精神障碍诊疗实行自愿原则的伦理辩护

精神病患者的自主权应当得到相应的尊重和保护,作为社会的弱势群体,精神病患者的认知和行为能力存有缺陷,无法完全对自身的健康与合法权益予以保护,“自愿原则”将精神病患者从历史“异端”拉进社会关爱中,并用法律予以规范,是法制与人权的进步。通过对维护患者利益原则、尊重自主权原则、知情同意权原则、维护公共利益原则和公正原则进行伦理精神分析,论述《精神卫生法》对精神障碍诊疗实行自愿原则的相关规定,提出“自愿原则”实施的伦理正当性,为衡平正义提供价值考量。     

两性畸形患者性别定位的选择及思考

探讨两性畸形患者性别定位的选择原则和由此引发的社会问题。患者应正确认识两性畸形疾病, 并且选择正确和完善的治疗方法。两性畸形患者作为社会弱势群体, 应当得到人们的理解、同情和帮助。近年来两性畸形患者的就诊数量不断增多, 患者性别选择后的生活状态可在一定程度上反映整个社会的进步情况。如何正确对待两性畸形患者, 不仅仅是医学上的问题, 而且涉及到伦理问题。对待这类患者, 遵循一定的性别定位选择原则, 将对患者的治疗和维持社会稳定具有重要意义。     

论体育的人道原则

本文分析了当今我国体育中所普遍存在的反人道现象。指出应该依据“使人自由”和“消除异化”两个正负原则,还体育以本来面貌,实现体育于人的自我完善与自由文化本质属性。     

Rawls and Research on Cognitively Impaired Patients: A Reply to Maio

In his paper, “The Relevance of Rawls’ Principle of Justice for Research on Cognitively Impaired Patients” (Theoretical Medicine and Bioethics 23 (2002):45–53), Giovanni Maio has developed athought-provoking argument for the permissibility of non-therapeutic research on cognitively impaired patients. Maio argues that his conclusion follows from the acceptance of John Rawls’s principles of justice, specifically, Rawls’s “liberty principle” Maio has misinterpreted Rawls’s “libertyprinciple” – correctly interpreted it does notsupport non-therapeutic research on cognitivelyimpaired patients. Three other ‘Rawlsian’ arguments are suggested by Maio’s discussion –two “self-respect” arguments and a “presumed consent” argument – but none of them are convincing. However, an alternative argument developed from Rawls’s discussion of “justice in health care” in his most recent book, Justice as Fairness: A Restatement, may justify certain kinds of non-therapeutic research on some cognitively impaired patients in special circumstances. We should not expect anything more permissive from a liberal theory of justice. This revised version was published online in June 2006 with corrections to the Cover Date.     

The blocking of reinforcement control

Two experiments were conducted to extend the blocking effect to the reinforcement of a response. A delayed reinforcement contingency was presented to subjects with or without a previously pretrained response available during the delay interval. The interpolated response had no scheduled effect on delivery of the reinforcer, but its availability reduced strengthening of the initial response, which completely extinguished for some subjects. The results were interpreted as support for blocking as a fundamental principle of behavior, and as evidence against the principle of reinforcement being stated solely in terms of temporal proximity between response and reinforcer.     

重复启动条件下语义启动效应减少的机制

采用重复启动范式探讨语义启动效应减少的机制。结果发现,在SOA为短的167ms条件下,重复/相同和重复/相关的启动效应无差异,且重复/相关启动并未导致语义启动效应的减少;而在SOA为长的1200ms条件下,重复/相同和重复/相关的启动效应差异显著,且重复/相关启动导致了语义启动效应的减少,而重复/相同未导致语义启动效应的减少。在抵消了期望和消退的作用后,在SOA为1200ms条件下所得到的重复/相同和重复/相关启动效应的差异,是由于扩散受到了阻碍而导致的。这一结论支持了激活扩散是有一定条件的观点。     

Desire: The unfolding of the other

The Confucian classic the Liji 禮記 defines ‘desire’ as ‘the arousal of nature’. In line with this classical definition, Dai Zhen 戴震 (1724–1777) sees desire as human nature in activation. However, while the Liji ascribes human deceits and debauchery to the susceptibility of human nature, Dai Zhen speaks highly of its responsiveness and receptivity. This article discusses Dai Zhen’s conception of desire and argues that Dai Zhen distinguishes himself from other Confucian moral thinkers by bringing to light the dimension of the Other in addressing the issue of desire. As the Confucian tradition has long been disturbed by an anxiety to keep desire in check, Dai Zhen draws our attention to how to cultivate the affective faculty inherent in human nature to develop our sensitivity to the needs and desires of others, especially those of the widow, the orphan, the solitary, the sick, and the weak.     

康复队伍建设对实现残疾人康复服务的影响

老年股骨颈骨折是常见的骨科病,但其治疗方案的选择并没有统一的标准。本文回顾了骨折治疗原则的发展历程和股骨颈骨折现有的治疗方法,旨在从系统论的最优化原则角度,初步讨论治疗老年股骨颈骨折的最优方案,认为应结合患者的生理年龄、预期寿命、骨的质量、骨折情况和经济条件等因素来选择治疗方案。     

构建医患会话的合作原则

通过对门诊医患会话的现场调查,发现经典的合作原则并不完全适用于门诊医患会话。这是因为医患会话中医生和患者之间存在着信息和权势两方面的不对称。为了适应新型的医患关系,在经典合作原则的基础上构建了医患会话的合作原则,以期规范和指导现实的医患会话。