创新健康观与死亡观对医学生的启发与指导

发布时间：2018-03-16 08:29

本文选题：健康观　切入点：死亡观　出处：《山西中医学院》2016年硕士论文　论文类型：学位论文

【摘要】：健康观与死亡观本质上是人的一种价值观,随着实践的深入而发展变化,同时又指导着实践的方向与目的,两者是相辅相成的关系。健康观与死亡观是医学模式的基础认识,受到社会发展、科技进步、医学伦理、认识水平、哲学观念等综合因素的影响,在指导人们的健康追求的过程中,又约束着医学的进步。健康观随着医学模式的发展经历了四个阶段,巫医时代健康观、自然哲学时代健康观、生物医学时代健康观、生物-心理-社会医学时代健康观。死亡观的发展变化主要在四方面:死亡标准、死亡方式、死亡态度、死亡处置。随着生物-心理-社会医学模式主导现代医学,形成了以生物、心理、社会三维一体的健康认识,在多年来的医疗实践中起了巨大作用。近年来生态危机的加剧给人类的生存与健康带来了巨大威胁,同时医学面临的困境如耐药菌的出现、慢性病与心理精神疾病的加速发展,生物-心理-社会医学模式不能给予合理的认识与有效的方法,倒逼着人类进行医学模式的反思。系统论科学、自然生态科学、可持续发展观、微生态学、生态危机根源说等一些理论学说的产生与发展,《黄帝内经》生态学思想,为大生态医学模式的提出奠定了基础。死亡观随着社会文明、科学技术、医学技术、哲学观念、伦理道德的发展而变化。医学、科学技术的发展,对部分心肺功能的停止通过抢救进行逆转,这就对现有的死亡标准提出了挑战,因而脑干不可逆转的功能消失被确立为新的死亡标准。安乐死的逐渐立法,临终关怀学科的发展,反应的是人们对死亡态度逐渐由恐惧、痛苦过渡到坦然、包容,死亡方式的选择是一种价值观的突破,是对死亡权利的要求。大生态医学健康观与死亡观是在进步理论、现实困境基础上的创新。健康是人的身体和精神心理状态与其生存环境的和谐适应与良性互动。第一,人的健康必须放在大生态背景下考虑,因为大生态健康是人生存与健康的前提。第二,突破人类中心主义价值观把伦理道德扩展应用到人与生态环境的关系处理。大生态内的生命与非生命都是道德主体,之间的关系是系统与系统的关系,并且人对生态负有责任与义务。第三,健康用程度衡量,并用动态的眼光认识健康。一个人不能用健康与不健康笼统的判断。健康不仅是当下人的基本状态,更是自身状态与周围环境的不间断的和谐适应。死亡是个体人与社会关系不可逆转的脱离和中断。第一,首次包含了人的生物、社会双重属性。第二,从本质上揭示死亡,具有哲学与现实双重意义。第三,对医学死亡标准的建立具有指导意义。健康死亡是指始终处于身心与生存环境和谐适应状态的人生实现生命的最后自然终结,就像机器磨损到极限而自然损坏一样。亦即《黄帝内经》中讲的“形与神俱而尽终其天年,度百岁乃去”那种境界。健康死亡的提出,调整了医学方向与目的。对于安乐死问题的解决提供了理论基础与指导。国内医学生健康观教育主要侧重基础的生物学认识与临床诊疗技术,对心理精神健康、社会医学、人文精神等方面教育缺乏。教育的功利性不利于生物-心理-社会医学模式的实践,导致多数医生依然重技术而轻人文。国民的死亡观受到传统文化的影响较大,消极的重生避死认识占主要。创新健康观与死亡观,有助于医学生树立健康生态观、养成良好的健康习惯以导向社会人群、建立客观理性地死亡观有助于安乐死与临终关怀学科发展、提高医学人文素质缓解国内的紧张的医患关系。
[Abstract]:The health view and the view of death is essentially a kind of people's values, with the deepening of the practice of development and change, but also guides the practice direction and purpose, the two are complementary relationship. Health cognition and basic concept of death is the medical model, by the development of society, the progress of science and technology, medical ethics, the level of understanding. The influence of philosophy concept of comprehensive factors, in the process of guiding people in the pursuit of health, and restrict the progress of medical health concept. With the development of medical model has experienced four stages, the witch doctor health concept era, healthy view of natural philosophy, health concept of biomedical technology, bio psycho social medical health concept. The development and change of concept of death mainly in four aspects: the standard of death, death, death attitude, death disposal. With the bio psycho social medical pattern of modern medicine, formed a biological, psychological, social three One dimensional health awareness, played a huge role in medical practice for many years. In recent years, the ecological crisis to human survival and health has brought a huge threat, while facing difficulties such as medicine of resistant bacteria, accelerate the development of chronic diseases and mental illness, bio psycho social medical model can not give a reasonable understanding and effective reflection method, forced down the medical mode of human beings. The system theory of science, natural science, the concept of sustainable development, microecology, the root of the ecological crisis that some of the emergence and development of the theory, "Huangdi Neijing > ecology thought, lays a foundation for the large ecological medicine with the view mode. The social civilization, science and technology, medical technology, philosophy of death, ethical development and changes. The development of science and technology, medicine, heart and lung function of part of the rescue into stop by For this reversal, the existing death challenges, and brainstem irreversible function disappeared was established as a new standard of death. Gradually the euthanasia legislation, the development of hospice care, the reaction is the people to death attitude gradually from fear, pain to calm, tolerance, death is a kind of choice the values of the breakthrough, is on the right to die. Ecological medicine health view and the view of death is in progress on the basis of theory, innovation dilemma. Health is harmonious to people's physical and mental state and their living environment and interaction. First, people's health must be placed on the ecological background to consider because of the large, ecosystem health is the prerequisite for human survival and health. Second, break through the anthropocentrism to ethics extended to deal with the relationship between the ecological environment and ecological life within. Life is a non moral subject, relationship between system and system, and who are responsible for the ecological health. Third, with a degree of measure, and use dynamic vision health. One cannot use healthy and unhealthy general judgment. Health is not only the basic state of contemporary people, is to adapt to their own state and the surrounding environment uninterrupted. Death is the harmonious relationship between individual people and society from irreversible and interrupt. First, for the first time including people's biological, social properties. Second, revealing death from the essence, philosophical and realistic significance. Third, has a guiding significance for the establishment of medical standard of death death is always in health. The physical and mental environment of living and harmonious adaptation life life finally achieve a natural ending, just like a machine worn to the limit and natural damage. That is the < Huang Di > About "the spirit and the body are all died of old age, is 100 degrees to that level. This health death, adjust the medical direction and purpose. To provide a theoretical foundation and guidance for solving the problem of euthanasia. The domestic medical students health education focuses mainly on the basis of biological recognition and clinical diagnosis and treatment technology of mental health, social medicine, lack of education of humanistic spirit and so on. The practice of education is not conducive to bio psycho social medical model, resulting in the majority of doctors still in technology and humanities. The national view of death is influenced by traditional culture, negative to avoid death rebirth. Knowledge occupies the main concept of health and innovation the concept of death, which is helpful for students to establish a healthy ecological outlook, develop good health habits to guide social groups, establish objective and rational view of death is helpful for euthanasia and hospice care development, improve The medical humanistic quality relieved the stressful doctor-patient relationship in China.

【学位授予单位】：山西中医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R-4;G641

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