白求恩精神与护士角色塑造

白求恩精神是医护工作者宝贵而巨大的精神财富,也是医学伦理本性的集中体现。在护士角色塑造中应秉承白求恩精神的三个层面,从外在形象、内在道德和技术水平三个维度来实践对护士角色的塑造。     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

The teaching of medical ethics

The following two papers, the first from Sweden, the second from the United States of America, form the first of a series on the teaching of medical ethics.

In Sweden the teaching of medical ethics is not obligatory but many professors and clinical teachers include it in their approach to the practice of the different branches of medicine. In the United States hundreds of formal courses are being offered and research projects and the tools of research are beginning to emerge.

Dr Blomquist defines the concept of medical ethics, and proposes criteria for its application, for example, to euthanasia. Dr Veatch and Miss Fenner outline the courses and provision for the teaching of medical ethics to undergraduate and postgraduate students both in the medical schools of America and in other university schools.

     

我国整形外科溯源及其早年发展概况

鸦片战争开始后,现代整形外科随西洋医学的东渐由传教士传入我国,经查阅我国解放以前的医学期刊文献资料,可以确认我国整形外科最早出现于１９３４年,由倪葆春创建,并查得与整形外科有关的论文共只２７篇,其所包含的内容基本可以反映该历史时期发展及其水平的概况,由此可认为在解放前这一学科尚处于萌芽阶段。     

The Medical Society of London

The Medical Society of London was founded in 1773 by the Quaker physician and philanthropist, Dr John Coakley Lettsom, who was convinced that a combined membership of physicians, surgeons, and apothecaries would prove productive. His revolutionary idea met with success and the Society has provided a forum for all branches of the medical profession for the last 231 years. Situated at the heart of London's medical community at Lettsom House, Chandos Street, near Cavendish Square, this is the oldest medical society in the United Kingdom.     

Do drug advertisements provide therapeutic information?

In this study of advertisements appearing in medical periodicals and by direct mail advertising to general practitioners, Dr. Stimson, a sociologist, concludes that from what is intended to provide therapeutic information hardly any therapeutic information is provided. He reminds the reader of the safeguards which surround all drug advertising by law and by the code of practice of the Association of the British Pharmaceutical Industry but these safeguards do not appear to control real or potential sins of omission. Frequently in these advertisements the literature relating to the drug is quoted but Dr. Stimson found that it was difficult to trace all the papers quoted in different types of medical library. (Some references quoted were to unpublished papers but surely the blame should be shared in this situation?) Dr. Stimson also gives a vivid and fascinating glimpse of what he calls the ''images and stereotypes'' of the patients who, it is claimed, would benefit from the drug being advertised. Certainly most general practitioners must be aware that when they prescribe that image is displaced by an individual but the portrait gallery is indeed depressing. However, to balance these advertisements drug companies issue data sheets which must be more informative than advertisements and conform to regulations in their format. Unfortunately data sheets are only issued every 15 months whereas the ''average general practitioner is potentially exposed to 1,300 advertisements every month''. In other words, the data sheet and not the advertisement should be the guideline but it arrives too infrequently to offset the lack of therapeutic information contained in advertisements.     

Dr. Xuan Guowei＇s Experience in Treating Dermatosis

Dr. Xuan Guowei has been engaged in medical practice, teaching and scientific research on dermatosis for nearly 40 years, and is famous for his meticulous scholarship and outstanding art of healing. The following are some examples of his unique academic ideas and creative clinical practice.     

A reply to Joseph Bernstein.

Dr. Bernstein suggests that anti-vivisectionists should be able to fill in a directive requesting that they receive no medical treatment developed through work on animals. It is replied that this would only be reasonable if research not using animals had long been funded as adequately and its results were currently available.     

Looking back and looking ahead as the CMA turns 130

The handful of "medical men" who founded the CMA 130 years ago this month could not have predicted the changes their association would witness. In this article Dr. John Bennett discusses some of these changes and considers some of the issues that may lie ahead.     

PEI's fixed link to mainland a living laboratory for occupational medicine.

Occupational health data suggested there would be many injuries and one fatality for every kilometre of the 12.9-km bridge that by next year will link Prince Edward Island to the rest of Canada. However, Dr. Scott Cameron reports that the project's safety record has far exceeded expectations. The family physician from Summerside, PEI, is delighted to be medical adviser for the history-making project.     

Dr. Shang Zhaokui＇s Experience in Acupuncture Treatment of ThreeObstinate Cases

Dr. Shang Zhaokui (尚兆奎) has accumulated a wealth of experience in the acupuncture treatment of obstinate diseases in his clinical practice for more than 30 years. The following are three examples I would like to share with my colleagues.     

When consent is unbearable: an alternative case analysis.

Dr Agich takes up a previous difficult case related by Dr Kottow in an earlier issue of the Journal. He analyses the three ethical problems as presented in the case and offers his own opinion of it as well as his own conclusions with regard to the medical ethical aspects of it. Unlike Dr Kottow, Dr Agich's reading of the case indicates that the application of the principle of informed consent does not rule out ethical decisions for the physician, but emphasizes the relevance of ethical analysis beyond the issue of informed consent.     

Dr. Max King: the sad life and early death of Mackenzie King''s physician brother

While researching her best-selling biography, Mrs. King: The Life and Times of Isabel Mackenzie King, CMAJ contributing editor Charlotte Gray discovered a wealth of information about Dr. Dougal Macdougall (Max) King. Although he never became as famous as his older brother Mackenzie, Gray presents a convincing argument that Dr. Max King's life and early death speak volumes about medicine and the medical profession at the turn of the century. She also argues that Mackenzie King's own life would have been much different had his brother not died at the too young age of 42. Gray's book was nominated for the Viacom Award, which honours the best nonfiction book published annually in Canada.     

孟河医派治疗咳嗽经验探析简

盂河医派是近代中医药最有影响的一大流派,以其和法缓治的医疗风格而著称。该文以孟河医家的传世著作中有关咳嗽的医论、医案为研究对象,从理、法、方、药等方面,分析孟河医家费伯雄、马培之、丁甘仁治疗咳嗽的主要经验。     

The teaching of medical ethics in the Federal Republic of Germany.

Eduard Seidler sets his discussion of the teaching of medical ethics in the Federal Republic of Germany against an historical background. Immediately after the Second World War the freshness of the memory of the 'Nuremberg Medical Trials' influenced the way in which moral dilemmas were treated in Germany. At the present time no systematic instruction in medical ethics is provided in either undergraduate or postgraduate or continuing medical education. As a result of this, an inquiry was set up in 1977/78. Questionnaires were sent out with a view to collecting information on how subjects referring to medical ethics are treated during medical training. The inquiry showed that no special discipline can claim to be the only competent one for medical ethics, but that everyone has something to contribute. Dr Seidler concludes by stating that basic curricula related to the problems of medical ethics would have to be developed and should be carried on continuously within the training programme.     

Symposium 1: The Arthur case--a proposal for legislation.

Following the acquittal of Dr Leonard Arthur in the case of the Down's syndrome infant the co-authors of the first paper in this symposium prepared a draft bill on the treatment of chronically disabled infants which has since been informally commended by the Director of Public Prosecutions. A second contributor, a law student, also argues for legislation as being the most effective way for society to have its standards clarified and observed. In a final paper Dr Havard, Secretary of the British Medical Association, opposes legislation believing it would raise far more problems than it would resolve. The first article was originally published in the Law Society's Gazette.     

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.     

Alternative medicine: methinks the doctor protests too much and incidentally befuddles the debate.

Dr Kottow in his paper Classical medicine v alternative medical practices (1) places the alternative/orthodox medicine debate within an historical context of anti-quackery literature. My paper explores the nature of science as it is applied to clinical practice and challenges the narrow view of the diagnostic process as outlined by Dr Kottow. Research methodologies more appropriate to 'whole person' medicine are suggested as having more ethical value than those based on the clinical trial.