From ‘Doctor Knows Best’ to Dignity: Placing Adults Who Lack Capacity at the Centre of Decisions About Their Medical Treatment

In 1989, the House of Lords first derived a ‘best interests’ test for the medical treatment of adults who lack capacity from the doctrine of necessity and, now codified, the test continues to apply today. The Mental Capacity Act 2005 sets out a non‐exhaustive checklist of relevant considerations, but it gives no particular priority to the patient's wishes. There is also no formal expectation that the patient will participate directly in any court proceedings in which her best interests are to be determined. This article will consider the advantages and disadvantages of providing additional guidance to decision‐makers in order to help them navigate both taking seriously the wishes of people who lack capacity and, at the same time, not abandoning patients who need help and support. More specifically, this article advocates formalising current best practice in the Court of Protection through the introduction of a series of rebuttable presumptions, or starting points.     

国外医疗保险一体化立法对我国的启示

实行社会保险型医疗保障制度的德国、日本等国家,近年来陆续修订原有法律,推动＂区分＂建设的医疗保险制度向一体化发展,医疗保险制度一体化已成为世界各国社会保障制度发展的趋势。借鉴国外经验,我国城乡基本医疗保险制度建设应引入经办机构竞争机制,提高医保运营活力;突出强制参保,扩大医疗保险覆盖面;推动管理部门职能整合,明确医保事业的责任主体,从而不断加快城乡基本医疗保险制度一体化进程。     

基本医疗保险服务协议的法律性质探讨

基本医疗保险服务协议是规范社会保险经办机构和定点医疗机构、定点零售药店双方行为的行为准则和重要法律依据,然而,对其法律性质的认定,学术界和实务界一直存有争议。行政私法合同是行政主体运用私法合同达致行政公法目的‘的手段,基本医疗保险服务协议符合行政私法合同的特征和本质属性,因此,基本医疗保险服务协议的法律性质是行政私法合同。     

后现代精神病学对现代精神病学的法哲学反思

中世纪的异教徒"疯子"们被监禁,施以酷刑,流放可谓不堪回首,我们可以说那是因为精神病学的概念还未真正产生。但是,伴随着精神病学的设立,现代精神病学的发展已经由惩罚性收容转变成治疗性措施。精神病人的行为举止让大家感觉到不一样,无法理解。我们对于自己无法理解的事,要么报以莫名的敬畏之心,要么想方设法将它们变得不可见,来获得自己生活的平静,这是对的吗?从法哲学的视角是否应该给予反思和拷问,以探寻精神病学之正义性。本文希望从现代精神病学发展的历史,以法哲学的批判思维分析了现代精神病学的缺陷,并展望后现代精神病学的特质及其替代现代精神病学之发展趋势。     

Performance Evaluation in the Arts and Cultural Sector: A Story of Accounting at Its Margins

In this article, I present a review of financial and management accounting literature on the arts and cultural sector. My objective is to understand to what extent this literature is able to offer a critical perspective on the study of performance evaluation practices in arts and cultural organizations, as it is currently missing in the arts management literature. Adopting a critical perspective means shifting the focus of research from the technicalities of evaluation rules and procedures to their embodiment by the different organizational and societal actors of the arts and cultural sector.     

城市社区老年群体就医行为影响因素分析

日益增长的老年人健康需求是老龄化带来的诸多挑战中的一个重要方面。新一轮医药卫生体制改革突出强调基本医疗服务供给和基层卫生服务体系建设,在缓解老年人健康压力方面有一定的积极作用。老年人在身体条件、经济能力、思想观念等方面的特点,使得其就医行为受到机构服务能力、距离、费用、就医过程等多方面因素影响。在新医改背景下,需要结合这些影响因素继续完善基层医疗服务体系,以更好地满足老年群体健康需求。     

The clown's carnival in the hospital: a semiotic analysis of the medical clown's performance

The medical clown's multimodal performance in the hospital takes place within its rigid space. A clown in a hospital is a paradox. “Medical clowning” is a metaphor taken from two seemingly unrelated fields of meaning, juxtaposing what is medical, scientific, serious and logical with clowning, emotions, carnival spirit and humour. The clown addresses barriers erected by illness, pain, alienation and distress with a continuous flexible performance of humour and fantasy tailored to changing conditions and circumstances. A clown, by definition, threatens the public order and seemingly has no place in the hospital paradigm. The current article compares medical clowns to carnival clowns, examines the medical clown's flexible performance, illustrates it with case studies, presents a semiotic analysis of the clown's journey through the hospital and examines the significance of the performance on the ideological level.     

性别·叙事性·语言学视角:露斯·佩奇的女性主义叙事理论评析

20世纪90年代以降,以北美为主导的女性主义叙事学得到了长足的发展,无论是在叙事理论建构还是在叙事批评实践上均取得了引人瞩目的成果.本文主要从性别、叙事性、研究方法以及研究课题等层面出发,评析英国学者露斯·佩奇的女性主义叙事理论.文章指出,一方面,佩奇采用文学与语言学的双重视角,对女性主义叙事学的发展做出了重要贡献;但另一方面,佩奇关于叙事形式可以脱离性别的论点又偏离了女性主义叙事学研究的主流.     

我国精神障碍者非自愿医疗的法律透视——以精神卫生法的出台为背景

随着精神卫生法的颁布,我国非自愿医疗法律制度初步建立,为良莠不齐的地方性立法提供了统一的依据,平等地保护了精神障碍者的合法权益。但该法律制度仍存在法律原则中缺乏明确的无病推定规定、非自愿医疗的分类标准单一、"去行政化"理念未能贯彻到位、精神障碍者与监护人利益冲突悬而未决、非自愿医疗的程序规范力度不够、精神卫生法与刑事诉讼法衔接不畅等诸多问题。为妥善解决这些问题,需要在人文主义的价值理念指引下进行完善,应当依据是否触犯刑法分类处理、畅通非自愿医疗的司法救济渠道、加强监护制度与非自愿医疗制度的耦合、细化非自愿医疗的出入院程序、强化无利益关系第三方的监督机制。     

公安机关对医疗单位治安保卫工作的监督

在医保体制和医疗制度改革进程中,由于医疗单位治安保卫工作的复杂性以及医疗单位本身管理不善,部分群众法律意识薄弱,引发医患关系紧张、医患磨擦增多、医疗事故难以按程序解决等社会问题,严重影响正常医疗秩序。为了切实维护医疗单位正常工作秩序,保障广大患者和医务人员的合法权益,公安机关必须加强对医疗单位治安保卫工作的监督检查。