医务人员劳动风险所致道德失范的规避与调整

简要概括了我国当前医务人员存在的主要劳动风险，以及由此引起的道德失范的主要表现，并对道德失范的主要原因进行了初步分析。在此基础上，重点探讨了开展医务人员道德重建工作的主要举措：①传承中国传统医德与借鉴西方医德规范并举；②加强医务人员道德教育和完善监督制约机制并举；③提高医务人员的待遇和建立保险机制并举；④提高医疗技术水平与加强服务补救并举。     

医务人员劳动风险所致道德失范的规避与调整

简要概括了我国当前医务人员存在的主要劳动风险，以及由此引起的道德失范的主要表现，并对道德失范的主要原因进行了初步分析。在此基础上，重点探讨了开展医务人员道德重建工作的主要举措：①传承中国传统医德与借鉴西方医德规范并举；②加强医务人员道德教育和完善监督制约机制并举；③提高医务人员的待遇和建立保险机制并举；④提高医疗技术水平与加强服务补救并举。     

当前我国医务人员职业道德失范的原因及对策

医务人员的职业道德(简称"医德")是指医疗机构的医务人员在从事医疗活动中所应遵守的行为规范。当前我国医务人员的医德现状不容乐观,医德建设总体上不够完善,存在较多失范现象,原因主要包括国家法律政策的不完善、利益最大化追求、医务人员自身的医德素质下滑和群众监督机制的缺失。本人针对医务人员医德失范的原因,从加强医德教育、加强监督、探索适当的激励措施和合理的补偿机制几方面提出了解决对策。     

医务人员劳动风险的道德规避与调整

本文剖析了医务人员所面对的劳动风险,指出解决劳动风险道德问题从传承中国传统医德与借鉴西方医德规范并举、加强医务人员道德教育和完善监督制约机制并举、提高医务人员的待遇和建立保险机制并举、提高医疗技术水平与加强服务补救并举四个方面入手,方能取得满意的效果。     

医德的嬗变与重建

随着改革开放和社会主义市场经济的不断深入发展。医院的管理体制、经营机制在变，医务人员的思想观念、价值取向、道德准则也在变。医务人员的竞争意识、进取意识、经济意识有了明显提高。同时一些负面影响也随之产生。传统的医德观念正经受着巨大变革的冲击而产生了嬗变，医务人员产生的道德失衡、道德失范、道德失调等现象已成为社会关注的热点。本文将针对这些问题，分析其产生的基本原因，着重从强化宣传教育、强化从业意识、强化敬业意识、强化自身素质等方面加强医德建设，并提出相关的建议和对策。     

医护道德在治疗过程中对患者的影响

医德是医护人员的职业道德，它具有高度的责任心，高水平的诊疗技术，吃苦耐劳的服务宗旨；为病人提供良好的服务条件，促使病人早日康复；叉反映当今社会的文明程度和文化素养，是衡量医务人员医护道德的标准。现浅谈医德在治疗过程中对病人的影响。     

当前医德建设存在的主要问题与对策

当前医疗行业医德建设存在的主要问题：部分医务人员价值取向错位；医务人员服务意识不够；出现医务人员自我保护性医疗现象。究其原因有：医德建设缺乏制度保障；医院在市场经济中自身面临着生存问题；卫生行政部门对医疗机构缺乏有效的监督和考评；医务人员的劳动报酬不能体现医疗工作的高技术风险性；医患双方存在着严重的信息不对称；医学教育课程设置缺乏社会人文学科。为此，要加强制度建设，为医德建设提供保障；树立“以人为本”的理念，内化医德；强化法律意识，以法治德；建立有效的医德考评制度。     

试论医学道德对医疗质量的影响

医学道德(以下简称医德)是医务人员应该具有的职业品德,它是规范医务人员与病人之间、医务人员相互之间以及医务人员与社会之间行为的基本准则。医院管理的最终目的是提高医疗质量和医疗服务工作的社会效益。而社会效益的提高需要通过每个医务工作者职业实践活动来体现。指导这一实践活动的思想和行为的规范,就是社会主义医德。开展医德教育,提高广大医务人员自身的医德素质是现代医院管理的灵魂。为了切实有效的搞好医     

关于医德重塑的几点思考

通过对当今社会上对于医师道德缺失现象的强烈反映,提出医疗领域法制法规不够健全、医疗服务商业化和市场化、医疗资源相对较少、保护性医疗手段的有用性,是部分医务人员医德失范的主要原因;并提出医德重塑的几点建议:建立大医德观、完善医德规范、将医德教育常态化、拓宽患者就医渠道、加大宣传正确引导等.     

学术道德与科研管理

本文讨论了学术道德与科研管理的关系，学术不端行为、学术腐败、学术浮躁等都是学术道德失范的表现。缺乏有效的管理措施，过多行政关系和人际关系干预及过渡强调目标的科研管理体系是学术道德失范的重要原因。为加强学术道德建设，应增加透明度，依靠独立调查，将监督落到实处；同时明确管理部门职能，建立合乎科学发展规律的科研管理体系。     

Medical ethics, moral philosophy and moral tradition

Medical ethics is commonly assumed to be a form of 'applied moral philosophy' in which practical moral judgments are deduced from moral theories. This account of the relationship between moral theory and moral judgment is inadequate in several reports. The deductivist approach often results in inadequate attention being given to social, historical and developmental contexts. It also fails to explain some common phenomena in practical moral reasoning. In contrast to the emphasis in deductivism, a case-centered or casuistic practical ethics insists on immersion in the particularities of cases and on interpretation of details in light of moral maxims and other mid-level forms of moral reasoning. Two features of casuistics that ought to be distinguished but frequently are not, are: (1) the emphasis on immersion and interpretation, and (2) a claim about the relation between moral judgment and moral theory as sources of moral knowledge. Once we consider case-centered moral judgments as sources of moral knowledge, we must also begin to look critically but open-mindedly to moral traditions which, upon examination, appear to be more dynamic and to have more reformist potential than is commonly assumed.     

Integrity and moral residue: nurses as participants in a moral community

Abstract This paper will examine the concepts of integrity and moral residue as they relate to nursing practice in the current health care environment. I will begin with my definition and conception of ethical practice, and, based on that, will go on to argue for the importance of recognizing that nurses often find themselves in the position of compromising their moral integrity in order to maintain their self‐survival in the hospital or health care environment. I will argue that moral integrity is necessary to a moral life, and is relational in nature. When integrity is threatened, the result is moral distress, moral residue, and in some cases, abandonment of the profession. The solution will require more than teaching bioethics to nursing students and nurses. It will require changes in the health care environment, organizational culture and the education of nurses, with an emphasis on building a moral community as an environment in which to practise ethically.     

Leadership and moral purpose

Max O. De Pree is Chair of the Board of Directors of Herman Miller, Inc., Zeeland, Michigan. The following Leon I. Gintzig Commemorative Lecture was delivered at the American College of Healthcare Executives Congress on Administration in March 1993. Portions of this address were previously delivered as the Distinguished Executive Lecture at Purdue University, 21 August 1992. Interested readers are encouraged to read De Pree's books, Leadership Is an Art (1989) and Leadership Jazz (1992).     

Teaching health care ethics: the importance of moral sensitivity for moral reasoning

Abstract My discussion reflects on the nature of moral sensitivity. The inquiry is guided by a pedagogical concern: if the goal of teaching practical‐minded nurses about health care ethics is to develop the capacity to be aware of ethical implications of certain acts, events and treatments in the health care setting as well as the skills to resolve ethical dilemmas, it seems important to have a clear sense of what it means to be morally sensitive. How, for example, does a health care worker come to recognize in a particular and institutionally defined situation his or her moral responsibilities towards the other? What exactly is moral sensitivity? Is it something that academic philosophers can teach? I argue that moral sensitivity is a capacity for relatedness indispensable to moral theorizing that can be either cultivated or undermined and therefore ought not to be ignored by educators nor those responsible for ethically weighted decision‐making situations.     

论医学伦理选择中的权变问题

由于医疗过程所处具体情境的特殊性或复杂性,即使是真诚认同医学伦理原则的人们,也会存在有意识或无意识地偏离某项医学伦理应用原则的情形.虽然这种偏离只是通权达变,但对医学伦理原则的影响十分巨大.医学伦理选择中的权变行为作为特殊情况下的变通措施,具有内在的必要性和合理性,但这只是对某项医学伦理原则的暂时性偏离,而非根本否定.在不同伦理原则发生冲突的情况下,伦理选择的权变要求对不同医疗行为的伦理价值进行判断与选择.恰如其分的医学伦理权变,依赖于医务工作者的高度理性,依赖于对各种医疗方案的伦理价值所做的正确判断.     

Tragedy in moral case deliberation

In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants. A case study design is used by conducting semi-structured interviews (N = 10) with health care professionals who both played a role in the treatment of the patient and attended the MCD. The results show that MCD helps people to deal with tragic situations. An important element of MCD in this respect is making explicit the dilemma and the damage, demonstrating that there is no simple solution. MCD prompts participants to formulate and share personal experiences with one another and thus helps to create a shared perception of the situation as tragic. The article concludes that MCD contributes to the sharing of tragic experiences, and fosters mutual interaction during a tragedy. Its value could be increased through explicit reflection on the aspect of contingency that characterises tragedy.