The positive aspects of medical ethics today

The author of this comment suggests that some of the important points made by Dr Adrian Rogers are vitiated by a tendency to contrast the worst of modern medical practice with an over-idealised view of the past. The state of medical ethics today, the author suggests, is more hopeful than Dr Rogers allows.     

充分发挥医德档案在医德医风建设中的作用

健全医德档案强调坚持医德考评归档制度，对医务人员的医德医风情况进行详实的考核登记，使医务人员有正确的思想导向、规范的从业准则、发挥工作潜力、减少医患矛盾。如何充分发挥医德档案在医德医风建设中的导向、自律、奖惩、调节作用，才是建立健全医德档案的主要目的和意义。     

弘扬"杏林"医德文化加强现代医德建设

祖国医学有着悠久而优秀的传统文化,她吸取了中国传统文化之精华,博大精深.在中国医学史上,有许多杏林佳话在世间历代流传,"杏林文化"在祖国医学界不断发扬光大,并逐步形成了为世人推崇的行医准则和道德标准,这些优秀的历史文化,对我们今天的医德建设也有极为重要的意义.     

从医德教育入手提升医疗服务公信力

医疗服务公信力下降是毋庸置疑的事实,其原因是多方面的,但可从医德教育角度增强医务人员的医德素养,提升医疗服务公信力。     

Focus: current issues in medical ethics: Medical ethics and child psychiatry

The authors, both child psychiatrists, discuss some of the ethical problems that arise in their practice, in relation to advice given in the British Medical Association's Handbook of Medical Ethics. They find that the main problems occur when multidisciplinary cooperation is needed.

Their concern about confidentiality is shared in the papers by Kenny, Pheby and their commentators, which follow this one.

     

Focus: current issues in medical ethics: The drawbacks of research ethics committees

Research ethics committees, while in many ways an excellent innovation, do have some drawbacks. This paper examines three of these. The first problem of such committees is that their approval of specific projects in their own institutions acquires intrinsic value.

The second problem relates to the possible devolution of responsibility from the investigator to the committee. The committee approves, the investigator feels relieved of some responsibility and things can be done to patients which neither the committee nor the investigator might countenance if they had sole responsibility.

The third problem arises directly from the bureaucratic nature of the committee itself. And one consequence of the resulting rigid guidelines is the insistence, by most committees, on the written consent of patients. Demanding this can, in some circumstances, mean giving the patient very disturbing information. The paper suggests that in patients with a fatal disease where trials compare two accepted therapies committees dispense with written consent.

There is a commentary on this paper by Dr D J Weatherall of the Nuffield Department of Clinical Medicine, University of Oxford.

     

Confidentiality and the ethics of medical ethics

In this paper we consider the use of cases in medical ethics research and teaching. To date, there has been little discussion about the consent or confidentiality requirements that ought to govern the use of cases in these areas. This is in marked contrast to the requirements for consent to publish cases in clinical journals, or to use personal information in research. There are a number of reasons why it might be difficult to obtain consent to use cases in ethics. Many cases concern people who are incompetent, and thus unable to give consent. Often the material is of a sensitive nature, it is not clear who should give consent, or the ethicist has no access to those involved. We argue that the use of cases in ethics research and teaching can be justified by appeal to the public interest argument, and suggest a number of areas for discussion and clarification.     

Teaching medical ethics: University of Edinburgh

The Edinburgh Medical Group Research Project is unique in Britain. Part of its function is to experiment with teaching medical ethics both inside and outside of the Medical School. The papers which follow have been written by two full-time reseach fellows working with the Project and two of the professional advisers, one nursing and one medical. Together they give a picture of the wide scope of exerimental teaching taking place in Edinburgh and present some preliminary results from these experiments.     

医学伦理学:医学研究中不可回避的问题

中华医学会杂志社通知各中华系列杂志编辑部在2005年的投稿须知中增加有关医学研究伦理方面的要求,其主要内容为：“当报道以人为研究对象的试验时,作者应该说明其遵循的程序是否符合负责人体试验的委员会(单位性的、地区性的或国家性的)所制定的伦理学标准并得到该委员会的批准,是否取得受试对象的知情同意”。这是一个非常重要的事件,是一个非常重要的信号,预示着我国医学研究,     

Focus: current issues in medical ethics.

The current debates about seat belts in motor cars and the evils of smoking may only be straws in the wind if the scenario sketched in this paper were translated into a social, political programme. Then ''illness would increasingly be seen as a failure to keep healthy and thus culpable. The failures [the patients] ... must either be irresponsible and hence punishable at least by the imposition of financial penalties or insane and thus in need of corrective therapy.'' If this sounds like 1984 the reader must read the whole argument set out in this paper and make his own judgment. He may not be encouraged by what he reads but he will be forewarned. There is no answer to the question, What shall I do, if this prophecy is true?