Comparing Conservation Priorities for Useful Plants Among Botanists and Tibetan Doctors

Perspectives of diverse constituencies need to be incorporated when developing conservation strategies. In Menri (Medicine Mountains) of the Eastern Himalayas, Tibetan doctors and professional botanists were interviewed about conservation of useful plants. We compare these two perspectives and find they differ significantly in conservation priorities (Wilcoxon Signed Ranks P < 0.05), both in how they prioritized, as well as the priorities themselves. Tibetan doctors first consider which plants are most important to their medical practice and, then secondarily, the conservation status of these plants. Additionally, perceptions of threatened medicinal plants differ among Tibetan doctors who received medical training in Lhasa, who were local trained, and who were self-taught. In contrast, professional botanists came to a consensus among themselves by first considering the conservation status of plants and then considering use. We conclude that, in order to effect community based conservation, opinions from both Tibetan doctors and professional botanists should be considered in establishing conservation priorities and sustainable conservation programs. Furthermore, we set our own research agenda based on combined perspectives.     

Doctors that Harm,Doctors that Heal: Reimagining Medicine in Post-Conflict Aceh,Indonesia

ABSTRACT

This article explores the fears and desires that conflict survivors invest in biomedicine in post-conflict Aceh, Indonesia. After examining common criticisms of Acehnese doctors, I go on to discuss the practise of Acehnese medical travel to Malaysia and the desirable depictions of biomedicine that are generated through cross-border clinical encounters. Building on Pinto [2004. Development Without Institutions: Ersatz Medicine and the Politics of Everyday Life in Rural North India. Cultural Anthropology, 19(3):337–364], I argue that in the post-conflict period, biomedicine acts as both a site of terror and ‘point of imagination and longing’ that guides my interlocutors' understandings of the changing world around them. The article brings debates about medicine and violence into dialogue with a body of post-conflict ethnography, showing how popular imaginaries of biomedicine can shape the process of post-conflict world building.     

医患关系双方认知差异比较研究

目的 为了解医患双方对医患关系认知的差异,从而对构建和谐医患关系提出具有针对性的对策和建议。方法 对北京、武汉和成都的6家医疗机构的375名医务人员和702名患者进行问卷调查。结果 医方认为医患关系紧张的比例明显高于患方,医患关系现状对医方影响较大;医患双方均认为医疗体制、媒体舆论是医患关系的主要影响因素;医患双方对现行医患纠纷的防范和解决措施认可度均较低。结论 加强医患间的有效沟通;健全医疗体制,促进和谐医患关系;树立舆论宣传的正确导向作用;建立健全有效的医患纠纷的解决机制,探索有效的预防措施。     

医患不信任问题对医方医疗行为的影响及对策分析

目的 客观真实的描述医患间的信任现状及其对医方医疗行为的影响,并提出相关对策建议。方法 对北京市5家三甲医院医务人员和患者共1 010人进行问卷调查,对25位医务人员进行定性访谈,通过统计分析描述并分析医患不信任问题现状及其对医方医疗行为的影响。结果 医方对于医患关系的评价低于患方,存在感觉患者不信任医方的担忧;继而产生了其言行过分谨慎、规避风险、消极自保的行为,甚至偏离医学科学原则的现象。结论 医患不信任情况的确存在,已经对于医方的医疗行为造成了不良影响,必须从政府、医院以及媒体3方面采取应对措施,以缓解医患间的不和谐关系,重建医患间不可或缺的信任。     

UNDERSTANDING DOCTORS' ETHICAL CHALLENGES AS ROLE VIRTUE CONFLICTS

This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis.     

肾内科进修生临床带教体会

进修教育是继续医学教育的重要组成部分,是基层医院医生深造的一条重要途径,是基层培养业务技术骨干的重要手段,也是大型综合性医院临床工作的重要组成部分。总结我科进修医生临床教学中的经验包括:分析构成,因材施教;理论知识与临床技能双管齐下;注重医德医风、职业道德的培养,强化法制观念,从多方面着手,培养高素质的肾内科进修医生,收到了满意的效果。     

医患信任的伦理困境及解决策略

当现代医患关系受到广泛诟病,医患不信任愈演愈烈之时,人们试图回归传统去寻求解决思路。传统的古代医患关系以信义为基础,强调以患者为本,医者需以德为先,同时注重医患沟通。然而古代医患信任关系也存在医家择病、择人及病家试医、择医等诸多弊端陋习。本文综述古代医患信任关系的伦理困境及解决策略,借古鉴今,在前人处理医患关系的利弊得失中,寻求医患信任关系建立的最佳处事之道,为当今医患信任关系的建立提供可资借鉴的思路和经验。     

李德新教授临证经验总结

作者通过分析李德新教授临证的辨证论治及临床经验,总结出李德新教授的诊疗特点：1）厘清病症本质,强调中医辨证;2）用药功专,处方精炼;3）注重中药炮制,减毒增强疗效;4）诸病善从脾胃论治;5）中医功底深厚,注重审察舌脉。以期望同道能从中得到启发。     

“以药养医”的根源分析与破除对策

通过对“以药养医”的分析认为：医疗服务价格体系不合理是“以药养医”的根源,“药价虚高”和医疗服务价格低于成本必然导致“以药养医”,而要破解“以药养医”必须同时切断医生账面收入和灰色收入与买药之间的关系。在此基础上,研究提出了放开药品定价和招标垄断、根据成本全面调整医疗服务价格、合理确定医务人员收入与社平工资倍数关系等3个方面的具体措施。