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Full-Text Articles in Philosophy

人權與國際生命倫理, Jonathan Chan Jan 2002

人權與國際生命倫理, Jonathan Chan

International Journal of Chinese & Comparative Philosophy of Medicine

The globalization of western biomedicine has become a phenomenon for which many bioethicists are concerned. It generates important ethical issues at the international level that call for the internationalization of bioethics and, thereby, the development of a theoretical framework for international bioethics. For some bioethicists, such a theoretical framework can be built upon a set of fundamental principles of morality that are universally accepted in all cultures and eras. The set enables people to make justifiable cross-temp oral and cross-cultural judgments. This moral position is sometimes labeled as "moral fundamentalism." In a paper published in an issue of the Kennedy ...


醫學道德的內在和外在標準, Tom L. Beauchamp Jan 2002

醫學道德的內在和外在標準, Tom L. Beauchamp

International Journal of Chinese & Comparative Philosophy of Medicine

醫學倫理學結論的基礎和依據何在?這些基礎和依據是內在還是外在的?根據近來的討論,有三種不同的說法:一種是內在的解釋;一種是外在的解釋;還有一種是內在因素和外在因素給合的解釋。第一種是從醫學角度以及專業實踐的標準中發展一套倫理觀。第二種解釋醫學倫理學中的規範是以外在的標準為依據。例如公眾的意見、法律、宗教倫理觀或哲學倫理觀等。第三種則認為個別的醫學倫理權是從個別的文化架構產生出來的,而每一種文化都有管制醫生的規範。

每一種觀點都有可取之處,但每一種也不足以支持它自己的論辯以及無法結合其他觀點中合理和可取的部分。本文建議的第四種解釋,它既可以提供一個避開上述三種觀點的限制的方法。同時又能保留每一種觀點當中最可圈可點的特徵。


基因工程與社會正義, Ser-Min Shei Jan 2002

基因工程與社會正義, Ser-Min Shei

International Journal of Chinese & Comparative Philosophy of Medicine

Genetic medicine has made so many unthinkable things possible these days that someday we might be able to determine the features of anyone's genetic profile. Once this is feasible, then the distribution of genetic profiles is no longer a matter of natural lottery. It is then to be decided by social institutions and to be assessed in term of social justice. This paper is concerned with the questions as to whether society then should provide genetic medical resources for parents so that the impact on opportunity of genetic inequalities could be neutralized or minimized, and whether society should bring ...


墮胎辯論的三種進路, King-Tak Ip Jan 2002

墮胎辯論的三種進路, King-Tak Ip

International Journal of Chinese & Comparative Philosophy of Medicine

Abortion is one of the most controversial moral problems in contemporary world. People believe that the heart of the problem is the conflict between the fetuses' right to life and the women's rights to abortion. However, do women take their rights seriously when they decided to go for an abortion? Or one should look at the issue from the interpretive and pluralist approach? This essay is an attempt to introduce our readers to the problem by looking at three feminist approaches.

Judith Jarvis Thomson and May Anne Warren represent those feminists defending the rights of women to choose abortion ...


死亡概念的綜合考慮, Tangjia Wang Jan 2002

死亡概念的綜合考慮, Tangjia Wang

International Journal of Chinese & Comparative Philosophy of Medicine

The term "science of death" appeared at one time in ancient Greece. Socrates even said that "philosophy is a practice of death". However, although death has been viewed as an important subject in many fields of cultural studies, a science of death in the strict sense of the terminology has not come into being due to the lack of a rational and sophisticated methodology as well as an organic combination of theoretical speculation and empirical research. Up to date we have not even succeeded in coming up with a relatively comprehensive conception of what death means, even though we can ...


知情同意的若干問題, Xiaomei Zhai Jan 2002

知情同意的若干問題, Xiaomei Zhai

International Journal of Chinese & Comparative Philosophy of Medicine

In Western societies, the idea of informed consent as a legal account has long been there and developed significantly. This idea originated from the "uremberg Code". In fact, informed consent is neither a mere "legal document" nor a "common decision" made by the physician and the patient. It is a concept rich in moral content. It is about how an individual perceives and intentionally (without being controlled by others) agrees and allows professionals to carry out certain actions on him/her.

China has a unique traditional cultural background and economic development level. Due to the emphasis on responsibility and collectiveness ...


北京大學和芝加哥大學醫學倫理學教育和實踐機制比較研究, Yali Cong Jan 2002

北京大學和芝加哥大學醫學倫理學教育和實踐機制比較研究, Yali Cong

International Journal of Chinese & Comparative Philosophy of Medicine

Based on the fact that medical students at Peking University and at the University of Chicago have different moral responses to a case of medical ethics, this essay raises a question regarding the education of medical ethics: how can medical students realize their medical morality? It firstly offers a general introduction to the distinct working systems of the Center of Clinical Ethics at the University of Chicago and the Teaching and Research Office of Medical Ethics at Peking University Health Science Center. Then it compares the essential differences of the two institutions in their working systems. Generally speaking, there exist ...


導言:中美生命倫理學--幼稚與無聊, Ruiping Fan Jan 2002

導言:中美生命倫理學--幼稚與無聊, Ruiping Fan

International Journal of Chinese & Comparative Philosophy of Medicine

“生命倫理學為何變得如此無聊?”這是美國的一位老牌生命倫理學家Albert Jonsen 在美國《醫學與哲學期刊》2000 年最後一期中的論文標題。在Jonsen 看來,美國的生命倫理學已經讓人不勝其煩,她的思想已無新意,問題和論証總是美國式的(domesticated ),而且太多的東西都轉不出美國的風水之外(too much at home in accustomed places)(頁691 )。Jonsen似乎懷念生命倫理學的先驅人物Paul Ramsey和Joseph Fletcher 在20 世紀60 年代包打天下 ,與當時的家長主義醫學大戰幾個回合的英雄時代。他們的充沛的思想激蕩,敏銳的政治感覺和無尚的道德勇氣在當今的生命倫理學中已屬昨日黃花,盛景不再(頁692)。

如何克服當今美國生命倫理學的無聊呢? Jonsen 開出了一服包含兩味葯劑的處方。其一,走出自己的專業(倫理學)行當,更多地瀏覽一下其他學科的情況--不僅包括生物學,醫學和法學,還包括社會學,人類學,經濟學,歷史學等社會科學。其二是走出國門,到其他文化中去觀賞一番。Jonsen認為,只有在外國生活過一段的人才能認識到祖國的重要特徵(頁696 )。只有通過與別人的比較才能看清美國生命倫理學的價值承諾,榮辱得失和根木所在(頁698 )。


弱勢群體捐獻器官的倫理問題:對一個個案的分析, Qingshan Yan Jan 2002

弱勢群體捐獻器官的倫理問題:對一個個案的分析, Qingshan Yan

International Journal of Chinese & Comparative Philosophy of Medicine

From an ethical view, the weak population is a group of people that need protection and assistance by society. Generally, their capacity for survival and supporting society is weaker than the others. It may cause an ethical dilemma when they want to succor the others. For one thing, their moral motive for the succor can be suspicious.

Modern Business, a local newspaper in Changsha, reported such a case in the early 2002. A divorcer, without a formal job but with a seriously disabled daughter, would desire to donate his kidney to a woman contracting uremia. He stated that he wanted ...


醫患信任, Chalmers C. Clark Jan 2002

醫患信任, Chalmers C. Clark

International Journal of Chinese & Comparative Philosophy of Medicine

建立醫患之間的信任關係是解決患者弱勢問題的必由之路。而如何激發信任成為關鍵問題。在這一方面,只要醫療行業能夠認識到要保護它的職業利益和職業自主權就必須培養患者信任,信任的激發就不成問題了。儘管醫患信任的重建必須有這樣一個狹隘的出發點,但維護信任對我們提出了更多的要求--在醫生職業教育中應該強調珀西瓦爾Percival的同情醫療的態度和技術。在這樣的前提下,未來的醫療從業人員就會把道德、愛心和信任作為職業宗旨的組成要素,做出更衷心的承諾,從而更好地維護醫患信任。


導言, Zhizheng Du Jan 2002

導言, Zhizheng Du

International Journal of Chinese & Comparative Philosophy of Medicine

知情同意是現代生命倫理學最重要的概念之一,也是現代生命倫理學所以充滿活力和備受世人囑目的重要原因。

知情同意這一概念雖然已經歷100 多年的歷史,但在《紐倫堡法典》誕生以前,知情同意往往只是作為醫生爭取病人的配合和支持,以提高治療效果,或者為防範醫療糾紛而採取的一種手段。只是在《紐倫堡法典》問世後,特別是伴隨著聯合國的《世界人權宣言》發表後50 多年的人權運動蓬勃發展,知情同意獲得了新的意義,它首先被理解為對人的生命權和健康權的尊重,對人的權利的尊重。的確,人的生命和健康首先是屬於自己的,因而對生命和健康的任何干預,當然理應得到本人的同意,儘管這種干預有益於生命和健康的維護。特別是在當代醫學對人體生命和健康干預的力度越來越大,後果越來越嚴重,影響越來越深遠的情況下,人們怎能不關心醫學可以給本人帶來的後果呢?怎能不把對本人生命和健康的處置權利掌握在自己的手中呢?正因為如此,知情同意在全世界不同地域、不間民族和不同文化背景的國家,都得到了廣泛的認同,並體現在許多國家醫事和科學研究的法律檔中,體現在廣大醫務人員的行動中。

但是,人們對知情同意的理解和認識,由於各自的文化背景和國家體制的差異,卻存在眾多的不同;同時,由於各自國家的醫療習慣和傳統的不同,在實踐知情同意原則時也遇到了各種各樣的問題。為了推動對這一問題的研究,本刊這一期就此發表了一組文章,從不同角度就知情同意原則做了分析,我們希望引起對知情同意的進一步討論和研究。


醫生告知義務的價值分析, Fanjun Kong Jan 2002

醫生告知義務的價值分析, Fanjun Kong

International Journal of Chinese & Comparative Philosophy of Medicine

The doctors' obligation to inform means that the doctor shall inform the patient of related information on diagnosis and treatment. Specifically, it includes the following three aspects: 1) Explanation of diagnosis, that is, the explanation made by the doctor about the health condition of the patient according to medical diagnosis; 2) Ex-planation of measures used in invasive diagnosis-both preliminary and final-and treatment plan according to the diagnosis; 3) Explanation of neither diagnosis nor treatment, that is, explanation on why no diagnosis and treatment are available due to the insufficient professional skills of the doctor or lack of medical equipments.

In ...


知情同意與語境, Deyan Wang Jan 2002

知情同意與語境, Deyan Wang

International Journal of Chinese & Comparative Philosophy of Medicine

Understanding, being closely associated with the context, is the basis of realization of informed consent. Physician often complains that patients cannot well comprehend medical information, while patients are often unsatisfied with the explanatory statements and technical terms given by physicians. Since 1980s the emphasis in the studies of informed consent has shifted from what should be presented to patient to how to present the related information to patients. Besides being concerned with the meaning of the narratives of patients, physician should pay close attention to the connection of the medical facts or information and the everyday language, to maintain the ...


知情同意臨床實踐中倫理學技術研究, Guobin Cheng Jan 2002

知情同意臨床實踐中倫理學技術研究, Guobin Cheng

International Journal of Chinese & Comparative Philosophy of Medicine

Informed consent is an ethical technique which emphasizes using the existing cultural traditions, theoretical resources and legal instruments to analyze and solve the problems reasonably and effectively. Informed consent can thus play a significant role in adjusting the relationship between patients and physicians. As an ethical technique, it focuses on the method of applying various ethical resources and not simply on the combination of the logical consequence and criteria. In a democratic society, informed consent is a necessary requirement for the right-duty relationship between patients and physicians. Informed consent is seen as a prerequisite obligation to physicians and implies certain ...


病人自主性與家庭本位主義之間的張力, Jin-Cheng Lei, Zhi-Qing Xie Jan 2002

病人自主性與家庭本位主義之間的張力, Jin-Cheng Lei, Zhi-Qing Xie

International Journal of Chinese & Comparative Philosophy of Medicine

Family has a long history. With China's small-scale peasant economy and traditional cultural background for centuries, family has been the most basic unit of polity, economy, and socio-cultural life. Interests and rights of the individual are always placed below those of family; individual autonomy is often included in family autonomy. All this can be called familism. There are deeper and determining economic reasons for familism. The economy of the family is controlled by the head of the family or clan so that the individual usually has no independent economic measures to support his or her autonomous rights.

Informed consent ...


《赫爾辛基宣言》縱橫談, Yali Cong Jan 2002

《赫爾辛基宣言》縱橫談, Yali Cong

International Journal of Chinese & Comparative Philosophy of Medicine

Along with the development of biomedical research cooperation between China and other countries since late 1980s, many ethical issues have occurred. It is not exaggerating to claim that research ethics is a bright star in the field of bioethics, especially since the end of the 20th-century. It is also appropriate to say that the Declaration of Helsinki consists of the core of contemporary research ethics. This paper will trace the history of Declaration of Helsinki and seek for the clue for positive changes. To do so should be able to help to raise the consciousness of research ethics in people ...


病人訪談:一個知情同意的故事, Shuqing Wu Jan 2002

病人訪談:一個知情同意的故事, Shuqing Wu

International Journal of Chinese & Comparative Philosophy of Medicine

The story reported in this article raises some questions on informed consent. To patients with no education and no medical knowledge, how do medical professionals perform informed consent? In the situation of emergence, should medical professionals be excused from the obligation of informed consent? Or should the patient and his or her family be informed after the illness is cured? If this is so, what is the meaning of informed consent? With the conflict between the interests and the patient and the hospital, the cost is a very importance issue. How does the patient express his or her opinions effectively ...