知情同意原则和医务人员的素质

从知情同意的兴起、发展和现状可以看出:知情同意作为规范医患关系的一项伦理道德原则,对医务人员提出越来越高的素质要求。试图探讨医务人员应具备的基本素质,以便更好地贯彻实施知情同意,减少医患纠纷。     

癌症基因组研究信息披露的伦理探讨

癌症基因组计划是当前研究热点,存在诸多伦理、法律及社会问题,如何有效地保障基因组研究参与者的知情同意是值得关注的内容。信息披露(disclosure)作为知情同意的第一要素具备深厚的伦理基础,然而与传统医学研究相比,癌症基因组研究由于其目的与内容的特殊性,研究中信息披露的内容和标准尚存在诸多伦理问题,需要深入探讨。     

“Consent is sexy”: A poster campaign using sex-positive images and messages to increase dyadic sexual communication

Abstract

Objective: “Consent is Sexy” (CIS) is a poster campaign incorporating sex-positive messages to promote consent and increase sexual communication among college students. We assess reactions to the campaign and associations between campaign recall and communication attitudes and behaviors. Participants: Male and female undergraduates at a Midwestern university were recruited (N?=?284). Methods: A cross-sectional survey was conducted. t-Tests, logistic and multiple linear regressions were used to analyze the data. Results: Over half (56%) of participants recalled the campaign and reactions were positive. Students who recalled CIS had more positive attitudes towards sexual communication (p?=?.04) and greater perceived behavioral control (PBC; p?<?.01). Conclusions: Results show many students paid attention and reacted positively to CIS posters and results offer dissemination insights. Consent campaigns should continue to cultivate positive attitudes and PBC in regards to sexual communication.     

同意观念的历史谱系与当代困境

通过提出明示同意与默示同意这两个不同的同意概念并强调有别于集体同意之个体同意的重要性，特别是通过对默示同意的分析和说明，洛克使得近代意义上的同意理论逐渐浮出水面。同意理论在颠覆君权神授理论、确认人民主权思想的过程中有着无可置疑的历史价值。虽然在现当代，同意理论因遭遇到越来越多的诟病而逐渐步入困境，但同意理论并非一无是处。对于当代中国社会来说，强调政府及政府行为必须经过人民的同意这一点，对于政治体制的改革以及政治秩序的合法构建来说仍然具有极为重要且深远的意义。     

Anticipated Ethics and Regulatory Challenges in PCORnet: The National Patient-Centered Clinical Research Network

PCORnet, the National Patient-Centered Clinical Research Network, seeks to establish a robust national health data network for patient-centered comparative effectiveness research. This article reports the results of a PCORnet survey designed to identify the ethics and regulatory challenges anticipated in network implementation. A 12-item online survey was developed by leadership of the PCORnet Ethics and Regulatory Task Force; responses were collected from the 29 PCORnet networks. The most pressing ethics issues identified related to informed consent, patient engagement, privacy and confidentiality, and data sharing. High priority regulatory issues included IRB coordination, privacy and confidentiality, informed consent, and data sharing. Over 150 IRBs and five different approaches to managing multisite IRB review were identified within PCORnet. Further empirical and scholarly work, as well as practical and policy guidance, is essential if important initiatives that rely on comparative effectiveness research are to move forward.     

Ethical Issues in Coparent Counseling

Coparent counseling is a method of helping moderate- and high-conflict divorced or separated parents improve their shared caretaking of their children. Because it is a relatively new modality, its practitioners face ambiguity and uncertainty in their efforts to practice ethically. In the present article, information and recommendations are provided regarding confidentiality, separate meetings with parents, interactions with attorneys and the court, meetings with the children, insurance billing, competence, and informed consent.     

Obtaining Informed Consent When a Profession Labels Itself as Providing Treatment for Mental Illness

Abstract

This paper examines when informed consent laws mandating explanation of the risks and benefits for proposed treatments (some talk intervention) and alternative to the proposed treatments (e.g., medications) apply to the social work profession. The reasons why an explanation of alternative treatments, including explaining medications, might be part of securing informed consent are proffered. Following this, consideration of how the task of explaining alternatives might be addressed is examined. The particular example of antidepressant medications provides a context for considering how to discuss medications as a treatment alternative. The kind of information a social worker might be obligated to possess and then impart to the client in fulfilling the task of obtaining informed consent is considered.     

Competence and consent to research: A critique of the recommendations of the national bioethics advisory commission*

Concern about the participation of incompetent subjects in psychiatric research has grown in the last several years. In response, the National Bioethics Advisory Commission (NBAC) recommended in its recent report that all investigations involving persons with mental disorders that may be associated with cognitive impairment that may pose greater than minimal risk to subjects utilize independent assessors to verify the capacities of subjects prior to entry into the study. This recommendation poses several problems for the conduct of research and the protection of research subjects. First, it fails to target that group of subjects most likely to be at risk for incapacity. Second, it focuses on too broad a range of research projects, many of which pose little risk to participants. The substantial costs of this approach are therefore not likely to be outweighed by concomitant benefits. In place of the NBAC recommendation, the author proposes a more flexible system of capacity assessment, designed to balance the costs with a greater likelihood of achieving meaningful protection for research subjects with mental disorders.     

Accountability and academic freedom: The battle concerning research on cold fusion at Texas A&M university

abstract

The Massachusetts Task Force on Human Subject Research has so far been the only serious attempt to investigate radiation experiments on humans. No other federal, state or private agency has looked at a specific experiment in detail. The President's Advisory Committee on Human Radiation Experiments (ACHRE) provided an overview of the entire nationwide research project, but without a thorough evaluation of any single experiment. The Massachusetts Task Force examined a group of experiments using institutionalized children at two state facilities, the Fernald and Wrentham schools, from 1943 to 1973. The experiments were performed under supervision by scientists at Harvard and MIT, and were funded by several federal agencies. The Task Force found that these experiments were conducted according to the ethical and protocol standard of their day. This did not prevent the Task Force from judging that the experiments violated human rights, and recommending apology and compensation to the victims.