Manipulation and free will in shared decision making

In recent years, there has been an increased focus on patient involvement in treatment planning in the health care system. To reduce the risk of the clinician moving towards paternalism, various methods have been introduced—shared decision making, among others. The goal of shared decision making is for the clinician and patient to share available evidence on the best treatment and to raise awareness on the needs and preferences of the patient as to make a genuinely informed choice. However, in the present article, we discuss to which degree paternalism can be avoided in light of the clinician's role as an authority with certain knowledge and expertise. Through the philosophical theory of reasons‐responsiveness, we discuss to which extend free will and control applies to the patient. Through theoretical analysis, we come to suggest that the clinician has a role as an ally rather than manipulator.     

Care under threat in the modern world

Despite enormous progress in the understanding and treatment of disease during the 20th century, the amount of care individuals receive from health professionals is arguably less than in previous decades. Being in the presence of caring people who practised human caring has always been the bedrock of services to individuals who were ill. With the rise of scientific positivism in the mid-19th century, traditional ways of caring for sick people, not susceptible to scientific investigation and intervention, were either abandoned or discouraged. The spread of outcome-orientated health services has led to care being redefined as the provision of the finest form of treatment that is financially viable. The spectre of a service in which the human dimension of caring is either prescribed or seen as invalid gives cause for concern. This paper argues for urgent re-examination of what we understand by 'care'.     

我国传统人居环境对健康元素的利用及其分析

当亚健康一词逐渐从理解转为重视之后,西方为此提出了一个新的模式,即健康是机体、心理与社会和环境的总合,并强调环境和社会对身心的影响。环境健康学对人居环境的要求是最大限度地、最全面地为人类的健康开发有利因素,不仅为近期的健康状况着想,也要为远期健康状况着想,并指出日照、小气候、空气质量等对健康的重要性。     

周德安教授针灸治神理论治疗不寐病的临床应用

周德安教授提出"治病先治神"的学术观点,建立了镇静安神法、补益安神法、重镇安神法、开四关法等一系列针灸治神方法,广泛应用于中医脑病以及与精神、情志密切相关的各科疾病。不寐病分虚实辨治,主要概括为肝郁气滞和久病及虚证,将不同的治神方法相互结合,辨证使用,配合不同的针刺补泻手法,取得良好疗效。     

《黄帝内经》七情调摄浅析

七情所诱发的情志疾病内因为患者本人,外因为医者治疗。患者要做到恬淡虚无、乐观向上、修身养神;医者要重视四诊尤重望与问,把握人格特性,对患者进行心理治疗。内、外因相辅相成、共同发展,内因是七情调摄过程中的根本,外因是治疗中不可或缺的部分,在防病与治病中起着关键作用。     

A Lesson in Spirituality

Understanding spirituality during palliative care training is not easy. It slowly unravels itself when one starts caring for patients and meeting their caregivers. One such experience in the hospice has been described in this narrative. A person with advanced incurable cancer is initially in severe distress. Over time, he slowly comes to terms with the situation and eventually, a question from his illiterate wife—an insightful question about any last wish—brings out his desire to have certain religious rituals that were alien to his own religion. After his death, the family members concur with his last wish and also indulge in some religious rituals of their own choice. This story reaffirms that the essence of spirituality is the coexistence of harmony and humanity.     

“大肠者传道之官”新识

在过去相当长的一段时期内,中医学界仅把大肠视为排泄器官。但大肠与神经传导、神经系统病变之间存在紧密联系,以"大肠主神志传导"补释"大肠者传道之官",而不使用"肠脑相通"新理论主要是因为以下2点:①中医学的发展要以经典为主线,凡是能够在原有理念下依附存在的学说,没有必要也不应该作为新的理论提出。②尚有很多周围神经病变的病位并不在中枢神经系统,无法用"肠脑相通"理论解释。"大肠主神志传导"一说旨在提出"神经系统病变从肠论治",更符合中医学整体、互联、恒动的观念。     

临床药学专业学生人文精神的内涵探究与测量

目前为止，对临床药学专业学生人文精神还没有形成统一的衡量标准。本文在借鉴众多学者研究成果的基础上，调研了来自各级医院、卫生管理部门、高校的临床药学、药事管理等方面的专家意见，对临床药学专业学生的人文精神内涵进行了系统全面地剖析，尝试对临床药学专业学生人文精神进行界定。通过问卷调研的方式量化上述研究内容并对调查问卷的数据进行因子分析，最终构建出临床药学专业学生人文精神测量指标体系。该指标体系可以用于临床药学教育的人文素质培养现状测试以及数据分析，对于临床药学专业人文素质教育有一定借鉴意义。     

周德安教授针药并用治疗颤证的临床经验

多数学者从风、火、痰、瘀、阴虚阳亢等角度论治颤证。周德安教授认为许多颤证的发生与阳虚水泛有关,临床上应用温阳利水的方法治疗颤证取得了显著的疗效。中药使用真武汤加减,针灸方面秉承针灸治神的学术观点(取四神方、督脉十三针、背俞穴),同时注重补肾健脾利水、调畅气血。针药并用,共奏温阳利水、熄风止痉之功,临床效果显著。