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The Concept of “Public Health” – A Critical Assessment “公共卫生”的概念——一个重要的评估
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.21860/j.13.1.6
Thomas Hoffmann
The article discusses the fundamental differences between an orientation towards individual health and the concept of health on which public health systems are built. It is shown that health in its original sense, as the “virtue of the body” (Aristotle), has to be understood as the ability to realize purposes in the actions of individuals. In public healthcare on the other hand, “health” has always been conceived as a public good and as an expression of certain public interests, a conception which does not have to be consistent with the interests of the individual in any way. “Public health” is normally designed in a utilitarian way and can be highly susceptible to ideology. In extreme cases the individual becomes subject to a “health obligation” which is to be rejected on legal, philosophical and ethical grounds. In place of a “scientific” medicine that reduces people to a statistical magnitude, a self-understanding of medicine should be restored which defines “health” from the point of view of the task of enabling real interpersonality in the space of the empirical existence of individuals self-determined as free.
本文讨论了个人健康取向与公共卫生系统赖以建立的健康概念之间的根本区别。它表明,健康在其最初的意义上,作为“身体的美德”(亚里士多德),必须被理解为实现个人行动目的的能力。另一方面,在公共保健方面,"健康"一直被认为是一种公共利益,是某种公共利益的表达,这一概念在任何方面都不必与个人利益相一致。“公共卫生”通常是以功利主义的方式设计的,很容易受到意识形态的影响。在极端情况下,个人会受到"健康义务"的约束,而这一义务在法律、哲学和道德上都应予以拒绝。应当恢复对医学的自我理解,以取代将人降低到统计量级的"科学"医学,这种医学从在自我决定为自由的个人的经验存在空间中实现真正人格间关系的任务的角度来定义"健康"。
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引用次数: 0
Psihosocijalne intervencije kod osoba oboljelih od Alzheimerove demencije i njihovih njegovatelja
Q4 Medicine Pub Date : 2021-07-08 DOI: 10.21860/j.12.1.4
Marina Milić Babić, Silvia Rusac, Tereza Oreb
Alzheimerova demencija (AD) je neurodegenerativna, progresivna bolest heterogene etiologije, čije je glavno obilježe oštećenje kognitivnih funkcija koje ima za posljedicu ozbiljne poteškoće u svim područjima funkcioniranja oboljele osobe i potrebu za pomoći neformalnih njegovatelja. Istraživanja pokazuju da rano dijagnosticiranje AD-a može osigurati bolji zdravstveni i razvojni ishod za oboljelog. Cilj je ovog rada istaknuti važnost rane intervencije u dijagnostičkom i rehabilitacijskom pogledu te naglasiti ključnu ulogu članova obitelji koji su preuzeli poziciju neformalnih njegovatelja oboljele osobe. Rana intervencija uključuje ranu dijagnostiku i ranu primjenu postupaka rehabilitacije, uključujući i programe podrške članovima obitelji, tzv. neformalnim njegovateljima. Mreža podrške oboljelima i neformalnim njegovateljima važan je čimbenik u kvaliteti skrbi za oboljele i njihove njegovatelje. U pružanju podrške njegovateljima važno je prepoznati potrebe njegovatelja članova obitelji i pružiti pravovremene i učinkovite mehanizme formalne podrške. AD je bolest uz koju se dobrobiti bilo koje vrste vrlo rijetko ističu, a upravo je uloga pomažućih profesija pronaći ih i pomoći oboljelom i obitelji.
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引用次数: 0
Parenting style and the active involvement of fathers in child-rearing 养育方式和父亲在养育孩子中的积极参与
Q4 Medicine Pub Date : 2021-07-08 DOI: 10.21860/j.12.1.6
Maja Brust Nemet, Gabrijela Vrdoljak, Viktorija Livaja Budaić
The active involvement of fathers in child-rearing affects the child’s overall growth and development, and the parenting style impacts the direction of the influence on individual aspects of a child’s life. In order to achieve gender equality in society, it is necessary to raise public awareness of the importance of a father’s gender role, a desirable parenting style, and his inclusion in all aspects of family life.The aim of the research is to determine the level of father involvement in child-rearing, as well as the dominant parenting style based on the children’s assessment. A total of 290 pupils from 10 elementary schools in Osijek-Baranja County participated in this research, all of whom were in grades 5-8. Sociodemographic data, the 2018 parent involvement questionnaire - URU18, and the parenting behavior questionnaire 29 - URP29 were used. The results are in line with research conducted so far, and they indicate the importance of a father’s education and a supportive parenting style aiming at his involvement in housework and child care. Father’s education significantly presupposes his involvement in housework, taking care of school-related duties and obligations, and participation in leisure activities. A supportive parenting style is a significant positive predictor of all forms of father involvement, i.e., housework, school-related duties and obligations, activities, child care, and counseling. The results of this research indicate the importance of raising parental awareness of the importance of the supportive parenting style and the fathers’ involvement in child-rearing.
父亲对养育子女的积极参与影响到儿童的全面成长和发展,而养育方式影响到对儿童生活各个方面的影响方向。为了实现社会上的性别平等,有必要提高公众对父亲的性别角色、理想的养育方式以及他在家庭生活各个方面的重要性的认识。这项研究的目的是确定父亲参与抚养孩子的程度,以及基于孩子评估的主要养育方式。来自奥西耶克-巴拉尼亚县10所小学的290名学生参加了这项研究,他们都是5-8年级的学生。采用社会人口学数据、2018年父母参与问卷(URU18)和父母行为问卷(URP29)。这一结果与目前进行的研究结果一致,表明了父亲教育的重要性,以及针对他参与家务和照顾孩子的支持性育儿方式的重要性。父亲的教育在很大程度上是以他参与家务、照顾与学校有关的职责和义务以及参与休闲活动为前提的。一个支持性的养育方式是所有形式的父亲参与的一个显著的积极预测因素,即家务,与学校有关的职责和义务,活动,儿童保育和咨询。本研究结果表明,提高父母对支持性育儿方式和父亲参与育儿的重要性的认识是非常重要的。
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引用次数: 3
Transhumanism: from Julian Huxley to UNESCO 超人类主义:从朱利安·赫胥黎到联合国教科文组织
Q4 Medicine Pub Date : 2021-07-08 DOI: 10.21860/j.12.1.8
C. Byk
Julian Huxley, founder and the first Director-General of UNESCO, is at the heart of contemporary debates on the nature and objectives of the concept of transhumanism, which he first used in the early 1950s. Therefore, the analysis of his idea of transhumanism - a tool to improve the quality of life and the condition of man - should lead us to question his heritage in terms of philosophy that inspires UNESCO’s action as it seeks to build a comprehensive approach to artificial intelligence that takes into account, among other things, the values and principles of universal ethics and aims to derive the best from the use of this technology. This title where the British biologist, the elder brother of the famous science fiction writer, Aldous Huxley, author of the Brave New World, coexists with the United Nations Organization in charge of Education of Science and Culture is obvious for those who know the history of this international organization or who like radio games: Julian Huxley was appointed as the first Director-General of UNESCO in 1946. But, beyond this evidence, there is a deeper link that highlights the history of the renewal of the idea of transhumanism (I) and questions about the role that UNESCO has, among the other international organizations (II).
联合国教科文组织创始人兼首任总干事朱利安·赫胥黎(Julian Huxley)在当代关于超人类主义概念的性质和目标的辩论中处于核心地位,他在20世纪50年代初首次使用了超人类主义概念。因此,分析他的超人类主义思想——一种改善生活质量和人类状况的工具——应该让我们质疑他的哲学遗产,这种哲学遗产激励教科文组织采取行动,寻求建立一种全面的人工智能方法,除其他外,考虑到普遍伦理的价值观和原则,并旨在从这项技术的使用中获得最佳效果。英国生物学家,著名科幻作家奥尔德斯·赫胥黎的哥哥,《美丽新世界》的作者,与联合国组织共同负责科学和文化教育的头衔,对于了解这个国际组织的历史或喜欢广播游戏的人来说是显而易见的:朱利安·赫胥黎于1946年被任命为联合国教科文组织的第一任总干事。但是,除了这些证据之外,还有一个更深层次的联系,突出了超人类主义思想的复兴历史(1)和关于联合国教科文组织在其他国际组织中所起作用的问题(2)。
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引用次数: 0
Is the Brazilian made Bioethics social? 巴西人的生物伦理学是社会性的吗?
Q4 Medicine Pub Date : 2021-07-08 DOI: 10.21860/j.12.1.5
Diego Carlos Zanella
This paper aims to present the panorama in which bioethics was found in Brazil. For this, exploratory descriptive and documentary research will be carried out on the emergence of bioethics as a field of research and its process of institutionalization in Brazil. In this sense, three facts are very significant: i) the creation of a bi-annual journal, Revista Bioética, published by the Federal Council of Medicine (CFM) in 1993; ii) the creation of the Brazilian Society of Bioethics (SBB) in 1995 to bring together researchers and people from different academic areas interested in bioethics; and iii) the edition of Resolution N.° 196 of October 10, 1996, of the National Health Council (CNS), which created the Brazilian Research Ethics System, that is, the Research Ethics Committees (CEP) and the National Research Ethics Commission (CONEP). These three facts will allow to identify which are the main defining elements and how they form the first theoretical models of Brazilian bioethics. Thus, this research will allow the building of a panorama of Brazilian bioethics, in which the characteristic notes of such a bioethical thought will be identified.
这篇论文的目的是呈现在其中的生物伦理学在巴西被发现的全景。为此,将对生物伦理学作为一个研究领域的出现及其在巴西制度化的过程进行探索性描述和文献研究。在这个意义上,有三个事实是非常重要的:1)创刊了一份双年刊,《生物通讯》,由联邦医学委员会于1993年出版;ii) 1995年成立了巴西生物伦理学协会(SBB),将对生物伦理学感兴趣的不同学术领域的研究人员和人员聚集在一起;国家卫生委员会(CNS) 1996年10月10日第196号决议的版本,该决议创建了巴西研究伦理体系,即研究伦理委员会(CEP)和国家研究伦理委员会(CONEP)。这三个事实将有助于确定哪些是主要的决定性因素,以及它们如何形成巴西生物伦理学的第一个理论模型。因此,这项研究将允许建立一个巴西生物伦理学的全景,其中这种生物伦理学思想的特征笔记将被识别。
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引用次数: 0
Communication Problems in Cases Addressed by Clinical Ethics Conferences 临床伦理会议讨论病例中的沟通问题
Q4 Medicine Pub Date : 2021-07-08 DOI: 10.21860/j.12.1.1
M. Shimoda
In the clinical ethics conference, individual cases are examined as problems to be addressed in a clinical setting. Various types of conflict over care policy are found in each case among the persons concerned–patients, their family members, and care providers–caused by differences of concept or practice of care, basic values, etc. Since these conflicts mostly arise in the form of communication problems, this article classifies some patterns of conversation model, analyzes the structure of the relationship among those concerned, and considers major points. By focusing on the mechanism of individual communication problems, a basic concept of the coping process is proposed.
在临床伦理会议上,个别病例被视为临床环境中需要解决的问题。在每一个案中,患者、患者家属和护理人员之间都存在着不同类型的护理政策冲突,这些冲突是由护理理念或实践、基本价值观等方面的差异引起的。由于这些冲突多以沟通问题的形式出现,本文对对话模式的几种模式进行了分类,分析了对话模式中各方关系的结构,并对其要点进行了思考。通过对个体沟通问题产生机制的研究,提出了应对过程的基本概念。
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引用次数: 0
Priziv savjesti u medicini
Q4 Medicine Pub Date : 2021-07-08 DOI: 10.21860/j.12.1.2
Hrvoje Vargić
Tema prava na priziv savjesti u medicini u posljednje vrijeme postaje sve aktualnija u javnoj raspravi. Kritičari tvrde da se tu radi o odbijanju vršenja legalne medicinske usluge ili zahvata, koje ne bi trebalo biti dopušteno, dok zagovornici inzistiraju da je priziv savjesti temeljno ljudsko pravo koje treba biti zaštićeno. Rasprave se često vode oko toga spada li izvršavanje pobačaja i sličnih zahvata (poput umjetne oplodnje i sl.) u nužni dio liječničke profesije, bez koje liječnik ne bi mogao biti liječnik. Ujedno, problematizira se spada li vršenje pobačaja u definiciju najvišeg standarda zdravstvenih usluga te koje su obveze države i liječnika po pitanju osiguravanja dostupnosti pobačaja. Članak analizira sva navedena pitanja te se izvode zaključci koji bi trebali informirati zakonodavno uređenje priziva savjesti.
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引用次数: 0
Bioethical aspects of robotics in surgery 机器人在外科手术中的生物伦理方面
Q4 Medicine Pub Date : 2021-07-08 DOI: 10.21860/j.12.1.7
E. Vvedenskaya
The article discusses the bioethical aspects of robotics in surgery and assesses the impact of this process on the relationship between the physician and the patient. An engineering model is gradually replacing the traditional paternalistic model of the physician-patient relationship. If paternalism implies the doctor’s attitude to the patient as his sick child, which requires compassion, help, and great responsibility on the part of the doctor, then when implementing the second model, the doctor, like a technical executor, performs only the responsibilities provided by the job description. On the one hand, the dominance of a technical-type model carries the threat of depersonalizing the patient and eliminating contact between the physician and the patient. On the other hand, this contributes to a radical change in the concept of medicine. Why people usually go to doctors? For establishing a diagnosis, prescribing a course of treatment, a prescription, and performing medical manipulations? Machines, leaving a human with a completely different role in the relationship between the physician and the patient, will increasingly perform these actions. The release of doctors from routine tasks will allow them to pay more attention to patient care, fully demonstrating their human qualities. The article analyzes the surgeon’s place in modern medicine and makes an attempt to determine which category the surgery belongs to, “machine territory” or “human territory”.
本文讨论了手术机器人的生物伦理方面,并评估了这一过程对医生和病人之间关系的影响。一种工程模式正在逐渐取代传统的家长式的医患关系模式。如果说家长主义意味着医生对待病人的态度就像对待生病的孩子一样,这需要医生的同情、帮助和巨大的责任,那么在实施第二种模式时,医生就像一个技术执行者,只履行职位描述所规定的责任。一方面,技术型模式的主导地位带来了患者去人格化的威胁,并消除了医生与患者之间的联系。另一方面,这有助于医学概念的根本变化。为什么人们通常去看医生?为了确定诊断,开疗程,开处方,进行医疗操作?在医患关系中,人类将扮演一个完全不同的角色,机器将越来越多地执行这些动作。将医生从日常工作中解放出来,可以让他们更多地关注病人的护理,充分展示他们的人文素质。本文分析了外科医生在现代医学中的地位,试图确定外科手术属于“机器领域”还是“人的领域”。
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引用次数: 0
„Je kako je, bit će bolje“
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.21860/j.12.2.1
Marijana Kletečki Radović, Ivana Tutić Grokša
Subjektivna dobrobit obuhvaća doživljaj trenutne i buduće životne situacije. Trenutna razina subjektivne dobrobiti može biti prediktor zdravlja, produktivnosti, prihoda, kvalitete socijalnih odnosa, čak i mortaliteta. Nezaposlenost je prepoznata kao jedna od životnih okolnosti koje na duži period najviše smanjuju subjektivnu dobrobit. Cilj provedenog kvalitativnog istraživanja bio je dobiti uvid u subjektivnu dobrobit nezaposlenih korisnika zajamčene minimalne naknade mlađe odrasle dobi. Tematskom analizom intervjua dobiveni su podaci o doživljaju životne situacije i percepciji budućnosti sudionika te su prikazani kroz ovaj rad. U zaključnim razmatranjima izneseni su prijedlozi za unapređenje prakse, s naglaskom na pristupu socijalnog rada i javnozdravstvenu pristupu.
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引用次数: 0
The Normative Space of Resilience 弹性的规范空间
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.21860/j.12.2.4
Susi Ferrarello
This paper intends to provide a way for reflecting on the normative space of resilience with the goal of creating a fruitful cross-disciplinary dialogue on well-being and health. I will point to the epistemological and temporal bias of resilience as two necessary problems that need to be tackled when considering resilience as a dynamic life process. I believe that this is timely research given the several attempts currently being pursued to shape the notion of health and well-being as it pertains to resilience (Rockström et al., 2009).
本文旨在提供一种方法,以反映弹性的规范空间,目标是就福祉和健康建立富有成效的跨学科对话。我将指出弹性的认识论和时间偏差,这是将弹性视为动态生命过程时需要解决的两个必要问题。我认为这是一项及时的研究,因为目前正在进行几次尝试,以塑造与恢复力有关的健康和福祉的概念(Rockström等人,2009年)。
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引用次数: 0
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Jahr
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