Academic literature on the topic '合一確定'

LANGUAGE NOTE | Document text in Chinese“全腦死亡”標準，在死後器官捐獻和對符合這些嚴格標準的病人終止治療方面，得到了西方文化的支持。但是，它們對亞洲文化和照顧持續性植物狀態的倫理學來說，沒有多少價值。本丈把“包括腦幹的整個腦”的標準作為一種默認的觀點，以此為基礎，本文為綜合性的統一確定死亡法規引入一個公式，但允許有行為能力的成年人通過事先指令在死亡過程中選擇其他確定死亡的標準。DOWNLOAD HISTORY | This article has been downloaded 28 times in Digital Commons before migrating into this platform.

本案之爭點在於：健保署對被保險人「合理住院日數」所為之判斷是否合法？此一問題涉及何謂「合理、適當之醫療服務」不確定法律概念的解釋與適用。本案判決援引判斷餘地理論，認為「被保險人合理住院日數」之判斷職權，涉及高度之屬人性、專業性、經驗性之專業判斷，鑑於法官審查能力有限與權力分立原則，法院應尊重健保署基於專業醫師本於專業審查結果之判斷，駁回原告之訴。本文歸納學說與司法實務已發展出之判斷餘地類型與法院審查項目，從法律的適用步驟建立行政法院對行政機關適用不確定法律概念之思考路徑。據此，檢視後得出結論：本案判決因限於專家迷思，未能指出健保署之原處分有應考量之因素而未考量與判斷理由不備之違法情事。<br />

作為一個以「執行」與「實踐」為主的專業，社會工作主要是以不同的介入手段，促成人或事情的改變；而為了保障我們的工作合符專業規範與水平，並且向服務資助方說明我們工作的專業性與價值，完善與具質素的文書紀錄、例如方案書、個案紀錄和計劃報告等，對社工都有重要的價值。或者因為文書工作的數量一直在增加，近年社工界興起的反管理主義討論中，文書工作就被認定為管理主義的標誌。而作為一位資深公務員社工，本文作者以日常工作經驗和反思，說明了文書工作對社工的確切重要性，並且提出改進相關能力的意見，以供同業參考。

LANGUAGE NOTE | Document text in Chinese對使用人類基因轉移技術治療健康問題與使用該技術增強或改善正常人遺傳特性加以區分已成為討論基因治療倫理學的標準。一些人對這一區分的規範力提出質疑，認為這忽視了如何在醫學上合法使用人類基因轉移技術預防疾病。例如，用基因工程增強免疫功能，改進DNA修復功能或增添細胞受體獲得和處理膽固醇的功能。一些批評者認為。如果疾病預防是醫學的正當目標，使用基因轉移技術增強人類健康維護能力將有助於實現這一目標。然而，“治療／增強”的區分法不能對合法的基因治療進行界定。我論證在基因治療的預防與增強（以及在基因治療醫學方面的正確使用與基因治療非醫學方面的使用）之間能夠劃一條線，但只有你願意接受以下兩種老式的主張：1）一些健康問題最好被理解為體現在生物系統中的各種過程或部分的實體，至少具備了像受抑制的功能一樣的本體論客觀性與理論意義。2）合法的預防性基因保健應該限於努力保護人的不受更強有力的病理實體的侵襲，而不是改變他們的身體以逃避社會的不公正。DOWNLOAD HISTORY | This article has been downloaded 15 times in Digital Commons before migrating into this platform.

抽象 本文在向心理論的框架下，討論漢語語篇中語句所包含的語義實體（即後指中心集合成員）顯著度等級排序的依據。這一排序是預測某一語句中語義實體相對於其隨後語句的篇章可及性的依據。我們計算並分析了漢語含「把」、「給」、「放」、「被」四類句式的敘述性語篇片段中這四類語句與其之前和隨後語句間回指中心的過渡方式。通過具體的數據分析和比對，我們發現了以下模式和傾向：(1)話題位置的語義實體是維繫篇章連貫性的關鍵，所有觀察的語句均通過話題位置的語義實體實現與其之前和隨後語句間的回指中心延續；(2)除話題位置的語義實體外，後指中心集合成員的顯著度等級排序遵循題元角色序列等級，以題元序列為參考，越靠近左端的題元角色顯著度等級越高，越有機會被作為回指及優選中心；(3)話題的顯著度不受題元序列的影響，因此漢語後指中心集合成員的排序應分為兩個層級，第一層確認話題，第二層將剩餘語義實體按照題元序列排序，該排序決定語句中每一個語義實體的篇章顯著度和篇章可及性。

LANGUAGE NOTE | Document text in Chinese對於那些即將死於艾滋病的人來說，在自殺協助可以得到的地方，如美國西海岸的同性戀社區和荷蘭，我們必須考察醫生和朋友（包括情人、配偶、家庭成員、宗教顧問、支持團體的成員，以及其他熟人）在協助一個艾滋病患者決定和行使自殺的過程中所起的不同作用。本文作出一個中心假定：在自殺協助可以獲得的地方，盡可能地保護和加強選擇的合理性是他人的道德義務。在關於艾滋病中自殺的理性選擇中，可以識別出四種成分－－不管它是贊成自殺的選擇還是反對自殺的選擇。艾滋病患者可能自問的問題可以表述如下：（1）“自殺是我想考慮的選擇嗎？”（2）“我應當保留治愈的機會嗎？”（3）“我應如何確定自殺的時間？”（4）“我將給他人的幸福和利益以何種份量？”儘管醫生經常作出與（1） 相關的斷言，但他們恰當地涉及的只是（3）；儘管朋友和親密的伙伴經常提供給病人與（3） 相關的趣聞軼事，但他們主要涉及的是（1）。簡言之，醫生和病人經常干預艾滋病患者就自殺所作出的選擇的錯誤部分。DOWNLOAD HISTORY | This article has been downloaded 16 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.確定死亡要分開三個層次：死亡的定義、死亡的判準、死亡的測試；當中既有醫學問題﹒也有哲學問題。“全腦死亡”（簡稱腦死亡）的提出，並非要修改傳統對死亡的定義；全腦死亡只是一個新的死亡判準，在死亡的測試上既可用新的腦功能測試，但也不排斥傳統的心肺功能測試，視情況而定。因此，全腦死亡判準，並沒有提出一個新的死亡觀來取代舊的死亡觀。反對全腦死亡判準的意見走向二個極端。有些人認為全腦死亡只是一個人的死亡的必要但非充分條件，還需心肺死亡配合才構成充分條件。但另一些人則認為，全腦死亡是作為萬物之靈的人之死亡的既非充分也非必要條件；真正的必要（或甚至充分）條件是上腦（大腦）死亡。要徹底處理這些醫學爭論問題，無可避免地我們要問“死亡是甚麼？”“生命是甚麼？”及進一步追問“人是甚麼？”這些哲學問題。This essays begins by noting the brief history of "updating" death since the Harvard Medical School Report in 1968. The deficiencies of this report are noted and the background of the President's Commission's Report on "Defining Death" are briefly explained. The author then discusses and endorses the three-fold distinction in the determination of death as suggested by other scholars, viz., the definition of, the criterion of, and the tests for death. While the test for death is basically a medical issue, and that the definition of death is basically a philosophical issue, the criterion of death is both medical and philosophical.Since the People's Republic of China does not have any brain death legislation, and since some recent Chinese biomedical ethics textbooks have an inaccurate understanding of brain death, the present author summarizes the major theses of "Defining Death" by the President's Commission of 1981. It is pointed out that the idea of "brain death" does not indicate a new definition of death; it only advocates a new criterion of death, and a new way of testing death (neurological) in addition to the conventional way of testing death (cardiac-pulmonary). Hence the precise idea of "brain death" is not as radical as some Chinese interpreters think it to be.This essay also analyzes the criticism of brain death criterion both from the left and from the right. The Jewish position, as articulated by Hans Jonas and others, that brain death is not the sufficient condition of human death is explained. The present author points out that Jonas' idea that the argument for brain death is value-laden is vindicated by many Chinese writings on biomedical ethics. The position in the other extreme, viz., whole brain death is not even a necessary condition of the death of persons, is also explained. The arguments in its favor and against it are both critically analyzed. The serious mistake of many Chinese writings of equating the condition of persistent vegetative state with whole brain death is criticized. The author also notes that according to Buddhist views, pvs patients still possess some degree of consciousness and hence should not be deemed dead.The philosophical issue of "what is death?" necessarily leads to another issue, viz., what is the nature of human life? The ancient Chinese discussions of the nature of the soul (shen) and the body-mind (xing-shen) problem are briefly discussed. The author points out the relevance of these discussions to the contemporary reflection on the nature of human death.DOWNLOAD HISTORY | This article has been downloaded 27 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.基因醫學的進步，有朝一日將使得一個人在出生時的基因組合，不再只是純然的運氣，而是社會體制可以影響和決定的。會這一天來臨時，社會正義是否要求社會提供給父母親必要的基因醫療資源，以避免讓下一代因為基因差異而在機會上不平等？是否要求社會應該提供所有成員必要的基因醫療服務，以確保人與人之間在基因組合上平等？本文從合理契約論的角度來分析對這兩個問題，提出負面的答案。合理契約論的正義觀結合了亞里斯多德與羅爾斯對於正義之概念的分析，主張：社會有欠於每個成員去選擇一個他不能合理拒絕的體制。在這個架構下，本文把基因差異所衍生出來的機會不平等，置於分配正義的脈絡來考察。本文分析了泛公平式的機會平等原則、中立化基因差異原則、基因平等原則，並且指出這些原則的困難。本文認為，為了避免社會成員因為基因缺陷而有生不如死的抗議，社會有義務要做到讓所有的人帶有一定程度的基因品質。但由於基因工程可能會改變人的同一性，本文論證，在合理契約論的架構下，社會並沒有義務去提供必要的基因醫療資源來中立化基因差異，更沒有義務去落實基因平等。但本文也論證，在允許資源不平等、尊重家庭自主性的體制裡，公平式的機會平等要求社會必須補償基因組合較差者。而為了避免補償不足，社會也許應該提供基因醫療資源，縮小人與人之間因為基因差異而衍生的機會不平等，雖然這並不是社會有欠於基因組合較差者的義務。Genetic medicine has made so many unthinkable things possible these days that someday we might be able to determine the features of anyone's genetic profile. Once this is feasible, then the distribution of genetic profiles is no longer a matter of natural lottery. It is then to be decided by social institutions and to be assessed in term of social justice. This paper is concerned with the questions as to whether society then should provide genetic medical resources for parents so that the impact on opportunity of genetic inequalities could be neutralized or minimized, and whether society should bring about genetic equality. I answer both questions negatively from the perspective of a conception of justice, which I have been developing. I call this conception reasonable contractarianism, which holds that society owes to each member a duty to choose an institutional scheme that he or she (if properly motivated) could not reasonably reject. I argued that the brute luck view of equal opportunity, which might give positive answers to the questions I pose, is implausible. In my view, society is obligated to make sure that no one could complain that given his genetic profile, he would rather prefer not being born at all to living. To discharge this obligation, I argue, society should provide gene-based medical resources to help parents give birth to genetically healthy babies. Such provision is necessary for society to do what it owes to its members. I also argue that choosing an institutional scheme that respects the autonomy of family allows unequal distribution of resources, amounts to choosing a scheme that is unfair to those who are genetically inferior. Society should compensate for them. In the end, I suggest that in order not to fail to provide sufficient compensation, society might have to reduce the inequality of opportunity induced by the autonomy of family via genetic measures, despite that this is not what society owes to those who would come to exist with genetically inferior profiles.DOWNLOAD HISTORY | This article has been downloaded 24 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.緩解癌痛是終末期癌症患者安寧療護的重要目標之一。世界衛生組織提出，嗎啡等鴉片類藥物被列為癌症止痛和安寧療護的首選或必備藥物。而談起嗎啡時，人們常常聯想到毒品。尤其在中國這樣一個深受兩次鴉片戰爭影響的國家，人們畏懼嗎啡，並更加謹慎地使用嗎啡。在臨床上，嗎啡的確能夠有效地緩解患者臨終前因癌症引起的疼痛，但不合理地使用也會引起患者的呼吸抑制，導致其死亡。那麼，臨床上到底應該如何正確地使用嗎啡？嗎啡的使用有哪些制度上的支援？嗎啡被當作主動安樂死的一種手段又是否能夠得到儒家倫理學上的辯護？筆者認為，無論在臨床中，還是在制定嗎啡的相關法律法規中，都應將嗎啡的兩種作用：合理劑量的鎮痛作用和加大劑量的主動安樂死作用嚴格的區分開來。用嗎啡安樂死的行為違背了儒家的孝道、弘毅美德以及儒家生命觀和仁愛的思想。本文將通過探究嗎啡的歷史、臨床使用、政策和儒家倫理四個方面，對嗎啡的使用進行具體的研究和分析。Pain control is one of the most important goals of end-of-life care for cancer patients in the terminal phase. The World Health Organization recommends that morphine be considered optimal and even indispensable as a means of relieving pain and providing palliative care. However, people often associate this opioid with illicit drugs, particularly in the context of Chinese culture, due to its close association with the two Anglo–Chinese Opium Wars of the mid-19th century. In clinical settings, morphine is usually the preferred treatment for moderate or severe cancer-related pain. However, excessive morphine use may result in respiratory depression and death. Exploring morphine’s history and clinical usage, relevant policies, and Confucian ethics, this essay shows that a clear distinction must be made between relieving pain and performing active euthanasia in cases of morphine use in current Chinese palliative care and bioethics. The essay offers an approach based on Confucian ethics to analyze how euthanasia via morphine use violates the principles of filial piety (xiao) and humaneness (ren), two virtues emphasized in Confucian tradition.DOWNLOAD HISTORY | This article has been downloaded 432 times in Digital Commons before migrating into this platform.

LANGUAGE NOTE | Document text in Chinese; abstract also in English.儘管醫學在飛速進步，但由於種種原因，放棄治療在臨床中有日益增多的趨勢。放棄治療是人們的一種理性選擇。合理的放棄治療是醫學人道主義在某種特殊情況下的理性表現。區分放棄治療的不同情況，正確界定放棄治療的範圍，合理選擇放棄治療的措施，確保不發生不應放棄治療的病人被放棄，在全過程中始終尊重病人的自主權，妥善處理對於是否放棄中的分岐，並維護病人的整體利益，是履行放棄治療中倫理學應予充分注意的問題。Many believe that giving up treatment always conflicts with physicians' duty and responsibility. However, although societies have achieved the rapid advancing of medical sciences and technologies, and although patients and families sometimes want to maintain life-sustaining interventions at any cost, renunciation of futile treatment remains an unavoidable issue facing physicians in their clinical practice. This is especially the case for Chinese society today. This paper argues that withdrawing life-sustaining therapy is not always opposite to moral requirement.Specifically, the paper explores the following important issues around the decision making of renouncing treatment. First, in what medical situation does the patient and the family's request for withdrawing treatment should be granted by the physician? this paper contents that a necessary condition must be that the patient suffers an incurable disease. Second, who has the right to make the decision of renouncing treatment? This paper argues that, in considerations of Chinese ethical and societal character, some practical measures should be establishes in Chinese society medical and moral consideration should all be balanced and integrated. Finally, in order to avoid unnecessary ambiguities and disputes, this paper suggests that legal and administrative procedures and guidelines should be adopted regarding the decision of renouncing treatment.DOWNLOAD HISTORY | This article has been downloaded 31 times in Digital Commons before migrating into this platform.

<p>基於社會關懷，善盡大學責任，政大行政管理碩士學程（MEPA）規劃「後疫情時代公共治理及社經發展研討會」多時，最後決定於2021年6月5日舉辦。但是2021年5月中旬適逢疫情再起，三級警戒，研討會於是改採線上視訊辦理。「後疫情時代 公共治理及社經發展研討會」聚焦在財經議題、社會發展及公共政策形成三大面向，結合實務與學術，期待透過公民社會的力量為臺灣社會找到出路。財經與社會，此二者屬於內外環境的衝擊，公共政策則是行政主體。新冠疫情的確是很不幸的考驗，可是疫情卻也給我們一個反思的機會。在抗疫期間，大家可以看到民間社會動員的力量，我們正是希望結合公民行動的力量，共同來因應全球化及疫情之下所遭遇到的問題。</p>