知识员工团队工作自主性与效能的关系研究

团队日益成为新经济时代背景下知识员工工作的主要方式。追求工作自主性同时也被认为是知识员工的核心特征之一。对杭州地区13家企业的35个工作团队的调查发现,工作自主性是一个二阶单因素结构,包含三个子维度:方法、进度和标准的自主性。回归分析显示:领导者信任在知识员工团队工作自主性与团队激励间起正向调节作用;反馈在团队激励与团队工作绩效及满意感间起负向调节作用。     

医患共同决策相关问题思考

医患共同决策作为西方较常见的临床决策模式,对减少决策失误和增进医患关系有着重要作用,但中国传统社会背景下患者的家庭结构、疾病认知度与就医模式等严重影响着医患关系和决策自主性;在医生与患者的责任分担上,专业壁垒的存在让医患共同决策可减轻医生决策压力的理论设定受到质疑,患者对医生既信任又怀疑的矛盾心境也使医生的角色进退两难。因此,医患共同决策模式作为较理想的决策模式在中国临床实践中还有待进一步探索与完善。     

医师职业精神的历史演变

《新世纪的医师职业精神——医师宣言》的发表,使医师职业精神概念被熟知。但一些医师或医学生对医师职业精神的提法和“患者利益至上”的表述及其内容都存在理解上的隔膜。其原因在于医师职业精神不只是一种精神,它是医学职业历史演进的缩影,也是一种医学专业建制的结果。所以如果不能从历史进程的角度,仔细审视源自希波克拉底的医学职业如何经历行会自治、专业化阶段和现代化挑战的发展,就难以理解医师职业精神究竟何为。

     

医联体实践中的认知误区——兼论实现“健康中国”目标的关键

从伦理学的视角探讨我国医联体实践中存在的伦理问题, 其中包括医联体的概念问题, 以及医联体实践的后果或效用问题, 并对医联体实践后果的解释进行了分析。进而, 根据对上述问题的研讨结果, 指出我国决策者在建立医联体上存在的认知误区。最后, 指出解决“看病难、看病贵”问题, 实现“健康中国”战略目标的关键是改造我国“支离破碎”的初级医疗系统, 使之成为健全的基础医疗卫生系统, 并将此置于整体医疗卫生工作的优先地位, 唯有在此健全的基础医疗卫生系统基础上, 才能使为特定目的建立的医联体发挥有效作用。     

数字药丸技术的两大伦理问题及解决对策

数字药丸技术能够使医生及其他监护人员通过网页或应用程序监测患者的药物摄入数据及其他生理数据,能够间接地提高患者的药物依从性。但是,数字药丸技术也会侵犯患者自主权与生理隐私。对于患者自主权,医生应最大程度地让自主能力受损的患者参与涉及他们自己的护理决策,特别是应该利用对患者偏爱和价值观的了解,尽可能地确定患者自己会做出什么样的决定;对于生理隐私,解决的核心是无论生产商还是医生与其他监护人员都要明确生理数据信息都是属于患者而非他人,特别是患者应该被告知自己的哪些生理数据被收集,哪些数据被使用以及如何使用数据。

     

How Can Ethics Support Innovative Health Care for an Aging Population?

The rapidly expanding aging population presents an urgent global challenge cutting through just about every dimension of worldly life, including the social, political, cultural, and economic. Developing innovations in health and assistive technology (AT) are poised to support effective and sustainable health care in the face of this challenge, yet there is scant (but growing) discussion of the ethical issues surrounding AT for older persons with dementia. Demands for ethical frameworks that can respond to frontline dilemmas regarding AT development and provision, and how the needs of aging persons themselves are defined throughout this development process, are increasing. This article suggests that fulfilling the promises of AT to provide effective and ethically informed solutions may demand shifting away from standard bioethical analyses that centralize the principle of respect for autonomy. An autonomy-centric paradigm is dubiously equipped to theorize the foundational ethical issues in dementia care and to effectively guide AT development and implementation. An agency-centered approach to dementia care, which could engage more adaptively with the perspectives and choices of older persons themselves while offering strong support to AT research and stakeholders, may offer an attractive alternative.     

After MacIntyre

In his influential book After Virtue, Alasdair MacIntyre identifies Kierkegaard's view of ethics with that of Kant. Both Kant and Kierkegaard, according to MacIntyre, accept the modern paradigm of moral activity for which freedom of the will is the ultimate basis. Ronald M. Green, in Kierkegaard and Kant: The Hidden Debt, accepts and deepens this alignment between the two thinkers. Green argues that Kierkegaard deliberately obscured his debt to Kant by a systematic “misattribution” of his ideas to other thinkers, and to classical philosophy in particular. This essay argues that MacIntyre and Green are mistaken in identifying Kierkegaard with the Kantian tradition of moral autonomy and that they overlook his debt to the classical conception of virtue. In casting Kierkegaard in the role of the quintessential exponent of a modern conception of freedom, they have perhaps overlooked one of the greatest critics of moral autonomy who has ever lived.     

Information Privacy for Technology Users With Intellectual and Developmental Disabilities: Why Does It Matter?

This article aims to explore the attitudes and behaviors of persons with intellectual and developmental disabilities (IDD) related to their information privacy when using information technology (IT). Six persons with IDD were recruited to participate to a series of 3 semistructured focus groups. Data were analyzed following a hybrid thematic analysis approach. Only 2 participants reported using IT every day. However, they all perceived IT use benefits, such as an increased autonomy. Participants demonstrated awareness of privacy concerns, but not in situations involving the use of technology; their awareness is not transferred to the abstract context of IT use. Privacy breaches were revealed to be a major risk for persons with IDD, who did not seem to understand how their personal information was used. Most protection mechanisms and tools reported were those suggested and implemented by caregivers and close relatives who had a great influence on the participants’ attitudes and behaviors toward IT and privacy. Our findings suggest that when using IT, persons with IDD often experience the consequences of a trade-off between autonomy and privacy. Further research and action is needed to support persons with IDD to understand and balance the benefits of IT use and the inherent threats to information privacy.     

The Normative Legitimacy Gap: International Sports Associations,Human Rights and Stakeholder Democracy

ABSTRACT

This conceptual paper explores whether the normative legitimacy of International Sports Associations (ISAs) such as Fédération Internationale de Football Association (FIFA) and Fédération Internationale de l’Automobile (FIA) requires an active promotion of human rights conventions. The contention is that ISAs, which are founded on principles of neutrality and autonomy, can no longer rely merely on their internal stakeholders to make legitimate decisions when it comes to episodes where sport and human rights clash. Two situations where this claim applies are the FIA’s funding of Syrian motorsport activities and the FIFA’s involvement in the Israel/Palestine conflict, which have created considerable debate outside the ISAs. These examples are therefore used as basis for a discussion of the ISAs’ philosophical stance on human rights as much as their legal duties as non-governmental organizations.     

Autonomy and radical evil: a Kantian challenge to constitutivism

Properly understood, Kant’s moral philosophy is incompatible with constitutivism. According to the constitutivist, being subject to the moral law cannot be a matter of free choice, and failure to comply with it is to be understood as a deficiency in one’s integrity as an intentional agent. I reconstruct Kant’s arguments to the conclusion that immorality, moral evil, consists in choosing to give one’s unity as an intentional agent supremacy over the moral law, and that one’s being subject to the moral law must be one’s own free choice. And I explain how Kant’s doctrine of radical evil, according to which we cannot be subject to the moral law without actually being morally evil, protects this conclusion from entailing the denial of the unconditionally binding character of moral principles, which character constitutivists correctly identify as the central concern of Kant’s – or any – moral philosophy.