老年社会护理机器人“欺骗”问题的伦理审视

老年社会护理机器人其拟人化特征涉及的欺骗性问题始终存在争议。批评者坚持认为机器的拟人化所带来的一切都是假象从而不断质疑护理机器人的欺骗属性,辩护者认为拟人化特征是促进人机融合的必备要素但却未提供有力的合理性证明。聚焦人机多个主体的协调融合,揭露背后欺骗即是背叛,进而为护理机器人不会也不应该存在欺骗补充了有力的证据,并从完善用户知情同意、加强用户自主权、制造商承担举证责任等方面提出防范“欺骗”风险的路径,为辩护的开展提供新的研究视角和可行出路。

     

ICU护士第二受害者经历与支持影响因素分析

采用一般资料调查表、不良事特征调查表、组织支持感量表、心理弹性量表和第二受害者经历与支持量表对大连市11所医院428名ICU护士进行调查。结果显示,ICU护士作为第二受害者经历与支持总分为（82.84±13.58）分;岭回归结果显示,是否经历了护理部层面的分析讨论或汇报、情感性支持、工具性支持、自强型是ICU护士第二受害者经历与支持水平的影响因素（β=−3.177～0.587,P＜0.05）,共同解释23.3%的变化。ICU护士发生不良事件后的心理体验情况不容乐观,医院管理者需重视ICU护士的负性情绪,可通过增加组织支持感和提升心理弹性水平以减轻第二受害者的痛苦体验。

     

关于实验动物运动模型建立的伦理思考

基于目前广泛应用的动物实验伦理3R和5F原则,通过深入分析已有运动干预文献中的动物运动模型构建方法,分别就运动模型建立前实验动物的选取,运动模式、运动剂量的确定,模型建立过程中不同阶段不同运动形式所涉及的伦理问题,以及实验动物安乐死等各个方面进行伦理分析,探讨伦理关怀在动物运动模型建立中的必要性和重要性。运动模型的构建作为研究运动干预的关键环节是极其重要的,此建立过程中涉及到诸多动物实验伦理问题。

     

互动支持者在临终病人与家属关于临终问题互动中的作用——基于田野研究之情境分析

通过在某三级医院安宁疗护科为期5个月的田野研究,分析临终病人与家属的临终互动过程,阐明互动支持者在促进其临终互动过程中的作用。期间共收集21例研究对象的20份家庭会议录音、79张照片、21份个案笔记,梳理出7个临终互动情境。研究显示,互动支持者发挥的作用有互动促发激发互动意愿、互动支持增加互动勇气和互动保障促进互动进行。由此得出结论,互动支持者作为病人与家属的互动桥梁,通过互动促发、互动支持和互动保障,翻译其行为背后的情感与期待、转述情感的表达,促进有效陪伴和及时表达爱,使病人善终、家属善别。     

安宁疗护患者生活质量评估工具的研究进展

准确评估临终患者的生活质量能更好地实施和评价安宁疗护。国内外相关评估工具各有特点,国外相关研究较为成熟,已有较完善且应用广泛的评估工具;而我国此方面的研究起步较晚,相关工具数量少且应用局限。介绍了国内外安宁疗护患者生活质量评估工具的发展过程、适用对象、测量内容、信效度以及使用方法,并对各工具的基本情况和应用现状进行比较分析,以期为临床研究选用合适的评估工具、国内学者汉化及开发相关评估工具提供参考。

     

国内外预立医疗照护计划社会经济效益的探讨

从卫生经济学视角,探讨预立医疗照护计划的社会经济效益。通过分析预立医疗照护计划的卫生经济政策、经济分析模式及社会经济效益评价研究等发现,预立医疗照护计划具有较明显的社会经济效益。借鉴国外经验和结合我国文化背景提出预立医疗照护计划在我国发展的对策和建议,包括建立相关政策突破发展障碍;构建激励制度,加强人才培养以支撑预立医疗照护计划发展;开展评价预立医疗照护计划经济效益的研究,以价值为导向构建本土化的医疗模式,以期为我国发展预立医疗照护计划的卫生经济学研究领域提供理论依据。

     

医务社会工作对医护联盟信任关系提升的支持研究

选取江苏省某医院的癌症幸存者、严重心脑血管疾病患者（术后）作为研究对象,采用医疗保健联盟问卷、医学面对方式、创伤后成长量表进行统计学分析,共发放问卷165份。结果显示,医护联盟在性别和年龄两个方面差异具有统计学意义（P＜0.05）。医护联盟与面对、创伤后成长呈显著正相关,屈服与医护联盟、面对呈显著负相关。且87.2%的重症患者对医护联盟的信任呈不满意状态。从医务社会工作的角度出发,探讨影响患者对于医护联盟的信任度的因素并提供建议。

     

Autonomy,Reciprocity, and Responsibility: Darwall and Levinas on the Second Person

Abstract

Stephen Darwall’s The Second‐Person Standpoint converges with Emmanuel Levinas’s concern about the role of the second‐person relationship in ethics. This paper contrasts their methodologies (regressive analysis of presuppositions versus phenomenology) to explain Darwall’s narrower view of ethical experience in terms of expressed reactive attitudes. It delineates Darwall’s overall justificatory strategy and the centrality of autonomy and reciprocity within it, in contrast to Levinas’s emphasis on the experience of responsibility. Asymmetrical responsibility plays a more foundational role as a critical counterpoint to ‘mean‐spirited’ reciprocity than Darwall’s laudable distinction between accountability and revenge, and responsibility even founds this distinction. The experience of being summoned to asymmetrical responsibility amplifies the meaning of ‘authority’, which is a presupposition for Darwall. Finally, asymmetrical responsibility helps develop decentred reasoning, invites risk beyond the boundaries of reciprocity at moments when autonomy appears endangered, reconciles respect and care at the experiential level, and presses to extend the scope of moral obligation.     

Effects of Hardiness and Years of Military Service on Posttraumatic Stress Symptoms in U.S. Army Medics

We examined the effects of hardiness on symptoms of posttraumatic stress (PTS) in postdeployed U.S. Army medics (N = 322). Medics endure a high level of work-related stress on and off the battlefield. Hardiness correlated negatively with reports of PTS symptoms and moderated the cumulative effects of years of military service on PTS symptoms. After controlling for socially desirable responding, PTS symptoms increased with years of military service for those with low levels of hardiness and decreased with years of military service for those with very high levels of hardiness. The military’s current resiliency training programs would likely benefit from incorporating hardiness measures and principles into its curriculum.     

Indulgences in the Catholic Reformation

Abstract

Ever since Luther’s ‘Ninety-five Theses’ (1517), indulgences have been synonymous with corruption in the Catholic Church, although their proper use was to be reaffirmed at the Council of Trent. This article comprises firstly, an exploration of the theory, nature, uses, and evolution of indulgences after Luther up to about 1700; secondly, an examination of indulgences as a product of ecclesiastical jurisdiction of popes and bishops; and thirdly, an exploration of the individual acquisition of pardons and the progression of different devotions over time. The focus will be on France as a case study. It will be shown how indulgences in Catholicism survived Luther, were reinvented and emerged as a powerful tool of personal and institutional reform. They provide a lens through which to explore the history of the institutional Church, in particular relationships between centre and periphery during the Catholic Counter-Reformation centuries.