"SARS歇斯底里"个案分析

从最初报告SARS开始 ,世界卫生组织就对人们的出游发出了警告 ,报纸也每天报道有关这一不断蔓延的流行病的详细信息。对于这种歇斯底里 ,曾有人提出了不同的看法 :4月 30日的《洛杉矶时报》刊登了著名病毒学家D .巴尔的摩的文章 ,文章公开反对媒体为恐惧流行病推波助澜 ,认为 ,别的不说 ,这种恐惧至少使得整个北美的中国城变得空空荡荡。从某种意义上说 ,巴尔的摩是正确的。人类丧失生命的悲剧从来就很惨烈 ,因此单凭SARS的死亡率尚不足以解释人们对它的关注。从2 0 0 2年 1 2月到 2 0 0 3年 4月 ,刚果的一个边远地区爆发了流行病埃博拉…     

Risk reduction or risk compensation? The case of mandatory safety-belt use laws

The technological approach to risk regulation seeks to lessen the incidence of mortality and morbidity by modifying environmental conditions. Insofar as risk-taking behavior is purposive, social scientists have predicted that technological progress may be negated by various forms of risk compensation. The validity of this hypothesis is tested in the transportation sector with data from the U.S. on the effects of new mandatory safety-belt-use laws. A fixed-effects model of traffic fatality counts is estimated using pooled data from 50 states during the 1975–1987 period. Results suggest that such laws have reduced mortality among car occupants to a degree that is compatible with the predictions of technologists. However, there is weak evidence of increased mortality among some nonoccupants, a pattern predicted by risk-compensation theorists. The lifesaving effects of belt-use laws are largest in states that permit primary police enforcement and appear to be somewhat larger for front-seat occupants age 21 and under. Although offsetting behavior appears to be small relative to lifesaving effects, it may take several more years for any compensatory behavior to achieve a new equilibrium.This research was supported in part by a grant from the Centers for Disease Control to the New England Injury Prevention Research Center.     

Neonatal euthanasia: attributions of students and nurses

An attributional analysis of neonatal euthanasia was undertaken in two studies to compare the responsibility attributions of nursing and non-nursing students (Study 1) and nurses (Study 2) toward a physician for a critically ill neonate's death. In both studies, vignettes about a newborn's death differed with respect to the physician's treatment of the critically ill newborn. In the student study, the physician was attributed the least responsibility for the newborn's death when cardiopulmonary resuscitation was attempted but failed, followed by the physician's issuance of either a "Do Not Resuscitate" order or an order to turn off the infant's respirator. Greatest responsibility was attributed to the physician when he ordered the infant's nutritional and hydration support to be terminated. In addition, the student's major (nursing vs. non-nursing) and the nursing student's educational cohort impacted the level of physician responsibility attributed. In contrast, the nurses' study found that the termination of nutritional and hydrational support was viewed as different from the physician's other three actions.     

Practical reasons and reasonable practice: the case of euthanasia in The Netherlands

Since the early 1970s the issue of euthanasia has been intensely debated in The Netherlands. Through these debates knowledge about medical practices involving the end of life was no longer confined to medical or legal quarters, but became public to a large extent. Following public opinion changes, the legal reaction to euthanasia changed. By prosecuting test cases the public prosecutors allowed the Dutch Supreme Court to formulate specific conditions in which euthanasia would go unpunished. The political debate about changing the criminal law, which still holds that euthanasia is a serious crime, developed at a much slower pace. Several extensive empirical studies were undertaken to gain valid knowledge about the medical practices. This article is concerned with a presentation of the various debates and the changes that took place in the fields of criminal law, politics, and medicine. The main conclusion is the hypothesis that a more open climate for medical practices concerning the end of life allows society to better control these practices.