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。     

DEFLATIONISM,CONSERVATIVENESS AND MAXIMALITY

We discuss two desirable properties of deflationary truth theories: conservativeness and maximality. Joining them together, we obtain a notion of a maximal conservative truth theory – a theory which is conservative over its base, but can’t be enlarged any further without losing its conservative character. There are indeed such theories; we show however that none of them is axiomatizable, and moreover, that there will be in fact continuum many theories of this sort. It turns out in effect that the deflationist still needs some additional principles, which would permit him to construct his preferred theory of truth.     

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.     

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.     

INTRODUCTION: RETHINKING PHILOSOPHICAL PRESUMPTIONS IN LIGHT OF COGNITIVE DISABILITY

Abstract: This Introduction to the collection of essays surveys the philosophical literature to date with respect to five central questions: justice, care, agency, metaphilosophical issues regarding the language and representation of cognitive disability, and personhood. These themes are discussed in relation to three specific conditions: intellectual and developmental disabilities, Alzheimer's disease, and autism, though the issues raised are relevant to a broad range of cognitive disabilities. The Introduction offers a brief historical overview of the treatment cognitive disability has received from philosophers, and explains the specific challenges that cognitive disability poses to philosophy. In briefly summarizing the essays in the collection, it highlights the distinctive contributions the collection makes to ethics, political philosophy, bioethics, and the philosophy of disability. We hope that the richness of the topics explored by these essays will be a spur to further investigation.     

SPECIESISM AND MORAL STATUS

Abstract: Many people believe that all human life is of equal value. Most of them also believe that all human beings have a moral status superior to that of nonhuman animals. But how are these beliefs to be defended? The mere difference of species cannot in itself determine moral status. The most obvious candidate for regarding human beings as having a higher moral status than animals is the superior cognitive capacity of humans. People with profound mental retardation pose a problem for this set of beliefs, because their cognitive capacities are not superior to those of many animals. I argue that we should drop the belief in the equal value of human life, replacing it with a graduated view that applies to animals as well as to humans.     

COGNITIVE DISABILITY AND COGNITIVE ENHANCEMENT

Abstract: This essay explores problems of consistency among commonsense beliefs about the comparative moral status of animals, fetuses, and human beings congenitally endowed with cognitive capacities and potential no higher than those of higher animals. The possibility of genetic cognitive enhancement exacerbates some of these problems, but also offers new resources for understanding the basis of our moral status as inviolable.     

When a man hits a woman: moral evaluations and reporting violence to the police

We use experimental data from a nationally representative sample to examine whether gender and the victim's relationship to the offender affect attitudes about the seriousness of the offense and whether the offense should be reported to the police. We find that respondents are particularly likely to condemn men's assaults on women, and to favor reporting them. The pattern appears to reflect both greater moral condemnation of men's assaults on women and the belief that the victims of these assaults are in greater danger. In general, moral judgments and attitudes toward reporting do not depend on the gender, age, level of education, or political ideology of the respondent. Condemnation of men's violence against women, and support for police intervention when it occurs, are apparently widespread across different segments of the population. Aggr. Behav. 35:477–488, 2009. © 2009 Wiley‐Liss, Inc.     

Regression I. Experimental approaches to regression

The concept of regression is considered with an emphasis on the differences between the positions of Freud and Jung regarding its significance. The paper discusses the results of experimental analyses of individual experience dynamics (from gene expression changes and impulse neuronal activity in animals to prosocial behaviour in healthy humans at different ages, and humans in chronic pain) in those situations where regression occurs: stress, disease, learning, highly emotional states and alcohol intoxication. Common mechanisms of regression in all these situations are proposed. The mechanisms of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the representation of low-differentiated (older) systems in the actualized experience. In all of the cases of dedifferentiation mentioned above, the complexity of the systemic organization of behaviour significantly decreases.