Ruey-Yuan Wu

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement

This thesis aims to answer this question: What role is morality to play in life? The answer is an inclusive view of the right life: segments of a right life is either morally justified or justified to oneself. The thesis begins with one of Bernard Williams' argument against morality, appearing in his often misunderstood article "Moral Luck." According to my interpretation, Williams' argument against the supreme authority of morality invokes a rather unfamiliar normative notion, i.e., the notion of self-justification: a morally offensive choice can be justified, overall speaking, by virtue of the fact that the agent is able to justify it to himself. Williams implies that an agent's self-justification carries normative weight with us in the sense that it not just expresses the agent's own attitude toward herself but also has the power to compel our overall attitude toward her. The argument hinges upon a plausible account of self-justification, which is to answer what counts as a self-justification and why it carries any normative weight with us. ;To complete Williams' argument against morality's supreme role in life, I discuss his analysis of two particular cases of self-evaluation: the cases of Gauguin and Anna Karenina. Then, I develop a general conception of self-justification, which takes an agent's self-justification as a result of an authentic way of living. In this conception, an agent can justify a choice to herself if and only if the agent can affirm the choice in light of a personal ideal which she creates and highly confirms, i.e., an ideal expressive of her true self. Thus, an agent who attains self-justification lives up to his true self, or put differently, leads an authentic way of life. ;As to the role of morality in life, my conclusion is that morality does not have supreme authority, but rather should be complemented by each individual's striving for authenticity. In a word, the right life is sought in the interplay between authenticity and morality