Re-Evaluating Professional Autonomy in Health Care

Professional autonomy, as the symbol of the traditional freedom ofdecision-making of medical professionals is criticized. This essayexamines the critique. It analyses the underlying assumption that theautonomy of health professionals is incompatible with the need fororganisation and management in order to control rising health carecosts. It is argued that the concept of professional autonomy should beredefined, not through restricting the decision-making freedom ofindividual health professionals, but through expanding the concept intothe sphere of management, so that managers will take responsibility forpatient care.     

Trust and the Healing Encounter: An Examination of an Unorthodox Healing Performance

Just why a patient should trust a particular healer isa question that has not been adequately explored inthe literature on healing. This ethnographiccase-report examines the healing performance of achiropractor and proposes that it contains fourintrinsic claims to trustworthiness: he claims to bea qualified and sincere healer who is inpossession of knowledge and techniques that derivetheir power from their truth content and whichempower him to make beneficial changes in thepatient. Taking each claim in turn I described thenature of the claim, how it might be adequatelyvalidated, ways in which his healing performance mightvalidate it and how he might be assisted by thepatient, and how their actual validation may bedistorted by the healer and patient. It is suggestedthat while unusual in many regards, this unorthodoxhealing performance may be a foil by which toexamine other more orthodox healing performances.     

从中西医学的竞争和渗透谈现代中医临床思维的变革

现代中医的临床思维正在发生着变革,一个以辨病为纲,辨证为目,辨病论治为经,辨证论治为纬的临床思维新模式,已经呼之欲出。这正是２１世纪中医学发展的必由之路,学术界必从唯物辩证法的角度来审视这场变革,并因其势而利导之。     

关于“中西医结合”基本概念的认识

本文对“中西医结合”、“中西医结合方法”、“中西医结合人才”、“中西医结合机构”、“中西医结合学科”、“中西医结合理论”、“中西医结合医学模式”及“中西医结合医学”等概念与定义,根据逻辑学原则予以分判。表明“中西医结合”的同类概念完全可以客观地被决定。     

Effects of perceived weight discrimination on willingness to adopt unhealthy behaviours: influence of genomic information

Objective: Weight-based discrimination negatively influences health, potentially via increased willingness to engage in unhealthful behaviours. This study examines whether the provision of genomic obesity information in a clinical context can lead to less willingness to engage in unhealthy eating and alcohol consumption through a mediated process including reduced perceptions of blame and discrimination.

Design: A total of 201 overweight or obese women aged 20–50 interacted with a virtual physician in a simulated clinical primary care environment, which included physician-delivered information that emphasised either genomic or behavioural underpinnings of weight and weight loss.

Main Outcome Measures: Perceived blame and weight discrimination from the doctor, and willingness to eat unhealthy foods and consume alcohol.

Results: Controlling for BMI and race, participants who received genomic information perceived less blame from the doctor than participants who received behavioural information. In a serial multiple mediation model, reduced perceived blame was associated with less perceived discrimination, and in turn, lower willingness to eat unhealthy foods and drink alcohol.

Conclusion: Providing patients with genomic information about weight and weight loss may positively influence interpersonal dynamics between patients and providers by reducing perceived blame and perceived discrimination. These improved dynamics, in turn, positively influence health cognitions.     

当今中国人人际关系与身心健康的关系──社会心理医学研究

从全国29个省、市、自治区回收的1433份有效问卷的统计结果显示,人们的人际关系与身体健康和心理健康是密切关联、相互影响的,人际关系高度影响身体健康和心理健康,但其对于心理健康的影响作用,比之对身体健康更大。     

关于医学与理工科学的比较及其结合

生物医学工程是医学与理工科学之间的一门交叉学科,近年发展十分迅速,但理工科学与医学具有非常不同的学科特点,充分认识其间的差异是非常必要和重要的。本文从认识论与方法论的角度讨论了医学研究与理工科学的不同特点及相应的问题,分析了医工结合的主要困难,提出了加强与改进医学与理工科学结合的途径。     

Clinical specificity and the non-generalities of science

Theoretical Medicine and Bioethics - How to improve clinical practice and, in particular, that of physical therapy? Currently, several strategies are used which all fit the label...     

Hermeneutics and the Philosophy of Medicine: Hans-Georg Gadamer'sPlatonic Metaphor

Taking as our starting point Plato'smetaphor of the doctor as philosopher we reflect on some aspects of the epistemological status of medicine. The framework to this paper is the hermeneutics of Hans-Georg Gadamer which shows the paradoxical nature of Western medicine in choosing the body-object as its investigative starting point, while in actual fact dealing with subjects. Gadamer proposes a model of medicine as the art of understanding and dialogue, which is capable of bringing together its various constituent parts, i.e. knowledge, knowing how to do and knowing how to be, in medical practice and in the physician'straining. The paper concludes with a brief discussion of the dyadic figure of the physician as Platonic master of the living totality and wounded healer, capable of activating the patient'sself-healing capacity.     

The Role of Science in Medicine

Theoretical Medicine and Bioethics - A suitable demarcation between pure science and applied research can be drawn in terms of their goals. This distinction of goals has methodological and cultural...