Medical Center Politics and Decisions: A Discussion

Presented as part of a symposium at the 1996 American Psychological Association Convention in Toronto, Canada, this paper reflects an historical overview of the political issues faced by psychologists in academic medical centers. Ivan Mensh, Ph.D., senior psychologist and founding member of the Association of Medical School Psychologists, suggests that those psychologists involved in medical education should learn who the decision makers are and how decisions are made at academic medical centers in order better to assure the continued viability of psychology in those settings.     

Referees, editors, and publication practices: Improving the reliability and usefulness of the peer review system

The documented low levels of reliability of the peer review process present a serious challenge to editors who must often base their publication decisions on conflicting referee recommendations. The purpose of this article is to discuss this process and examine ways to produce a more reliable and useful peer review system. The author is a Senior Research Scientist & Biostatistician, Child Study Center and Department of Psychiatry in the Yale University School of Medicine. Note: The main points of this report were presented at the Annual Meeting of the American Association for the Advancement of Science (AAAS) in Baltimore, Maryland, on February 9, 1996.     

Advance Directives Outside the USA: Are They the Best Solution Everywhere?

This article evaluates the potential role of advance directives outside of their original North American context. In order to do this, the article first analyses the historical process which has promoted advance directives in recent years. Next, it brings to light certain presuppositions which have given them force: atomistic individualism, contractualism, consumerism and entrepreneurialism, pluralism, proceduralism, and American moralism. The article next studies certain European cultural peculiarities which could affect advance directives: the importance of virtue versus rights, stoicism versus consumerist utilitarianism, rationalism versus empiricism, statism versus citizens' initiative, and justice versus autonomy.The article concludes by recognising that autonomy has a transcultural value, although it must be balanced with other principles. Advance Directives can have a function in certain cases. But it does not seem adequate to delegate to advance directives more and more medical decisions, and to make them more binding everyday. It is indispensable to develop other decision-making criteria.     

同性恋的社会伦理评价

按照WHO的健康定义与Engel疾病模式,同性恋仍然是一种疾病;也仍然是一种性偏离或性变异。同性恋如同其他性行为或性变异一样,必须受到社会控制和道德控制。而男同性恋对艾滋病传播的负面影响绝不能忽视。     

循证医学与医学教育改革

循证医学这一新的医疗模式反映了世界医学的发展趋势,代表了现代医学的前进方向。医学教育必须应这一趋势,按照循证医学的基本精神促进观念更新,推进医疗模式、教学内容、教学方法和继续教育等方面的改革,全面提高医学教育质量。     

论医学人文精神的重塑

重塑医学人文精神是一个无法回避而又必须作出回答的紧迫问题。把现代医学技术放到人文哲学的大视野中去体认,从人学本体论意义上现代医学技术的价值理性,进一步澄清人们对医学技术无限崇拜的工具理性的错误认识;阐述了现代医学人文精神的内涵,认为以人为本,确立科学理性对医学技术的指导地位,适时约束医学技术行为应该成为现代医学人文精神的核心理念;提出了重塑现代医学人文精神的基本原则,即：坚持医学技术进步与人的全面发展相一致的原则,坚持医学技术进步与医学工作者道德健全相一致的原则,坚持医学进步与卫生事业持续、协调、健康发展相一致的原则。     

论《医疗事故处理条例》的特点和作用

与1987年颁布的《医疗事故处理办法》相比,国务院2002年4月颁布的《医疗事故处理条例》具有系统性,科学性,透明性,公正性,可操作性等特点,一方面,条例为我们提供了一套相对公正有效的医疗纠纷处理程序,另一方面,程序本身所具有的正当性对于防范医疗纠纷,维护社会安定团结以及缓和医患邓质样具有重要的意义。     

关于癌症病人知情权问题探讨

目前全球癌患者人数超过1000万,中国每年新增癌症病例约160万,探讨如何处理癌症病人的知情权问题,贴近社会公众,具有重要的现实意义.     

医学院校教学医院临床实践教学的现状与对策

国家赋予医学院校教学医院救死扶伤和教书育人的两个职能,它在现行医疗体制改革的情况下与病人的维权发生了激烈的碰撞,临床实践教学出现了滑坡现象.在分析了医学院校教学医院临床实践教学现状的基础上,作者试从制定相应法规,保障临床实践教学;践行行医准则,尊重病人权利等几个方面进行了阐述,以期保证医学院校教学医院临床实践教学的质量.     

21世纪新的医学目标与高等医学教育改革

面对21世纪社会发展和卫生保健系统的新困境,传统的医学目标遇到很多挑战,现代医学的目标已经形成新的目标.医学教育改革必须适应新的医学目标,以培养高素质医学人才.