人道功利主义视域下罕见病防治伦理治理路径研究

对罕见病伦理困境的焦点在于人道主义与功利主义之争,只讲人道不讲功利,制度只能沦为形式;只讲功利不讲人道,制度也会沦为企业逐利的工具。由此引入人道功利主义理论,试图调和人道主义与功利主义的矛盾,并从理论与实践层面证明人道功利主义适用于罕见病伦理困境的解决。在此基础上,提出宣传罕见病防治的重要意义,动员社会舆论支持和赞助;加强罕见病精细化管理,分层次、分阶段应对罕见病;目前孤儿药以国外引进为主,同时加大激励本土自主研发;利益相关主体风险分担;倡导多方合作,尤其是全球合作应对罕见病的伦理治理路径。

     

研究者伦理培训与多角度调查分析对培训优化的思考

通过对新入职的医务人员（医生、护士、药师）进行科研伦理培训和问卷调查研究,分析临床研究实践中暴露的科研伦理问题,并根据培训后考试结果,了解参加临床试验的研究者在进行培训后对伦理审查认知的提升度。同时,分析设置的培训课程所存在的问题,认为常规模式化的培训并不能满足临床研究者的需求。根据培训所应侧重的内容及方式,对培训内容、培训频率、培训人员角色、培训方式、培训师资、培训管理进行优化,使参加临床试验研究者的伦理认知态度得到显著提升,为落实临床研究者伦理素养的培训的培育需求,提供参考。

     

临床医学家的特点及其创造性研究

医学科学家尤其是临床医学科学家在创造性活动中,有着与其它学科的学者既相同又不尽相同的行为和思维特点,依据301医院百名医学家亲自撰写的巨著《名医手记》和关于创造性的理论,试图从能力、个性心理、思维三个方面对临床医学家的创造性特点做一点初浅的概括。     

我国人体临床试验和研究中有关伦理审查的若干问题

目前我国对涉及人体的临床试验与研究进行伦理审查时,存在的主要问题是:(1)对伦理审查的目的、意义不是足够清楚;(2)伦理委员会的构成不符合要求,缺少独立性;(3)有盲目运用伦理准则或方法,忽视文化、心理的差异的倾向。这些影响了伦理审查的效用,需要有针对性地加以改进。     

精神分裂症肠道微生物与脑影像和临床表征的关系

微生物-肠-脑轴假设在精神分裂症发病机制中的研究受到越来越多的关注。以往研究初步考察了肠道微生物的构成与精神分裂症患者脑影像和临床表征之间的联系,但具体的作用路径尚不明确。当前研究通过总结最新研究进展,并在此基础上提出肠道微生物影响精神分裂症患者大脑结构和功能的机制假设。相关内容对于进一步阐明精神分裂症的病理机制,为将肠道微生物纳入精神分裂症的评估与干预提供理论基础。     

Dilemmas of Practice: Challenges to Program Quality Encountered by Youth Program Leaders

To create and sustain high quality youth development programs it is important to understand the challenging situations and dilemmas that emerge in program leaders’ daily work with youth. In this research the experiences of leaders in 12 programs were followed over a 2–9 month period, which led to the identification of 250 dilemma situations. Qualitative analyses identified 5 categories and 12 subcategories of dilemmas that reflected distinct types of considerations (e.g., youth’s personalities, relationships with the community). The analyses also found that the experienced leaders in the study typically responded to these dilemmas in ways that were youth-centered and that balanced multiple considerations. It is argued that researchers need to go beyond identifying features of high quality programs, and more fully examine how effective leaders create and sustain high quality in response to the challenging situations of practice.     

Clinical psychologists' attitudes to lesbians

This study begins the process of examining clinical psychologists' competence in dealing with lesbian clients by assessing their attitudes to lesbians and lesbianism. Attitudinal questionnaires were sent to 200 chartered clinical psychologists and 69 (34.5%) were returned. Respondents displayed generally positive attitudes, with only two out of 12 attitudinal items failing to attract attitudinally positive responses from more than three-quarters of the sample. Yet, because of the possible unrepresentativeness of the sample and the potentially tenuous attitude–behaviour link, it is recommended that consideration of lesbian issues should be explicitly addressed in clinical psychology training.     

Ethical Issues in Psychologists' Professional Practice: Agreement Over Problematic Professional Behaviors Among Spanish Psychologists

A sample of 703 Spanish psychologists completed an online survey containing 114 behaviors related to professional practice in different areas. The aim of the study was to learn which professional behaviors create ethical dilemmas most often for psychologists and how they respond to these issues. Findings suggest that psychologists who have actually faced a particular dilemma are less strict on judging the inappropriateness of a possible ethical transgression than those psychologists who have not experienced it. Also, four clusters can be identified according to the attitude of respondents toward the dilemmas, namely “rejection,” “aprioristic,” “utilitarian,” and “no conflict.”     

单纯胸椎骨折合并迟发性血胸的诊治及临床特点

为了探讨单纯胸椎骨折合并迟发性血胸的临床特点及诊治方法,回顾分析了11例单纯胸椎骨折合并迟发性血胸患者的诊疗情况并总结其临床特点。结果显示,所有病例均获得明确诊断,10例通过胸穿治疗获得治愈,1例行割胸探查术。提示单纯胸椎骨折合并迟发性血胸临床较少见,伤后体温逐渐升高、胸闷、氧分压下降或剧烈咳嗽、翻身拍背后突然出现呼吸困难、发绀、大汗常为其临床特点,大多可通过保守治疗获得痊愈。     

Code of ethics: Day-to-day applications

The following article was originally presented as a workshop at the 1992 NSGC Annual Education Conference. It was the first in a series of programs designed to fulfill the educational component of the Board of Directors' charge to the Ethics Subcommittee of the interpretation, education and application of the Code of Ethics. Applications of the Code to actual problems experienced by genetic counselors are presented. The Code is shown to be a practical guide in the areas of confidentiality and patient advocacy. Because the Committee has received several communications regarding sexual harassment, the need for addressing this issue seemed particularly timely. The third scenario presents a more general discussion regarding this topic.