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In an analysis of recent work on nudging we distinguish three positions on the relationship between nudging founded in libertarian paternalism and the protection of personal autonomy through informed consent. We argue that all three positions fail to provide adequate protection of personal autonomy in the clinical context. Acknowledging that nudging may be beneficial, we suggest a fourth position according to which nudging and informed consent are valuable in different domains of interaction. 相似文献
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Czarkowski M 《Science and engineering ethics》2006,12(1):131-138
The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and
one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the
international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of
patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a
free, secret ballot should be preferred to direct appointment), the avoidance of conflict of interest during the election
of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should,
on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’
rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all
medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove
to be especially valuable in this setting.
This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic
and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005.
The author is Chairman, Bioethics Committee of the Warsaw Regional Chamber of Physicians and Dentists. 相似文献
55.
Research on treatments for reducing pathological worry is limited. In particular, academic worry is a common theme in generalized anxiety disorder (GAD) samples as well as non-clinical student samples. Given the high cost of anxiety disorders to society, research is needed to examine the efficacy of self-administered treatments designed to reduce pathological worry. The primary goal of this study was to investigate the benefits of three self-administered interventions for reducing academic worry. College students (N = 113) experiencing clinically significant academic worry were randomized to either: (a) worry exposure (WE); (b) expressive writing (EW); (c) relaxation consisting of pulsed audio-photic stimulation (APS); or (d) waitlist control (WLC). Participants were instructed to practice their interventions three times per week for one month and completed home practice logs online to track treatment adherence. Academic worry, general anxiety, and perceived stress were assessed at baseline and post-treatment. Academic worry and general anxiety were also assessed at a three-month follow-up. Those assigned to the WE and APS conditions showed significant improvement relative to EW and WLC at post-treatment. All treatment conditions showed continued improvement by follow-up, with no between-group differences. Treatment and public health implications are discussed. 相似文献
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了解临床护士心理弹性现状,分析影响护士心理弹性的因素,为管理者掌握临床护士心理健康状况,提高心理弹性水平提供参考依据。采用中文版心理弹性量表(CD—RISC),对535名临床护士进行调查。结果显示,临床护士心理弹性总分为(56.78±18.43)分;其心理弹性在不同人口统计学方面差异均有统计学意义(P〈0.05);多元逐步回归分析显示心理弹性的主要影响因素是:工作年限和是否为独生子女。临床护士心理弹性处于中等水平,医院管理者应重视培养个体心理弹性素质,有针对性地开展弹性拓展训练,提高护理质量。 相似文献
58.
为适应全球卫生事业的迅猛发展,面对医学教育落后于医学发展的现状,转化医学教育迫在眉睫。在第三代“以系统为基础”的教育改革中,培养医学生的哲学思维无疑是其重要环节之一。思维方式必须在医学生步入临床时就要开始正确培养,一旦开始阶段就养成不正确的思维方式、不但会导致医疗过程中的失误,而且再想改变将会有很大难度。本文通过对医学哲学重要性的探讨,剖析医学生哲学思维的不足,阐述了医学生,临床实习过程中应掌握的几种哲学思维方式。旨在提高医学生的哲学理念,促进以岗位胜任能力为导向的医学教育转型发展。 相似文献
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转化医学在当今世界发展迅速,虽然在我国起步较晚,但取得了巨大的成就,建立了许多转化医学研究机构,积极开展合作交流,但不可避免地存在一些问题,诸如创新能力不足、顶层设计不够和人才缺乏等,为此提出相应对策和未来发展的前景,同时指出转化医学在我国不仅是学术问题,而且是社会问题. 相似文献
60.
Laura Weiss Roberts Teddy D. Warner Laura B. Dunn Janet L. Brody Katherine A. Green Hammond Brian B. Roberts 《Ethics & behavior》2013,23(1):19-50
The effects of research ethics training on medical students' attitudes about clinical research are examined. A preliminary randomized controlled trial evaluated 2 didactic approaches to ethics training compared to a no-intervention control. The participant-oriented intervention emphasized subjective experiences of research participants (empathy focused). The criteria-oriented intervention emphasized specific ethical criteria for analyzing protocols (analytic focused). Compared to controls, those in the participant-oriented intervention group exhibited greater attunement to research participants' attitudes related to altruism, trust, quality of relationships with researchers, desire for information, hopes about participation and possible therapeutic misconception, importance of consent forms, and deciding quickly about participation. The participant-oriented group also agreed more strongly that seriously ill people are capable of making their own research participation decisions. The criteria-oriented intervention did not affect learners' attitudes about clinical research, ethical duties of investigators, or research participants' decision making. An empathy-focused approach affected medical students' attunement to research volunteer perspectives, preferences, and attributes, but an analytically oriented approach had no influence. These findings underscore the need to further examine the differential effects of empathy-versus analytic-focused approaches to the teaching of ethics. 相似文献