医者不可不慈仁，病者不可猜鄙——构建和谐的医患关系

医患和谐是医学的本质要求。目前医患关系紧张是在市场经济和高科技背景下,价值选择和制度安排失当造成的。要充分利用传统文化的资源,同时适应时代要求,在价值选择和制度安排上促进医患和谐。     

DO CHILDREN PREFER CONTINGENCIES? AN EVALUATION OF THE EFFICACY OF AND PREFERENCE FOR CONTINGENT VERSUS NONCONTINGENT SOCIAL REINFORCEMENT DURING PLAY

Discovering whether children prefer reinforcement via a contingency or independent of their behavior is important considering the ubiquity of these programmed schedules of reinforcement. The current study evaluated the efficacy of and preference for social interaction within differential reinforcement of alternative behavior (DRA) and noncontingent reinforcement (NCR) schedules with typically developing children. Results showed that 7 of the 8 children preferred the DRA schedule; 1 child was indifferent. We also demonstrated a high degree of procedural fidelity, which suggested that preference is influenced by the presence of a contingency under which reinforcement can be obtained. These findings are discussed in terms of (a) the selection of reinforcement schedules in practice, (b) variables that influence children's preferences for contexts, and (c) the selection of experimental control procedures when evaluating the effects of reinforcement.     

Global surrogacy: exploitation to empowerment

Commercial surrogacy has gone global in the last decade, and India has become the international centre for reproductive tourism, boasting numerous high-quality and low-fee clinics. The growth of the surrogacy industry in India raises serious concerns of global gender justice, in particular whether the option is inordinately enticing for women who lack other remunerable options and whether the conditions are adequate and the compensation fair. In this paper I argue that the moral harm of global commercial surrogacy lies in the exploitative nature of transactions involving unequally vulnerable parties. More specifically, I argue that the practice exploits Indian surrogates on the basis of an inter-contractual failure of both justice and consent. I go on to consider an important objection to my use of exploitation as the relevant conceptual tool of analysis. The ethnographic challenge holds that the exploitation lens Occidentalizes surrogacy by conceptualizing the practice in universalizing terms, thereby eclipsing the particularities of the global surrogate's lived experience. I respond by showing that in fact the exploitation and the ethnographic models are not so at odds as they might seem. Provided we are careful in our use of the former to nuance our analysis by appeal to narrative evidence supplied by the latter, we are thereby best situated to identify and address the moral difficulties generated by commercial surrogacy under conditions of global injustice.     

Evaluating Environmental Arrangement as Setting Events: Review and Implications for Measurement

Environmental arrangement alters the physical, social, or programmatic aspects of classrooms to increase task engagement, facilitate prosocial behaviors, and reduce or prevent the challenging behaviors of children and youth. Research shows specific arrangements can affect student engagement and deportment, but this literature is not well integrated theoretically or empirically with other effective behavior change tactics. This article proposes that some environmental arrangements may serve as setting events for child behavior change. Setting events and environmental arrangement were defined and critically outlined. A total of 43 physical environmental arrangement articles were reviewed as to the specific type of arrangement and research methodology. Several methodological problems (e.g., lack of measurement or control of antecedents, consequences, or environmental arrangements, manipulation of more than one environmental arrangement) precluded conclusions about the setting event function of environmental arrangements. Suggestions for future research on setting events and environmental arrangements are proposed.     

Within-family reproductive technologies as a solution to childlessness due to infertility: Psychological issues and interventions

Patients choosing new reproductive technologies benefit from psychological consultation as they face unforeseen emotional and interpersonal sequalae from these procedures. This paper focuses on those patients who choose family members or close friends (i.e., known donors) to donate sperm or eggs or uteri in order to conceive and produce their babies. Medical family therapy offers these patients and families a framework from which to examine the biological, psychological, and interpersonal issues involved in these within-family solutions to childlessness due to infertility.This paper is a revision of a talk, Medical Family Therapy, Infertility, and the New Reproductive Technologies, given at the 1994 annual meeting of the American Psychological Association on August 4 in Los Angeles, CA, as part of the Mini-convention on Families panel on Clinical Issues in Families and Health.     

产权安排是社会道德的基础

作为社会经济生活中的一种根本制度安排和人们的一种基本权利,产权是社会道德的基础。一定的利益差别和产权界定,是道德产生的前提;社会产权制度的性质和变迁,规定着社会道德体系的特质和演变;社会产权安排的结构和状况,影响和制约着人们的道德行为选择和社会道德风尚。健全的产权安排有利于规范和约束人们的行为选择,安定人们的生活心态,创造积极的道德环境和条件,从而优化人们的道德行为选择,促进良好社会道德秩序的形成。     

Evaluating preschool children's preferences for motivational systems during instruction

Preschool teachers rely on several strategies for motivating children to participate in learning activities. In the current study, we evaluated the effectiveness of and preference for three teaching contexts in which embedded, sequential, or no programmed reinforcement was arranged. The embedded context included highly preferred teaching materials, the sequential context included highly preferred edible items for correct responding, and a control context included neither. In addition, an exclusively play-oriented activity was included as a fourth option to determine if one of the direct teaching contexts could compete with a relatively unstructured and exclusively child-led activity. All participants preferred the sequential context (use of high-quality consequences) over the embedded context (use of high-quality teaching materials), 2 of the 4 participants preferred some motivational system to none at all, and the play area was selected over all variants of the instructional contexts during the majority of trials. We found either no or small differences in correct responding in the different instructional contexts; however, rates of undesirable behavior were highest in the least preferred interaction area for 3 of the 4 participants. Implications for the design of effective and preferred teaching environments for young children are discussed.     

刺激放置朝向对返回抑制的影响:一项ERPs研究

返回抑制(inhibition of return, IOR)是指个体对出现在先前提示位置上的刺激反应更慢的现象。尽管大量ERPs研究发现呈现在线索化和非线索化位置上的靶刺激诱发的ERPs在250-300ms处存在一个稳定的差异(Nd250),但这一差异的方向却并不一致。本研究采用事件相关电位技术(Event-related Potentials, ERPs),结合经典的线索-靶子范式,考察刺激放置的朝向是否会影响到IOR中Nd250效应的极性。结果显示虽然刺激放置朝向并未有影响到Nd250的极性,却对早期P1成分的线索化效应的地形图分布有着显著的影响。这表明1）过往ERPs研究中的Nd250效应极性的不一致并非源于刺激放置朝向的作用;2）刺激的放置朝向会导致早期线索化效应(P1)在地形分布上出现差异。     

英国“代孕”合法化二十年历史回顾

在英国,代孕人工生殖是合法的医疗手段。《布雷热报告》等调查报告对英国代孕立法产生了深远影响。为实现生殖自由、子女利益和社会秩序的平衡,英国拟制定一部专门的《代孕法》。     

An evaluation of the value of choice with preschool children

The current study examined the reinforcing effects of choosing among alternatives in a four-part evaluation. In the first study, initial-link responses in a concurrent-chains arrangement resulted in access to terminal links in which the completion of an academic task resulted in (a) the choice of a reinforcer (choice), (b) the delivery of an identical reinforcer (no choice), or (c) no material reinforcer (control). Three patterns of responding emerged: persistent preference for choice (3 participants); initial preference for choice, which did not persist (2 participants); and preference for no choice (1 participant). Additional evaluations determined if preference for choice could be enhanced (Study 2) or established (Study 3) by including more stimuli from which to choose. Choice-link selections systematically increased for all participants when more items were available from which to choose. Study 4 identified the precise value of the opportunity to choose by progressively increasing the response requirement during the choice terminal links for 3 children and determining the point at which these children stopped selecting the choice link. All children continued to select the choice link even when the work required in the choice link was much greater than that arranged in the no-choice link.