美国医院伦理委员会产生的原因探析

医院伦理委员会在促进现代医院管理、推进现代医疗卫生事业的发展和现代医学科学的发展以及现代社会的发展进步中发挥着特别重要的作用.美国是世界上医院伦理委员会产生最早的国家.文章就美国医院伦理委员会产生的原因进行了客观深入的探析,透视了美国医院伦理委员会产生的背景,这对推进我国医院伦理委员会的建设与发展必将有重要的启发.     

上海市医院伦理建设的实践探索与未来挑战

本文根据上海市医院伦理建设的工作情况,结合2011年上海市医院伦理委员会对部分医院伦理委员会的督导情况,对我市医疗机构伦理建设的实践进行总结分析,并对未来工作的挑战进行前瞻思考,提出上海市医院伦理建设工作的政策建议.     

上海市医院伦理委员会日常运行管理现状分析

对上海市设有医院伦理委员会的33所公立医院伦理委员会开展的包括伦理审核的申请、日常会议的召开、利益冲突的控制、文档资料的管理、委员会日常经费的来源、伦理培训以及伦理服务的收费情况等日常运行和管理现况的调查内容进行分析，并对上海市医院伦理委员会建设提出建议。     

涉及人的生物医学研究国际伦理准则

伦理委员会审查质量和能力的提高,是生物医学研究符合科学性和伦理合理性的保汪。本文通过介绍复旦大学附属华山医院如何借鉴WHO／TDR伦理委员会评估标准和第三方评估,来进行医院伦理委员会审查能力建设和规范化管理,并取得了一定的成效,总结了一些体会。     

上海市医院伦理委员会机构建设与功能定位的现状分析

通过对上海市33所公立医院机构与医务人员的问卷调查，分析了解了医院伦理委员会机构建设与功能定位的现状。调查显示上海市医院伦理委员会组织与功能框架基本形成，但对于临床医疗服务项目的伦理审核和咨询以及对医务人员生命伦理的教育与培训功能需加强。     

上海市医院伦理委员会功能与管理状况研究概述

介绍上海市医院伦理委员会功能与管理状况研究的背景、内容与方法以及研究的基本结论与建议，为上海市及全国加强医院伦理委员会的规范化建设提供决策信息。     

PDCA循环法在临床研究的伦理初始审查工作中的应用

目的 探讨PDCA循环模式在某医院医学伦理委员会初始审查管理工作中的应用及可行性,以期推进伦理委员会审查能力的持续性建设.方法 本研究运用PDCA循环法,从计划、实施、检查及处理共4个环节对某医院伦理初始审查管理工作进行质量改进.结果 通过明确伦理审查范围、加强制度的实用性和可操作性、规范科研项目伦理审查工作流程、加强...     

从医院等级评审谈医院伦理委员会建设

通过对照医院等级评审标准,阐述了评审标准对医院医学伦理学建设的相关要求,分析了医院伦理委员会建设中存在的问题,提出了推进医学伦理建设的建议。文章强调,推进伦理学教育,加强医德医风建设;严格伦理学督导,提高医疗科研水平;遵循伦理学原则,构建和谐的医患关系。     

上海市医院各类人员对伦理委员会功能与管理状况的综合评价

根据对上海市医院伦理委员会委员、医院管理者与一般医务人员的调查，发现上海市医院伦理委员会工作状况受到良好评价；建议应加强医院伦理委员会管理与工作绩效的研究，应建立医院伦理委员会的认证体系。     

医院伦理委员会建设中的问题及对策

为了解决临床科研中的伦理问题,和谐医患关系,医院伦理委员会应运而生。本文通过回顾医院伦理委员会的发展历程,介绍其主要功能和职责,探讨和分析其运行中存在的问题,并提出相应的对策,以期对医院伦理委员会的普及和发展提供有益参考。     

Maryland hospitals get plan for creating ethics committees

The Maryland Hospital Association's Advisory Committee on Medical Ethics, charged to assist member hospitals in forming ethics committees, focused on four concerns: study and development, physician support, patient/family participation, and potential issues. The committee recommended as a first step in establishing an ethics committee the creation of a study group. It warned hospitals not to expect a fully operational ethics committee immediately. A start-up period, according to the committee, should be used to develop a process for handling ethical questions and for educating the hospital community about the committee's role. To promote the best possible decision making, the hospital ethics committee should function as a support unit, for physicians as well as for patients, families, and hospital personnel. Clearly stated policies will provide a basis for appropriate intervention and help gain physician cooperation, the committee said. Such policies should encourage ethics committees to anticipate problems and to review decisions already made. While recognizing the need to involve patients' families in decision making, the advisory group agreed that the question of their presence at committee meetings should be addressed by each institution. In cases of controversial treatment or disagreement about the course of treatment, patient/family access to the committee should be clearly defined. The advisory committee suggested that each institution prepare its own list of topics that an ethics committee might consider. It also prepared a "model statement" of an ethics committee's purposes, membership, and procedures.     

The Functioning of Hospital Ethics Committees: A Multiple-Case Study of Four Canadian Committees

A multiple-case study of four hospital ethics committees in Canada was conducted and data collected included interviews with key informants, observation of committee meetings and ethics-related hospital documents, such as policies and committee minutes. We compared the hospital committees in terms of their structure, functioning and perceptions of key informants and found variation in the dimensions of empowerment, organizational culture of ethics, breadth of ethics mandate, achievements, dynamism, and expertise.     

药物临床试验中医学伦理委员会运作模式的探讨

鉴于当前国际和我国对临床研究的伦理重视程度日益提高,各级医疗机构相应成立了医学伦理委员会。本文结合医院伦理工作实际,试从伦理委员会的组成、职责、任务及工作模式等有关内容,探讨伦理委员会在当前药物临床试验中的运作模式,从而更好地发挥其在临床试验中的重要地位作用。     

The Presence of Ethics Programs in Critical Access Hospitals

The purpose of this study was to assess the presence of ethics committees in rural critical access hospitals across the United States. Several studies have investigated the presence of ethics committees in rural health care facilities. The limitation of these studies is in the definition of ‘rural hospital’ and a regional or state focus. These limitations have created large variations in the study findings. In this nation-wide study we used the criteria of a critical access hospital (CAH), as defined by the Medicare Rural Hospital Flexibility Program (Flex Program, 2007), to bring consistency and clarity to the assessment of the presence of ethics committees in rural hospitals. The Flex Monitoring Team conducted a national telephone survey of 381 CAH administrators throughout the United States. The survey covered a wide variety of questions concerning hospitals’ community benefit, impact activities, and whether the hospital had a formally established an ethics committee. About 230 (60%) of the respondents indicated they had a formally established ethics committee or ethics consultation program at their CAH. The prevalence of ethics committees declined as the CAH location became increasingly rural along a rural–urban continuum. Unlike CAHs, all rural Department of Veterans Affairs Medical Centers have ethics committees. The results of this study provide an understanding of the limited presence of ethics committee in rural America and the need to consider new approaches for providing ethics assistance. A virtual ethics committee network may be the most efficient and effective way of providing rural hospitals access to a knowledgeable ethics committee or consultant.     

上海市医院伦理委员会伦理审核工作现状分析

对上海市33所公立医院进行了涉及人体生物医学研究的伦理审核状况的调查，结果显示，绝大多数医院伦理委员会均设有初始审核、快速审核与不良事件审核的相应操作规程和要求，但跟踪审核和不良事件审核需进一步加强，上海市医院伦理委员会的伦理审核程序需进一步统一。     

医学伦理原则在医学实践中的作用

医学伦理对规范、约束、指导、监督医学行为,保护患者权益,调节医患关系起着越来越重要的作用。本文通过阐述医学伦理的基本原则,探讨如何加强医院医学伦理建设。要着眼职能作用发挥,强化医院伦理委员会的机构建设;要着眼医学实践应用,全面把握医学伦理原则的规范体系;要着眼行业特点需求,构建患者至上医者仁心的医院文化。     

加强临床医学研究管理促进临床研究良性发展

随着我国医学的发展,临床医学研究项目逐渐增多,管理的相关问题也逐渐显现.为了规范临床医学研究管理,使研究的结果真实可靠,研究结果真正受益于广大患者,中山大学孙逸仙纪念医院通过规范申请程序;发挥学术委员会及伦理委员会的作用;加强项目的过程管理;对研究者加强培训等几个方面严格临床研究项目的管理,促进了医院临床医学研究的良性发展.     

Present status of ethics committees of the medical schools in Japan

Present features and functions of ethics committees in 80 Japanese medical schools were surveyed through inquiries to those institutes by the author. Seventy nine schools have already started their own committees in each campus by the end of 1990, and the remaining one is preparing for its start in near future. The major role of the ethics committee may be said to roughly correspond to that of the Institutional Review Boards (IRB) in the USA, although a role of the hospital ethics committee has been played in addition to its proper functions in many schools. Among many problems two major drawbacks seem necessary to be removed urgently. The first one is an inappropriate composition of the committee in the majority of schools. More members from the outside of the campus, younger generations, and female reviewers should be added to the committee. The second point is the essentially closed review systems in most schools. The process of the review has not been effectively opened to the public yet, even in case in which no privacy of the patients or volunteers appears in the discussion. Several schools are preparing for opening now and the situation will be improved gradually. It was fortunate that the ethics committees in Japanese medical schools were founded by wills and efforts of members of each campus without having any suggestions, recommendations, or orders from the national government or other officials.     

Ethics committees in neonatal care: substantive protection or procedural diversion?

The federal government, the American Academy of Pediatrics, and the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research have all proposed the establishment of hospital ethics committees to solve decision making dilemmas in neonatal as well as other critical care areas. Annas argues that education, consultation, and policy making are inappropriate committee functions and identifies individual case adjudication as the only role uniquely suited to ethics committees. He concludes that the first priority is the development of substantive standards on which committee decisions can be based.     

医学伦理委员会的发展历程、特点及思考

介绍国内外医学伦理委员会的发展历程,指出了医学伦理委员会在发展过程中所呈现的特点,并对我国医学伦理委员会的建设提出四点建议:构建医学伦理委员会认证评估体系,完善生命伦理相关法律制度,加强医学伦理委员会专业人才队伍建设,在吸收国内外公认的基本伦理原则基础上,努力挖掘传统文化.