The design and use of the Bioethics Consultation Form

The emergence of the ethics consultation as a means to resolve moral crises in clinical medicine has revealed the need for a worksheet that would facilitate intake and analysis. The author developed the Bioethics Consultation Form as an attempt to remedy this need. The form is arranged in an outline format and is a useful asset to ethics committee discussions and record keeping. The first section covers basic intake data concerning the patient's medical and personal information, advance directives, and values, as well as the values of the physician and family. After the intake section is completed with the above data, the ethics consultant then turns to the analysis section. This second section allows for (1) the discussion of conflicting values, (2) the identification of priorities, and (3) the elucidation of ethical norms relevant to the case.The Bioethics Consultation Form was adopted by the Patient Care Advisory committee of the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The methodology in the use of the form will be discussed. Further, the potential spectrum of consultative cases that can be analyzed using the form will be highlighted.     

ICU临终患者治疗抉择的伦理问题

医生面对ICU临终患者很难抉择是应该积极治疗到底还是提供舒适的保守治疗,目前相关的伦理及法律问题仍尚需完善,伦理指导是一项解决纠纷、政善沟通有效的工具,成立伦理委员会对医生进行合理的建议和指导是非常必要的。     

Getting Beyond Form Filling: The Role of Institutional Governance in Human Research Ethics

It has become almost a truism to describe the interaction between research ethics committees and researchers as being marred by distrust and conflict. The ethical conduct of researchers is increasingly a matter of institutional concern because of the degree to which non-compliance with national standards can expose the entire institution to risk. This has transformed research ethics into what some have described as a research ethics industry. In an operational sense, there is considerable focus on modifying research behaviour through a combination of education and sanctions. The assessment of whether a researcher is ‘ethical’ is too often based on whether they submit their work for review by an ethics committee. However, is such an approach making a useful contribution to the actual ethical conduct of research and the protection of the interests of participants? Does a focus on ethical review minimise institutional risk? Instead it has been suggested that ethics committees may be distorting or frustrating useful research and are promoting a culture of either mindless rule following or frustrated resistance. An alternative governance approach is required. There is a need for a strong institutional focus on promoting and supporting the reflective practice of researchers through every stage of their work. By situating research ethics within the broader framework of institutional governance, this paper suggests it is possible to establish arrangements that actually facilitate excellent and ethical research.     

加强医学伦理学教育指导医疗实践

通过对五所医院医务人员和两所医科大学的学生从医学伦理学教育和伦理培训等四方面进行现场调查和分析,提出目前在医科大学,医学伦理学已经逐步被认识和接受;医学伦理在临床实践和医疗科研中已有较大的影响;医学伦理委员会的工作需要进一步加强;医学伦理教育任重道远.     

The development of computer ethics: Contributions from business ethics and medical ethics

In this essay, we demonstrate that the field of computer ethics shares many core similarities with two other areas of applied ethics, Academicians writing and teaching in the area of computer ethics, along with practitioners, must address ethical issues that are qualitatively similar in nature to those raised in medicine and business. In addition, as academic disciplines, these three fields also share some similar concerns. For example, all face the difficult challenge of maintaining a credible dialogue with diverse constituents such as academicians of various disciplines, professionals, policymakers, and the general public, Given these similarities, the fields of bioethics and business ethics can serve as useful models for the development of computer ethics. A version of this paper was presented at ETHICOMP98, the Fourth International Conference on Ethical Issues of Information Technology, March 25–27, 1998, Erasmus University, the Netherlands. Kenman Wong, Ph.D., is an Associate Professor of Business Ethics; Gerhard Steinke, Ph.D., is Professor of Management and Information Systems. Both authors are at Seattle Pacific University's School of Business and Economics.     

Conflict of interest in biomedical research: a view from Europe

In this paper I address the conflict of interest (CoI) issue from a legal point of view at a European level. We will see that the regulatory framework that exists in Europe does state the need for the independence of ethics committee involved in authorisation of research and clinical trials. We will see that CoI is an element that has to be closely monitored at National and International level. Therefore, Member States and Newly Associated States do have to address CoI in the authorisation process of research and clinical protocols of biomedicine. The opinions here expressed are personal and do not commit the European Commission. An earlier version of this paper was delivered at a Conference on Conflict of Interest and Its Significance in Science and Medicine, 5–6 April, 2002, Warsaw, Poland. The author is a Scientific Officer in the Programme Science and Society dealing with ethics and science (Unit C.3).     

How to Regulate a Practice: The Case of Cosmetic Surgery

How should a practice, subservient to a public good, be regulated in order to guarantee fair access without encouraging improper claims? In the first place, a clear understanding of the goal of the practice is indispensable for knowing what criteria the regulation must contain. As to the purely formal aspect, the regulation of any practice must include both general rules and particular instances. Finally, to resolve conflicts, committees in which different kinds of expertise are represented should be installed. These three theses are illustrated by the Dutch regulation for cosmetic surgery.     

医学伦理审查如何适应转化医学的要求

随着转化医学的兴起,医学伦理审查面临前所未有的机遇与挑战.如何使医学伦理审查工作更好地适应转化医学发展的需要,提高审查质量,成为亟需解决的问题.在分析当前我国医学伦理审查工作现状和主要问题的基础上,进一步探讨了可行的解决方法,如进一步明确和强化管理部门服务功能、保证伦理委员会成员多样性和重视伦理审查多视角、强化伦理委员会后续跟踪审查、规范伦理审查委员的培训与继续教育等,为我国医学伦理审查工作的规范化发展和医学伦理审查质量的进一步提高提供参考.     

守护受试者的权益——对“药物研究与应用的伦理监督”

如何保障和守护临床试验研究中受试者的权益?这既是医生、患者(受试者)、工业界与公众注目的问题,也是医院伦理委员会工作面临并要解决的基本而至关重要的问题。从华西医院伦理委员会工作角度出发,分析了临床试验研究中的权益冲突和对受试者权益的科学、伦理与政策守护的要素,论述了如何保障受试者权益问题。     

医院伦理委员会建设的探索

面对日益突出的医患矛盾、临床与医学科研中的伦理问题,各国都在探索医院伦理委员会的建设。通过阐述我国医院伦理委员会建设的发展历程,并介绍其性质、构成、职责、工作形式和存在的问题等,对其规范化建设进行积极的探索。