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Objective:Public health emergencies expose a significant threat to human life and health. How to efficiently conduct biomedical research while complying with ethical norms is an important way to response to public health emergent events such as pandemic outbreak. In 2023, the National Health Commission, the Ministry of Education, the Ministry of Science and Technology, and the National Administration of Traditional Chinese Medicine jointly issued the " Measures for Ethical Review of Life Sciences and Medical Research Involving Human Subjects", which requires the ethics committee to construct an ethical review system in advance, including, generally, the ethics committee should conduct ethical review and provide review opinions within 72 hours. Is this measure feasible and does it have any unreasonable aspects?Methods:Literature review and status quo analysis are two main methods, this article combs the international guidelines issued by World Health Organization, the Council for International Organizations of Medical Sciences and the Nuffield Council of Bioethics, selects the content related to research under the circumstances of public health emergencies, take the Hofstede′s Cultural Dimensions Theory into consideration of the complexity of quality and quantity of research during the COVID-19 pandemic in China.Results:After analyzing, this article argues preliminarily that the requirement and emphasize on ethical review system development issued by the four ministries in China is very timely and necessary. However, the requirements for review time limits is inconsistent with international consensus, and might pose substantive challenges to the independence of the ethics committee's work.Conclusions:Scientificity and ethics are the soul of biomedical research, and the basic requirements of these two aspects cannot be undermined due to the special nature of public health emergencies. However, procedures simplifiable are worth exploring.
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The defense for paternalism is based on that family members' decisions are usually beneficial for patients' best interests.However,this premise remains to be demonstrated.The moral theory of maintaining family members' interests challenged the ethical principle of respecting patients' autonomy,which believed that treatment decisions should be discussed by the whole family members.However,the principle of autonomy does not always dissever the relationship between individual and family members.It resorted East Asia family autonomy of Chinese traditional culture and emphasized on the value of objective goodness and family dependence.However,patients often do not play a proper role in families' decision-making.Besides,the Confucian bioethics also needs to provide more sufficient argumentation to deal with the relationship between subjective goodness and objective goodness.The unconditional acquiescence of family members' domination in decision-making is worthy reflecting in the current medical environment.
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Starting on the research findings from a study on cancer patients decision making,the author tried to further analyze the Doctor-Patient-Relationship in China from the historical perspective.Having the disease re-moved or treat the patient responsibly,represents different meaning and implication on how a society regards the medicine as profession,and how define the role of physicians.Considerations on these issues are hoped to facilitate the improvement of doctor-patient relationship in China.
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The ambiguous diagnosis,the public's insufficient understanding of AMR and improper use of antibiotics in agriculture are the main reasons for accelerating antibiotic resistamce(AMR).At present,the main coping strategies are limited to technical means while lacking ethical consideration.The related ethical issues are,mainly,tensions of personal health interests and public health interests,the conflicts between agricultural development and human health benefits,the distributive justice,inter-generational justice.Understandings and addressing these issues rely on value judgments based on the moral theories.And then it will form an effective and reasonable antibiotic management solution which will help to deal with AMR fundamentally.
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Objective To evaluate the ethical management status quo of Capital Medical Research Fund in 2007.Methods Cross-sectional study was applied to analyze the ethics management and ethics self-evaluation in applications.Results There were 652 applications,covering with 14 districts and 2 counties in Beijing,from 128 Hospitals.Applicants have some knowledge of the ethical issues in clinical research accounted for 88.7％ ; informed consent of subjects considered in 72.5％ ;the potential risk and protection involved in application accounted for 62.0％; personal privacy protection of subject accounted for 49.4％.Unfortunately,the benefit vs risk assessment was only involved in 28.7％ applications.Applicants from general hospitals had more ethical issue knowledge (90.2％) than those from community hospitals (84.6％).Applicants from university hospitals had more ethical issue knowledge (93.9％) than those from military hospitals (80.2％).Applicants aged 55 0r over had less ethical issue knowledge (70.0％) than other applicants (89.2％).The applicants to study on descriptive research and etiological research had less ethical issue knowledge than others.578 applications filled out the approval from ethics committee or research management department.62.6％ of the written were acceptable.Conclusion The applicants for clinical research had preliminary understanding for ethical issues in Beijing in 2007.Hospital ethics committees or research management departments had conducted clinical research ethical review applications for funds management.It has taken place the external conditions to carry out the ethical management in clinical research fund management.
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As human subject protection become more and more significant in China,it' s imperative for China to learn more experiences from U.S for which developed a normative and well designed HRPP system during past decades.In this article,we gave a brief introduction of the Human Subject Protection Program at Duke University to help us have a better understanding of the HRPP at institutional level.After which we have further discussion of the status quo and challenges facing in HRPP construction in China,especially,Peking University as an example.
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The results of the arterial blood study in 30 patients of cor pulmonale in acute exacerbation were reported.The study included gas analysis, and dominations of serum lactate,pyruvate, potassium,sodium and chlorine.All the items were determined simultaneously.The data demonstrated that when the arterial oxygen tension of the patients with cor pulmonale in acute exacerbation dropped below 60mmHg, the blood lactate concentration was most likely to show a rise, which was related not only to hypoxemia but also to alkalosis.Observations of the changes in concentration of blood lactate and pyruvate in some patients led us to believe that these changes were associated with the seriousness of the disease. Regular measurement of blood lactate and pyruvate concentrations might be helpful to judge the condition of the patient. Persistent rise in blood lactate concentraion suggested poor prognosis.