医院的社会责任：伦理学视角

讨论了评价医院管理行动的伦理框架,严峻的卫生形势,医院的社会责任,其中着重讨论参与全面建设小康社会;向社会提供公平的卫生保健服务;重建医患信托关系以及调整与企业关系防止利益冲突。     

论英美医事法立法体系

我国现阶段的有关医疗方面的法律、法规,在整个医疗卫生活动中起到了规范和制约的作用,但仍不完善。了解国外医事立法的历史和现状,有利于我国医事立法工作的开展。从英美法系医事立法出发,对英美法系的医事立法进行讲解和论述,从而起到借鉴的作用。     

How does evidence-based practice in psychology work? – As an ethical demarcation

Evidence-based practice in psychology (EBPP) is ordinarily understood to demarcate between legitimate and illegitimate psychotherapy practice, based upon the epistemic demarcation distinguishing scientific from non-scientific knowledge. EBPP emphasizes the value of effective and efficient interventions identified through randomized controlled trials and cost-benefit analyses. Basing the template for choice of action or strategy on randomized controlled trials and cost-benefit analyses create a deceptive appearance of ethical neutrality. However, there is an implicit ethical demarcation at work in EBPP, which favors a non-articulated specific position in normative ethics. More particularly, evidence-based practice in psychology is structured according to a utilitarian framework, severely limiting the kinds of ethical perspectives available to assess psychotherapy practice. The latter point is illustrated through a new mode of delivering psychotherapy services called “Internet-based guided self-help” (IBGSH). In EBPP the only relevant ethical question is to what extent any intervention, such as IBGSH, is effective and efficient. Some of the limiting effects of the ethical, utilitarian, demarcation are showcased by presenting three alternative ethical perspectives by which psychotherapy practice in general and IBGSH in particular can be analyzed. The analysis concludes that EBPP is not suited to ethically regulate the practice of psychotherapy.     

心理学研究中的伦理

本文介绍了美国心理学会关于科学研究的伦理原则和相关的规定,以及结合心理学科研实践讨论怎样实施这些原则与规定。本文对我国心理学的伦理建设有一定参考价值。主要内容如下:1.人类参与的研究; a.知情同意及欺骗; b.自由退出; c.保护免受伤害和事后情况说明; d.清除有害后果; e.保密。2.动物研究的伦理:a.反对研究动物的论点; b.赞成研究动物的论点。c.研究动物的指南。3.科学欺诈。4.监督伦理实践。     

Is There Social Consensus Regarding Researcher Conflicts of Interest?

Consensus around what constitutes researcher conflicts of interest (COIs) and awareness of their influence on our research are two critical steps in ensuring the integrity of our science. In this research, data were collected from individual scholars via 2 surveys 5 years apart and from journals and associations to examine the level of social consensus and moral awareness among scholars, journals, and associations regarding researcher COIs. Although we observed increases in level of social consensus and moral awareness between 2012 and 2017, results still revealed limited agreement about what relationships constitute a COI and limited awareness about the presence of and the ethical issues surrounding COIs. Although all journals and associations we examined supported COI disclosure, most did not provide researchers with detailed COI-related information, guidance, or disclosure tools. Limited social consensus and moral awareness regarding COIs is problematic because it inhibits the recognition, disclosure, and management of COIs and limits ethical decision making. We need to continue and enhance discussions about COIs and aim to create consensus and awareness where we do not have it with the goal of reducing potential scientific misconduct related to COIs.     

Serious Ethical Violations in Medicine: A Statistical and Ethical Analysis of 280 Cases in the United States From 2008–2016

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances (97%) of intentional wrongdoing (99%), by males (95%) in nonacademic medical settings (95%), with oversight problems (89%) and a selfish motive such as financial gain or sex (90%). More than half of cases involved a wrongdoer with a suspected personality disorder or substance use disorder (51%). Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions.     

Students' Ethical Decision‐Making When Considering Boundary Crossings With Counselor Educators

Counselor education students (N = 224) rated 16 boundary‐crossing scenarios involving counselor educators. They viewed boundary crossings as unethical and were aware of power differentials between the 2 groups. Next, they rated the scenarios again, after reviewing 1 of 4 ethical informational resources: relevant standards in the ACA Code of Ethics (American Counseling Association, 2014), 2 different boundary‐crossing decision‐making models, and a placebo. Although participants rated all resources except the placebo as moderately helpful, these resources had little to no influence on their ethical decision‐making. Only 47% of students in the 2 ethical decision‐making model groups reported they would use the model they were exposed to in the future when contemplating boundary crossings     

Review of refugee mental health and wellbeing: Australian perspectives

This review covers refugee mental health and wellbeing within the Australian context to assist psychologists who provide services for, or who conduct research with, refugees. It provides a brief overview of the refugee movement, prior to examining evidence relating to the impacts of pre‐displacement, displacement and resettlement factors on psychological adjustment in the resettlement phase, and the systemic and sociopolitical factors that influence the process of adaptation during resettlement. Australian findings suggest that mental health and wellbeing outcomes are influenced by a complexity of pre‐displacement, displacement, resettlement and systemic factors; the detention or award of temporary residence to refugees who are already experiencing psychological distress on arrival are cases in point. Limitations of the findings are considered. More research into the combined, pathwise relations between the psychosocial pre‐determinants and psychological sequelae of the refugee experience is required. Finally, suggestions for the development of practice, training and ethical guidelines are offered.     

小学数学真实性问题解决的调查研究

在常规课堂上对来自北京市两所小学148位10-12岁的小学生进行真实性问题的测验,研究结果表明:1)被试中对真实数学问题作出真实性解答的人数比例约为四分之一,高于国外同类研究中比例.2)作出常规解答的人数比例约为一半,显著高于作出真实解答的人数比例.3)六年级被试作出真实解答的人数比例普遍高于四年级,但是在某些问题上,六年级被试中作出常规解答的人数比例反而高于四年级.4)被试对不同真实问题的反应存在一定的差异,这可能与真实问题的特点有关.     

Epistemic Justice and a Role for Virtue in the Politics of Knowing

The dual aim of this article is to reveal and explain a certain phenomenon of epistemic injustice as manifested in testimonial practice, and to arrive at a characterisation of the anti–prejudicial intellectual virtue that is such as to counteract it. This sort of injustice occurs when prejudice on the part of the hearer leads to the speaker receiving less credibility than he or she deserves. It is suggested that where this phenomenon is systematic it constitutes an important form of oppression.