对医院伦理委员会建设的几点认识

对20年来我国医院伦理委员会建设步伐不够大进行了反思,分析了存在的主要原因;阐述了对生物医学技术的实施进行伦理审查评价的必要性;对我国医院伦理委员会的建设提出展望,对医院伦理委员会工作发表了自己的认识。     

公民逝世后器官捐献伦理审查的思考与建议

通过参与观察研究和文献梳理,总结当前我国公民逝世后器官捐献伦理审查存在的问题,如审查机构不明确、审查时间滞后、审查形式有缺陷、审查内容及标准不具体、审查监管不足等。依据人体器官捐献的伦理原则及我国相关法律法规和文件规定,针对谁来审查、何时审查、怎样审查、审查什么、如何监管5个问题提出规范伦理审查的建议,以期加强器官捐献伦理审查制度建设和伦理委员会审查能力建设,促进我国器官捐献与移植工作由高速度增长向高质量发展转型。

     

联合国教科文组织国际生命伦理学委员会第七届会议报告

在厄瓜多尔政府的盛情邀请下,国际生命伦理学委员会(IBC)第七届会议于2000年11月7～9日在基多举行。来自50个国家的170余名学者到会。IBC讨论了两个工作小组关于胚胎干细胞研究伦理学问题及在人类基因组研究中发达国家与发展中国家之间的团结与合作问题的报告。几位专家召开了一次主题为“生命伦理学教育”的圆桌会议。IBC还就人类基因组研究中经济方面的问题召开了一次工作会议。     

Not without hope: a Reformed analysis of sickness and sin.

A Reformed understanding of sickness requires that connections be drawn between the structural effects of sin and the ways that sickness is experienced in people's lives. Such an understanding can be an important resource for the bioethicist, both the bioethicist who speaks from the Reformed tradition and the bioethicist who speaks to patients and caregivers who may assume that sin and sickness are connected, but may understand that linkage in overly simplistic ways.     

Ethical implications in the allocation of scarce medical resources in Poland

The health care system in Poland is undergoing major change and it is possible that these changes could affect clinical research. Therefore, the situation of funding of health care is important for the future of medical research in this country. Some questions relevant in this field will be addressed. Since funds for health care and scientific research remain inadequate, their allocation raises moral, economic, legal and organisational dilemmas. The clinical aspects of resource allocation also include physicians’ responsibilities towards their patients. Scientific research, clinical medicine, and clinical research have a common denominator: they rely on trust. The physician should be a fiduciary of the patient as well as being a researcher for the benefit of the patient and for society. Some physicians and researchers, despite unethical conduct, escape disclosure and punishment, but decision-makers who wrongly allocate funds for health care and research are never held accountable for their actions. An earlier version of this paper was presented at a symposium, Scientific Misconduct: An International Perspective, organised by The Medical University of Warsaw, 16 November, 1998.     

The wisdom of nature in integrating science, ethics and the arts

This paper deals with an approach to the integration of science (with technology and economics), ethics (with religion and mysticism), the arts (aesthetics) and Nature, in order to establish a world-view based on holistic, evolutionary ethics that could help with problem solving. The author suggests that this integration is possible with the aid of “Nature’s wisdom” which is mirrored in the macroscopic pattern of the ecosphere. The corresponding eco-principles represent the basis for unifying soft and hard sciences resulting in “deep sciences”. Deduction and induction will remain the methodology for deep sciences and will include conventional experiments and aesthetic and sentient experiences. Perception becomes the decisive factor with the senses as operators for the building of consciousness through the subconscious. In this paper, an attempt at integrating the concepts of the “true”, the “right” and the “beautiful” with the aid of Nature’s wisdom is explained in more detail along with consequences. The author is a bioprocess engineer with a research interest in environmental issues.     

Against over-estimating the role of ethics in technology development

The role of ethics in technology development has been often questioned, especially in the early days of societal reflection of technology. However, the situation has changed dramatically. Ethical consideration now is generally declared to be indispensable in shaping technology in a socially acceptable and sustainable way. The expectations of ethics are large; often even a kind of “New Ethics” is postulated. In the present paper an over-estimation of the role of ethics for technology development is rejected. It is argued that ethical reflection is, indeed, indispensable in certain problem areas and situation types; but there is, on the other hand, space for technology development free from the requirement for ethical reflection. The absence of a requirement for ethical reflection, however, always has to be considered relative to some “morale provisoire” (provisional morality) as an accepted normative framework within which technology development may occur without explicit ethical reflection. If this framework, however, is doubted or is shown to be insufficient the situation changes completely. Ethical reflection in this case becomes necessary, to consider this normative framework in order to offer modifications or supplements.     

医务人员对医学科研伦理的认知及培训情况调查

调查某三甲医院医务人员对医学科研伦理的认知及培训情况。选取该院300名医务人员作为研究对象,了解其对医学伦理委员会的认知情况以及教育培训情况。结果显示,医务人员对医院设置医学伦理委员会、科研需通过委员会审核的认知及工作期间参加医学伦理学培训的占比分别为48.33%、39.33%和54.00%;医生对医学伦理委员会的知晓情况优于技师和护士,硕士及以上学历的医务人员对医学伦理委员会的知晓情况优于大专及以下学历,差异均有统计学意义(P<0.05)。医务人员对医学伦理学的认识不足,工作期间接受的培训也较少,医院应重视医学伦理学的建设工作。     

注重全人群、全方位、全过程——论受试者知情同意伦理审查的强化

通过对医药学研究人体试验受试者知情同意的伦理审查发展现状的说明,分析现阶段知情同意伦理审查工作中存在流于形式,审查结果不够科学、客观和公正等问题。再结合医药学研究的发展需要,说明知情同意伦理审查的工作情况和不断发展的要求。提出对知情同意做到全人群、全方位、全过程的伦理审查的覆盖。并通过实施全人群、全方位、全过程的伦理审查的过程,提高人体试验受试者知情同意伦理审查水平,促进医药学研究和社会医学的发展。     

浙江省三级医院伦理委员会运行现状调查及对策分析

自行设计问卷调查浙江省三级医院伦理委员会建设及运行现状,包括伦理委员会成立时间、设置数量、委员会组成人员、工作人员专职情况及是否有独立办公场地、每年审查项目数量、审查程序、审查时间及通过率,以及工作中存在的困难等。结果显示,浙江省三级医院伦理委员会设置率较高,达96.9%,委员人数设置合理,项目审查及时、高效,工作流程较为规范,但仍存在专职人员偏少,伦理审查工作量大,信息化程度低,资金及硬件设施支持不足等问题。伦理委员会需进一步完善人员选聘、准入机制,明确职责分工,加强审查人员伦理知识以及相关法律法规的培训及考核,建立健全伦理审查信息平台,并提供有利的资金支持和设施保障。