Rethinking the Asymmetry

According to the Asymmetry, we’ve strong moral reason to prevent miserable lives from coming into existence, but no moral reason to bring happy lives into existence. This procreative asymmetry is often thought to be part of commonsense morality, however theoretically puzzling it might prove to be. I argue that this is a mistake. The Asymmetry is merely prima facie intuitive, and loses its appeal on further reflection. Mature commonsense morality recognizes no fundamental procreative asymmetry. It may recognize some superficially similar theses, but we will see that they derive from more familiar principles, and are compatible with there being moral reason to bring happy lives into existence.     

The ethics of intergenerational relationships

Abstract

According to the relational approach we have obligations to members of future generations not because of their interests or properties but because, and only because, they are our descendants or successors. Common accounts of relational duties do not explain how we can have obligations to people who do not yet exist. In this defence of the relational approach I examine three sources of intergenerational obligations: the concern of parents for their children, including their future children; the desire of community members to pass on a heritage to their descendants; and the relationship of citizens in an intergenerational polity.     

Beyond Eschatology: Environmental Pessimism and the Future of Human Hoping

In much environmentally concerned literature, there is a burgeoning concern for the status and sustainability of human hope. Within Christian circles, this attention has often taken the form of eschatological reflection. While there is important warrant for attention to eschatology in Christian examinations of hope, I claim that to move so quickly from hope to eschatology is to confuse a species of Christian hope for a definition of hope itself; as such, it is important for theological ethicists to examine hope also from the experiential perspective of the human hoper. In particular, this is important today given the shortcomings of an eschatological focus in addressing anxieties arising due to the environmental crisis. Through examining hope as a fallible human activity, one can come to better understand hope's importance to human life, its profound ambiguity, and the potential threat that the environmental crisis poses to it.     

TORTURE WARRANTS AND DEMOCRATIC STATES: Dirty Hands in an Age of Terror

In the aftermath of September 11, 2001, policy makers and others have debated the question of whether or not the United States should torture in an effort to prevent terrorist attacks. In a series of controversial essays, the legal theorist Alan Dershowitz argues that, if a democratic society is going to torture, it should at least be done under the cover of law. To that end, he recommends establishing a legal mechanism by which a judge could issue torture warrants—much as they do now for search warrants. In this essay, I examine Dershowitz's proposal in light of Michael Walzer's classic essay on dirty hands. Just as Walzer uses political theater as a lens for viewing the issue of political assassination, I similarly draw upon a dramatic response to Dershowitz's proposal to think through the issue of torture warrants.     

临床医学类学术论文应正确使用“随机化”

"随机化"是科学研究的基本原则之一,是研究结果外推的重要保证。虚假"随机化"把偶然现象上升为规律,极大地玷污了科学研究的客观真实性,危害无穷。本文以具体的案例剖析了临床研究论文"随机化"的误用和乱用,并提出了应对的措施。     

略论“延续性医德教育”模式的内涵与构建

目前医德教育在教育时间与教育手段等方面缺乏延续性。通过对医德教育的特点和规律以及传统医德教育存在的弊病、医疗领域不正之风的负面影响等问题的分析,提出应着手构建在校医学生—实习生—在职医务人员"三位一体"的"延续性医德教育"模式,实现"第一课堂与第二课堂"、"系统医德理论与实践"、"被动性与自主性"医德教育三结合。     

常染色体显性多囊肾手术治疗的临床决策

多囊肾去顶减压术是目前治疗常染色体显性多囊肾的主要手术方式。为了探讨多囊肾去顶减压术的临床效果,本文对81例常染色体显性多囊肾患者进行研究,分析其术后肾功能和症状改善情况。本文旨在客观评价多囊肾去顶减压术,并指出选择适当的手术时机是获得满意疗效的关键,为临床决策提供了依据。     

胎盘提前老化分娩时间与方式决策的浅思

胎盘提前老化(Premature aging of placenta)是指妊娠足月前胎盘提前出现退行性的结构改变,是妊娠结局不良的一个敏感预测指标。因此分娩时间及方式是胎盘提前老化临床处理的关键问题。临床上需要对其病因、产科合并症、健康效益、医疗代价、产前监测等进行辩证综合分析,进行正确判断,科学决策,从而减少不良后果发生。     

从雌激素替代治疗的历史看临床决策的影响因素

20世纪40年代,动物实验提供的致癌效应证据限制了雌激素替代治疗的应用。20世纪60年代,价值观因素极大地推动了雌激素替代治疗,以至于关于致癌效应的证据被忽视。20世纪70年代,人群研究提供的致癌效应证据使得雌激素替代治疗的应用不断减少。20世纪80年代,致癌效应的消除和观察性流行病学研究提供的心脏保护证据,将雌激素替代治疗的应用推向了顶峰。20世纪末,大规模随机对照试验提供的有害效应证据推动了雌激素替代治疗应用的大幅下降。雌激素替代治疗一波三折的历史体现了证据、价值观在不同时期对临床决策的不同影响,说明只有遵循循证医学的实践模式,基于现有最佳的科学证据,并结合医生的临床经验与患者的价值观,才可能做出科学、有效的临床治疗决策。     

对外科急腹症诊疗中伦理学矛盾的探讨

由于外科急腹症的特殊性,产生了与其他科室不同的伦理学矛盾。本文探讨了急腹症诊疗中存在的伦理学矛盾和相应对策。在急腹症诊疗过程中,要重视伦理学矛盾产生的原因,完善急腹症诊疗中存在的流程问题,自觉实践医学伦理学的知情同意原则,有助于化解医患矛盾,减少医疗纠纷;同时也要减轻医生工作压力,加强团队合作精神。