猝死、医疗纠纷与尸体剖检

貌似“健康”的人突然死亡(即猝死),由于事先无任何预兆,出乎人们意料往往使人们对死因产生怀疑,若死者是在因病就医过程中突然死亡,特别是在刚注射或服药后死亡,很容易被认为是医护人员的医疗活动及其相关活动有问题而引发医疗纠纷,每位医务人员应高度重视,若死因不明,尸检则是解决这一棘手问题的关键。     

心理学在社会服务体系中作用的思考——以复原力建设为例

在社会心理服务体系建设中, 心理学到底起着什么样的作用?怎样才能更好地构建全面系统的多主体社会心理服务体系?在社会心理服务体系建设中如何推动心理学自身的发展?这些问题一直受到广大心理学者的关注。以复原力为例, 通过对个体、团队以及社区心理复原力建设路径的理论总结, 加上实践案例, 以期为社会心理服务体系建设提供知识借鉴与参考, 并反思心理学在此过程中的作用与角色。心理学专业研究团队可以通过整合其在社会支持体系中的应用, 推动心理学在社会服务体系中的应用。     

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.     

新型农村合作医疗制度进一步发展的瓶颈分析

提出制约新农合制度发展的瓶颈有：筹资方式及筹资成本问题、筹资水平、补偿内容的设计问题、过多照搬了城镇职工基本医疗保险的资金管理方式、管理能力与管理手段、位于卫生局内的合管办、无法实现“解决因病致贫、因病返贫”的政策目标。     

Attention-Deficit Hyperactivity Disorder: The Medicalization of Misbehavior

During the past decade, there has been an increase in the diagnosis and treatment of Attention-Deficit Hyperactivity Disorder (ADHD). This syndrome, typically diagnosed in childhood, is characterized by inattention, hyperactive motor behavior, and distractibility. Current prevalence rates obtained in various countries generally exceed the 3–5% reported by DSM-IV. Reasons for increased ADHD prevalence include changes in diagnostic standards, overlap between ADHD and other externalizing disorders, nonspecific behavioral criteria, and the rapid effects of stimulant medication on cognitive functioning. However, social, cultural, and economic factors may also contribute to increased diagnosis. ADHD has become a common topic in the lay media. Popular discussions of ADHD may serve as a metaphoric expression of social anxieties, particularly with respect to children. At the same time, ADHD has rapidly become incorporated into a medical model, with emphasis on pharmacological treatment. Reductions in mental health and educational services, as well as economic pressures of managed care, may also contribute to medicalization of behavioral problems. Collaboration between psychologists and primary care physicians can lead to more accurate diagnosis and appropriate treatment of ADHD and related disorders.     

Long Term Outcomes to Family Caregiver Empowerment

The Vanderbilt Caregiver Empowerment Project evaluated a training program designed to enhance empowerment of caregiver and their subsequent involvement in the mental health treatment of their children. The intervention utilized a multi-component parent training curriculum that was designed to enhance: (a) knowledge of the service system; (b) skills needed to interact with the mental health system; and (c) the caregiver' s mental health services self-efficacy designed to improve caregivers beliefs in their ability to collaborate with service providers. The resulting increased empowerment was hypothesized to increase caretaker involvement, which should affect service use and ultimately the mental health status of the child. A randomized design was used to test the effectiveness of this model with caregivers of children receiving mental health services. The results one-year after the training replicated the intermediate outcomes of the project conducted 3-months after the training. The initial training continued to significantly influence the parent's knowledge and mental health services self-efficacy. However, the intervention had no effect on caregiver involvement in treatment, service use or the mental health status of the children.     

Sexual ethics and communal judgments: on the pluralism of virtues, values, and practices.

Different judgments by Christian communities on issues in sexual ethics involve different weightings of various sources of moral authority, different understandings of the normativity of the natural, and different assessments of the scope of freedom to be exercised in relation to the goods of marriage. These fundamental differences of interpretation can be exemplified by the ongoing Roman Catholic discussion of the legitimacy of voluntary sterilization in certain "hard cases." The contributors to this issue of Christian Bioethics, in their spirited exchange on that issue, exemplify the need for careful attention to the ways that differences of theological emphasis and moral method lead to different judgements in particular cases, both within and between particular Christian communities.     

Medical semiotics in the 18th century: A theory of practice?

Medical semiotics in the 18th century was more than a premodern form of diagnosis. Its structure allowed for the combination of empirically proven rules of instruction with the theoretical knowledge of the new sciences, employing the relation between the sign and the signified.     

Prescriptions: Autonomy,Humanism and the Purpose of Health Technology

My purpose is to examine two of the foundations of medical ethics: the principle of autonomy and the concept of the human. I also investigate the extent to which health technology makes autonomy and humanness possible. I begin by underlining Illich's point that the same health technology designed to promote health and autonomy also is pathogenic. I proceed to analyse the Kantian concept of autonomy, a concept which is closely associated with health and which continues to determine current ethical thinking. In so doing, I uncover an unexpected ontological function of health technology, a function described in Heidegger's work on technology. Based on this discovery, I suggest that calls for Kantian autonomy may often be self-defeating or even sometimes harmful. I conclude by calling for continued ethical vigilance, but also for a questioning of the hitherto virtually unquestionable concepts of ethics and humanness which may themselves play a role in our era's greatest problems.