可否允许器官买卖?——来自道义论和后果论的挑战

主要从道义论和后果论角度反对器官买卖，并提出可供参考的建议。器官买卖将人体器官商品化，侵犯了人的价值，同时，在器官买卖中卖者的自主性和知情同意是难以做到的；器官买卖足以使器官移植技术只为少数有钱人服务，变成富人的专利，加剧了社会的不平等，会导致富人对穷人的剥削。并在论证当中分别反驳了国外颇为流行的观点。     

Development and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults

PurposeWe developed and validated a measure that assesses the latent construct of sexual and reproductive empowerment among adolescents and young adults. A specific measure for this group is critical because of their unique life stage and circumstances, which often includes frequent changes in sexual partners and involvement from parents in decision-making.MethodsAfter formative qualitative research, a review of the literature, and cognitive interviews, we developed 95 items representing nine dimensions of sexual and reproductive empowerment. Items were then fielded among a national sample of young people aged 15–24 years, and those who identified as sexually active completed a 3-month follow-up survey. We conducted psychometric analysis and scale validation.ResultsExploratory factor analysis on responses from 1,117 participants resulted in the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults, containing 23 items captured by seven subscales: comfort talking with partner; choice of partners, marriage, and children; parental support; sexual safety; self-love; sense of future; and sexual pleasure. Validation using logistic regression demonstrated that the subscales were consistently associated with sexual and reproductive health information and access to sexual and reproductive health services measured at baseline and moderately associated with the use of desired contraceptive methods at 3-month follow-up.ConclusionsThe Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults is a new measure that assesses young people’s empowerment regarding sexual and reproductive health. It can be used by researchers, public health practitioners, and clinicians to measure sexual and reproductive empowerment among young people.     

High vs. low entrustment behaviors in the operating room

BackgroundOperative experience with an appropriate degree of supervised autonomy is critical to resident training. Progressively greater intraoperative entrustment has been associated with gradually higher levels of resident autonomy. This study attempts to identify consistently observed intraoperative behaviors that are linked with higher resident entrustment.MethodsThis qualitative study analyzed observational notes recorded by trained raters who provided entrustment scores for 204 surgical cases at Michigan Medicine from 2015 to 2017. Notes were coded in NVivo12. Thematic analysis was used to identify themes and patterns within the data.ResultsThe analysis generated 144 codes. Codes were clustered into 10 themes. These themes manifested differently in intraoperative behaviors strongly associated with high entrustment versus low entrustment.ConclusionThis study demonstrates key differences in intraoperative behaviors exhibited by residents and faculty in high and low entrustment interactions. Awareness of behaviors that enhance entrustment can help faculty augment resident learning and enable higher resident operative autonomy.     

Identification of promotion and prevention associated surgeon behaviors in the operating room to facilitate resident self-regulated learning

BackgroundThe regulatory focus theory (RFT) posits that people can pursue goals with a promotion or prevention focus. Greater alignment of RFT motivational styles between faculty and residents may enhance resident operative autonomy. This study establishes a set of faculty behaviors residents can identify to infer faculty motivational styles.Methods10 behaviors associated with promotion and prevention motivational styles were identified. General surgery residents rated faculty on how strongly they exhibit these behaviors. Faculty conducted a self-assessment of how strongly they exhibit these behaviors.ResultsThere is a positive correlation between resident and faculty ratings for the promotion-associated behaviors of “works quickly,” “high energy,” and “mostly provides broad oversight,” and for the prevention-associated behaviors of “works slowly and deliberately,” “quiet and calm,” and “preference for vigilant strategies.”ConclusionResidents can observe faculty operative behaviors to infer faculty motivational styles. Residents may use this knowledge to adjust to faculty motivational styles and enhance operative interactions.     

Repenser le handicap : leçons du passé, questions pour l’avenir. Apports et limites du modèle social,de la sociologie des sciences et des techniques,de l’éthique du care

In this article, I analyze one evolution in disability research over the past 30 years: the shift from an individual to a social approach to disability. While most disability research has currently “socialized” disability or at the least situates disabled people within a social context, not all do so in the same way nor based on the same assumptions. They lead to different concepts of the person and society and different concepts of disability and normalcy. I analyze this evolution by looking at three approaches to disability: the social model, the approach taken in the sociology of science and technology, and the ethics of care. I show how each, by renewing the analysis of disability, has brought about changes for disabled people and transformed ways of “living together” and “making society”. I also show the limits of these approaches and propose lines of thought for the continuation of our research, notably around the question of autonomy. I propose that we rethink autonomy from the standpoint of the notion of “recalcitrance”.     

The Developmental Method in Drama Therapy

No abstract available for this article.     

Les enjeux de l’autonomisation de jeunes adultes confrontés à des troubles psychiques

In this paper, we offer to describe and analyze the social uses of the notion of autonomy in the life courses of young adults facing psychic disorders. We will rely on a three-year long longitudinal survey that was conducted in the context of a sociology thesis with 21 young adults treated in psychiatric and medico-social institutions. We will describe in what manner issues relating to these young users’ commitment in the support put in place around them emerge amongst differentiated or shared representations of autonomy.     

Principles of effective communication with patients who have intellectual disability among primary care physicians

ObjectiveExamine physicians’ implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors.MethodsFocus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID.ResultsSubjective knowledge of ID and more patients with ID increased utilization of effective communication principles. Provision of knowledge that allows patients to make their own medical decisions was predicted by more patients with ID, lower attitudes that treatment of this population group is not desirable, less negative affect and greater perception that treatment of this group is part of the physician's role. Effective preparation of patients with ID for treatment was predicted by higher perception of treatment of this group as part of the physician's role, lower perception of this field as undesirable and higher perception of these individuals as unable to make their own choice. Simplification of information was predicted by a greater perception of treatment of this group as part of the physician's role and more negative affect.ConclusionGreater familiarity may enhance care for these patients.Practice implicationsIncrease exposure to patients with ID within training.