Conference Sponsors |主办方
University of Chicago Center in Beijing
Peking Union Medical College Hospital
Center for Biomedical Ethics
Chinese Academy of Medical Sciences & Peking Union Medical College
MacLean Center for Clinical Medical Ethics
University of Chicago Transplant Center
芝加哥大学北京中心
北京协和医院
中国医学科学院北京协和医学院生命伦理学研究中心
芝加哥大学MacLean临床医学伦理研究中心
芝加哥大学移植中心
Co-Chairs | 会议组织者
Yilei Mao, M.D.
Xiaomei Zhai, Ph.D.
Mark Siegler, M.D.
Peter Angelos, M.D., Ph.D.
J. Michael Millis, M.D.
毛一雷, M.D., Ph.D.
翟晓梅, Ph.D.
Mark Siegler, M.D.
Peter Angelos, M.D., Ph.D.
J. Michael Millis, M.D.
Conference Summary | 会议介绍
The overarching theme of the conferences will be that surgery is much more than a technical discipline. There are many life and death issues that arise in surgery where it is critical for the surgeon to be sensitive to the ethical dimensions of the decisions that are made. Cases will be presented followed by panelist commentary and case discussion.
本次会议的首要议题是，外科并不仅仅是一个技术性的专业。在外科有许多生死攸关的事情，因此外科医师在决策过程中重视伦理因素至关重要。
FRIDAY, MARCH 25
Session I Opening Session
Moderator: J. Michael Millis, M.D
Professor of Surgery
Vice Chair for Global Surgery
Director, University of Chicago Transplant Center
Chief, Section of Transplantation
University of Chicago Medicine
1:00 – 1:15 PM Welcome and Introductions – J. Michael Millis, M.D.
Co-Chairs – Drs. Zhai, Mao, Siegler and Angelos
Keynote Speaker – Jeifu Huang, M.D.
1:15 – 1:45 PM Keynote SpeechDSC_3434
China’s Organ Transplantation Reform
Jiefu Huang, M.D.
Professor of Surgery
Peking Union Medical College Hospital
Former Vice Minister of Health
President, Organ Transplantation Foundation
Chairman, China OPO
1:45 – 2:30 PM Organ Donation and Allocation in China
Haibo Wang, MBBS, MSc, MPH
Professor, Department of Surgery
Hong Kong University
Director, China Liver Transplant Registry（CLTR）
2:30 – 3:00 PM Break
Session II Defining Surgical Ethics
3:00 – 3:45 PM Is Surgical Ethics Different from Medical Ethics?
Peter Angelos, M.D., Ph.D.
Linda Kohler Anderson Professor of Surgery and Surgical Ethics
Chief, Endocrine Surgery
Associate Director of the MacLean Center for Clinical Medical Ethics
University of Chicago Medicine
3:45 – 5:00 PM Case Presentations and Discussion
J. Michael Millis, M.D.
Professor of Surgery
Vice Chair for Global Surgery
Director, University of Chicago Transplant Center
Chief, Section of Transplantation
University of Chicago Medicine
Case 1: The liver transplant surgeon who is willing to accept financial payments in order to allow access to surgery for wealthy patients from outside of his own country. This practice is clearly contrary to many of the ethical norms of transplant surgery. It is also illegal in many countries. One question is whether this is, in fact, selling of organs or simply helping wealthy donors who are willing to fund research. The argument in favor of this practice is that these funds could ultimately help many patients.
Case 2: A famous surgeon who operates on his wife. The argument is that the surgeon is perhaps the best qualified at his institution to perform the operation. There may be other surgeons, but they are less experienced. Can this practice be justified? What are the conditions in which it would be ethically acceptable to operate on a close family member? Are there differences in different countries with respect to this question?
Case 3: A vascular surgeon who, in an attempt to save the life of a patient with an abdominal aortic aneurysm that extends above the renal vessels infuses University of Wisconsin solution into the renal arteries to try to preserve the kidneys in vivo. This is an unproven therapy and this case raises the questions of when it is acceptable to utilize an unproven therapy to try to help an individual patient.
All three of these cases raise questions for the audience including, do you believe that this practice is ethical? Would this situation ever happen in your area of practice? Would you condone this behavior if your colleagues performed it? Is there any circumstance in which this behavior would be considered acceptable?
Panelist Commentary and Case Discussion
Moderator
J. Michael Millis, M.D.
Panel
Xiaomei Zhai, Ph.D.
Mark Siegler, M.D.
Yilei Mao, M.D.
Jiefu Huang, M.D.
Peter Angelos, M.D., Ph.D.
3月25日，星期五DSC_3265
第I节 开幕式
主持人: J. Michael Millis, M.D.
外科学教授
全球外科副主席
芝加哥大学移植中心主任
芝加哥大学医院移植科主任
1:00 – 1:15 PM 致欢迎词、介绍嘉宾—— J. Michael Millis, M.D.
共同主席——翟晓梅教授、毛一雷教授、Siegler教授、
Angelos教授
主旨演讲者– 黄洁夫教授
1:15 – 1:45 PM 主旨演讲
中国的器官移植改革
黄洁夫, M.D.
北京协和医院外科学教授
前卫生部副部长
中国器官移植发展基金会理事长
中国人体器官捐献与移植委员会主任
1:45 – 2:30 PM 中国的器官捐献和分配
王海波, MBBS, MSc, MPH
香港大学外科学教授
中国肝移植注册中心主任
2:30 – 3:00 PM 茶歇
第II节 定义外科伦理学
3:00 – 3:45 PM 外科伦理学是否有别于医学伦理学?
Peter Angelos, M.D., Ph.D.
Linda Kohler Anderson外科和外科伦理学教授
内分泌外科主任
MacLean临床医学伦理研究中心副主任
芝加哥大学医院
3:45 – 5:00 PM 病例展示和病例讨论
J. Michael Millis, M.D.
外科学教授
全球外科副主席
芝加哥大学移植中心主任
芝加哥大学医院移植科主任
病例1: 肝移植外科医生想收钱，以允许来自国外的富裕病人接受手术。这种做法显然违背了移植外科的多个伦理学规范。在许多国家，这还是非法的。问题是，这实际上是贩卖器官，还仅仅是为愿意资助研究的富裕捐献者提供帮助。支持这种做法的理由是，这些资金最终可以帮助许多的患者。
病例2: 一位著名的外科医生为自己的妻子做手术。理由是，这位外科医生是该医院做手术最好的医生。还有许多其他的外科医生，但是他们的经验都不足。这种做法合理吗？在什么情况下，医生为关系亲密的家庭成员做手术是在伦理上被接受的？ 对于这个问题，不同的国家有差异吗？
病例3: 一位血管外科医生在尝试挽救患者的生命，该患者的腹主动脉瘤累及肾血管上方。医生对肾动脉输注威斯康星大学保存液，以试图在体内保存肾脏功能，但这是一种未经证实的方法。这个病例提出的问题是，什么时候允许用未经证实的方法来帮助患者。
这三个病例都对听众提出了以下问题：您相信这种做法符合伦理吗？这种情况曾经发生在您的临床实践中吗？如果您的同事做了这种行为，您能容忍吗？在什么情况下，您会认为这种行为是可接受的呢？
专家点评和病例讨论
主持人: J. Michael Millis, M.D.
专家组: 翟晓梅, Ph.D.
Mark Siegler, M.D.
毛一雷, M.D.
黄洁夫, M.D.
Peter Angelos, M.D., Ph.D.
SATURDAY, MARCH 26
Session III Keynote II
9:00 – 9:10 AM Introduction of Keynote Speaker – Mark Siegler, M.D.
9:10 – 10:00 AM A Surgeon is A Physician … and More.
Bernard Lo, M.D.
President & CEO
The Greenwall Foundation, New York
Professor of Medicine Emeritus
Director Emeritus, Program in Medical Ethics
University of California San Francisco
10:00 – 10:30 AM Break
Session IV When Idealism Meets Reality
10:30 – 11:15 AM Medicine: Business or Profession
Xiaomei Zhai, Ph.D.
Dean and Professor, School of Humanities and Social Sciences
Peking Union Medical College
Executive Director, Center for Bioethics
Chinese Academy of Medical Sciences and Peking Union Medical College
11:15 – 12:15 Case Presentations and Discussion
Mark Siegler, M.D.
Lindy Bergman Distinguished Service Professor of Medicine and Surgery
Executive Director, Bucksbaum Institute for Clinical Excellence
Director, MacLean Center for Clinical Medical Ethics
University of Chicago Medicine
Case 1: A patient presents for evaluation from a surgeon for an operation that the patient has read about and believes would be helpful for her. However, she does not have an indication for surgery. The patient states, “if you are not willing to do the operation, I will go to the competing medical center where I can readily get it done.”
Case 2: The surgeon is willing to operate on a patient when there is absolutely no prospect for the patient to pay for the care rendered. In other words, the surgeon sees the duty to provide care as outweighing the potential financial detriment of operating on someone with no financial means and no insurance.
Case 3: Video segment of Dateline Broadcast.
Panelist Commentary and Case Discussion
Moderator
Mark Siegler, M.D.
Panel
Di Zhang, Ph.D.
Peter Angelos, M.D., Ph.D.
Yali Cong, Ph.D.
Bernard Lo, M.D.
12:15 – 1:30 PM – Lunch at the Center
Session V Education
1:30 – 2:00 PM How and When to Teach Medical Ethics in a Modern Scientific World
Mark Siegler, M.D.
Lindy Bergman Distinguished Service Professor of Medicine and Surgery
Executive Director, Bucksbaum Institute for Clinical Excellence
Director, MacLean Center for Clinical Medical Ethics
University of Chicago Medicine
2:00 – 2:30 PM Education for Medical Ethics in China Mainland—Problems and Challenges
Di Zhang, Ph.D
Center for BioMedical Ethics
School of Humanities and Social Sciences
Chinese Academy of Medical Sciences and Peking Union Medical College
2:30 – 3:00 PM Medical Ethics Teaching
Reidar Lie, M.D., Ph.D
Professor and Head of Department of Philosophy
University of Bergen, Norway
Adjunct Professor
Center for BioMedical Ethics
School of Humanities and Social Sciences
Chinese Academy of Medical Sciences and Peking Union Medical College
3:00 – 3:30 PM Reflection on Surgical Ethics Teaching: Who Should Make Final Decision on Withholding and Withdraw of Care
Yali Cong, Ph.D.
Medical Ethics Program
Peking University Health Science Center
3:30 – 4:00 PM Break
Session VI Informed Consent and Advanced Ethics
4:00 – 4:30 PM The Legacy of Nuremberg Code: Informed Consent in China
Professor Renzong Qiu
Adjunct Professor, School of the Humanities and Social Sciences, Peking Union Medical College
Chair for Academic Committee of Center Bioethics, Chinese Academy of Medical Sciences and Peking Union Medical College
4:30 – 5:00 PM The Crisis of the Informed Consent Communication between the Physician/Surgeon & Patient/Family in Mainland China: A Cross-cultural Perspective.
Ruiping Fan, Ph.D.
Professor of Philosophy
Department of Public Policy
City University of Hong Kong
Kowloon, Hong Kong
5:00 – 5:30 PM The Ultimate Surgical Ethics Specialty
J. Michael Millis, M.D.
Professor of Surgery
Vice Chair for Global Surgery
Director, University of Chicago Transplant Center
Chief, Section of Transplantation
University of Chicago Medicine
3月26日，星期六
第III节 主旨演讲 II
9:00 – 9:10 AM 介绍主旨演讲者 —— Mark Siegler, M.D.
9:10 – 10:00 AM 外科医生是医生… 又不仅仅是医生
Bernard Lo, M.D.
纽约绿墙基金会主席、首席执行官
内科荣休教授
医学伦理系荣休主任
加州大学旧金山分校
10:00 – 10:30 AM 茶歇
第IV节 当理想遇到现实
10:30 – 11:15 AM 医学是工作还是职业？
翟晓梅, Ph.D.
北京协和医学院人文和社会科学学院院长、教授
中国医学科学院北京协和医学院生命伦理学研究中心
执行主任
11:15 – 12:15 病例展示和讨论
Mark Siegler, M.D.
Lindy Bergman杰出内科和外科学教授
Bucksbaum卓越临床研究所执行主任
MacLean临床医学伦理研究中心主任
芝加哥大学医院
病例1: 一名患者来找外科医生做评估。患者阅读了一个手术的相关资料，相信这个手术对自己有帮助，要求医生为她做这个手术。然而，她并没有手术适应征。患者说，“如果您不愿意做这个手术，我会去找您的竞争对手，我可以在那儿做手术。”
病例2: 在患者绝对不可能支付医疗费用的情况下，外科医生也愿意为该患者做手术。换句话说，外科医生提供医疗服务的职责应该高于为资金不足且没有保险的患者做手术带来的财务损失。
病例3: 日界线（Dateline Broadcast）的视频片段。
专家点评和病例讨论
主持人: Mark Siegler, M.D.
专家组: 张迪, Ph.D.
Peter Angelos, M.D., Ph.D.
丛亚丽, Ph.D.
Bernard Lo, M.D.
12:15 – 1:30 PM 午餐（芝加哥大学北京中心）
第V节 教学
1:30 – 2:00 PM 在现代科学世界中，何时讲授，如何讲授医学伦理学
Mark Siegler, M.D.
Lindy Bergman杰出内科和外科学教授
Bucksbaum卓越临床研究所执行主任
MacLean临床医学伦理研究中心主任
芝加哥大学医院
2:00 – 2:30 PM 中国大陆的医学伦理学教育——问题与挑战
张迪, Ph.D.
生命伦理学研究中心
人文和社会科学学院
中国医学科学院北京协和医学院
2:30 – 3:00 PM 医学伦理学的教学
Reidar Lie, M.D., Ph.D.
教授、哲学系主任
挪威卑尔根大学
兼职教授
生命伦理学研究中心
人文和社会科学学院
中国医学科学院北京协和医学院
3:00 – 3:30 PM 对外科伦理教学的反思：谁应该做停止治疗的最终决定
丛亚丽, Ph.D.
医学伦理学系
北京大学医学部
3:30 – 4:00 PM 茶歇
第VI节 知情同意与高级伦理学
4:00 – 4:30 PM 纽伦堡法典的遗产：知情同意在中国
邱仁宗教授
兼职教授，人文和社会科学学院
北京协和医学院
生命伦理学研究中心学术委员会主任
中国医学科学院北京协和医学院
4:30 – 5:00 PM 中国大陆内科医生/外科医生与患者/家属知情同意沟通方面的危机：跨文化视角
范瑞平, Ph.D.
哲学教授
公共政策学系
香港城市大学
5:00 – 5:30 PM 最终的外科伦理学专业
J. Michael Millis, M.D.
外科学教授
全球外科副主席
芝加哥大学移植中心主任
芝加哥大学医院移植科主任
