大学生宗教信仰的社会心理学分析

随着大学教育、教学活动与社会联系的日益深入,宗教文化在大学校园中也有一定程度的渗入和传播,信教的大学生人数呈上升趋势。导致大学生宗教信仰的原因既有西方宗教文化的影响等外部因素,也有大学生好奇心强、追求自我实现等内部心理因素。高校一方面应尊重大学生的宗教信仰,另一方面应采取加强对大学生的无神论教育等措施引导大学生树立科学的世界观和人生观,为社会主义建设事业培养更多的合格人才。     

Medically futile care: the role of the physician in setting limits.

In an effort to clarify the concept of "medically futile care," two types of futile care are identified: 1) care that produces no demonstrable effect; and 2) care that produces an effect that is believed by the speaker to be of no net benefit. It is the second type of futile care, when a patient or surrogate and the clinician disagree over the benefit that the patient will receive from an intervention, that is most interesting morally and that cannot properly be labelled medically futile. As such, decisions to limit access to care deemed futile should not rest with medical professionals. This Article argues for a limited duty of clinicians to provide life-prolonging and some other fundamental care that is equitably funded and desired by the patient while competent, even if the clinician believes that such interventions will produce no net benefit.     

Talking about death: patterns of lay and professional change

For the past thirty years, researchers have surveyed attitudes of providers and patients to the disclosure of the diagnosis and prognosis to the dying cancer patient. Though the lay population has expressed the wish to know over time, a change in provider attitudes is apparent: physicians are now more likely to inform their dying patients of the truth than before. This trend is viewed against a number of precipitating factors: changes in perception of the impact of disclosure and changes in the basic ethical norms related to disclosure with new cohorts of younger physicians reflecting these changes. These correlate with changes in underlying social structure brought about in part by the shift to chronic disease as the paradigm for medical care. With increasingly bureaucratized health care delivery, the physician must collaborate with others who may hold different judgments about what ought to be disclosed. Some nurses not only find it right to disclose, but also in their professional interest. In such settings, honesty may be necessary to avoid conflicting messages to the patient. These shifts may signal underlying shifts in the sick role and in the medical professional role with the patient more active and more knowledgeable in medical decisions and the physician serving as a source of information and counsel.     

Limits of guardian treatment refusal: a reasonableness standard

The debate concerning the legal and ethical bases of guardian refusal of medical treatment on behalf of incompetent patients often ignores critical distinctions among types of patients and guardians. For example, patients who have expressed preferences regarding treatment while competent are distinguishable from patients who have always lacked the competency requisite to expressing a treatment preference. "Bonded guardians," whose relationship with the patient preexisted guardianship, should have a different role in the decision-making process than "non-bonded guardians," who were strangers to the patient prior to the guardian-ward relationship. This Article proposes criteria for guardian treatment refusal on behalf of incompetent patients. Under the model for guardian decision making presented here, bonded guardians should be preferred over non-bonded guardians, and bonded guardians should be allowed discretion to make treatment choices, limited only by a standard of reasonableness policed by the courts. The Author presents legal and ethical justifications for the bonded guardian's heightened role. Finally, he considers the proper roles of health professionals, hospital ethics committees, and judges in the decision-making process.