应急药物储备及其优化的伦理研究

应急药物在应对突发公共卫生事件中起到保障人类健康和维护国际安全的作用,然而当前的应急药物储备策略在实践中面临着资源分配不公、社会公正性有待提升及储备灵活性亟待增强等伦理问题,以伦理学视角为基础,对应急药物储备的优化路径进行探索,提出应急药物储备的优化应建立在公平公正、优先性及公益性等伦理原则基础上,逐步完善应急药物储备公正价值观、加强药品供应链资源的合理配置、健全应急医疗药物储备的制度体系等政策措施,以期为应急医疗药物储备管理模式的发展提供参考和借鉴。

     

Virtual morality in the helping professions: Simulated action and resilience

Recent advances in virtual technologies have allowed the investigation of simulated moral actions in aversive moral dilemmas. Previous studies have employed diverse populations to explore these actions, with little research considering the significance of occupation on moral decision-making. For the first time, in this study we have investigated simulated moral actions in virtual reality made by professionally trained paramedics and fire service incident commanders who are frequently faced with and must respond to moral dilemmas. We found that specially trained individuals showed distinct empathic and related personality trait scores and that these declined with years of experience working in the profession. Supporting the theory that these professionals develop resilience in moral conflict, reduced emotional arousal was observed during virtual simulations of a distressing dilemma. Furthermore, trained professionals demonstrated less regret following the execution of a moral action in virtual reality when compared to untrained control populations. We showed that, contrary to previous research, trained individuals made the same moral judgements and moral actions as untrained individuals, though showing less arousal and regret. In the face of increasing concerns regarding empathy decline in health care professionals, we suggest that the nature of this decline is complex and likely reflects the development of a necessary emotional resilience to distressing events.     

对急危重症患者家属签署知情同意书中不同意的病例回顾分析

分析在急危重症患者中签署知情不同意的原因,探讨对策.选择我院2010年6月1日～2011年12月30日在ICU抢救已出院归档的急危重症患者家属签署的600份知情同意书中52份不同意的病例进行分析总结.52份病例的知情同意书签字不同意,原因多方面.知情不同意是患者或家属的权力,如何保障更好行使此权利,同时保障其健康是医务人员努力的目标,也需要对出现的问题进一步探讨.     

急诊医学中的人文关怀

人文关怀是对人、人类社会的生存和发展、命运和前途的关心,是对人性和人权的尊重和保护,是对人独立思想和人格的容许与提倡。随着医学模式的转变和急诊医学的发展和完善,越来越需要重视对病人的人文关怀,也就是对病人人权和人格的重视。在急诊医学教学当中,不但要传授相关的专业知识,而且需要将人文关怀的理念贯穿于教学始终,培养医学生人文关怀的素养,教师同时要重视医学生自身对人文关怀的需求。     

急症产科子宫切除术知情同意的分析

为保留产妇的生命权而牺牲其生育权的子宫切除术,仍是控制产科出血的最后手段。产科急症时,患者本人无法做出意思表示,子宫切除术的知情同意权由其法定代理人行使。子宫切除围术期,实施知情同意,仍存在许多法律盲点及实践困难。本文阐述了产科子宫切除术告知的法律义务、行为主体,以及告知患者子宫切除的方式。     

逃生决策中的信息源直觉和分析对采纳偏向的影响

选取82名被试,探讨在突发危急事件的逃生判断和决策中人们对不同信息源的采纳偏向,同时探讨直觉和分析两种思维倾向以及直觉和分析两种决策风格对逃生判断和决策中信息源采纳的影响。结果：（1）在模拟突发危急事件的逃生判断和决策中人们对不同信息源的采纳倾向存在明显差异,来自权威、熟悉以及具有高信任度的信息源更容易被采纳;（2）直觉性思维倾向启动条件下和分析性思维倾向启动条件下的信息源采纳倾向差异不明显;（3）直觉型决策风格对信息源的采纳倾向具有明显预测性,而分析型决策风格对信息源的采纳倾向不具有明显预测性。主要结论     

Supreme Emergencies Without the Bad Guys

This paper discusses the application of the supreme emergency doctrine from just-war theory to non-antagonistic threats. Two versions of the doctrine are considered: Michael Walzer’s communitarian version and Brian Orend’s prudential one. I investigate first whether the doctrines are applicable to non-antagonistic threats, and second whether they are defensible. I argue that a version of Walzer’s doctrine seems to be applicable to non-antagonistic threats, but that it is very doubtful whether the doctrine is defensible. I also argue that Orend’s version of the doctrine is applicable to non-antagonistic threats, but that his account is not defensible, regardless of whether the threats are antagonistic or not.

红色标识腕带在急诊危重患者安全管理中的应用

为使急诊危重症患者得到及时、快捷、有效的救治,确保急救绿色通道畅通,保证医疗护理安全,2007年7月起,我院急诊科开展了“红色标识腕带”服务.凡佩戴红色标识腕带的急诊危重患者在院内接受就诊、挂号、缴费、检查、治疗、用药、用血、手术、住院等一系列流程中,享有全程优先特权.红色标识腕带的应用不仅起到了准确的身份识别的作用,更增强了医护人员的急救服务意识,尤其缩短了危重患者的急诊等候时间,有效地减少了纠纷,提升了抢救成功率,提高了医院整体的急诊工作效率和急救服务水平,在急诊安全管理中具有非常重要的意义.     

突发公共卫生事件与政府应急能力建设

政府如何加强应急体系建设,提升应对突发公共卫生事件的能力,是关系社会秩序能否稳定和谐的重大问题。为此应在坚持行政应急性原则的基础上,从公共卫生应急资源的准备供给、管理供给和补偿供给三方面形成实现应急能力的支持系统,以消解突发公共卫生事件所引发的社会影响或动荡。