当代医学伦理学的四种研究进路及其反思

当代中国医学伦理学尚未形成统一的学科范式,但主要有四种研究进路：应用伦理学进路、经验主义进路、道德教育进路和生命伦理学进路。这四种进路在学术界占据着主导地位,构成了医学伦理学的基本知识图景。但是任何未经反思的知识前提都是不可靠的,需要从本体论、知识论和价值论的层面对它们进行认真的反思,以构建更加科学和系统的理论体系。在本体论上,需要考虑伦理学概念的本质属性及其与医学实践的联系。在知识论上,需要质疑伦理理论和具体应用之间的适用性和相关性。在价值论上,需要考虑伦理学研究和实践中所涉及的价值取向。

     

非医疗卫生机构医学伦理委员会现状及挑战

我国非医疗卫生机构正处于建立健全伦理委员会的阶段,其伦理委员会常见问题包括无针对性的伦理审查规范,审查能力无法匹配需求,伦理监管难以护航创新,可参考的指南和标准操作规程有限,研究者伦理知识有待提高,跟踪审查落实困难。鉴于此,建议落实法规基本规定,建立健全伦理委员会,人财物支持,提升委员审查能力,实行研究者准入制,建立伦理委员会认证制度和借鉴国外高等院校经验,以期加快非医疗卫生机构伦理委员会建设。

     

毒品原植物药用研究的“负责任创新”基本策略

毒品原植物具有药品和毒品双重属性,这种特殊性使其在科研创新活动中面临诸多伦理困境。立足解决国内毒品原植物医药研究面临的困境,参照负责任创新四维理论模型提出五个负责任行为框架,即政府主导为主、大众监督为辅,提倡多主体共同责任、资质认证与审查制度、全过程嵌入式伦理反思、建立负责任创新价值观和预后问责制,在提升创新动力方面提出部分性开放科学推进成果共享、创新监管机制以降低科研机构的风险。以中医药科研实践为基础,引入科学技术哲学思辨,为中医药毒品原植物科研创新规避风险,为提升创新动力提供有益思路。

     

尤金·加菲尔德与SCI述论

《科学引文索引》 (science citation index, SCI) , 是由尤金·加菲尔德创建于20世纪60年代, 通过文献引证关系建立起来的多学科文献检索工具。创建过程中先后受到弗兰克·谢泼德、威廉·阿德尔、戈登·艾伦和乔舒亚·利德伯格等思想的影响, 进行了大量的研究与试验。其主要功能是通过引文关系检索到不同学科领域的相关文献, 并基于自身结构特点兼具有一定科研评价功能。SCI引入中国后, 除作为检索工具外, 其科研评价功能备受青睐, 从而引发很多争议。通过SCI创建历史回顾和其主要功能阐述对以上争议试做回应。     

医学人文精神培育路径的质性研究

在文献梳理和焦点小组访谈的基础上, 运用质性研究方法, 采用编码技术, 通过开放性编码、主轴编码和选择性编码, 识别出医学人文精神培育的主要路径, 即人文课程体系的构建与实践、医学专业课程中融入医学人文精神教育、临床实践中融入医学人文精神教育及其主要维度。提出了较为系统的、科学的医学人文精神培育路径体系。研究结论对医学院校人文教育具有重要的理论意义和应用价值。     

中国心理学研究的现状与发展——基于第二十二届全国心理学大会的分析

采用Bicomb及SPSS软件对第二十二届全国心理学大会进行统计分析,探讨中国心理学的研究现状及发展趋势。本届会议分为31个专题,共收录1295篇论文摘要,产生42个高频关键词。研究结果表明,中国心理学目前仍处在蓬勃发展期,门类分支较细,研究成果丰硕,研究机构主要以师范类院校及专业研究结构为主; 关键词共词分析发现中国心理学研究具有五个热点领域。未来应进一步做好纵向研究,采用更为先进的研究方法,并结合心理学分支领域的会议来判断中国心理学研究的现状及发展。     

Association rule learning in neuropsychological data analysis for Alzheimer’s disease

Efficient methods of analysis readily available for clinicians continue to be limited within neuropsychological assessment at the raw data level. Here, a novel approach for generating predictive response patterns and analysing neuropsychological raw data is offered. In order to assess the usefulness of association rule learning as an analysis tool for neuropsychological raw data, Frequent Pattern Growth (FP-Growth) was used to mine patterns from the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NB) database. Complete assessment data for 84 post-mortem confirmed Alzheimer’s disease (AD) cases and 294 age, race, and education matched controls were analysed across baseline and one-year follow-up using FP-Growth, for the purpose of assessing the clinical utility of a finer analysis at the raw data level and the feasibility of predicting response patterns for clinical/control groups. Output from FP-Growth, in terms of the number of frequent itemsets retained across both evaluation timepoints, was discernable between controls, mild, and moderate to severe Alzheimer’s disease cases (p < .001, and η² = .488). Patterns within raw data scores, both in terms of frequent itemsets and predictive association rules, appear to be differentiable across groups within neuropsychological analysis, which indicates that FP-Growth is applicable as a supplementary analysis tool for neuropsychological assessment by means of offering an additional level of data analysis, predictive item response capabilities, and aiding in clinical decision making.     

The Nature and Meaning of the Near-Death Experience for Patients and Critical Care Nurses

This study was designed to develop a conceptual framework for the near-death experience (NDE), reflecting its nature and meaning for the patient and the critical care nurse. The study used naturalistic inquiry to examine the question: What is the nature and meaning of an NDE and how has it influenced the individual's view of the self, the future, and feelings and beliefs about life and death? The NDE Scale (Greyson, 1983) was used with patients and semi-structured interview guides were used with both nurses and patients to explore the NDE from a comprehensive perspective. An NDE was defined as the report of “unusual” recollections associated with a period of unconsciousness during either serious illness or injury, or resuscitation from a cardiac or respiratory arrest. The sample included 12 patients who experienced an NDE and 19 nurses who cared for patients who experienced NDEs. This study highlighted the emotional aspects of the NDE. Patients described how the NDE transformed their lives and nurses reported how their experiences with patients changed them personally and professionally.     

新时期医学生整体素质培养的几点思考

随着知识经济时代的到来,在我国传统医学教育模式下培养的大多数临床医学生,越来越难以适应现代医学发展和新时期群众对医疗服务的需求。因此,必须加强医学生整体素质培养,主要是职业道德素质、全面技能、人文文化、创新攻关精神、实事求是态度这几个方面的重点培养,以适应医学人才发展需要。