关于医疗、科研的一点认识

临床医疗是医院的根本使命,在权重上医疗自然重于科研.医疗实践是科研的出发点与归宿,决定了科研的基本走向.当前,科研工作受到前所未有的重视,科研作为医疗人员绩效考核的权重过大,偏离了医院的根本使命,会对科研、医疗、医护人员乃至整个社会造成伤害.SCI论文与临床关系不密切,不宜用来评价临床医师的水准.应该建立科学的考评机制,考核标准应细化、全面,对科研的奖励应适度.对于医护人员的考核应以医疗为主、科研为辅.     

Alternative death rituals in Switzerland: building a community of shared emotions and practices

New alternative death rituals are gaining significance in Switzerland, like in other contemporary Western societies. This article discusses how celebrants who are independent of any religious community shape alternative funerals and why such rituals may be able to function as a coping resource for a certain kind of participants. I argue that these rituals, co-produced by celebrants and the bereaved and including actively involved participants, can be seen as a re-conquest of ritual agency for lay people. By encouraging physical and mental contact with the deceased, the celebrants try to enable emotional arousal and create a temporary community of shared experiences and emotions and of the living and the dead. Elements of an individually crafted spirituality and a kind of nature religion represent both separation and continuing bonds between the living and the dead. As a consequence, such funerals serve as a resource in the face of death by integrating a singular death with the wider context.     

Ideology,inquiry, and antiquity: a critical notice of Lloyd's The Ideals of Inquiry: An Ancient History

A discussion of Lloyd's Tarner Lectures at Trinity College. The importance of Lloyd's previous scholarship is characterized and these sweeping, erudite lectures are placed in the context of that scholarship. In the broadest terms, the lectures are a call to culturally and historically comparative study of human reasoning. At their heart is a comparative history of scientific theorizing from the ancients through to modern science. Lloyd rejects the positivist picture, and the view of modern and ancient science as discontinuous; he urges scholars to undertake comparative work on the ancient sciences in different traditions. This critical notice evaluates Lloyd's view and raises several questions for further reflection.     

Who’s afraid of the big bad wolf? The interweaving of values and science

The role of values in the scientific process is widely debated. But evidence and values cannot be neatly separated. Instead, values infuse the entire scientific process, starting with the choice of research questions. Research avenues are selected based on prior beliefs about the workings of the world. In fact, informally assigned prior probabilities and normalizing constants play an essential role in distinguishing causes from correlations and ignoring irrelevant associations that would otherwise be suggested by raw data. But since these initial probabilities often have a heterogeneous pedigree – often not all that went into their formation is known or knowable – it becomes difficult to cleanly separate evidence from values. At the same time, this reality does not undermine science’s unique status in generating knowledge. This is because it is not the evidence per se generated by science, but rather the method by which science generates it, that justifies science’s privileged role.     

Further evidence for the case against neuropsychoanalysis: How Yovell,Solms, and Fotopoulou's response to our critique confirms the irrelevance and harmfulness to psychoanalysis of the contemporary neuroscientific trend

In their paper “The case for neuropsychoanalysis” Yovell, Solms, and Fotopoulou (2015) respond to our critique of neuropsychoanalysis (Blass & Carmeli, 2007), setting forth evidence and arguments which, they claim, demonstrate why neuroscience is relevant and important for psychoanalysis and hence why dialogue between the fields is necessary. In the present paper we carefully examine their evidence and arguments and demonstrate how and why their claim is completely mistaken. In fact, Yovell, Solms, and Fotopoulou's paper only confirms our position on the irrelevance and harmfulness to psychoanalysis of the contemporary neuroscientific trend. We show how this trend perverts the essential nature of psychoanalysis and of how it is practiced. The clinical impact and its detrimental nature is highlighted by discussion of clinical material presented by Yovell et al (2015). In the light of this we argue that the debate over neuropsychoanalysis should be of interest to all psychoanalysts, not only those concerned with biology or interdisciplinary dialogue.     

Engineering Values Into Genetic Engineering: A Proposed Analytic Framework for Scientific Social Responsibility

Recent experiments have been used to “edit” genomes of various plant, animal and other species, including humans, with unprecedented precision. Furthermore, editing the Cas9 endonuclease gene with a gene encoding the desired guide RNA into an organism, adjacent to an altered gene, could create a “gene drive” that could spread a trait through an entire population of organisms. These experiments represent advances along a spectrum of technological abilities that genetic engineers have been working on since the advent of recombinant DNA techniques. The scientific and bioethics communities have built substantial literatures about the ethical and policy implications of genetic engineering, especially in the age of bioterrorism. However, recent CRISPr/Cas experiments have triggered a rehashing of previous policy discussions, suggesting that the scientific community requires guidance on how to think about social responsibility. We propose a framework to enable analysis of social responsibility, using two examples of genetic engineering experiments.     

Private-Sector Research Ethics: Marketing or Good Conflicts Management? The 2005 John J. Conley Lecture on Medical Ethics

Pharmaceutical companies are major sponsors of biomedical research. Most scholars and policymakers focus their attention on government and academic oversight activities, however. In this article, I consider the role of pharmaceutical companies’ internal ethics statements in guiding decisions about corporate research and development (R&D). I review materials from drug company websites and contributions from the business and medical ethics literature that address ethical responsibilities of businesses in general and pharmaceutical companies in particular. I discuss positive and negative uses of pharmaceutical companies’ ethics materials and describe shortcomings in the companies’ existing ethics programs. To guide employees and reassure outsiders, companies must add rigor, independence, and transparency to their R&D ethics programs.