知情同意的临床实践存在的问题及对策

临床医疗实践中贯彻实施知情同意原则旨在保护病人的权益不受侵犯,然而知情同意原则实施起来并不简单,它常常会受到主客体两方面种种因素的制约,陷入意想不到的困境。分析了知情同意原则在实施过程中可能出现的一些难以回避的问题,并针对这些问题探讨了若干对策。     

JUST WAR THEORY,HUMANITARIAN INTERVENTION,AND THE NEED FOR A DEMOCRATIC FEDERATION

The primary purpose of government is to secure public goods that cannot be achieved by free markets. The Coordination Principle tells us to consolidate sovereign power in a single institution to overcome collective action problems that otherwise prevent secure provision of the relevant public goods. There are several public goods that require such coordination at the global level, chief among them being basic human rights. The claim that human rights require global coordination is supported in three main steps. First, I consider Pogge's and Habermas's analyses as alternatives to Hobbesian conceptions of justice. Second, I consider the core conventions of international law, which are in tension with the primacy of state sovereignty in the UN system. Third, I argue that the just war tradition does not limit just causes for war to self‐defense; it supports saving innocent third parties from crimes against humanity as a just reason for war. While classical authors focused less on this issue, the point is especially clear in twentieth‐century just war theories, such as those offered by the American Catholic bishops, Jean Elshtain, Brian Orend, and Michael Walzer. Against Walzer, I argue that we add intractable military tyranny to the list of horrors meriting intervention if other ad bellum conditions are met. But these results require us to reexamine the “just authority” of first resort to govern such interventions. The Coordination Principle implies that we should create a transnational federation with consolidated powers in place of a treaty organization requiring near‐unanimity. But to be legitimate, such a global institution must also be directly answerable to the citizens of its member states. While the UN Security Council is inadequate on both counts, a federation of democracies with a directly elected executive and legislature could meet both conditions.     

A JEWISH CONCEPTION OF HUMAN DIGNITY

This paper depicts the meanings of human dignity as they unfold and evolve in the Bible and the Halakhah. I posit that three distinct features of a Jewish conception of human dignity can be identified in contrast to core characteristics of a liberal conception of human dignity. First, the original source of human dignity is not intrinsic to the human being but extrinsic, namely in God. Second, it is argued that the “dignity of the people” has precedence over personal autonomy and liberty, which are core liberal pillars. The third characteristic pertains to the potential conflict between personal autonomy and liberty, and God's commandments. The theoretical analysis of human dignity is then examined in light of several Supreme Court decisions in Israel during the 1990s. I illustrate that Jewish religious and secular‐liberal conceptions pull in different directions in the rulings of liberal and religious Justices in Israel.     

THE ETHICS OF LAND RESTITUTION

Many indigenous communities were dispossessed of their land during the period of colonial rule. This long process resulted in forced demographic removals and perennial poverty. Nowadays these communities, especially Third World groups, seek redress of this situation through legal processes of land restitution. This process is met by resistance from landowners in these countries, the colonial powers of old, as well as from big corporations that benefited from the dispossession. The investigation undertaken in this article addresses the ethics of land reform from a Christian ethical perspective. The policy of land restitution in South Africa is used as a case study, but the results of this research are also applicable to other parts of the world where land restitution is considered. The article first evaluates the biblical teachings of land and land reform and their implications for modern ethics. In the light of these issues, the article addresses the question of whether land ownership can be considered as a fundamental human right. The article also focuses on the legality of expropriation and dispossession of land for the purposes of restitution. Moreover, guidelines for fair and legal restitution within the context of Christian ethics and legal philosophical principles are proposed.     

Is subjective ambivalence toward gays a modern form of bias?

Theoretically, modern racism and sexism are characterized by ambivalence. We directly examined the consequence of being higher in subjective ambivalence toward gays (i.e. attitudes that feel “torn”) with regard to gay rights support. In Study 1, greater subjective ambivalence was associated with more negative attitudes (and not more positive attitudes), more ideological opposition to gays, more negative intergroup emotions, and less gay rights support. In Study 2, less opposition to gay bullying was predicted by: (a) greater subjective ambivalence (through lower intergroup empathy); and (b) experimentally-salient bullying justification norms (through lower collective guilt). These effects held controlling for Attitudes toward Lesbians and Gay Men (i.e., traditional negative attitudes). Although not overtly negative, individual differences in subjective ambivalence tap a unique, subtle, and less objectionable form of bias, consistent with aversive racism and justification–suppression frameworks of explaining modern biases.     

THE RIGHTS OF MUSLIM WOMEN: A Comment on Irene Oh's The Rights of God

This review of Irene Oh's The Rights of God focuses on women's rights in Islamic theory and practice. Oh suggests that religious establishments, and the texts they disseminate, often press believers to recognize and reject social problems, such as racial and gender discrimination. Islamic scholars and texts have played a more ambiguous role in efforts to recognize women's rights within Muslim states. Modernist intellectuals have used Islamic texts to support the advancement of women's rights, but members of the more conservative religious establishment have typically curbed or rejected these efforts. Muslim women themselves have established various responses to the question of Islam's compatibility with women's rights. While some embrace the value and compatibility of both, others reject the propriety of either Western conceptions of rights, or the Islamic tradition, as harmful for women. Muslim reformers and feminists have much to learn from comparative studies with other faith communities that have undergone similar struggles and transformations.     

Libertarianism vs. Marxism: Reflections on G. A. Cohen‘s Self-Ownership, Freedom and Equality

Self-Ownership, Freedom and Equality is G.A. Cohens attempt to rescue something of the socialist outlook on society from the challenge of libertarianism, which Cohen identifies with the work of Robert Nozick in his famous book, Anarchy, State, and Utopia. Sympathizing with the leading idea that a person must belong to himself, and thus be unavailable for forced redistribution of his efforts, Cohen is at pains to reconcile the two. This cannot be done – they are flatly contrary. Moreover, equality is a nonsense principle, calling for such things as equal distribution of natural resources. But resources, as goods, are not natural: all require work to utilize. The only thing exchanged on markets is services, and estimates of value received are relevantly made only by those party to the exchanges in question. Imposition from above on voluntary exchange can only be socially counterproductive.     

Introduction: An Emerging Consensus?

This paper is an introduction to a special issue on Nationalism, Multiculturalism and Liberal Democracy. It attempts to describe the state of the debate on issues of multiculturalism and nationalism within liberal-democratic theory. I suggest that there may be an emerging consensus on liberal culturalism – the view that certain group-specific rights or policies aimed at recognizing or accommodating ethnic and national groups are legitimate so long as they operate within certain constraints of liberal justice. I explore the possible reasons for this emerging consensus (including the lack of clear alternatives), and conclude with some suggestions about the likely avenues for future research in this area.