冲突与共识：《泥泞时节的两个流浪汉》的应用伦理学解读

罗伯特·弗罗斯特诗作《泥泞时节的两个流浪汉》以直面现实的态度忠实记录了发生在大萧条时期的一场富于伦理意味的冲突。传统伦理批评强调对是非善恶做出判断和选择，在面对此类道德悖论时往往陷入两难僵局。应用伦理学倡导直面冲突、依靠商谈程序、寻求道德共识和容错纠错，恰好为这首诗的解读提供了钥匙。     

论侵犯知情同意权的类型

如何有效防范和化解医疗纠纷是医院和社会面临的共同问题。对医疗纠纷进行类型化研究，分析医疗纠纷产生的原因。结合现实案例，对侵犯知情同意权纠纷类型划分为：未取得患者同意而实施治疗行为、告知义务存在瑕疵以及侵犯知情权引起的纠纷三种。     

Heritability,family, school and academic achievement in adolescence

We demonstrate how genetically informed designs can be applied to administrative exam data to study academic achievement. ACE mixture latent class models have been used with Year 6 and 9 exam data for seven cohorts of Polish students which include 24,285 pairs of twins. Depending on a learning domain and classroom environment history, from 58% to 88% of variance in exam results is attributable to heritability, up to 34% to shared environment and from 8% to 15% depends on unique events in students’ lives. Moreover, between 54% and 66% of variance in students’ learning gains made between Years 6 and 9 is explained by heritability. The unique environment accounts for between 34% and 46% of that variance. However, we find no classroom effects on student progress made between Years 6 and 9. We situate this finding against the view that classroom peer groups and teachers matter for adolescent learning.     

Is aspiration and sclerotherapy treatment for hydroceles in the aging male an evidence-based treatment?

Symptomatic hydroceles are commonly treated with surgical repair. They are associated with sexual dysfunction in the aging male. Patients who are not fit for surgery often undergo aspiration and sclerotherapy of the hydrocele. There is a range of sclerosing agents used in the literature. I performed a literature search to assess whether one sclerosant was better than the others. STDS is the sclerosing agent with the best cure rate after a single injection and low side effect rates. The cure rates of sodium tetradecyl sulphate (STDS) after a single aspiration and injection were 76%. After multiple treatments 94% achieved a cure. Patient satisfaction rates at mean 40 months were 95%. Complication rates were generally low and much lower than surgical repair. Aspiration and sclerotherapy have a role in treating symptomatic hydroceles. This literature review shows that this is over and above its current use in the UK, where it is used for patients unfit for general anaesthetic. If the patients are carefully selected for this procedure, they can have a good outcome and avoid the higher complication rate and longer recovery rates of surgical repair. Patients should be counselled about aspiration and sclerotherapy as part of the informed consent process.     

Ableism,ambiguity, and the Anna Stubblefield case*

This article discusses the ongoing case of Anna Stubblefield, a former Rutgers University philosophy professor who was convicted of the sexual assault of an African American man with cerebral palsy. On appeal, the conviction was reversed, and as of this submission Stubblefield is awaiting news from the state of New Jersey Supreme Court as to whether there will be a retrial. This piece engages with Sherry’s article in this journal, and dissects the many layers of ableism at play in this case, arguing that justice will not be served until the alleged victim gets to be heard.     

Community confidentiality,consent, and the individual research process: Implications for demographic research

Institutional review boards are increasingly meticulous about informed consent and risks and benefits to study participants. Concurrently, heated debate in a number of fields has advanced the notion of community risk and benefit. When research is conducted in communities, and the results may “do harm to” communities socially, economically, or medically, should informed and voluntary consent be obtained from communities as well? We argue that for demographers – by definition interested at the phenomena at the population level – concern for individuals as a part of communities is critical to the research process. Questions of community consent, confidentiality, and participation will be pushed to the fore as demography delves into new areas and methods of investigation. This paper provides a brief overview of the historical development of ethics in human subjects research and the subsequent ties to community-level concerns. Drawing on current examples from a variety of settings, we explore definitions of community, the scope and viability of community participation in research, and the implications of these for demographic enquiry. We find that in contrast to substantive debates, little attention has been given to ethical issues in the demographic research process. Research accountability to communities, including the documentation of community risks and benefits, and community representation and consultation in the research process are recommended.     

是民主的“多数”,还是“多数”的民主——论民主之多数决定原则

民主与＂多数＂天生不可分离,民主之所以能够实现是依赖于多数决定;离开多数决定原则,则任何一项决议都不可能形成。但多数决定意味着牺牲＂少数＂,且＂保护少数＂亦难以达到民主。因此,多数决定原则必须回归＂公意＂,即＂多数＂决定之可行乃是因其对＂公意＂判断的准确性得到人民（包括＂少数＂）的认同;＂少数＂与＂多数＂的形成并不是利益对抗的结果,而是因对＂公意＂判断的分歧所致。这就决定了民主的＂多数＂代表的是共同利益而非＂多数＂利益,也正因为如此,民主才不至于沦落为＂多数＂的民主。     

准确把握医疗知情同意权 构建和谐医患关系

医疗知情同意权实现的好坏直接影响着医患关系的走向,保证知情同意权的切实履行,医患双方进行积极有效的沟通是关键,文章阐述了阻碍医患沟通的因素,提出合理分配医疗资源,引导患者理性就诊;进一步完善相关法律法规;加强医院就诊条件的人性化设计及提升医院的社会形象。     

美国史学界对流行文化与其受众关系的研究

流行文化研究,是当今美国的热门学术领域;对流行文化与其受众关系的探讨,则是其中的一个重要课题。美国史学界关于这一课题的研究,不仅涉及到对某些历史事实的叙述,更是透视美国史学理论发展的一个重要窗口。综述“无权”与“有权”两种观点的主要著作,勾勒美国史学界流行文化受众研究的发展历程,或许有助于把握美国当代文化史研究的发展方向,有利于进一步深入理解流行文化研究在史学界的发展脉络。此外,西方马克思主义的一支———法兰克福学派对流行文化问题的探讨对美国史学界关于受众研究也产生了重大影响。     

知情同意--临床医疗服务观念的变革

随着社会文化价值观念的变革 ,以及伦理道德的逐步规范 ,知情同意在临床医疗服务过程中的作用越来越重要。阐述了知情同意概念的提出及必要性 ,分析了知情同意实行存在的一些障碍 ,认为实行知情同意医方应向患者提供明确的信息