (1) the basic nature of religion, (2) the basic principles of major world religious traditions, and (3) the basic principles of religious ethics. The new understanding of religious ethics will involve a better understanding of our rights and responsibilities, as individuals and groups, with respect to other individuals and groups of humans, other living species, and the nonliving universe. This improved understanding will benefit not only human individuals and human societies, local and global, but also local and global ecosystems.