scholarly journals 倫理學的辯護和支持: 放棄治療

2000 ◽  
Vol 3 (1) ◽  
pp. 111-126
Author(s):  
Zhizheng DU
Keyword(s):  
Necessary Condition ◽  
Chinese Society ◽  
Medical Sciences ◽  
Incurable Disease ◽  
Digital Commons ◽  
Futile Treatment ◽  
Administrative Procedures ◽  
The Right ◽  
Society Today ◽  
Medical Situation

LANGUAGE NOTE | Document text in Chinese; abstract also in English.儘管醫學在飛速進步，但由於種種原因，放棄治療在臨床中有日益增多的趨勢。放棄治療是人們的一種理性選擇。合理的放棄治療是醫學人道主義在某種特殊情況下的理性表現。區分放棄治療的不同情況，正確界定放棄治療的範圍，合理選擇放棄治療的措施，確保不發生不應放棄治療的病人被放棄，在全過程中始終尊重病人的自主權，妥善處理對於是否放棄中的分岐，並維護病人的整體利益，是履行放棄治療中倫理學應予充分注意的問題。Many believe that giving up treatment always conflicts with physicians' duty and responsibility. However, although societies have achieved the rapid advancing of medical sciences and technologies, and although patients and families sometimes want to maintain life-sustaining interventions at any cost, renunciation of futile treatment remains an unavoidable issue facing physicians in their clinical practice. This is especially the case for Chinese society today. This paper argues that withdrawing life-sustaining therapy is not always opposite to moral requirement.Specifically, the paper explores the following important issues around the decision making of renouncing treatment. First, in what medical situation does the patient and the family's request for withdrawing treatment should be granted by the physician? this paper contents that a necessary condition must be that the patient suffers an incurable disease. Second, who has the right to make the decision of renouncing treatment? This paper argues that, in considerations of Chinese ethical and societal character, some practical measures should be establishes in Chinese society medical and moral consideration should all be balanced and integrated. Finally, in order to avoid unnecessary ambiguities and disputes, this paper suggests that legal and administrative procedures and guidelines should be adopted regarding the decision of renouncing treatment.DOWNLOAD HISTORY | This article has been downloaded 31 times in Digital Commons before migrating into this platform.

scholarly journals 關於放棄臨床無效治療的倫理學思考

2000 ◽  
Vol 3 (1) ◽  
pp. 127-140
Author(s):  
Yongsong GUO
Keyword(s):  
Social Situation ◽  
Final Decision ◽  
Moral Pluralism ◽  
Medical Progress ◽  
Digital Commons ◽  
The Family ◽  
Futile Treatment ◽  
Definition Of ◽  
The Right ◽  
Other Regarding

LANGUAGE NOTE | Document text in Chinese; abstract also in English.對於沒有臨床救治希望的病人，要不要繼續治療？誰有最終的決定權？這既是臨床醫療問題，又是一個涉及社會倫理法規的問題。對於這樣的病人，不放棄治療可能意味著要消耗更多的醫療資源但又無法挽救病人，但是如果放棄治療，可能會遇到更多的來自社會傳統的、倫理法規的問題。筆者認為，在社會多元化發展的今天，面對臨床無效治療，應在尊重病人或病人家屬有最終決定權的前提下，以一定道德、法規為依據，按照一定的醫療程式和法律手續進行處理，可能是更為符合人道和社會公眾利益的理性選擇。There has not been a clear medical definition of futility. The concept of futile treatment involves not only medical, but also social, ethical, and legal components. This paper argues that in today's pluralistic moral circumstances, the patient and/or the family should have the final right to decision regarding futile treatment.Some are opposed to renouncing futile treatment, whatever futility is defined. For them, first, abandoning treatment is in conflict with the physician's basic duty of offering treatment. Second, giving up treatment also gives up the chance of making medical progress by attempting to treat the patient. Third, the patient would thereby lose the opportunity of prolonging the life. And finally, it would change the good image of the physician (as taking care of the patient). On the other hand, those who support renouncing futile treatment offer different reasons. First, giving up futile treatment will turn out to be respecting the value of the patient's life. Second, It would help people recognize the natural limit of contemporary medical development. Third, it would facilitate a reasonable pattern of distributing scarce medical resources. And finally, it could reduce the suffering of the patient. As a result, we face a social situation of moral pluralism: people disagree with each other regarding renouncing futile treatment.A difficult practical issue is who has the right to decide renouncing futile treatment. This paper argues that, giving individuals hold conflicting views of life, valoue and morality, the patient should have the final decision power regarding his/her own treatment. If the patient is incompetent, then the family should have the deciding right. In this respect we should overcome the longstanding medical paternalism. In addition, society should establish a prcocedure to regulate and facilitate the decision-mading of renouncing futile treatment.DOWNLOAD HISTORY | This article has been downloaded 16 times in Digital Commons before migrating into this platform.

A rare variation in the formation of the lower trunk of the brachial plexus its embryological basis and clinical importance - a case report

2012 ◽  
Vol 6 (4) ◽  
pp. 49-52
Author(s):  
N Satyanarayana ◽  
R Guha ◽  
P Sunitha ◽  
GN Reddy ◽  
G Praveen ◽  
...  
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Clinical Importance ◽  
Medical Sciences ◽  
Nerve Roots ◽  
Rare Variation ◽  
Lower Trunk ◽  
Male Cadaver ◽  
The Right

Brachial plexus is the plexus of nerves, that supplies the upper limb.Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare. Here, we report one of the such rare variations in the formations of the lower trunk of the brachial plexus in the right upper limb of a male cadaver. In the present case the lower trunk was formed by the union of ventral rami of C7,C8 and T1 nerve roots. The middle trunk was absent. Upper trunk formation was normal. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 49-52 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6727

scholarly journals Agency and the Successive Structure of Time-Consciousness

Erkenntnis ◽  
2021 ◽  
Author(s):  
Camden Alexander McKenna
Keyword(s):  
Temporal Structure ◽  
Basic Structure ◽  
The Self ◽  
Necessary Condition ◽  
Epistemic Status ◽  
Mental Attitude ◽  
Time Consciousness ◽  
Possibility Space ◽  
The Right ◽  
Wrong Sort

AbstractI argue for constraining the nomological possibility space of temporal experiences and endorsing the Succession Requirement for agents. The Succession Requirement holds that the basic structure of temporal experience must be successive for agentive subjects, at least in worlds that are law-like in the same way as ours. I aim to establish the Succession Requirement by showing non-successively experiencing agents are not possible for three main reasons, namely that they (1) fail to stand in the right sort of causal relationship to the outcomes of their actions, (2) exhibit the wrong sort of epistemic status for agency, and (3) lack the requisite agentive mental attitude of intentionality. I conclude that agency is incompatible with non-successive experience and therefore we should view the successive temporal structure of experience as a necessary condition for agency. I also suggest that the Succession Requirement may actually extend beyond my main focus on agency, offering preliminary considerations in favor of seeing successive experience as a precondition for selfhood as well. The consequences of the Succession Requirement are wide-ranging, and I discuss various implications for our understanding of agency, the self, time consciousness, and theology, among other things.

Journal selection behavior among early-career academicians in Iran: how they choose the most appropriate journal for their publications

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Amrollah Shamsi ◽  
Brady D_ Lund ◽  
Shohreh SeyyedHosseini ◽  
Reza BasirianJahromi
Keyword(s):  
Early Career ◽  
Medical Sciences ◽  
Online Questionnaire ◽  
Scholarly Journals ◽  
Content Type ◽  
Academic Promotion ◽  
Promotion Policies ◽  
Medical Researchers ◽  
Selection Behavior ◽  
The Right

Purpose Journals are the essential tools of researchers, especially academicians, to present their scientific findings. So, choosing the right journal helps not only science development but also their academic promotion. The purpose of this study is to examine the factors that Iranian medical researchers consider when selecting scholarly journals in which to submit their work. Design/methodology/approach A self-administered online questionnaire was emailed in May 2021, with 101 responses received. The sample included all the faculty members with the role of “lecturer” in Iranian medical universities and who have 1–5 articles in the Scopus database as early-career Iranian medical researchers. The questionnaire consisted of 36 items, divided into five sections: basic information, attitudes and beliefs, ways to choose a journal, problems and familiarity with the components of scientometrics/validity metrics related to journals. Findings The findings indicate that these researchers value the expertise of experienced researchers and professionals, like librarians, when selecting publication venues. They often use journal indexes to guide journal selection. They also consider factors like the length of typical peer review and the complexity of submission guidelines when making decisions. Research limitations/implications The study of one country, though detecting requirements of journal selection behavior, cannot be generalized to the entire region. Practical implications The current study has academic implications as far as decisions on journal selection are concerned. University policymakers in Iran may consider re-examining their emphasis on academicians’ promotion policies at Iranian universities of medical sciences. Originality/value These findings may support the work of early-career researchers and those individuals (e.g., librarians) that serve them, as well as publishers and editors of scholarly journals.

scholarly journals Morphology of the vertebral artery in Asian population

2014 ◽  
Vol 5 (4) ◽  
pp. 84-88 ◽  
Author(s):  
Maryna Alfaouri-Kornieieva ◽  
Azmy M Al-Hadidi
Keyword(s):  
Vertebral Artery ◽  
Asian Population ◽  
Outer Diameter ◽  
Medical Sciences ◽  
The Third ◽  
Asian Patients ◽  
Distal Loop ◽  
The Right ◽  
Occipital Lobes ◽  
The Brain

Background: Recent clinical trials have shown a rising trend of stroke in Asian population. Approximately 20% strokes of total occur at the vertebrobasilar basin that supplies the occipital lobes of the brain, the cerebellum, and the brainstem. The anatomical features and variability of the third segment of the vertebral artery (VA) in Asians are analyzed in this study. Methods: A prospective cohort study of 68 consecutive Asian patients underwent MRA examination for head and neck in the Department of Radiology of Hospital of University of Jordan from 1.10.2011 to 30.04.2012. The 116 VA were analyzed on the obtained angiograms. Results: The third segment (V3) of the VA was studied according to its conventional division into vertical, horizontal, and oblique parts. The mean outer diameter of the V3 varied up 3.18 ± 0.73 to 4.28 ± 1.08 mm. The parameter prevailed on the left in 91% cases and was greater in males, than in females. The distal loop of the VA projected downward in 26 cases on the right (78%) and in 28 cases on the left (74%). The tortuosity of loop?formations of V3 was evaluated subject to angles between their ascending and descending bends. Conclusion: In comparison with other ethnic groups, the V3 of the VA in Asians has lesser outer diameter, especially along its oblique part; the zero?distance between the occipital bone and horizontal segment of VA occurs more often (up to 26%); the Lang’s III type of V3 variability is the most common in Asians. DOI: http://dx.doi.org/10.3126/ajms.v5i4.6150 Asian Journal of Medical Sciences 2014 Vol.5(4); 84-88

Hyperprolactinemia prevents short photoperiod-induced changes in brown fat

1989 ◽  
Vol 256 (1) ◽  
pp. R174-R180
Author(s):  
K. S. Kott ◽  
B. J. Moore ◽  
L. Fournier ◽  
B. A. Horwitz
Keyword(s):  
Protein Content ◽  
Fat Mass ◽  
Carcass Composition ◽  
Brown Fat ◽  
Short Photoperiod ◽  
Necessary Condition ◽  
Tissue Mass ◽  
The Right ◽  
Induced Changes ◽  
Thermogenic Capacity

Previous studies demonstrated that short photoperiod exposure significantly decreases circulating prolactin levels. The present study investigated the possibility that concomitant changes in brown fat tissue mass, protein content, thermogenic capacity, and carcass composition are dependent on this change in prolactin levels. Male golden (Syrian) hamsters were sham operated and exposed to a short (10L:14D) or long (14L:10D) photoperiod. A third group was implanted with exogenous pituitaries under the right kidney capsule and exposed to a short photoperiod. In experiment I, 4 wk of short- vs. long-photoperiod exposure did not result in significant changes in circulating prolactin levels, nor was there an increase in brown fat mass, protein content, or thermogenic capacity. Four weeks of short-photoperiod exposure did significantly increase carcass lipid content. However, this increase did not occur in hamsters exposed to 4 wk of short photoperiod but made hyperprolactinemic (implanted with two exogenous pituitaries). Ten weeks of short photoperiod significantly reduced circulating prolactin levels. Concomitantly, brown fat mass, protein content, and thermogenic capacity, as well as carcass fat, were increased. These short-photoperiod-induced changes were not observed in similarly exposed hamsters that were made hyperprolactinemic via two implanted pituitaries. In experiment II, similar changes in brown fat and body composition occurred in sham-operated hamsters exposed to 10 wk of short photoperiod. These changes were prevented in hamsters exposed to 10 wk of short photoperiod but made hyperprolactinemic via only one implanted pituitary. These results suggest that decreased prolactin is a necessary condition for the increased brown fat mass, protein content, and thermogenic capacity that occurs when golden hamsters are exposed to short photoperiod.

儒家如何看待脱離婚姻的生育行為——由單身女性「凍卵」問題引發的法律與倫理討論

2019 ◽  
Vol 17 (1) ◽  
pp. 29-47
Author(s):  
Jie BAI
Keyword(s):  
Marriage Rate ◽  
Single Women ◽  
Confucian Ethics ◽  
Single Woman ◽  
Digital Commons ◽  
The Family ◽  
Conservative Policy ◽  
The Status ◽  
The Right ◽  
Reproductive Activities

LANGUAGE NOTE | Document text in Chinese; abstract also in English.近年來得益於女性地位的提升與名人效應，單身女性凍卵問題日趨成為社會輿論關注的焦點，由此也引發了法學界對單身女性生育權的討論。然而，單身女性凍卵不僅僅是一個法律議題，更是一個倫理問題。不僅法律和法規的制定和修訂中多有涉及對倫理的關照，凍卵的臨床實踐中也廣泛存在對倫理的考量。在結婚率和生育率持續走低當下社會，相當一部分單身 女性選擇凍卵的動機是希望脱離婚姻而進行自主的生育行 為。值得深思的是，東亞的儒教國家對輔助生殖的使用限制最為嚴格、政策最為保守。本文試圖通過分析儒家會如何看待脱離婚姻的生育行為，來探討儒學倫理對單身女性凍卵抱有怎麽樣的態度、能夠帶來怎麽的啟示。本文認為，儘管在法律維度上應該肯定單身女性擁有生育權，但在倫理層面上，脱離婚姻的生育行為應該極為審慎，因為其有違儒家倫理中對家庭秩序的看重，同時也讓“雙親撫育”難以得到實現。In recent years, thanks to the promotion of the status of women and the celebrity effect, the issue of the frozen eggs of single women has become a focus of public opinion, leading to discussion of the reproductive rights of single women in the legal arena. However, single women's frozen eggs are also an ethical issue. The laws and regulations not only involve ethics, but also ethical considerations in the clinical practice of frozen eggs. In today's society, in which the marriage rate and fertility rate continue to decline, many single women choose to freeze their eggs to distinguish between reproductive activities and marriage. It is worth thinking about the fact that Confucian East Asia has the strictest restrictions and most conservative policy on the use of assisted reproduction. This paper explores how Confucian ethics have a different position on single women’s frozen eggs by analyzing how Confucianism views fertility behaviors that are separated from marriage. It argues that although it is certain that a single woman has the right to give birth in the legal dimension, ethically, the procreative behavior of marriage should be taken with caution, as it violates the Confucian ethic of the family order by making parental care more difficult.DOWNLOAD HISTORY | This article has been downloaded 45 times in Digital Commons before migrating into this platform.

Persistent left superior vena cava and its clinical correlation - A cadaveric study

2021 ◽  
Vol 12 (4) ◽  
pp. 118-121
Author(s):  
Sachendra Kumar Mittal ◽  
Rekha Parashar ◽  
Pankaj Kumar Singh ◽  
Leena Jadon
Keyword(s):  
Superior Vena Cava ◽  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Medical Sciences ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Male Cadaver ◽  
The Right ◽  
Brachiocephalic Veins

Background: Presented is a case of persistent left superior vena cava draining into the right atrium through coronary sinus and finally opens into right atrium. Abnormalities of the vascular system are more commonly seen due to its importance in circulation. Persistent left superior vena cava is rare but important congenital vascular anomaly. It results when the left superior cardinal vein caudal to the innominate vein fails to regress.The venous anomaly of a persistent left superior vena cava (PLSVC) affects 0.3%–0.5% of the general population. Normally the superior vena cava is a single vascular structure formed by the union of right and left brachiocephalic veins which are in turn formed by the union of internal jugular and subclavian veins of corresponding side, draining the head and neck as well as the superior extremity. Aims and Objective: To evaluate the accuracy of persistent left superior vena cava and to find out the opening of PLSVC and formations of both SVC. Materials and Methods: During routine dissection of Thorax, we have opened the thoracic cage and take out the Heart. during that we found separate SVC and then we did the study on this PLSVC in the Department of Anatomy, Jaipur National University Institute for Medical Sciences and Research Centre (JNUIMSRC) Jaipur and National Institute of Medical Sciences and Research (NIMS & R). Results: We found persistent left superior vena cava in two cadavers out of 30 cadavers (6.66%) one was 64-year-old male cadaver and another 72-year-old male cadaver. Both the vena cavae were formed as of brachiocephalic veins of the corresponding side. The persistent left superior vena cava opened into the enlarged coronary sinus that drained into the right atrium between the opening of inferior vena cava and right atrio-ventricular orifice. Conclusion: It has important clinical implications in certain clinical interventions. It may complicate placementof cardiac catheters or pacemaker leads.

The Principles Governing Public Authority Liability in Poland

2020 ◽  
pp. 66-68
Author(s):  
Marek Wierzbowski ◽  
Marek Grzywacz ◽  
Joanna Róg Dyrda ◽  
Katarzyna Ziółkowska
Keyword(s):  
General Principle ◽  
Civil Code ◽  
The State ◽  
Public Authority ◽  
Administrative Action ◽  
General Terms ◽  
Administrative Procedures ◽  
Per Se ◽  
Polish Law ◽  
The Right

Before 1989, Polish courts in some cases affirmed the liability of the State on the basis of existing legislative provisions. After 1989, the Constitution admits administrative liability in very general terms, because everyone shall have the right to be awarded damages for any harm done by administrative action contrary to the law. The more detailed provisions of the Civil Code implement such general principle. More generally, the liability of administrative authorities is regarded as being subject to private law standards. However, in some cases illegality per se will not suffice for liability. This is the case, in particular, for administrative acts that are characterized by real discretion. Moreover, administrative procedures are regulated by parliamentary legislation. Another particular feature of Polish law is that, to prove the unlawfulness of the action taken by administrative authorities, on both procedural and substantive grounds, claimants must bring an action before administrative courts.

scholarly journals HOW TO PUBLISH: FROM START TO FINISH AND BEYOND

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S223-S223
Author(s):  
Laura P Sands
Keyword(s):  
Social Sciences ◽  
Best Practices ◽  
Round Table ◽  
Open Access Journal ◽  
Medical Sciences ◽  
Gerontological Society ◽  
Oxford University ◽  
Gerontological Research ◽  
The Right ◽  
The Impact

Abstract This symposium, organized by the Gerontological Society of America’s (GSA) Publications Committee, will provide information on the publication process from the perspective of several editors of GSA’s scientific journals that publish diverse types of gerontological research, basic to applied across multiple disciplines. This session is comprised of three parts including: 1) Podium presentations from editors-in-chief from GSA’s The Gerontologist, Innovation in Aging (GSA’s new open access journal), and Journal of Gerontology-Series B, Social Sciences. Editors will describe how to prepare your manuscript for submission, choose the right journal, and revise the manuscript for resubmission; 2) A presentation about how to assess and maximize the impact of published work given by a representative from Oxford University Press (OUP); and 3) Round table discussions with editors from the Journals of Gerontology-Series A (Medical Sciences) and B (Psychological and Social Sciences), The Gerontologist, and Innovation in Aging and OUP representatives. Editors will answer questions related to the podium presentations and other questions specific to each journal. Intended audiences include emerging and international scholars, and authors interested in learning more about best practices and tips for getting their scholarly work published. Current and future published authors will also gain information about how to leverage already published work.

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