Euthanasia and persistent vegetative state individuals: the role and moral status of autonomy

This paper offers a philosophical consideration and evaluation of several different criteria of moral standing, and discusses their implications for persistent vegetative state (PVS) individuals who were once competent. It is argued that the only criterion PVS individuals meet is that of being human, which is not the best test of moral standing. Accordingly it is, in principle, morally acceptable to perform passive or active euthanasia on PVS individuals or to use their bodies for research or for organ harvest. Nevertheless, the autonomous choices made by the persons the PVS individuals used to be can still impose moral obligations. Indeed, it is argued that the capacity for autonomy is a particularly appealing criterion of moral standing, and that the implications of this standard for PVS individuals confirm that appeal.     

The implementation of the healthy cities project in developing countries: lessons from Chittagong

The Chittagong Healthy City Project was carried out in late 1994 in Chittagong, Bangladesh. This paper presents findings of an evaluation of the project based upon internationally generated process indicators related to the institutional aspects of the project. The following issues are discussed with regard to project implementation: the institutional organization of local authorities, institutions' conceptual understanding of the project, formal insertion of the project into public authorities' activities, institutional leadership of the project, central-local relations, the lack of interministerial coordination, the project's office, international projects, and community organization. Giving consideration to these issues may help program planners detect problems in forthcoming projects prior to their implementation.     

Changes in health, mortality, and disability and their impact on long-term care needs

The need for long-term care is driven both by the growth of the elderly population and changes in the age relations of morbidity, disability, and mortality. Data show these relations changed in the U.S. elderly population from 1982 to 1989. Chronic disability prevalence declined between the 1982 and 1989 U.S. National Long Term Care Surveys. Among those impaired, many persons using personal assistance to meet their needs shifted to the use of assisted housing and special equipment. The relation of these trends to other changes--such as the increasing educational level of the elderly population--is examined to estimate how future changes in disability and morbidity may affect the demand for long-term care. Disabilities at specific times as well as their transition rates were examined to determine how long individuals need long-term care. The analyses suggest that, while the amount of long-term care services needed will increase rapidly, the types and amounts of services used by the U.S. elderly population will undergo significant change.     

Physician organizations. Part 1: A report from the trenches of a start-up PO

How has Community Health Partners, a physician organization based in Kansas City, turned the corner as it rolls into the second year of operation? The biggest indicator is that CHP hammered out the city's first professional risk contracts and the PO has grown from 23 to more than 50 physician member/owners. Looking back, there are at least 10 reasons why CHP made it this far. These are not reasons you learn about in medical school or an MBA program. There is no one-size-fits-all template for building POs. No fixed organizational chart. No neon signs pointing to the best capital partner. Part I explores five reasons for success, such as having a strong board and physician leadership, as well as educating participating physicians about capitation and affiliating with any hospital or payer that really knows how to partner with physicians. Part 2 will focus on five more lessons learned from the trenches of a start up PO.     

Medical savings accounts. Power and choice

As the market becomes more saturated and matures, keeping people healthy will become a bigger source of profits and true health maintenance will become increasingly important. Right now, however, the name of the game is restricting services, particularly in new markets. What is sorely needed is a balance between the individual and organizational agendas, between the individual and society. There is a tremendous opportunity for hospital-physician groups contracting directly with employers using Medical Savings Accounts (MSAs) and catastrophic insurance as a core strategy. Are MSAs a viable insurance vehicle? Some argue that those enrolled in MSAs will put off receiving needed medical care. But it can also be viewed that MSAs, by their very nature, put costs back into the negotiation phase between patients as customers and physicians and hospitals as providers--and save money and resource consumption as patients shop around for competitive prices to do what needs to be done.     

谈红学的学域──“还‘红学’以学”论质疑

什么是红学？这个看来不是问题的问题,现在竟成了一个大问题,引起了红学界的争议。周汝昌先生早在1982年就提出：红学"不是用一般小说学去研究一般小说的一般学问","而是以《红楼梦》这部特殊小说为具体对象而具体分析它的具体情况、解答具体问题的特殊学问",因此"不能用一般研究小说的方式、方法、眼光、态度来研究《红楼梦》①．最近又在《还'红学'以学》一文中进一步指出：红学"应是中华文化之学"②．而在鲁迅之后"这种以真'学'为素质的'红学',竟然毫无发展与进境",甚至"沦为非学术的某些名场利域的附属工具",走上了"以非学充学之…     

《〈红楼梦〉精解》序

为红学专著写序,在我还是破天荒第一次。五年前,我在为贵州博雅苑陈列馆赠词中自嘲道："谁知红学海洋深,苦钻十年未人fi．"以我这样起步很晚（几乎与志尧和海天同时起步,我是1983年、他们是1984年开始发表红学论文）,才流学浅,"半路出家",还未人红学之门的门外汉,却要为他们的专著写序,岂不要贻笑大方？可是,志尧和海天却不嫌我的浅薄无知、学无所成,竟驰书万里之外给我,以多年研究《红楼梦》的心血结晶相托,使我在受宠若惊之余,更觉难以辞却,非得率尔操觎,班门弄斧不可了．志尧和海天之所以要找我这样的人来写序,大概有两…     

Treatment issues for survivors of physical and sexual abuse*

Many clients who participate in family therapy have experienced trauma such as physical and sexual abuse in their families of origin. Extensive literature suggests that abusive experiences can result in post-traumatic stress disorders, depression, anxiety, personality disorders, and other long-term effects. Without recognition of the effects that abuse can have on individuals, it is possible to misdiagnose clients or fail to provide them with adequate assistance. This study is an attempt to compare the symptomology of nonabused clients with physically and sexually abused clients using an empirically sound measure. The results demonstrate that the majority of clients who experienced physical and/or sexual abuse in their backgrounds scored in the clinical range on scales from the Millon Clinical Multiaxial Instrument (MCMI) (Millon, 1984). In contrast, clients who did not report abuse had significantly lower scores than the abused clients, and the majority of the nonabused clients scored in the nonclinical range on the scales of the MCMI. Treatment and theoretical implications surrounding the issues of abuse are discussed, and recommendations for marriage and family therapists are provided.     

我院组织抵制和清除精神污染理论报告会

<正> 山东社会科学院党委于去年十二月十四日和二十三日,在全院同志深入学习邓小平同志在党的十二届二中全会上的讲话和有关文件的基础上,组织了两次关于清除精神污染的理论报告会.会上,主要对近凡年来理论界、文艺界在异化、人道主义、人性论等问题上出现的错误进行了讨论和分析批评.关于异化问题,哲学研究所、经济研究所、部门经济研究所和科学社会主义研究所的四位同志发了言,分别从哲学、政治经济学和科学社会主义的不同角度分析批判了"社会主义异化论".有的同志全面地考察了"异化"一词的基本含义和"异化"概念的产生、发展、使用及其演变过程,说明了