Arguing ‘for’ the Patient: Informed Consent and Strategic Maneuvering in Doctor–Patient Interaction

As a way to advance integration between traditional readings of the medical encounter and argumentation theory, this article conceptualizes the doctor–patient interaction as a form of info-suasive dialogue. Firstly, the article explores the relevance of argumentation in the medical encounter in connection with the process of informed consent. Secondly, it discloses the risks inherent to a lack of reconciliation of the dialectical and rhetorical components in the delivery of the doctor’s advice, as especially resulting from the less than ideal conditions of the internal states of the doctor and the patient, and the lack of symmetry in their status.     

EMERGENCE EVERYWHERE?! REFLECTIONS ON PHILIP CLAYTON'S MIND AND EMERGENCE

Abstract. Emergence is a powerful concept marked by great emotional, aesthetic, and intellectual appeal. It makes inroads into the understanding of the most diverse phenomena. Emergence appears to have the potential of explaining anything from the behavior of atoms, ant colonies, and traffic jams to insurance risks, human consciousness, and divine action. Philip Clayton's book Mind and Emergence (2004) offers much‐needed clarification of the philosophical grounding of emergence theory. To a large extent, emergence hinges on the concept of levels and hierarchies in nature. The preferred metaphor is that of a ladder. Given the tendency of concepts like emergence to build ideology, a careful analysis of language and metaphor is called for, however. I argue that the preference for the ladder metaphor does not do justice to the differentiated relationality that is a distinct mark of emergence. This oversight may have detrimental consequences when emergence theory is transferred from natural to social and cultural processes. A hermeneutical analysis suggests that better metaphors and visualizations need to be found. As an invitation to consider alternatives, some examples of complex regular poly topes are offered.     

The Logic of Critique

This paper attempts to define the concept of critique, explain its function␣and properties and distinguish it from the close concept of evaluation. It is argued that, beyond the argument, a critique is concerned with the position of the proponent relatively to the reality the argument is about. Moreover, a critique is itself an argument in which assumptions regarding the position of the proponent are justified for a given audience on the basis of the proponent’s argumentative background within a specific domain.     

呼吸危重症临床决策中的若干问题

在临床实践中,呼吸危重症的诊断和治疗存在着一些不同的观点。就其中某些热点问题,如慢性阻塞性肺疾病合并哮喘的诊断和机械通气的指征、肺栓塞的诊断、急性呼吸窘迫综合征的治疗、呼吸重症监护病房的建设和呼吸危重症的伦理学问题进行阐述,以期提高对呼吸危重症的认识。     

Exploring the trainees' view of a socio‐political approach within UK clinical psychology

This paper aims to provide preliminary insights into the relationship between clinical psychology and a socio‐political approach known as Critical Community Psychology (CCP). Methodologically, it uses statements about CCP as stimulus material, and utilizes both quantitative and qualitative exploratory techniques, to survey the opinions of 354 UK trainee clinical psychologists. Participants' ratings of the stimulus material and their qualitative comments reveal many positive endorsements of the socio‐political approach. However, themes from the qualitative data raise questions about how socio‐political ideas can be incorporated into clinical practice and highlight uncertainty over the relationship between clinical psychology and politics. Copyright © 2006 John Wiley & Sons, Ltd.     

护理实践中的辩证思维

用辩证思维方法分析护理实践中存在的问题,从事物的异同性、矛盾的对立统一性、护理工作的两重性、主从性等方面探讨辩证思维在护理实践中的运用,有利于培养护士的人文素养和哲学思维能力,能在工作中缕出头绪、抓住问题的根本,提高护理工作效率和质量,收到事半功倍的效果。     

Becoming human,becoming sober

Two themes run through Kierkegaard’s authorship. The first defines existential requirements for “becoming human”—reflective honesty and earnest humor. The second demarcates the religious phenomena of sobriety when human becoming suffers insurmountable collisions. Living with existential pathos teaches the difference between the either/or logic of collisions and the both/and logic of development and transitions. There is a difference between self-transformation and a progressive individual and social development. In the developmental mode self experiences gradual progression or adaptive evolution; in the self-transformative mode self undergoes qualitative upsurges, leaps, gestalt switches, musical key transpositions of becoming in individual and social evolutions. Each individual in every epoch begins at the beginning. The author traces the movements of becoming in their parallel dimensions, drawing a fork through Kierkegaard’s writing. The first leads through the existence spheres of his pseudonymous authorship. The second intensifies the movement on the spot and in the moment.

关于严重突发事件危机干预的研究评述

对国外关于严重突发事件危机干预的研究作了概览与评述。认为有两点值得关注：其一,危机干预中的评估的重要性。在干预中,评估是进行干预的前提条件,更贯穿干预过程的始终。干预者必须通过不断评估确定危机的严重程度,不断确定当事人的心理状态,才能确定采用相应的应付策略和支持系统等。其二,国外许多不同的干预模式具有3个特征：一是阶段划分技术,将干预过程划分为不同的阶段,针对不同阶段的特点采取不同的措施与策略。二是整合倾向,将不同的干预模式、支持资源加以整合,使干预的效果达到最佳水平。三是特异性发展,即针对不同人群、不同应激情境作深度拓展,发挥干预的特异性效果。“非典”流行对我国的危机干预体系是一个严峻的考验,我国面对严重突发事件的危机干预体系还有待于健全。虽然不能照搬外国的干预模式,但是其思路与技术、经验与教训还是值得我们借鉴的。     

The Operationalistic and Hermeneutic Status of Psychoanalysis

Hermeneutic and anti-hermeneutic sides in the debate about psychoanalysis are entangled in an epistemological and methodological antinomy, here exemplified by Grünbaum's and Spence's paradigmatic views. Both contain a partial element of truth, which they assert dialectically one against the other (§§ 1 and 2). This antinomy disappears only by reconciling an operationalist approach with man's ability to suspend the effectiveness of the‘laws’ applied to him (§ 3). The hermeneutic way in which the technical-operational criterion of truth works in psychoanalysis demands that clinical and extra-clinical testing methods work synergically, through a fruitful self-correcting strategy, grounded on the very psychoanalytic object: the unconscious (§ 4). This revised version was published online in August 2006 with corrections to the Cover Date.