传统医德教育与转型期医学生职业道德教育的实践创新

医学院校对医学生的职业道德教育,不仅要遵循一般高等院校职业道德教育的普遍规律,而且必须结合医学院校和医学职业活动的特点,侧重加强医德教育.传统医德教育对培育医学生的民族精神、人文精神,牢固树立医学专业思想等方面具有现实意义,但在新的历史条件下,若再以单纯的传承传统医德观念,则难以适应医疗卫生事业发展的需要,探讨传统医德的传承和提高医学生职业道德教育有效性的实现路径,已经成为医学教育的必然需求.     

Imagination in practice.

Current focus in the health care ethics literature on the character of the practitioner has a reputable pedigree. Rather than offer a staple diet of Aristotelian ethics in the undergraduate curricula, perhaps instead one should follow Murdoch''s suggestion and help the practitioner to develop vision and moral imagination, because this has a practical rather than a theoretical aim. The imaginative capacity of the practitioner plays an important part in both the quality of the nurse''s role enactment and the moral strategies which the nurse uses. It also plays a central part in the practitioner''s ability to communicate with a patient and in the type of person which the practitioner becomes. Can the moral imagination be stimulated and nurtured? Some philosophers and literary critics argue that not only is this possible, but that literature is the means of doing so. If this is the case then a place should be made for literature in already crowded health care curricula.     

Medical ethics and medical practice: a social science view.

This paper argues that two characteristics of social life impinge importantly upon medical attempts to maintain high ethical standards. The first is the tension between the role of ethics in protecting the patient and maintaining the solidarity of the profession. The second derives from the observation that the foundations of contemporary medical ethics were laid at a time of one-to-one doctor-patient relations while nowadays most doctors work in or are associated with large-scale organisations. Records cease to be the property of individual doctors, become available not only to other doctors but also to educational and social work personnel. Making records openly available to patients is suggested as the only antidote to this irreversible loss of individual practitioner control. The importance for doctors of understanding the nature of professional and bureaucratic organisations in order to deal with the hazards involved is stressed as is the responsibility of the General Medical Council to regulate medical competence as well as personal behaviour.     

医学生医德实践现状的调查与思考

目的调查广州医学院临床专业学生人校时的医德状况,指导实习生医德教育。方法要求一年级学生（183人）回答“流浪汉需急救”时采取的医疗实践行为。依照《卫生部医务人员医德规范及实施办法》进行分类统计。结果99．45％的学生认为应立即抢救;28．96％的学生会使用价廉物美的药物;仅38．80％的学生提到患者情绪。且男女间无差异（P〉0．05）。结论一年级学生已有“救死扶伤”意识,但需学习如何将医德付诸实践。     

医学伦理学教学模式的改革与实践

依据全面素质教育思想、互动式教学和系统育人理念,基于资料统计和调查方法,形成了新的教学模式。围绕以学员为中心、提高医德素养的教学理念,在培养理念、内容、途径、条件和考核方式等方面对医学伦理学课程进行全方位、多层次的教学改革,构建了“三结合”的教学模式。     

Risk and medical ethics.

Quantitative estimates of risk, and their comparison with quantitative estimates of benefit, contribute usefully to decision-making in many fields. In medicine, our assessments of the probability of harm, and of the likelihood of benefit, resulting from many procedures are at present very limited. Moreover, the comparison of risk and of benefit is difficult to make in any quantitative way, whether for a procedure in general or, even more so, for its application in any particular patient. Yet it must be ethically insecure to propose or to use a procedure without some assessment, however approximate, of the hazards involved, and without some indication of whether those hazards will be clearly offset by the likelihood of benefit that should result from use of the procedure.     

Metaphysics and medical ethics.

I take issue with Frank Leavitt's sketch of a pragmatic criterion for the relevance of metaphysics to medical ethics. I argue that appeal to the potential for confusion generated by metaphysical subtlety establishes a need for better communication rather than shows philosophical insight beside the point. I demonstrate that the proposed Criterion of Relevance has absurd consequences, and I claim that the relevance of philosophical doctrines, whether ethical or metaphysical, is best accounted for in terms of improved understanding.     

Law and medical ethics.

Summarising the interrelationship between law and medical ethics, I would say that in cases which do not touch the patient's body or integrity, such as professional secrecy, statutory law may take precedence over rules of medical ethics. But in cases where the human subject becomes a victim because of domestic statutory laws which are in contradiction with medical ethics, the medical practitioners should insist on adhering to their professional standards in such a way that the legislators will have to adapt their legislations to the laws of humanity and public conscience. Legislators, as well as medical practitioners, should not forget that the term 'being' is preceded and qualified by 'human'.     

Computer-aided medical ethics.

This paper describes COMET, the first 'expert' computer system to incorporate a comprehensive set of the rules of law and medical ethics relating to consent to medical treatment.