贾伟乐,王龙,曹宗雁,高岩涛,付继芸,迟学斌,高卫国,汪林望 超级计算中心,复旦大学,劳伦斯伯克利国家实验室 中国科学院计算机网络信息中心
生命伦理学若干前沿问题 翟晓梅 中国医学科学院/中国协和医科大学...
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Transcript of 生命伦理学若干前沿问题 翟晓梅 中国医学科学院/中国协和医科大学...
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(problem oriented) v.
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19451945
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Bioethics ()
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vs.vs.vs.()()(universal)(global)()
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/(Dilemmas)v./v.
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DNA
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Nonmaleficence Beneficence Respect Justice
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/Above all, do no harm
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//(1)(2)(3)(4)/(paternalism)
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(distributive justice) (formal) (substantial)(retributive justice)
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1TarasoffTarasoff
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2Z45L25ZL
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319981013RG50302
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Outline PVS
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PVS
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1 211975414 120705.23MA1 7
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7313 21Medicare450PVS 912
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201976691985
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1.Human Being 2.Person 1. 2. 3.
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Human Being: Person 1. 2. 3.
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person Homo Sapiens
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Human Being Person
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/X1969
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219851110541Pelle LindberghPelle LindberghLindbergh,Lindbergh5
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3Highland2817383
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1959coma depassebeyond coma1968H. Beecher
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Presidents Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research12
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ICU, Intensive Care Unit
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PVS
PVS PVS
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Persistent Vegetative State PVS Jennett Plum
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PVSPVSPVS
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123
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1 5430199312199498
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2 198519937199413115
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1
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4193991275,000
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3 Euthanasia the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reason of mercy.
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4Tom Beauchamp
Tom Beauchamp
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Euthanasia eu--; thanasia---
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A
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2. BAA
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4. ABBA
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1 BWA2 BAA3AAA.4ABBA5A5
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natural deathaccident deathsuicide deathhomicide deatheuthanasia
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---- ---- Aryan supremacy----
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beneficence ( autonomy ) ( justice)
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beneficenceBeneficence----;
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XY 1. Y 2 . X 3. X 4 . XX 5. YX
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(autonomy )Autonomy----autos ( self ) nomos ( rule, governance, law
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(justice) John Rawls
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Quinlan person human beingperson H. Tristram Engelhardt human being self-reflexivity 1 Homo Sapiens23Engelhardtperson 2 PVS 3xuninteractionPVS Homo Sapiens
1 person
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/19684424< 32.2oC22X1969
20 19851110541Pelle LindberghPelle LindberghLindberghPelle Lindbergh5 Pelle Lindbergh
1959coma depassebeyond coma H. Beecher1968 Presidents Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Defining Death :Medical ,Legal and Ethical Issues in the Determination of Death, Washington: Government Printing Office, July 1981.
ICU, Intensive Care Unit
197010 ICU, letting diett1,3 PVSpersistent vegetative state PVS
1968PVS
PVS Jennett Plum1972 Jennett PlumvegetatevegetativeJennett Plum brain-stem199643 1 1persistent vegetative state1permanent vegetative state
20 8729process of dying 80030199696.53885.9287811.01%32.8 2000
123 15430199312199498
2 198519937199413115
1 2 3 193991275,000500
Euthanasia the act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reason of mercy.
Tom Beauchamp
Euthanasia
A 1. BA
ABAAAB A 2. BAABA
living willadvanced directiveA
3. AAA
killingmurdercausing death 4. ABBA
ABB
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1 BWA2 BAA3AAA.4ABBA5A 5
natural deathaccident deathsuicide deathhomicide death
euthanasia program 19381942500 clinical context volkvolkAryan supremacy
. withholding or withdrawing life-support measures
1212 Daniel CallahanThe Goals of Medicine: Setting New Priorities1234
4 . slippery slope argumentsLeo Alexanderz
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volk
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----beneficencebeneficencebeneficence 1234 XY 1. Y2 . X3. X4 . XX5. YX
(autonomy )autonomyautos ( self ) nomos ( rule, governance, law )self-rule
(justice) desertJohn Rawls //// Roe vs. WadeRoe vs. WadeReinhardt797