医学专业精神的初步研究

由于历史和社会文化的差异,中西方对医学专业精神有着不同的理解。在中西不同语境下,分析了“Profession”和“Professionalism”这两个核心概念的涵义,并从中西对比的视角,对中西方医学专业精神所面临的几个共同问题进行了初步研究,包括医学专业核心道德价值观念、利益冲突、行业自治等。在此基础之上,还对我国医学专业精神的发展提出建议。     

中国传统伦理对医院道德管理之贡献

随着经济的腾飞,儒家管理思想在文化、伦理道德层面上给予医院经营管理以深刻影响。在医院道德管理的建设中,中国传统儒家伦理起着重要的作用,“仁”是医院经营发展的中心,“义”是医院经营立足的根本,“礼”是医院经营成功的保证,“智”是医院经营腾飞的关键,“信”是医院经营兴旺的标志。     

防范医疗纠纷的载体建设——天津市人民医院投诉中心的绩效浅析

利用现代医学伦理的人本理念,将投诉中心作为防范医疗纠纷的载体,有效地解决就医者的投诉接待和处理,无疑是一种全新的理念和尝试。通过对投诉制度建设、投诉处理标准化流程、有效投诉信息的利用等方面的经验性论述,阐明了投诉中心的载体建设,为减少医疗纠纷、加强伦理道德建设、构建和谐的医患关系产生了积极的作用。     

MORAL REFORM,MORAL DISAGREEMENT,AND ABORTION

Abstract: Bernard Gert argues that legitimate moral disagreement calls for tolerance and moral humility; when there is more than one morally acceptable course of action, then intolerance and what Gert calls “moral arrogance” would be objectionable. This article identifies some possible difficulties in distinguishing moral arrogance from moral reform and then examines Gert's treatment of abortion as a contemporary example of moral disagreement that he characterizes as irresolvable.     

Categorical Ontology of Levels and Emergent Complexity: An Introduction

An overview of the following three related papers in this issue presents the Emergence of Highly Complex Systems such as living organisms, man, society and the human mind from the viewpoint of the current Ontological Theory of Levels. The ontology of spacetime structures in the Universe is discussed beginning with the quantum level; then, the striking emergence of the higher levels of reality is examined from a categorical—relational and logical viewpoint. The ontological problems and methodology aspects discussed in the first two papers are followed by a rigorous paper based on Category Theory, Algebraic Topology and Logic that provides a conceptual and mathematical basis for a Categorical Ontology Theory of Levels. The essential links and relationships between the following three papers of this issue are pointed out, and further possible developments are being considered.     

On Being Responsible and Holding Responsible

A number of philosophers have recently argued that we should interpret the debate over moral responsibility as a debate over the conditions under which it would be “fair” to blame a person for her attitudes or conduct. What is distinctive about these accounts is that they begin with the stance of the moral judge, rather than that of the agent who is judged, and make attributions of responsibility dependent upon whether it would be fair or appropriate for a moral judge to react to the agent in various (negative) ways. This is problematic, I argue, because our intuitions about whether and when it would be fair to react negatively to another are sensitive to a host of considerations that appear to have little or nothing to do with an agent’s responsibility or culpability for her attitudes or behavior. If this is correct, then theories which make attributions of responsibility dependent upon the appropriateness of our reactions as moral judges will turn out to be fundamentally misguided. I am grateful to Barbara Herman, T. M. Scanlon, and two anonymous reviewers for The Journal of Ethics for their helpful comments on earlier drafts of this paper. I am also grateful to Pamela Hieronymi and the members of her Fall 2201 graduate seminar on moral responsibility at UCLA, and to the audience members at Simon Fraser University, for their valuable feedback on earlier versions of this material. My biggest debt of gratitude goes to Jean Roberts, for stimulating discussion and insightful commentary on multiple drafts of this paper.     

More on the Motive of Duty

A number of neo-Kantians have suggested that an act may be morally worthy even if sympathy and similar emotions are present, so long as they are not what in fact motivates right action–so long as duty, and duty alone, in fact motivates. Thus, the ideal Kantian moral agent need not be a cold and unfeeling person, as some critics have suggested. Two objections to this view need to be answered. First, some maintain that motives cannot be present without in fact motivating. Such non-motivating reasons, it is claimed, are incoherent. Second, if such motives are not in fact motivating, then nonetheless the moral agent's performance of right action will be objectionably cold and unfeeling. While the first objection is not compelling, since the alternative according to which all motives in fact motivate but differ in strength suffers from the very same problems attributed to the neo-Kantian view, the second has force, and any account of moral worth must make room for motives such as sympathy actually motivating right action.     

With Hope and Imagination: Imaginative Moral Decision-Making in Neonatal Intensive Care Units

Although the role of imagination in moral reasoning is often neglected, recent literature, mostly of pragmatist signature, points to imagination as one of its central elements. In this article we develop some of their arguments by looking at the moral role of imagination in practice, in particular the practice of neonatal intensive care. Drawing on empirical research, we analyze a decision-making process in various stages: delivery, staff meeting, and reflection afterwards. We show how imagination aids medical practitioners demarcating moral categories, tuning their actions, and exploring long-range consequences of decisions. We argue that imagination helps to bring about at least four kinds of integration in the moral decision-making process: personal integration by creating a moral self-image in moments of reflection; social integration by aiding the conciliation of the diverging perspectives of the people involved; temporal integration by facilitating the parties to transcend the present moment and connect past, present, and future; and epistemological integration by helping to combine the various forms of knowledge and experience needed to make moral decisions. Furthermore, we argue that the role of imagination in these moral decision-processes is limited in several significant ways. Rather than being a solution itself, it is merely an aid and cannot replace the decision itself. Finally, there are also limits to the practical relevance of this theoretical reflection. In the end, it is up to care professionals as reflective practitioners to re-imagine the practice of intensive care and make the right decisions with hope and imagination.

道德敏感性的研究现状与展望

道德敏感性是对情境的道德含意的领悟和解释能力,是道德行为产生过程中逻辑上的初始心理成分。道德敏感性与个体对情境的自动化加工及其伴随着的直觉情绪有着密切的关系。情境的背景与特征,个体的角色卷入、道德图式以及人格特点等因素都可能影响个体的道德敏感性。道德敏感性研究已在儿童早期发展、职业伦理以及测验方法等领域取得一定成果,但其理论构建仍需进一步完善、深化,与教育干预密切相关的发展研究有待加强,研究方法也需拓展和改进     

情绪状态对大学生道德判断能力的影响

采用道德判断测验(MJT中文版),以300名大学生为被试,考察了情绪状态对大学生道德判断能力的影响。结果发现:(1)大学生道德判断能力的年级差异显著;(2)情绪状态对大学生道德判断能力具有显著影响,快乐状态下的道德判断能力高于悲伤状态,这与国外的研究结论正好相反;(3)道德判断任务的自我相关性对大学生道德判断能力的影响不显著。