论医学生从业素质的要求与培养

21世纪的高等医学教育应该适应卫生事业发展、医学模式转变,特别是社会进步与医学科学发展的宏观背景,以综合素质、创新能力和创新精神、适应社会需求、多维学科结构等要素为培养目标,以脑科学研究和信息技术为重要手段,改革和构建21世纪医学教育新模式,以培养出更多优秀的21世纪所需要的创造性医学人才。     

吉林省医务人员吸烟现况及知识态度分析

为了更好地了解吉林省医务人员的吸烟状况,为进一步开展控烟工作提供科学依据,对吉林省50家医疗机构的3787名医务人员进行问卷调查,调查结果显示,男性医务人员吸烟率较高；医务人员对烟草危害认识不全面,控烟意识较为薄弱.应加强对医务人员烟害知识等方面的培训,以改变其吸烟行为、提高控烟责任意识.     

国内外农村医疗保障的政府规制比较分析

运用政府规制理论，从政府规制机构、政府规制标准和对筹资的规制三个方面对国内外农村医疗保障中的政府规制进行比较分析，从而启发我们要精简规制机构，提高规制效率；完善规制标准，提高规制效力；用法律来规制各级政府对医疗保障补助资金的转移支付。     

Germ-line gene therapy and the clinical ethos of medical genetics

Although the ability to perform gene therapy in human germ-line cells is still hypothetical, the rate of progress in molecular and cell biology suggests that it will only be a matter of time before reliable clinical techniques will be within reach. Three sets of arguments are commonly advanced against developing those techniques, respectively pointing to the clinical risks, social dangers and better alternatives. In this paper we analyze those arguments from the perspective of the client-centered ethos that traditionally governs practice in medical genetics. This perspective clarifies the merits of these arguments for geneticists, and suggests useful new directions for the professional discussion of germ-line gene therapy. It suggests, for example, that the much discussed prospect of germ-line therapy in human pre-embryos may always be more problematic for medical genetics than adult germ-line interventions, even though the latter faces greater technical difficulties.     

Political and interpersonal aspects of ethics consultation

Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff seem important, especially where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record.     

Report of the Working Group on Governance and Administration

Prepared by the Working Group on Governance and Administration from the November 1995 Georgetown conference sponsored by the Association of Medical School Psychologists, this paper delineates the various trends in health care that may impact upon organizational structures for psychologists within academic medical centers. Ten variables that describe various functional issues within academic medical centers or health science centers are defined. Finally, seven organizational guidelines and recommendations pertaining to governance of psychological services are detailed.     

Marketing Psychology at Academic Health Centers

The administrative structure of academic health centers is reviewed, with a view to understanding the issues of marketing psychological services within that setting. The slow changes at academic health centers to new practice styles requires psychology to formulate a market strategy addressing the traditional specialist model and another plan responsive to the emerging model emphasizing primary care. Market targets for psychologists include administration, physicians, and patients. Presently, the Association of Medical School Psychologists is working with the Association of Academic Health Centers to design a marketing program targeting leaders at academic health centers.     

The clinical psychologist as program consultant: When is enough enough?

One of the most influential roles clinical psychologists play in health care settings is as consultant to medical colleagues. The psychologist consultant typically approaches either clinical or programmatic questions intending to tap both empirical research and clinical judgment perspectives in trying to answer them. This paper describes a specific “program consultation case,” a not atypical consultation situation in which graduate medical education directors asked for advice about their residency training program. The purpose is to use this example to generate ideas and provoke discussion about such consultation processes and their usefulness in the health care training and service delivery world. The psychologist may be faced with questions that have meaningful implications beyond the specific consultation. What if the concerns being posed by this particular program are concerns which have been raised before, have been researched before, and have generated reasonable suggestions, conclusions, and strategies for improvement? And what if no one has paid attention, so that the questions are being raised again? When empirical and clinical data consistently combine to identify problems within health-related training or service delivery systems, and when suggestions or alternatives for their solutions have been presented and, also presumably, ignored, what does the clinical psychologist consultant do next?     

The anthropological tradition in the philosophy of medicine

The tradition of anthropological medicine in philosophy of medicine is analyzed in relation to the earlier interest in epistemological issues in medicine around the turn of the century as well as to the current interest in medical ethics. It is argued that there is a continuity between epistemological, anthropological and ethical approaches in philosophy of medicine. Three basic ideas of anthropologically-oriented medicine are discussed: the rejection of Cartesian dualism, the notion of medicine as science of the human person, and the necessity of a comprehensive understanding of disease. Next, it is discussed why the anthropological movement has been superseded by the increasing interest in medical ethics. It is concluded that the present-day moral issues cannot be interpreted and resolved without clarification of the underlying anthropological images.     

AIDS and ‘dirt’: Reflections on the ethics of ritual cleanliness

AIDS and the responses and attitudes it evokes surpass the analytic abilities of standard bioethics. These responses and attitudes are explored in terms of literary and anthropological categories, such as dirt, disorder, pollution and ritual cleanliness. Implications for medical education are suggested.