当代中国临床医学伦理准则建设论纲

我国当代临床医学伦理准则亟待出台，建设时机现已水到渠成，为积极参与这项重要的建设工程，本文提出了找准现实生长点为根本课题的基本建设思路，并以病人中心准则为核心探索性地设计出了准则体系。     

《侵权责任法》背景下临床决策新路径与方法探讨

我国新颁布实施的《侵权责任法》对临床决策产生了重大影响,需要我们医务人员高度认识新法律的地位与作用,需要认识临床决策的真正内涵。通过深化医患沟通职能建设、患方参与医疗小组、健全医患权益协议书、加强患者医学与健康教育等,探索临床决策的新路径和方法。     

口腔临床医疗实践中知情同意的实现

知情同意是一项重要的伦理学原则和患者自主权的具体表现形式。本文分析了在口腔临床医疗实践中知情同意存在的突出问题和原因,并探讨了实现的方法和途径。本文认为只有遵循全面、精确、真实的告知原则,让患者在充分理解的基础上做出自主地选择,才能保障知情同意原则的实现。     

胃癌辅助化疗的选择和应用

局部进展期胃癌手术后是否给予全身辅助化疗以及关于标准方案的临床研究,一直是临床关注的热点问题,对ⅡB期以上的进展期胃癌术后给予辅助治疗已经成为共识,但对于采用何种方案作为标准方案尚缺乏循证学依据,而且东西方医学界的意见存在较大的争议,我们一方面期待具有更高级别证据的临床研究结果,另一方面在现有证据下对胃癌术后进行最大程...     

应用批判性思维法探讨内分泌学临床思维的建立

应用内分泌学中常见的肾上腺皮质腺瘤所致原发性醛固酮增多症,甲状腺功能减退所致垂体腺瘤样增生等。典型病例探讨批判性思维法做为一种重要的思维方式,在内分泌学复杂的临床诊疗过程中的应用,力争做到思维与客观实际相一致,逐渐培养科学的内分泌学临床思维模式。     

Should I save or should I not kill? How people solve moral dilemmas depends on which rule is most accessible

The literature on how people solve moral dilemmas often focuses on situations in which individuals have to make a decision where different moral rules are in conflict. In some of these situations, such as in footbridge dilemmas, people have to choose between sacrificing a few people in order to save many. The present research focuses on how people decide what to do in dilemmas involving conflicting moral rules. We propose that the rule that is cognitively most accessible during the decision making process (e.g., “Save lives” or “Do not kill”) will influence how people solve these moral dilemmas. Three studies are reported that indeed demonstrate that the most accessible rule influences willingness to intervene within footbridge dilemmas. This effect is found even when the accessibility of the rule is induced subliminally.     

The give-or-take-some dilemma: An empirical investigation of a hybrid social dilemma

We describe and empirically investigate a hybrid social dilemma that merges give-some and take-some dilemmas by allowing individuals to choose to either give or to take resources from a shared resource pool. Study 1 finds that (a) group size increases the inequality among group members and the likelihood of creating the public good, while reducing the amount of wasted resources; (b) larger bonuses increase provision rates; and (c) asymmetry in the wealth distribution of the group members induces higher levels of inequality of the final outcomes. Following the logic of appropriateness, players with high (low) endowments were more likely to give toward (take from) the shared resource. Study 2 finds that the tendency of the players with high (low) endowments to give (take) is amplified as the difference between endowment levels increased, and the players’ behavior is correlated with, and predictable from, independent judgments of what is perceived as appropriate.     

How special are the specialties? Workplace settings in counseling and clinical psychology in the United States

How special are the specialties? Although clinical and counseling psychology each have distinctive origins, past research suggests their potential convergence across time. In a survey of 5666 clinical and counseling psychologists, the similarities and differences between their workplace settings were examined during early-, mid-, and late-career phases to explore the distinctiveness of the two specialties. Overall, clinical and counseling psychologists reported markedly similar workplace settings. However, some significant differences remained; a greater proportion of counseling psychologists reported working in counseling centers, while a greater proportion of clinical psychologists reported working in medical settings. In addition, during late-career, substantially more counseling and clinical psychologists worked in independent practice contexts than in community mental health centers, medical settings, academia, or university counseling centers. Findings are discussed in relation to the ongoing distinctiveness of the two specialties and the implications of this for training and service in the field of professional psychology.     

对几种临床定势思维的思考

思维定势有权威定势、从众定势、经验定势、唯书本定势、情感定势。思维定势制约我们创新思想的发展,要更好实践临床工作,必须客观评价各种思维定势,主动进行创新思维训练。本文分别对各种思维定势在临床工作中的体现、优劣进行表述,并举例说明。     

家族企业成长中的伦理困境及其对策——以浙江省温州市受访企业为例

家族企业和其他类型的企业相比,在产权结构、管理方式、家族介入和控制权安排(包括继承权安排)等方面都表现出了自身的伦理优势,同时在这些方面也遭遇到不少伦理困境。从伦理的角度讲,将家族主义作为企业经营的伦理理念,并将之无条件地泛化到企业经营的所有方面,这是家族企业遭遇伦理困境的根由之所在。强化伦理主体性,确立权利义务意识,参照现代企业制度的相关要求,实现从身份到契约的转变,打造具有民族特色和时代特色的家族企业管理伦理新模式,是家族企业走出伦理困境的当然选择。