英国研究伦理审查体系及其启示

全面介绍了英国当前医学研究伦理审查体系与现行法规,总结其特色在于:建立了全国自上而下的中央化审查管理模式,独立于研究者、资助方、申办方以及开展研究的机构;分布在不同区域的各类别伦理委员会采用全国统一的标准操作规程运行;通过电子信息化系统统一受理全国的伦理申请;伦理审查采用与项目特点相称的审查形式,并关注公众参与及受试者权益保护等。结合国内现状,提出建立更全面的伦理监管体系并探索多样化的伦理审查形式。另外,医疗机构内应加强临床研究全流程管理,确保伦理委员会聚焦并围绕受试者权益保护,进行充分、有效的伦理审查。     

Ethical issues in genetic counseling: A comparison of M.S. counselor and medical geneticist perspectives

New technologies available in the field of medical genetics have increased the importance of responsible ethical decision-making among genetic counselors. A 1985 national survey of M.D. and Ph.D. genetic counselors assessed ethical attitudes using case scenarios designed to simulate dilemmas faced in genetic counseling (Wertz and Fletcher, 1988b). The current study focuses on attitudes of M.S. genetic counselors using similar scenarios, allowing for effective comparisons. M.S. counselors were more willing than M.D. and Ph.D. counselors to maintain patient confidentiality when screening for Huntington's Disease and occupational diseases, and a greater number would agree to counsel patients pursuing prenatal testing for sex selection. A majority of M.S. counselors would disclose an XY karyotype to a phenotypically female patient. M.S. counselors reasoned that respect for patient autonomy and patient confidentiality justified their decisions in many cases. The importance of these principles is discussed and questioned.     

医学研究中的机构伦理问题探究

机构作为医学研究活动的主体,在构建国家科研伦理治理体系和倡导负责任的医学研究方面发挥着个体科研人员不可替代的作用,也引发了一系列独特而又时常被忽视的伦理问题和挑战。为此,引入一个全新的观点“机构伦理”,并辨析其与管理伦理、制度伦理、组织伦理之间的区别和联系,进而厘清机构伦理的概念和主要内容。重点剖析了医学科研机构中的两大伦理议题:机构伦理责任和机构利益冲突。医学科研机构的责任担当和有效规避利益冲突,在促进公众对医学研究的信任及营造良好的科研伦理环境方面具有重要意义。     

程序伦理在破解新冠肺炎疫情引发伦理难题中的价值

伦理程序是做出伦理决策与辩护、进行伦理审查与评价等道德决断的行为过程;程序伦理是具有一定时空顺序地做出伦理决断的行为过程伦理,保证人们遵循"应该做什么"和"应该如何做"等道德规范的伦理,有利于道德规范和实质伦理的实现。国内外新冠肺炎疫情防控遭遇或引发了积极防控是否应该和值得,防控措施限制人们的权利是否适度,卫生资源到底应该如何公正分配等大量的伦理难题。破解这些难题,程序伦理要求通过伦理行为决策、辩护、评价以及伦理审查等程序,并在程序中遵循公开与透明决断信息,沟通与协商决断措施以及评议与审查伦理决断的伦理要求。     

审美主体与伦理主体的比较研究

本文通过对审美主体和伦理主体的比较研究揭示了个体存在的伦理层面的含义。首先考察了老庄和海德格尔的后现代宗教式的主体和儒家形而上的宗教主体,以及儒家就伦理问题对于老庄的挑战。结论是他们都缺乏把他者的生存作为自己的绝对的责任的伦理含义,因而是审美主体：其次,通过对于环境主体和伦理主体及审美主体的关系的讨论,阐释了这样一个哲学基本问题：伦理存在必须以有限性存在为前提;而后者只是一个哲学的抽象。片面地强调人的有限性(尼采),片面强调有限存在与超越者的关系(老庄和海德格尔),或否认人的有限性,这些观点都忽略了人在这个世界上的伦理责任。后现代伦理学是指我,作为一个个体(me),对于他者的一切负有不可推卸的责任。     

The importance of meta-ethics in engineering education

Our shared moral framework is negotiated as part of the social contract. Some elements of that framework are established (tell the truth under oath), but other elements lack an overlapping consensus (just when can an individual lie to protect his or her privacy?). The tidy bits of our accepted moral framework have been codified, becoming the subject of legal rather than ethical consideration. Those elements remaining in the realm of ethics seem fragmented and inconsistent.Yet, our engineering students will need to navigate the broken ground of this complex moral landscape. A minimalist approach would leave our students with formulated dogma—principles of right and wrong such as the National Society for Professional Engineers (NSPE) Code of Ethics for Engineers—but without any insight into the genesis of these principles. A slightly deeper, micro-ethics approach would teach our students to solve ethical problems by applying heuristics—giving our students a rational process to manipulate ethical dilemmas using the same principles simply referenced a priori by dogma. A macro-ethics approach—helping students to inductively construct a posteriori principles from case studies—goes beyond the simple statement or manipulation of principles, but falls short of linking personal moral principles to the larger, social context. Ultimately, it is this social context that requires both the application of ethical principles, and the negotiation of moral values—from an understanding of meta-ethics.The approaches to engineering ethics instruction (dogma, heuristics, case studies, and meta-ethics) can be associated with stages of moral development. If we leave our students with only a dogmatic reaction to ethical dilemmas, they will be dependent on the ethical decisions of others (a denial of their fundamental potential for moral autonomy). Heuristics offers a tool to deal independently with moral questions, but a tool that too frequently reduces to casuistry when rigidly applied to “simplified” dilemmas. Case studies, while providing a context for engineering ethics, can encourage the premature analysis of specific moral conduct rather than the development of broad moral principles—stifling our students’ facility with meta-ethics. Clearly, if a moral sense is developmental, ethics instruction should lead our students from lower to higher stages of moral development.     

我国医疗卫生改革中的伦理缺席

“中国的医疗卫生体制改革从总体上说是不成功的”结论的发表在社会上引发了对卫生改革的种种议论,从卫生改革的设计、实施和评估三方面论述了由于政府的缺位和伦理学的缺席,将卫生改革引向功利主义的死胡同,使得卫生改革背离了公正的目标而导致失败。但退回计划经济体制下的办医模式同样没有出路,在今后的深化改革中,必须强调医学目的,贯彻以人为本的指导思想,加大政府的投入,围绕公正目标,建立覆盖全民的医疗保障体制。     

知情不同意

自主原则是医学伦理学的基本原则之一,自主权是患者的基本权利.从临床实践出发,分析了患者知情后拒绝治疗的自主选择与其他利益相冲突的情况,总结了医生尊重患者自主权利的伦理条件,对指导临床实践具有一定的现实意义.     

伦理关怀与社区管理

社会结构在变化 ,我们的思想理念及社会有效管理也必须随之变化。社区是社会公民生养栖息的主要场所 ,又是一定生活群体的精神共同体的培养凝聚基地 ,更重要的是社区在现代已发展为社会管理中新的基层平台。伦理关怀在社区管理中的更多介入 ,在探索新的社会管理模式方面 ,尤其在凝聚整合社会向心力方面发挥着重要作用。     

基于伦理学视域的失能老人照护服务体系研究

研究失能老人照护服务体系问题,对于保障失能老人的生命尊严与生存权利、促进社会和谐发展等具有重要意义.基于失能老人生存需要的服务供给、人才培养、制度安排、组织监管等问题,是照护服务体系构建的基本元素.坚持人本理念以及资源配置的公平、公正与效益目标,是照护服务体系构建的伦理原则.