东西方医学伦理思维之共通性

从中国古代医者的行医事迹、著作来探寻中国的医者是否在行医过程当中勤守医者的本份,也即类似原则思维的表现。虽然中国古代并没有"医学伦理"这个名词,但从历代具有代表性之医者身上发现,其实在中国古代医者的行医事迹当中,就表现出类似的医学伦理情操。因之,医学伦理原则是俱普世价值的,也即世界上有所谓的共同道德存在。     

ART伦理督导的实践与评价

在生殖中心(医院)中,将伦理原则的学习与技术规范的掌握相结合,将伦理学评价与员工的奖惩机制相结合,将伦理学研究与管理骨干的培养相结合,将伦理原则的贯彻与工作总结相结合;发挥医学伦理委员会监督的权威作用,重视群众监督手段的督促作用,借助国家行政督导机构和行业法规的震慑作用,是ART增强道德约束能力的有效机制。     

医师协会行业自律：医学伦理建设的一个有效机制

中国医师协会自2002年成立以来,做了大量工作,但其主要集中在维护医师权益方面,在自律建设方面却作为不够。医师协会加强行业自律方可有效维权,这是医师协会开展工作的一种策略。在此基础上,进一步研究了"加强行业自律"这个医学伦理建设的有效机制。     

对我国《人体器官移植条例》的伦理审视

《人体器官移植条例》已经颁布实施,人体器官移植是一种公认的涉及敏感伦理问题的外科手术。通过分析《条例》是否充分体现了国际通行的生命/医学伦理原则,研究了人体器官移植进行进一步伦理规范的必要性,提出了人体器官移植应遵循的具体医学伦理原则。特别强调了其中的"公正"实体原则和"伦理审查"程序原则。     

Early identification of mental health problems in schools: The status of instrumentation

When embedded within a continuum of mental health services including both prevention and treatment, school-based mental health identification programs can promote improved academic and mental health functioning among students. This article describes the scientific status of assessment instrumentation that may be used for early mental health identification in schools. Currently available instruments are described in terms of their ability to accurately detect youth with mental health problems. Implications for selecting mental health screening and assessment instruments and integrating them into schools are discussed. Finally, a range of approaches to early identification in schools as well as some of the broader ethical and practical issues related to the integration of these strategies into a school-wide continuum of services are presented.     

On ethical order

The existent ethical relationships are the result of the historical amalgamation of objective and subjective conditions. Ethical relationships are essential relationships in the real and rational order, which are maintained by a system of regulations on morals, laws and customs, and infused with a spirit of subjectivity. Rationality and legitimacy are the primary concerns of those relationships. A distinction between morals and ethos needs to be made when studying ethical order. Sound ethical order lies in effective regulation of morals and effective control of law. In the process of social reform, ethical order promotes social development through the dialectical movement of freedom and necessity. A harmonious society is a society which is based on legitimate and just ethical order. Translated by Cui Hui from Lunlixue yanjiu 伦理学研究 (Studies in Ethics), 2007, (5): 1–8     

道德敏感性：概念理解与辨析

道德敏感性是新科尔伯格取向的重要概念,是道德行为发生之前逻辑上的心理初始成分,是对情境的道德领悟与解释,典型地反映了道德认知和道德情感的相互作用。对这个概念的性质和内涵理解存在能力观和经验观等不同观点;该概念也常操作化地为道德觉察、道德意识、后果意识、确认道德问题等;它与伦理敏感性、道德直觉等相近概念有着不同程度的区别和联系。     

Which is more critical in identification of random figures,endpoints or closures?1

The present study intended to examine the criticality of the presence of endpoints and its complementary state, the presence of closures, in early figural identification. Three experiments used a same/different judgment task for simultaneously presented pairs of random figures. Rigorous control over the selections of stimulus figures containing closures and endpoints was ensured. Latencies predicted by six explanations of figural identification (i.e. parallel and the presence of endpoint detection; parallel and closure detection; serial, exhaustive and endpoint detection; serial, exhaustive and closure detection; serial, self‐terminating and endpoint detection; and serial, self‐terminating and closure detection) were evaluated by the obtained patterns of latencies. The experiments persistently indicated that serial, self‐terminating feature detections were executed as the means of the identification. Experiments 1 and 2 showed that closures were detected faster than endpoints. Experiment 3 further suggested that multiple closures were detected faster than a single closure.     

On boredom: A close encounter with encapsulated parts of the psyche

The psychoanalytical literature has numerous scattered references to the analyst's experience of boredom, especially amongst writers working with primitive mental states. In the present paper, the author tries to gather some of these references in an attempt to integrate the various facets of this widespread phenomenon, and reflect on some clinical issues and dilemmas it raises. It is suggested that the experience of boredom in analysis may be a reaction to an encounter with a hidden, encapsulated part of the psyche, a bidimensional area of experience in which mental activity has been suspended, and experience remains meaningless. This is a barren area of lack, an encounter with the autistic core of the psyche. However, boredom may also be an experiential expression of despair, a re-living of primitive object relations with an emotionally non-existent primary object. Through bringing the emptiness and desolation into analysis, the individual makes room for the empty, blunt, dead inner object which resides within him, and that needs to be integrated into the psyche. This inner object is a vital part of the patient's inner world, part of his history, and can neither be erased nor filled in order to eradicate the emptiness. This is illustrated by clinical material from patients along the spectrum of autism, autistic reaction following trauma and autistic barriers in neurotic patients.     

Murdered father; dead father: Revisiting the Oedipus complex1

This paper recovers the notion of the sacrifice of sexuality as the central, tragic, element of the oedipal structure. This notion has been largely abandoned in the psychoanalytic literature that has tended to reduce the oedipal structure to processes of exclusion. The paper traces the development of the theoretical and clinical transformations of Freud ’s ideas on the role of the father and suggests that they allow us to more fully comprehend the Oedipus complex proposed by Freud. A paradox is explored: the killing of the father is, in Freud ’s view, the requirement for the creation of the social order which, from then on, prohibits all killings. The father, however, has to be killed metaphorically only, as the actual exclusion of the father lies at the origin of so many psychopathologies from violence to the psychoses and perversions. The paper analyses the fundamental asymmetry that is present in the Oedipal structure and suggests that the three elements of the oedipal triangle constitute the law (of the dead father, that institutes the sacrifice of sexuality), desire (for the lost object) and identification (with both father and mother). Two clinical examples are discussed. In the first, one can identify a perverse structure in which the father has been murdered; in the second, there is a progressive construction of the dead (symbolic) father in the analytic process.