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。     

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.     

美国医疗纠纷替代性解决机制现状及发展

美国医疗纠纷替代性纠纷解决机制卓有成效,其不仅包含作为传统非讼手段的调解、仲裁、和解。还创设出监察员制度、事实调查、建立共识、混合式ADR、聘雇退休法官程序、微型审理、简易陪审团审判、诉前审查庭等多种方式。因受到司法机关与行政单位的重视和民间团体的大力支持,美国ADR制度已经发展成为与民事诉讼制度双轨并行、相互补充的重要纠纷解决机制。当前,针对我国医患纠纷事件频发,伤医事件愈演愈烈的情况,将ADR机制导引入国内医疗纠纷领域,不失为一条妥善解决医疗纠纷的有效可行的途径。     

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。     

论自愿戒毒:法规范、定位与制度创新

《戒毒条例》将自愿戒毒单独列为一章,使其成为我国的一项基本戒毒制度。但关于自愿戒毒,《戒毒条例》并不是简单地对《禁毒法》的相应规定进行细化,而是存在着严重的规范并用和冲突现象。只有对我国自愿戒毒的法律定位予以科学把握,才能发现和解决其在制度设计的相应问题。要从自愿戒毒的基本立场,即保护戒毒者的权利出发,推动我国自愿戒毒工作的开展,就必须进行相应的制度创新。一是将自愿戒毒作为首选性戒毒制度;二是加强戒毒医疗机构建设;三是推进戒毒药物维持治疗。     

The Need for Gender-Sensitive Medical Interpreters for Victims with Limited English Proficiency in Sexual Assault Examinations

Abstract

The difficulties and trauma associated with sexual violence are exacerbated by language difficulties. Language difficulties pose particular barriers in accessing legal, social, medical and support services. This presents additional challenges for sexual assault response teams (SART). The SART members serve critical functions in supporting a victim of sexual violence from trauma to trial.

This paper addresses the need for trained gender-sensitive medical interpreters for adult female victims with limited English proficiency (LEP) in sexual assault examination, and thus the need for inclusion of trained medical interpreters in SART. Such needs were articulated from interviews with advocates and medical interpreters in the US, from literature reviews and conversations with women with LEP in the US. The paper closes with a set of specific recommendations that will promote comfortable accessible service to female victims of sexual violence with LEP.     

Dealing With Breast Cancer： The Journals of Audre Lorde

This paper analyzes how Caribbean-American poet and activist Audre Lorde textualizes the experience of breast cancer in her journals. Lorde confronts the narrative of the female body provided by the biomedical approach and challenges the passive role she is expected to play as a sick person. She deplores misinformation to patients and the insistence on reconstructive surgery after a mastectomy. Lorde denounces the discursive aggression toward women that is the result of the hidden patriarchal impositions insidiously operating within medical practices. She believes medical discourse has often been used to implement many of the precepts that underlie a male-centered society, shaping the gendering of women in line with a patriarchal worldview. This paper examines how Lorde faced with such a hostile situation, managed to overcome it, by speaking up and putting her fears and her hopes into words. Her personal diaries, The Cancer Journals （1980） and A Burst of Light （1988）, constitute today a fundamental point of reference and an important contribution to the feminist cause.