With Hope and Imagination: Imaginative Moral Decision-Making in Neonatal Intensive Care Units

Although the role of imagination in moral reasoning is often neglected, recent literature, mostly of pragmatist signature, points to imagination as one of its central elements. In this article we develop some of their arguments by looking at the moral role of imagination in practice, in particular the practice of neonatal intensive care. Drawing on empirical research, we analyze a decision-making process in various stages: delivery, staff meeting, and reflection afterwards. We show how imagination aids medical practitioners demarcating moral categories, tuning their actions, and exploring long-range consequences of decisions. We argue that imagination helps to bring about at least four kinds of integration in the moral decision-making process: personal integration by creating a moral self-image in moments of reflection; social integration by aiding the conciliation of the diverging perspectives of the people involved; temporal integration by facilitating the parties to transcend the present moment and connect past, present, and future; and epistemological integration by helping to combine the various forms of knowledge and experience needed to make moral decisions. Furthermore, we argue that the role of imagination in these moral decision-processes is limited in several significant ways. Rather than being a solution itself, it is merely an aid and cannot replace the decision itself. Finally, there are also limits to the practical relevance of this theoretical reflection. In the end, it is up to care professionals as reflective practitioners to re-imagine the practice of intensive care and make the right decisions with hope and imagination.

Hypothetical Retrospection

Moral theory has mostly focused on idealized situations in which the morally relevant properties of human actions can be known beforehand. Here, a framework is proposed that is intended to sharpen moral intuitions and improve moral argumentation in problems involving risk and uncertainty. Guidelines are proposed for a systematic search of suitable future viewpoints for hypothetical retrospection. In hypothetical retrospection, a decision is evaluated under the assumption that one of the branches of possible future developments has materialized. This evaluation is based on the deliberator’s present values, and each decision is judged in relation to the information available when it was taken. The basic decision rule is to choose an alternative that comes out as morally acceptable (permissible) from all hypothetical retrospections.

两难中合作行为研究的回顾和展望

如何预测人们将做出合作行为,是社会两难决策研究中重要的问题。该文回顾了社会两难研究的进展情况,包括社会两难的特征、来源、类型、研究方法和理论基础;综述了两难中影响合作行为的个人因素和情景因素,重点介绍了目前存在争议的制裁系统和合作的关系研究,以及为什么它们之间会表现出一些自相矛盾之处;对合作行为研究存在的问题进行了初步探讨,未来的研究将更侧重于合作决策的理论建构、文化内涵和认知过程的揭示     

心理账户的作用机制与儿童认知发展

心理账户是普遍存在于个体心理中的一套或者多套记账体系。这种体系往往是以非预期的形式存在,并对个体的行为决策产生潜在的影响。由于心理账户的存在,使得个体在行为决策时往往无意识地偏离正常的价值判断或者计算法则,从而做出非理性的决策。心理账户的非替代性作用机制可以解释儿童心理理论、价值判断、情感决策以及自我控制等认知能力的发展。     

自然灾难后身心反应的影响因素:研究与启示

所有经历自然灾难的人都会出现应激反应。随着时间的推移, 这些反应或消退, 或转化为一种创伤后成长(PTG), 或恶化为创伤后应激障碍(PTSD)等。根据危险因素模型, 这一过程受三类因素影响:(1)前灾难因素, 如性别、年龄等;(2)当下灾难因素, 如创伤暴露程度等;(3)后灾难因素, 如社会支持、复原特征等。其中, 后灾难因素得到了更多的关注。在危险-保护因素模式及机体主动模式的基础上, 分析了后灾难因素的作用机制, 通过研究的整合, 探讨了其对于灾后研究和干预的启示。     

防治血管剩留风险的决策探讨

针对冠心病和（或）2型糖尿病患者,已有许多有效的防治措施。然而,尽管接受了当前的标准治疗,这类患者仍会反复发生许多大血管和微血管事件,这种现象称之为血管剩留风险。有许多因素影响血管剩留风险的存在,其中最为重要的是致动脉粥样硬化性血脂异常。因此,采取积极的全面干预措施如改善生活方式、联合降脂以改善所有的脂质异常指标,是最大程度降低血管剩留风险的动向。     

产后抑郁相关危险因素分析

本文通过分析引发产后抑郁的相关危险因素及其对健康的影响,为探索干预措施提供依据。危险因素重要性的分析显示“夫妻关系不佳”位居危险因素之首;产妇的性格特征和孕期心理状态是产后抑郁发生的重要心理影响因素。因此,丈夫角色不容忽视,社会支持系统的建立意义重大,干预效果显著的因素应作为研究重点。     

ICU患者外出检查风险分析与对策

为了探讨ICU危重患者外出检查风险的原因,从而降低ICU危重患者外出检查风险,本文通过对312例ICU患者外出检查风险因素进行讨论分析,研究降低风险的对策,即在规范ICU患者外出检查流程、做好检查前准备和注意途中安全及返回后的护理,结果提示285例患者无意外发生,安全返回病房,其余27例患者存在一定风险,但在相应处理措施下均安全返回病房。     

Ergonomie cognitive d’un conseil génétique pour le test présymptomatique de maladie de Huntington

We would like to propose the analysis of a multidisciplinary genetic counselling activity. More precisely, we study an interaction that took place in the consultation between an asymptomatic patient who requests for a predictive genetic testing of Huntington’s disease and two doctors successively. We describe the failure of the multidisciplinary team’s attempt to influence the conviction, or the personal rationality, of the patient for the genetic risk perception. More generally, this study illustrates the communication practices which are engendered by modern medicine can be very delicate. Therefore, this information is carried by the act of informing. This action is made of processes which are relatively independent.     

INFLUENCING CHILDREN'S PREGAMBLING GAME PLAYING VIA CONDITIONAL DISCRIMINATION TRAINING

Past research has demonstrated a transformation of stimulus functions under similar conditions using gambling tasks and adults (e.g., Zlomke & Dixon, 2006), and the present study attempted to extend this research. Experimenters exposed 7 children (ages 7 to 10 years) to a simulated board game with concurrently available dice differing only by color. Following initial exposure to the game, participants were trained to discriminate between two contextual cues representing the relational frames of more than and less than. Following the training procedure, experimenters reexposed participants to the simulated board game. Six of the 7 participants demonstrated an increased preference toward the die with the color that had been paired with more than during the conditional discrimination training.