卫生保健政策与医学伦理学

卫生保健政策是卫生资源、价值目标和伦理原则三者的结合。医学伦理学是卫生政策的重要基础。当代卫生事业的特点,卫生保健服务面临的挑战以及医学伦理主体与客体的变化,决定了医学伦理学在当代卫生保健政策中的特殊意义。在医学面临全民保健的阶段,一个科学的符合人民健康利益的卫生保健政策是不言而喻的。摆脱当前卫生政策面临的困难,要求必须在医学伦理学方面作出正确的选择。     

Cultural Similarity, Foreign Policy Actions, and Regime Perception: An Experimental Study of International Cues and Democratic Peace

This study examines previous explanations of democratic peace in light of sociocultural factors and foreign policy actions that influence public perceptions of another country. Two experiments assessed the effects of relevant sociocultural and foreign policy action cues on perception of the regime type of a target nation and on public approval of the use of force. The findings suggest that sociocultural cues affect regime perception. Moreover, perceived similarity of a target nation and foreign policy actions are significant determinants of the public approval of the use of force in addition to perceptions of regime type.     

The relation of learning disabilities to the long-term outcomes of concussion

ObjectiveThis study sought to cross-sectionally evaluate the relation between learning disorders (LD) and long-term concussion outcomes.MethodSeventy-three asymptomatic male university athletes (23 history of concussion with LD; 24 history of concussion no LD; 26 controls) completed the Beck Depression Inventory-2 (BDI-II), the Profile of Mood States (POMS), the Cogstate battery, and an Oddball task during which event-related brain potentials were recorded.ResultsConcussed athletes with LD exhibited greater depressive symptoms (BDI-II), greater total mood disturbance (POMS), decreased accuracy on the One-Card Learning and the N-back task (Cogstate), decreased accuracy on the Oddball task, and reduced ERN amplitude relative to both the concussed athletes without a LD and controls. Concussed athletes with LD also exhibited prolonged P3 latency relative to controls. Irrespective of LD, concussed athletes exhibited increased anger-hostility and decreased Pe amplitudes relative to controls. No differences were observed in P3a amplitude or latency.ConclusionHaving LD may be a significant factor moderating the neurophysiological, cognitive and psycho-affective outcomes of concussion, and may explain a significant portion of the persistent deficits observed by researchers and clinicians.     

The complex challenges of ethical choices by engineers in public service

This paper proposes that engineers in public service are confronted with unavoidable complexity in their ethical considerations. The complexity begins with interactions among venues of ethical choices. Engineers must make ethical choices simultaneously at the individual, professional, organizational and societal levels. These ethical domains often conflict. The complexity also stems from situations in which physical properties may remain stable, but important social, economic, institutional and political conditions can change substantially. The paper proposes that the reflective learning approach of pragmatism can help with these challenging situations. This approach depends upon employing Dewey’s five stage process of inquiry to engage the ethical complexity inherent in the practice of engineering in the public service. An earlier version of this paper was presented at the 2005 conference, Ethics and Social Responsibility in Engineering and Technology, Linking Workplace Ethics and Education, co-hosted by Gonzaga University and Loyola Marymount University, Los Angeles, CA, USA, 9–10 June 2005.     

A team-taught interdisciplinary approach to engineering ethics

This paper outlines the development and implementation of a new course in Engineering Ethics at the University of Tennessee. This is a three-semester-hour course and is jointly taught by an engineering professor and a philosophy professor. While traditional pedagogical techniques such as case studies, position papers, and classroom discussions are used, additional activities such as developing a code of ethics and student-developed scenarios are employed to encourage critical thinking. Among the topics addressed in the course are engineering as a profession and its role in society; ethical successes and failures; risk, safety, and the environment; professional responsibilities; credit and intellectual property; and international concerns. The most significant aspect of the course is that it brings both engineering and non-engineering points of view to the topics at hand. This is accomplished in two ways. First, as mentioned previously, it is team-taught by engineering faculty with an interest in ethical and societal issues, and by philosophy faculty with expertise in the field of professional ethics and an interest in science and technology. Second, the course is offered to both engineers and non-engineers. This mix of students requires that all students must be able to explain their technical and ethical decisions in a non-technical manner. Work teams are structured to maximize interdisciplinary interaction and to foster insights by each student into the professional commitments and attitudes of others. An earlier version of this paper was presented at the 2005 conference, Ethics and Social Responsibility in Engineering and Technology, Linking Workplace Ethics and Education, co-hosted by Gonzaga University and Loyola Marymount University, Los Angeles, CA, USA, 9–10 June 2005.     

The President’s New Freedom Commission: Capitalizing on Opportunities to Advance School-Based Mental Health Services

The report from President George W. Bush’s New Freedom Commission on Mental Health (NFC), Achieving the Promise: Transforming Mental Health Care in America(2003), proposes goals and recommendations for improving mental health services. This report has significant implications for the delivery of mental health services through the schools. A focused discussion of the potential opportunities and challenges of implementing NFC recommendations related to school-based mental health is presented. Strategies for addressing five key areas at the intersection of school mental health and the Commission’s recommendations include: stigma reduction, suicide prevention, expansion and improvement of school mental health, and screening and treatment of co-occurring mental health and substance abuse disorders.     

The Impact of Economic Globalisation on Health

The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches.     

"形而上"与"形而下"的近代分离--《易》与经学时代中国学者的学术兴趣

近代科学在欧洲的产生,乃得益于"文艺复兴"以来欧洲学术上"形而上"与"形而下"的大规模分离.而汉以来"独尊儒术"的实现,<易>作为儒家主要经籍以其"仰观天文,俯察地理,中知人事"的宏大叙事与终极关怀,影响了经学时代中国学者的学术兴趣,导致他们将绝大多数精力投入到了以史学为主的"人事"中而非自然事物的研究对象与形而下的研究路径.两个相对独立的历史进程与历史体系或无何可比性:近代科学在欧洲产生只有在产生近代科学的欧洲自我历史进程与历史体系中才能得到解释,中国没有产生近代科学亦复如此.至于将中国科学落后的原由单一性地归结于<易>或儒家经学,这未必符合历史的因果真相与思维的有效推理.     

Pragmatism and Developmentalism in Brazilian Educational Thought in the 1950s/1960

This article proposes to analyse some aspects of the appropriation of New School thinking in Brazil, particularly Deweyan pragmatism, in the 1950s and 1960s. The analysis is based on the assumption that the developmentalist ideology that punctuated the debate on the economic, political and social restructuring of the country in these two decades constituted fertile ground for the return and expansion of pragmatist thinking amongst Brazilian educators, articulating itself, sometimes in contradictory ways, with this ideology. The focus of the analysis will be on the writings of the group of educators which circulated around the figure of Anísio Teixeira, at the time director of the National Institute for Pedagogic Studies (INEP), an organ linked to the Ministry of Education and Culture (MEC), which set itself the task of producing research that would support public policy in the field of education, as well as constituting itself as a center for teacher education and the stimulus and development of innovative experiences in the public school system. The appropriation of Deweyan pragmatism, in this context, had a triple perspective: pragmatism as scientific method, implying a specific conception of science, particularly the social sciences, with emphasis on the application of scientific knowledge in the solution of practical problems; as a way of democratic life; and as a synonym for experimentalism, in the sphere of schooling.     

The University and the Moral Imperative of Fair Trade Coffee

This paper examines the relationship between the university and fair trade coffee campaigns in North America. In recent years, fair trade coffee sales internationally have increased substantially but have still not grown large enough to meet the needs of fair trade producers in the South. In consequence, fair trade activists have sought to expand the market by pressuring public institutions to adopt fair trade purchasing policies. In North America, the university has emerged as a central focus of fair trade coffee campaigns. Thus far, university administrators have been reluctant to support fair trade. This paper explores this reluctance and asserts that the university has a moral responsibility to support fair trade. However, it also argues that the potential exists for administrators to employ fair trade as an ethical fig leaf to mask the growing corporatization of the university under the weight of neoliberal reforms. This has become a common strategy of many neoliberal institutions in the North. Contrary to the assumptions of much of the emerging literature, it cannot be assumed that the impact of fair trade will necessarily be beneficial in the North unless activists work to ensure fair trade does not become employed as an ethical fig leaf.